Objective
To determine the prevalence of signs and symptoms of HTLV‐1 and 2 infection in paediatric patients.
Methods
We included cohort, case‐control and descriptive observational studies that ...reported the prevalence of signs and symptoms of HTLV‐1 and 2 infections in paediatric patients. Searches were performed in MEDLINE® (Ovid), EMBASE and LILACS from inception to the present, and we saturated information with other sources of published and unpublished literature. We decided not to perform meta‐analysis according to heterogeneity.
Results
A total of eight studies met the inclusion criteria for qualitative analysis. No studies of HTLV‐2 were found. Females predominated and there was vertical transmission in nearly 100% of cases. Infective dermatitis was a common manifestation of HTLV in paediatric patients. In addition, persistent hyperreflexia, clonus and the Babinski sign were early neurological alterations observed in patients carrying the virus.
Conclusion
HTLV screening is recommended in patients presenting infective dermatitis, persistent hyperreflexia, walking disturbances and in those who come from endemic zones.
Objective
To determine the factors for failure of endoscopic ureteric stenting in patients with malignant ureteric obstruction.
Methods
We performed a search strategy in the Medical Literature ...Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica dataBASE (EMBASE), the Literatura Latino‐Americana e do Caribe em Ciências da Saúde database (LILACS), and the Cochrane Central Register of Controlled Trials (CENTRAL) databases. We included patients with malignant ureteric obstruction, who had a JJ catheter insertion. The studies reported the percentage of failure and risk factors, e.g. bladder invasion or deformity of the trigone, hydronephrosis, renal failure, previous radiotherapy, age, obstruction aetiology, and patient’s health status. We performed a meta‐analysis using R software (‘meta’ and ‘metafor’ libraries).
Results
We included nine studies that met the inclusion criteria, with 761 patients and an average age of 60.5 years. The studies assessed the time to failure during the first 30 days. The reported failure rate was 32% (95% confidence interval CI 21–45%; I2 = 88%). Regarding risk factors for failure, bladder invasion or deformity of the trigone had a hazard ratio (HR) of 4.8 (95% CI 1.28–8.5; I2 = 97.4%); severe hydronephrosis had a HR of 3.92 (95% CI 0.32–7.52; I2 = 93.9%); and age <65 years had a HR of 0.93 (95% CI 0.8–0.9; I2 = 0%).
Conclusions
We found a high probability of failure for endoscopic urinary decompression in patients with malignant ureteric obstruction. Factors such as bladder invasion or deformity of the trigone and age >65 years had an increased risk of failure.
Immunonutrition hope? Oral nutritional supplement on cancer treatment García‐Perdomo, Herney Andrés; Gómez‐Ospina, Juan Camilo; Reis, Leonardo Oliveira
International journal of clinical practice (Esher),
November 2021, 2021-Nov, 2021-11-00, 20211101, Letnik:
75, Številka:
11
Journal Article
Recenzirano
Odprti dostop
Objectives
To determine the efficacy and safety of antitumoral nutritional supplement (Oncoxin®), and to describe its mechanism of action.
Methods
Scoping review according to the recommendations of ...the Joanna Briggs Institute included patients older than 18 years who have any kind of tumour and receive Oncoxin® as a supplement regarding the efficacy in terms of antitumoral properties, quality of life and survival, safety in terms of adverse events, and the mechanism of action. With no limit for language or setting, MEDLINE (Pubmed), EMBASE (Scopus), LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database inception to May 2021.
Findings
A promising increment of survival and quality of life in terms of Karnofsky and EORTC scales. Regarding the mechanism of action, studies suggest that it modifies inflammatory mediators’ expression, as evidenced by the reduction of COX‐2, IL‐1β, IL‐6, TNF‐α, IL‐1β, IL‐12 and IFN‐γ. Besides, it promotes an arrest in the progression of cells from G1 into S, along with an increase in p27 and a decrease in cyclin D1 and pRb. It decreases the levels of pro‐inflammatory cytokines, it can also decrease cytokines with antitumor activity such as IFN‐γ, which should be further explored in larger trials and the long term.
Interpretations and implications
Current literature shows promising complementary effects of oral supplements to the standard treatment of cancer patients in diverse scenarios. It might help patients to deal with toxicities and adverse effects related to cancer treatment and improve their nutritional or clinical profiles.
Objective
To determine the effectiveness and degree of implementation of interventions for the control of Aedes aegypti in Latin America and the Caribbean (LAC) as reported in scientific literature.
...Methods
We searched MEDLINE, EMBASE, CENTRAL, SOCINDEX, and LILACS, for experimental and observational studies, economic assessments and qualitative experiences carried out in LAC from 2000 to 2016. We assessed incidence and morbimortality of Aedes aegypti‐related diseases and entomological indices: Breteau (containers), House, and Pupae per Person. We used GRADE methodology for assessing quality of evidence.
Results
Of 1826 records retrieved, 75 were included and 9 cluster randomised clinical trials could be meta‐analysed. We did not identify any intervention supported by a high certainty of evidence. In consistency with qualitative evidence, health education and community engagement probably reduces the entomological indices, as do the use of insecticide‐treated materials, indoor residual spraying and the management of containers. There is low certainty of evidence supporting the use of ovitraps or larvitraps, and the integrated epidemiological surveillance strategy to improve indices and reduce the incidence of dengue. The reported degree of implementation of these vector control interventions was variable and most did not extend to whole cities and were not sustained beyond 2 years.
Conclusions
We found a general lack of evidence on effectiveness of vector control in the region, despite a few interventions that showed moderate to low certainty of evidence. It is important to engage and educate the community, apart from achieving the implementation of integrated actions between the health and other sectors at national and regional level.
