Background: Myelomeningocele is a lifelong condition that features several comorbidities, such as hydrocephalus, scoliosis, club foot, and lower limb sensory and motor disabilities. Its management has progressed over time, ranging from supportive care to early postnatal closure to prenatal closure of the defect. Recent research discovered that fetal myelomeningocele closure (fMMC) provided superior neurological outcomes to those of postnatal closure. When performed at 12 months of age, fMMC can avert or delay the need for a ventriculoperitoneal shunt and reversed the hindbrain herniation. Moreover, fMMC reportedly enhanced motor function and mental development at 30 months of age. However, its long-term outcomes remain dubious.Purpose: This systematic review aimed to determine the long-term neurological cognitive, behavioral, functional, and quality of life (QOL) outcomes after fMMC. Methods:The PubMed, Directory of Open Access Journals, EBSCO, and Cochrane databases were extensively searched for articles published in 2007-2022. Meta-analyses, clinical trials, and randomized controlled trials with at least 5 years of follow-up were given priority.Results: A total of 11 studies were included. Most studies revealed enhanced long-term cognitive, behavioral, functional, and QOL outcomes after fMMC. Conclusion:Our results suggest that fMMC substantially enhanced patients' long-term neurological cognitive, behavioral, functional, and QOL outcomes.
Introduction: Concussion is a common complaint among adult and adolescent athletes around the world and poses a safety risk in competitive, recreational, and noncontact sports. It is estimated that concussions occur at a rate of 0.5 per 1000 playing hours; however, the precision of this estimate is uncertain due to variations in the interpretation and reporting of concussions. Athletes with a history of concussions are more likely to sustain additional concussions, which can result in cognitive decline, depression, and early degenerative change. In order to lessen the likelihood of future difficulties, this study compiles the research on preventing sports-related concussion in soccer and presents a summary of the findings. Material and Methods: We performed a literature search on PubMed, EBSCO (Elton B. Stephens Company), DOAJ (Directory of Open Access Journals), and Cochrane for the past 20 years. The search strategy was using Boolean terms based on any of the search terms of sports-related-concussion, soccer, and prevention. The studies were included based on inclusion and exclusion criteria. Results: This research identified three systematic reviews, seven literature reviews, five cross-sectional studies, one randomized controlled trial, three prospective studies, and one retrospective study. As concussion prevention measures in soccer, several strategies can be implemented, including concussion education, rule/regulation changes, proper heading technique, behavioral skills training, vision training to improve sensory and anticipation, the use of supplements to prevent severe concussion and accelerate recovery, as well as prevention in youth sports and head impact detection. Conclusion: Good education, good technique, good training, and a good strengthening program can be implemented to prevent concussions in soccer. To determine the relationship between prevention and concussion, however, additional research is required.
Latar Belakang: Cedera otak traumatis merupakan salah satu penyebab kematian dan kecacatan tertinggi di dunia. Angka mortalitas pasien cedera kepala dengan tekanan intrakranial di bawah 20 mmHg adalah 18,4%, sedangkan angka mortalitas setinggi 55,6% dilaporkan pada pasien dengan tekanan intrakranial melebihi 40 mmHg. Terapi hiperosmolar dengan manitol atau saline hipertonis merupakan tata laksana medis utama untuk menangani peningkatan intrakranial akibat cedera otak traumatis. Tinjauan sistematis ini bertujuan membandingkan efektivitas kedua terapi hiperosmolar tersebut dalam tata laksana cedera otak traumatis. Metode: Penelitian ekstensif dilakukan pada database PubMed, DOAJ, dan Cochrane dengan kriteria inklusi publikasi dalam dua puluh tahun terakhir. Artikel penelitian dalam bentuk meta-analisis, uji klinis, dan uji acak terkontrol lebih diutamakan. Kriteria eksklusi adalah pernyataan tidak jelas, korelasi yang tidak relevan dengan topik utama, atau fokus pada penyakit lain. Hasil: Sebelas penelitian menyimpulkan bahwa efektivitas saline hipertonis sebanding dengan manitol, enam penelitian menunjukkan bahwa saline hipertonis