Review of the Prevalence of Opioid Use Disorder Following Traumatic Brain Injury.

BACKGROUND: Opioid use disorder is a worldwide economic and health concern. Opioid use seems to be increased in those who sustained traumatic brain injury (TBI). The aim of the current systematic review is to examine the prevalence of opioid use disorders among individuals with TBI. METHODS: A literature review was conducted using the following databases: Cochrane Library, Google Scholar, PubMed, Wiley, and MEDLINE. The pertinence of any study to the inclusion criteria was determined by assessing the title, key words, and abstracts. Data were extracted using multiple variables that were formulated with the study aim and then further analyzed. RESULTS: Twenty studies published between 2013 and 2022 met inclusion criteria. From a total of 20 included articles, 2 were reviews, 1 was a prospective cohort study, and the rest were retrospective studies. Most data were collected from electronic medical records, and 11 studies were conducted on military-affiliated samples. Prevalence varied differently among studies and different populations, where greater numbers were seen in patients who required greater care in intensive care units, for example. CONCLUSIONS: Opioid use disorder is an imminent danger worldwide. Firm regulation for an opioid prescription for patients with TBI during hospitalization or in rehabilitation centers tackles co-existing behavioral problems, frequent follow-up, and the use of nonopioid medications as possible to control chronic pain in this vulnerable subgroup. Future prospective studies to measure the effect of different intervention methods to mitigate the increased risk of opioid use post-TBI are needed.

Early Onset Colorectal Cancer in Arabs, Are We Dealing with a Distinct Disease?

Early-onset colorectal cancer (EOCRC) incidence is increasing worldwide. Efforts are directed to understand the biological and clinical signatures of EOCRC compared to late-onset colorectal cancer (LOCRC). EOCRC is thought to present differently across different ethnic groups and geographical regions. This study was an attempt to contribute with data from the Arab world toward the understanding of the clinicopathological parameters of EOCRC compared to LOCRC. Data from 254 CRC patients diagnosed at Sultan Qaboos University Hospital from the period 2015-2020 were studied. About 32.6% of all diagnosed CRC patients are below 50 years old, with no differences in gender distribution between EOCRC and LOCRC (p-value 0.417). Rectal involvement and tumor laterality were comparable among the two groups. Adenocarcinoma accounts for 83.3% and 94.2% of EOCRC and LOCRC, respectively. More mucinous and signet ring adenocarcinoma (8.3% each) were reported in EOCRC than LOCRC (2.9% and 2.2%, respectively). MLH1 and PMS2 loss are more common among LOCRC, but MSH6 loss is more frequent in EOCRC. The overall survival of EOCRC and LOCRC was comparable (median survival 64.88 and 67.24 months, respectively). This study showed comparable clinicopathological parameters between EOCRC and LOCRC from Arabs, which adds to the bigger picture of understand the disease.

Predicting Patients at Risk for Prolonged Hospital Stays Following Pediatrics Traumatic Head Injuries in High-Income Developing Country: A Retrospective Cohort Study.

BACKGROUND: Traumatic brain injuries (TBIs) in pediatrics are the most common cause of long-term morbidity and mortality, generating a considerable burden on the health care system. In the current retrospective study, we aimed to identify the predictors that contribute to prolonged hospital stays in pediatric TBI. METHODS: A retrospective cohort study including all pediatric cases (age younger than 14) who presented to Khoula Hospital with TBI and were seen from January 2015 to December 2019. The multivariate binary logistic regression analysis has been used to determine the independent predictors of prolonged hospital stay. Prolonged hospitalization was defined as mean ± 2 standard deviation days. RESULTS: A total of 866 cases of pediatric TBI were documented. The mean age was 4.33 years. The length of hospital stay ranged from <1 day to 90 days (mean = 3.65, standard deviation = 6.84). Prolonged hospitalization was calculated to be >17 days. Thirty-one patients had prolonged hospital stay out of the studied cohort, with an incidence proportion of prolonged stay = 3.6% (95% CI = 2.4%-5.0%). Prolonged hospitalizations were associated with motor vehicle collision injuries (odds ratio [OR]: 27.028, 95% confidence interval [CI] = 2.744-266.194, P = 0.005); pedestrian injuries (OR = 11.667, 95% CI = 1.017-133.805, P = 0.048), and Glasgow Coma Scale score on arrival of <9 (OR = 8.149, 95% CI = 1.167-56.921, P = 0.034). CONCLUSIONS: The current study identified motor vehicle collision and pedestrian injuries, as well as initial Glasgow Coma Scale score of <9 as independent predictors of prolonged hospitalization in pediatrics TBI.

Systemic Review and Meta-analysis of the Intellectual Integrity of Children with Neurofibromatosis Type 1.

BACKGROUND: Cognitive impairment is a common neurologic complication of neurofibromatosis type 1 (NF-1) in childhood. A great number of learning disabilities appear in 30%-65% of children with NF-1. The aim of the study is to compare intelligence quotient (IQ) scores between children with NF-1 and comparable control groups. METHODS: A literature review was conducted using the following databases: Cochrane, PubMed, Wiley, Microsoft Academic, and Google Scholar. We identified 180 papers. The pertinence of any study to the inclusion criteria was determined by assessing the title, key words, and abstracts. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed. RESULTS: Eleven articles met our criteria, with the highest level of evidence of 3c. A total of 483 NF1 and 443 control participants were included in this meta-analysis. The average and standard deviation of the age was 9.15 ± 3.15 years with an age range of 3.3-18 including 488 male and 438 female. The pooled estimate of the mean difference in all 3 parameters used full-scale IQ, verbal IQ, and performance IQ. Statistically, there was a significantly lower IQ in the NF-1 group compared with the control group with a 95% CI and (P < 0.00001). CONCLUSION: The current meta-analysis illustrated a significant intellectual deficit in children with NF-1 compared with their typically developed peers who were matched by age. Performance IQ was significantly impaired compared with verbal IQ in NF-1 children. The current findings may guide experts to tailor individualized educational programs for children with NF-1.