Objectif
Déterminer l'efficacité et le degré d'implémentation des interventions de lutte contre Aedes aegypti en Amérique latine et dans les Caraïbes (ALC), tels que décrits dans la littérature scientifique.
Méthodes
Nous avons effectué des recherches dans MEDLINE, EMBASE, CENTRAL, SOCINDEX et LILACS pour des études expérimentales et d'observation, des évaluations économiques et des expériences qualitatives réalisées dans la région ALC de 2000 à 2016. Nous avons évalué l'incidence et la morbimortalité des maladies liées à Aedes aegypti et les indices entomologiques: Breteau (conteneurs), Maison et Pupe par Personne. Nous avons utilisé la méthodologie GRADE pour évaluer la qualité des données.
Résultats
Sur 1.826 articles retrouvés, 75 ont été inclus et 9 essais cliniques randomisés en grappes ont pu être méta‐analysés. Nous n'avons identifié aucune intervention étayée par une certitude élevée. De manière cohérente avec les preuves qualitatives, l’éducation pour la santé et la participation de la communauté réduisent probablement les indices entomologiques, de même que l'utilisation de matériaux traités à l'insecticide, la pulvérisation de résidus à l'intérieur et la gestion des conteneurs. Il existe peu de certitude quant aux données soutenant l'utilisation des ovitraps ou des larvitraps et de la stratégie de surveillance épidémiologique intégrée visant à améliorer les indices et à réduire l'incidence de la dengue. Le degré d'implémentation rapporté pour ces interventions de lutte antivectorielle était variable et la plupart ne s’étendaient pas à l'entièreté des villes et ne duraient pas plus de deux ans.
Conclusions
Nous avons constaté un manque général de preuves sur l'efficacité de la lutte antivectorielle dans la région, malgré quelques interventions montrant une certitude modérée à faible. Il est important d'impliquer et d’éduquer la communauté, outre la mise en œuvre d'actions intégrées entre le secteur de la santé et d'autres secteurs aux niveaux national et régional.
Sexuality in cancer patients is a complex area. It is estimated that 81% of patients with urological cancer develop problems in their sexual functionality, even from the moment of diagnosis and ...aggravated during treatment due to direct injury to the genitalia. Currently, there are few avenues of care within the field of urology that address sexual health and quality of sexual life in penile cancer survivors, which causes many of them to lose self‐esteem and have problems with their partners. To review the literature on what are the consequences on the sexual life of penile cancer survivors in terms of their performance, including risk factors associated with penile cancer and what are the alternatives they must recover their sexual life. Most penile cancer survivors develop alterations in sexual performance and functionality, such as loss of sexual interest, dysfunctional ejaculation, and loss of orgasm, increasing the risk of depression and anxiety. Sex therapy is presented as an alternative to improve the quality of life of these patients, proposing sexuality as something more than genitalia and helping to lead a better life. Sex therapy is an alternative and should be contemplated in the therapeutic plan of patients with urological cancer, especially penile cancer, since sexuality is part of an individual's life, and its loss affects the quality of life.
Urologic perspective of genitourinary syndrome of menopause González‐Arboleda, Andrés Augusto; Arias‐Castillo, Liliana; García‐Perdomo, Herney Andrés
International journal of urological nursing,
March 2024, 2024-03-00, 20240301, Letnik:
18, Številka:
1
Journal Article
Recenzirano
Background
Experts define the Genitourinary Syndrome of Menopause (GSM) as a collection of signs and symptoms associated with decreased oestrogen levels. Its prevalence ranges between 13% and 87% in ...postmenopausal women.
Objective
We aimed to describe the main pathophysiology mechanisms of GSM affecting the lower urinary tract and the manifestations and treatment options for lower urinary tract dysfunction in GSM.
Results
Several treatments and recommendations have been proposed to enhance patients' ability to manage their symptoms, such as regular sexual activity or masturbation, to increase this physiological response and reduce the severity of GSM.
Conclusion
GSM is a multifactorial and complex syndrome that affects postmenopausal women. Impairment of urogenital structures implies diverse manifestations of genital atrophy and lower urinary tract symptoms.
Aim
To describe the association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome.
Methods
A scoping review was performed according to the ...recommendations of the Joanna Briggs Institute. Moreover, we performed a search strategy using the MEDLINE, EMBASE, and CENTRAL databases. We included the available information, evaluating the conditions of partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome, and their molecular and physiological mechanisms and clinical presentation.
Results
We identified 207 articles and chose eight studies published between 2001 and 2021. The total number of patients was 34, and their mean age was 28.2 years. Moreover, in 84% of the studies, the pathophysiology of the events was related to microtrauma or prolonged perineal compression. Additionally, 94.2% of the patients had some degree of erectile dysfunction. In addition, out of all patients, 94% underwent magnetic resonance imaging (MRI). However, patients with hard flaccid syndrome did not show relevant findings in these studies. Conversely, MRI showed asymmetry in the proximal corpora cavernosa, thrombosed corpus cavernosum segments, and mainly cavernous fibrous septum in patients with partial cavernous thrombosis and partial priapism.
Conclusion
Partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome occurred more frequently in young patients, possibly related to microtraumas that generate cavernous fibrosis and trigger alterations in the erection of the distal portion of the penis. Additionally, they cause proximal hardening of the pelvis, perineal pain, painful ejaculations, and cavernous asymmetry. Moreover, the imaging characteristics are similar in patients with partial priapism and partial cavernous thrombosis.
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