lebih unggul. Simpulan: Saline hipertonis layak dipertimbangkan sebagai alternatif untuk manitol, direkomendasikan untuk pasien dengan hipovolemia, hiponatremia, atau gagal ginjal. Penelitian lebih lanjut diperlukan untuk mendapatkan dosis terapi dan konsentrasi saline hipertonis yang optimal. Background: Traumatic brain injury is one of the leading causes of death and disability worldwide. Mortality rate of head injuries with intracranial pressure below 20 mmHg was reported 18.4%, whereas those with intracranial pressure more than 40 mmHg had a 55.6% mortality rate. Hyperosmolar therapy with mannitol or hypertonic saline is the mainstay of medical management for treating elevated intracranial pressure in traumatic brain injury. This systematic review aimed to compare the effectiveness of these two hyperosmolar therapies in the management of traumatic brain injury. Methods: The PubMed, DOAJ, and Cochrane databases were used to perform extensive study, with the inclusion criteria of publications in the last twenty years. Meta-analyses, clinical trials, and randomized controlled trials were included. Unclear statements, irrelevant correlation with the main topic, or focusing more on other diseases were the exclusion criteria. Results: Eleven researches stated that the effectiveness of mannitol and hypertonic saline are comparable, six researches showed that hypertonic saline was better. Conclusion: Hypertonic saline should be considered as a preferable alternative to mannitol, recommended for patients with hypovolemia, hyponatremia, or renal failure. Further studies are required to find the optimal therapeutic dose and concentration of hypertonic saline.
<p>Latar Belakang: Cedera otak traumatis merupakan salah satu penyebab kematian dan kecacatan tertinggi di dunia. Angka mortalitas pasien cedera kepala dengan tekanan intrakranial di bawah 20 mmHg adalah 18,4%, sedangkan angka mortalitas setinggi 55,6% dilaporkan pada pasien dengan tekanan intrakranial melebihi 40 mmHg. Terapi hiperosmolar dengan manitol atau saline hipertonis merupakan tatalaksana medis utama untuk menangani peningkatan intrakranial akibat cedera otak traumatis. Tinjauan sistematis ini bertujuan membandingkan efektivitas kedua terapi hiperosmolar tersebut dalam tatalaksana cedera otak traumatis. Metode: Penelitian ekstensif dilakukan pada database PubMed, DOAJ, dan Cochrane dengan kriteria inklusi publikasi dalam dua puluh tahun terakhir. Artikel penelitian dalam bentuk meta-analisis, uji klinis, dan uji acak terkontrol lebih diutamakan. Kriteria eksklusi adalah pernyataan tidak jelas, korelasi yang tidak relevan dengan topik utama, atau fokus pada penyakit lain. Hasil: Sebelas penelitian menyimpulkan bahwa efektivitas saline hipertonis sebanding dengan manitol, enam penelitian menunjukkan bahwa saline hipertonis lebih unggul. Simpulan: Saline hipertonis layak dipertimbangkan sebagai alternatif untuk manitol, direkomendasikan untuk pasien dengan hipovolemia, hiponatremia, atau gagal ginjal. Penelitian lebih lanjut diperlukan untuk mendapatkan dosis terapi dan konsentrasi saline hipertonis yang optimal.</p><p>Background: Traumatic brain injury is one of the leading causes of death and disability worldwide. Mortality rate of head injuries with intracranial pressure below 20 mmHg was reported 18.4%, whereas those with intracranial pressure more than 40 mmHg had a 55.6% mortality rate. Hyperosmolar therapy with mannitol or hypertonic saline is the mainstay of medical management for treating elevated intracranial pressure in traumatic brain injury. This systematic review aimed to compare the effectiveness of these two hyperosmolar therapies in the management of traumatic brain injury. Methods: The PubMed, DOAJ, and Cochrane databases were used to perform extensive study. The criteriion was publication within the last twenty years. Meta-analyses, clinical trials, and randomized controlled trials were included. Unclear statements, irrelevant correlation with the main topic, or focusing more on other diseases were the exclusion criteria. Results: Eleven researches stated that the effectiveness of mannitol and hypertonic saline are comparable, six researches showed that hypertonic saline was better. Conclusion: Hypertonic saline should be considered as a preferable alternative to mannitol, recommended for patients with hypovolemia, hyponatremia, or renal failure. Further studies are required to find the optimal therapeutic dose and concentration of hypertonic saline.</p>
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