Safety and Effectiveness of F-18 Fluoroestradiol Positron Emission Tomography/Computed Tomography: a Systematic Review and Meta-analysis

Background@#We conducted a pooled analysis of the diagnostic accuracy of F-18 fluoroestradiol (F-18 FES) positron emission tomography/computed tomography (PET/CT) assessing estrogen receptor expression of patients who have recurrent or metastatic breast cancer. @*Methods@#Two investigators and seven related experts (from the departments of nuclear medicine, hematological oncology, surgery, and evidence-based medicine) evaluated the effectiveness of F-18 FES PET/CT according to diagnostic accuracy and correlation with immunohistochemistry tests via systematic literature review, and safety according to test-related side effects. The present study was conducted in accordance with the Scottish Intercollegiate Guidelines (SIGN), and the Cochrane, and Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. The SIGN tools were used for quality assessment. @*Results@#Of the 512 articles retrieved in the literature search, 8 were deemed to be eligible for inclusion. Results of the evaluation indicated that the F-18 FES PET/CT test was safe because patients who reported pain in the injection site in the analyzed articles are most likely to be caused by mechanical injury from needle injection not by administration of radioactive materials. Assessment of diagnostic accuracy based on data from seven studies revealed a pooled sensitivity and specificity of 0.86 and 0.85, respectively. @*Conclusion@#As such, the test was evaluated to be a safe and effective and, considering the anatomical site where only invasive tests are possible, the test was deemed to have high clinical utility.

Shear wave elastography: a systematic review and meta-analysis

Shear wave elastography is a novel noninvasive technique that involves application of local mechanical compression on soft tissue while using shear waves to assess tissue stiffness and acquiring strain images that show the tissue response. The objective of this review is to evaluate the safety and effectiveness of shear wave elastography. Searches were conducted of eight Korean databases including KoreaMed, National library of Korea, National Assembly Library, Korean Library Information System Network, Research Information Sharing Service, Koreanstudies Information Service System, Korea Institute of Science and Technology Information, Medical Digital Library Information System, Medline, Embase, and the Cochrane Library. From these sources, 1,604 articles were located, and total of 10 studies were included for this review. On the basis of current data, we conclude that shear wave elastography is a safe and effective tool for detecting lesions and monitoring disease severity in patients.

Efficacy of the Phosphorylated tau 181 in Differential Diagnosis of the Alzheimer's Disease: A Systematic Review and Meta-Analysis

BACKGROUND: The purpose of this study was to evaluate the value of phosphorylated tau with epitopes threonine 181(p-tau181) in cerebrospinal fluid (CSF) for the differential diagnosis of Alzheimer's disease typed dementia from other type of dementia. METHODS: A systematic literature search was performed to identify studies on p-tau181. Two evaluators independently evaluated the quality of the ten studies using the Scottish Intercollegiate Guidelines Network (SIGN) tool. The literature review covered from October 27, 1946 to October 22, 2013, and eight domestic databases including KoreaMed and international databases including Ovid-MEDLINE, EMBASE, and Cochrane Library were used. Tau concentrations were compared to healthy controls and to subjects with Alzheimer's disease (AD) using random effect meta-analysis. Outcome measures were Cohen's delta, sensitivity and specificity. RESULTS: Finally, 8 studies (8 diagnostic evaluation studies) were identified to evaluate CSF p-tau181. The effectiveness of this test was evaluated based on diagnostic accuracy. The diagnostic accuracy for identifying AD by ELISA was high which revealed pooled sensitivity as 0.843 (95% CI 0.818-0.867), pooled specificity as 0.799(95% CI 0.768-0.828) and summary receiver operating characteristic area under the curve 0.9082+/-0.0236. CONCLUSIONS: CSF p-tau181 concentrations in other type of dementia are intermediate between controls and AD patients. Overlap between both controls and AD patients results in insufficient diagnostic accuracy, and the development of more specific biomarkers for these disorders is needed.

Efficacy of Feeding Pump for Patients on Enteral Tube Feeding: A Systematic Literature Review and Analysis / 대한소화기학회지

BACKGROUND/AIMS: This study was conducted to establish a guideline on the utilizing of feeding pump in patients requiring enteral tube feeding. METHODS: As a first step, textbooks on nutrition and guidelines from regional clinical nutrition societies were analyzed. Afterwards, data on the efficacy, safety, and practicality of feeding pump application were collected and evaluated by systematically reviewing the related literature. As data sources, 8 domestic databases including KoreaMed and global databases such as Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were utilized. A total of 2,016 related articles was selected by applying the keyword "(enteral feeding.mp AND pump.mp)". RESULTS: Textbooks and guidelines were not able to draw conclusions on the effects of the feeding pump because the injection speed, tube size, and etcetera were different for enteral feeding. Feeding pump assisted enteral tube feeding was an efficient, safe, and practical procedure for reducing maladjustment-related complications of enteral tube feeding, which are obvious obstacles for maintaining nutritional balances in patients requiring tube feeding. CONCLUSIONS: Feeding pump application can be considered an efficient and safe measure that is acceptable in patients on small intestinal tube feeding, critically-ill patients on gastro-intestinal tube feeding, premature babies, and critically-ill or severely malnourished children (recommendation grade D).

Demographic and Health-related Risk Factors for the Recurrence of Primary Spontaneous Pneumothorax

PURPOSE: This study was conducted to examine the relationships between the recurrence of pneumothorax with demographic and health-related risk factors. METHODS: Demographic factors (age and gender) and health-related risk factors (Body Mass Index, smoking, exercise, stress, fatigue, and morbidity from colds) were measured from 60 patients admitted to two acute care institutions due to pneumothorax. RESULTS: The study results showed significant differences in factors such as height and minutes of performing exercise per week, between the first occurrence and recurrence groups. However, other risk factors did not show significant differences between the two groups. CONCLUSION: Prevention of recurrences is important for the treatment and management of pneumothorax. More studies are required to accumulate empirical evidence for health-related risk factors and pneumothorax recurrence, as the relationship between all factors and recurrence were not obtained by the study results.