ABSTRACT
BACKGROUND: The arterial anatomy of the pelvic region is highly variable, and variations in the anatomy of the ILA may often be observed in its point of origin. The main objective of the present meta-analysis was to provide the most up-to-date and evidence-based data regarding the complete anatomy of the iliolumbar artery (ILA. It is hoped that our results may aid in reducing possible complications associated with various procedures performed in the pelvis. MATERIALS AND METHODS: To perform this meta-analysis, major online medical databases - PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar - were searched through to find all studies considering the anatomy of the ILA. RESULTS: The pooled prevalence of the ILA originating from the Internal Iliac Artery, in the overall analysis, was found to be 93.62% (95% CI: 82.96-99.63%). Mean diameter of the ILA was found to be 2.67 mm (Standard Error = 0.19 ; Lower Limit = 2.29 ; Upper Limit = 3.05). Mean length of the ILA was established at 12.50 mm (Standard Error = 1.64 ; Lower Limit = 9.28 ; Upper limit = 15.73). CONCLUSIONS: The anatomy of the ILA was found to be quite constant, in contrast to what has been discussed in the literature. The said artery originated most frequently from the internal iliac artery (93.62%). Most frequently, this artery originated from the internal iliac artery (observed in approximately 93.62% of cases). Notably, the results of our current meta-analysis indicate that the average distance between the ILA's point of origin, the lower margin of the L5 vertebra, and the bifurcation site of the common iliac artery were 43.20 mm and 28.58 mm, respectively.
ABSTRACT
Background: The anatomical characteristics of the anterior ethmoidal artery (AEA) exhibit a high degree of variability, especially regarding its topography. Methods: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to identify all studies that included information regarding the morphometric and topographical characteristics of the AEA. Results: Ultimately, a compilation of 38 studies meeting the predetermined criteria, and possessing comprehensive and pertinent data, were incorporated into the current meta-analysis. In the overall analysis, reports of the AEA being embedded within the skull base or at the level of the skull base producing a bony protrusion were found in 56.91% of cases (95% CI: 43.55-69.80%). The mean diameters of the AEA in the intraorbital and intracranial areas were 0.94 mm and 0.76 mm, respectively. Moreover, the artery coursed most commonly between the second and third lamellae, with a prevalence of 65.82% (95% CI: 55.39-75.56%). Conclusions: The AEA may be at a high risk of iatrogenic injury during various sinus and skull base surgeries, especially if the surgeon performing these procedures is unfamiliar with the vast number of variations this vessel may exhibit. The spatial relationship between this vessel and the skull base is especially variable, and understanding this variability goes hand in hand with intraoperative safety.
ABSTRACT
BACKGROUND: The objective of this meta-analysis was to investigate the anatomical variations of the mandibular lingula (ML) and its relationship to surrounding anatomical structures. Understanding such variations is crucial to help determine the site and depth of a successful inferior alveolar nerve (IAN) anesthetic block as well as a safe area for oral and maxillofacial invasive procedures in order to minimize the risk of neurological or hematological damage to the inferior alveolar nerve. MATERIALS AND METHODS: A systematic search was conducted in which all studies were searched on the anatomy of ML. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library were searched. RESULTS: All of the results were based on a total of 4694 subjects. The overall height of the ML was found to be 8.17 mm (SE =0.22). The Triangular Type of the ML was found to be the most common one. The pooled prevalence of this variation was found to be 29.33% (LCI = 23.57% ; HCI = 35.24%). The pooled prevalence of the Nodular Type was set to be 27.99% (LCI = 22.64% ; HCI = 33.67%). CONCLUSIONS: The present meta-analysis provides clinically relevant information regarding the shape, location, and height variations of the ML. Understanding such variations of the ML is crucial when performing malocclusion corrections procedures that require the ML as a landmark, namely sagittal split ramus osteotomy, and intraoral vertical ramus osteotomy. Furthermore, effective anesthetic blocks during oral and maxillofacial procedures can be accomplished with a higher success rate if the correct site of injection is identified. The possible locations of the ML should be considered in order to determine the location of the mandibular foramen and, therefore, inferior alveolar bundle in order to prevent motor, sensory, or perfusion pathology during maxillofacial and oral procedures of the lower jaw.
ABSTRACT
The present study analyzed the characteristics of phase IV clinical trials in oncology using data from the ClinicalTrials.gov registry. The included trials were conducted between January 2013 and December 2022 and were examined for key characteristics, including outcome measures, interventions, sample sizes, and study design, different cancer types, and geographic regions. The analysis included 368 phase IV oncology studies. An amount of 50% of these studies examined both safety and efficacy, while 43.5% only reported efficacy outcome measures, and 6.5% only described safety outcome measures. Only 16.9% of studies were powered to detect adverse events with a frequency of 1 in 100. Targeted therapies accounted for the majority of included studies (53.5%), with breast (32.91%) and hematological cancers (25.82%) being the most frequently investigated malignancies. Most phase IV oncology studies lacked sufficient power to detect rare adverse events due to their small sample sizes and instead focused on effectiveness. To ensure that there is no gap in drug safety data collection and detection of rare adverse events due to limited phase IV clinical trials, there is a significant need for additional education and participation by both health care providers and patients in spontaneous reporting processes.
Subject(s)
Neoplasms , Routinely Collected Health Data , Humans , Medical Oncology , Neoplasms/drug therapy , Outcome Assessment, Health Care , Research Design , Clinical Trials, Phase IV as TopicABSTRACT
INTRODUCTION: Our umbrella review aimed to summarize and revisit the evidence from all of the meta-analyses and systematic reviews regarding the treatments of oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS: Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, BIOSIS, and EBSCO were searched. The overall search process was conducted in 3 stages. RESULTS: Finally, a total of 28 studies met the inclusion criteria and were included in this study. Out of those 28 meta-analyses, a total of 315 primary studies were screened in order to extract the data and perform the statistical analysis. In total, data from 22,619 patients was analyzed. CONCLUSION: The main objective of the present umbrella review was to summarize and analyze all of the evidence-based data provided by numerous meta-analyses and systematic reviews regarding the treatment of OPSCC. Our study delivers the most up-to-date and evidence-based results regarding the different therapeutic modalities of this malignancy in one concise review, making it the ultimate tool for physicians treating OPSCC.
