OBJECTIVE A review article assessing all the risk factors reported in the literature for postoperative cerebellar mutism syndrome (pCMS) among children remains absent. The authors sought to perform a systematic review and meta-analysis to evaluate this issue. METHODS PubMed, Embase, and Web of Science were queried to systematically extract potential references. The articles relating to pCMS were required to be written in the English language, involve pediatric patients (≤ 18 years of age), and provide extractable data, which included a comparison group of patients who did not develop pCMS. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale. Data were pooled using RevMan 5.4, and publication bias was assessed by visual inspection for funnel plot asymmetry. The study protocol was registered through PROSPERO (ID: CRD42021256177). RESULTS Overall, 28 studies involving 2276 patients were included. Statistically significant risk factors identified from univariate analysis were brainstem invasion (OR 4.28, 95% CI 2.23–8.23; p < 0.0001), fourth ventricle invasion (OR 12.84, 95% CI 4.29–38.44; p < 0.00001), superior cerebellar peduncle invasion (OR 6.77, 95% CI 2.35–19.48; p = 0.0004), diagnosis of medulloblastoma (OR 3.26, 95% CI 1.93–5.52; p < 0.0001), medulloblastoma > 50 mm (OR 8.85, 95% CI 1.30–60.16; p = 0.03), left-handedness (OR 6.57, 95% CI 1.25–34.44; p = 0.03), and a vermis incision (OR 5.44, 95% CI 2.09–14.16; p = 0.0005). On the other hand, a tumor located in the cerebellar hemisphere (OR 0.23, 95% CI 0.06–0.92; p = 0.04), cerebellar hemisphere compression (OR 0.23, 95% CI 0.11–0.45; p < 0.0001), and intraoperative imaging (OR 0.36, 95% CI 0.18–0.72; p = 0.004) reduced the risk of pCMS. CONCLUSIONS This study provides the largest and most reliable review of risk factors associated with pCMS. Although some risk factors may be dependent on one another, the data may be used by surgeons to better identify patients at risk for pCMS and for intervention planning.
Objectives:The variety of clinical presentation on the topic of carbon monoxide (CO) intoxication ranges from slight headache to coma or death. YouTube allows patients to search not only for entertainment but also medical advice. Therefore, the aim of this study was to evaluate the content and quality of YouTube videos concerning CO poisoning as a source of knowledge for non-medical audience. Material and Methods: On the December 8, 2020 a YouTube search was conducted for the following phrases: "carbon monoxide poisoning, " "carbon monoxide symptoms, " "CO poisoning, " "carbon monoxide asphyxiation, " "carbon monoxide intoxication" using the "incognito mode" and without attachment to Google Account. The search results were set as: "default" in the YouTube browser. The first 50 results were taken into consideration. Two raters, a specialist in emergency medicine and a specialist in clinical toxicology rated videos with Quality Criteria for Consumer Health Information (DISCERN), Global Quality Score (GQS) and Journal of the American Medical Association (JAMA). "VidIQ Vision for YouTube" plug-in was used. Results: Ninety-five videos were included. The interclass coefficient for DISCERN, GQS and JAMA scores were: 0.8, 0.74 and 0.62 reaching good and moderate reliability. The mean DISCERN/GQS/JAMA was 28.1 (SD 7.9), 2.5 (SD 0.8) and 1.1 (SD 0.7) respectively. Higher DISCERN/GQS/JAMA had videos providing information on: exposure time, treatment options, hyperbaric chamber indications as well as physician speaker (p < 0.05). Video Power Index was higher when the video contained animations and presented patients own history of CO exposure but not influenced the DISCERN/ GQS/JAMA scores. Videos providing misleading information had a higher like ratio. Conclusions: The overall video quality was poor indicating inappropriate educational and informative value for patients who search information about carbon monoxide poisoning. Int J Occup Med Environ Health. 2022;35(3)
Background. dextromethorphan (dXM) is a widely used over-the-counter antitussive drug. in supratherapeutic doses, it exerts psychoactive effects. Use of dXM seems very common among people seeking 'illegal or legal highs'. Objectives. the aim of the study is to assess the social and psychological features of dXM users. Material and methods. data on dXM poisoning (n = 103; adults and youths) in lodz Province from January 2011 to March 2015 were obtained. Furthermore, analyses of the psychological or psychiatric examination of patients were performed. the symptoms of acute intoxication and ingested doses were reported to evaluate the course and possible tolerance. Results. recreational dXM poisoning was the main reason for the admission of the majority of patients (53%). this phenomenon was observed mainly in the group of adolescents and young adults. the average dose ranged from 5 up to 120 pills of 15 mg each. coadministration with alcohol was reported in 45% of patients. clinical presentation included predominantly balance disorders, psychomotor retardation and agitation. there was a difference in psychosocial risk factors between genders: living alone and relationship problems were significantly more frequent in females. Conclusions. our study highlights gender differences in psychosocial risk factors for dXM use, a potential role of the family environment, substance addiction, and organic diseases in the development of dXM dependence. SummaryISSN 1734-3402, eISSN 2449-8580 this is an open access article distributed under the terms of the creative commons attribution-noncommercial-sharealike 4.0 international (cc by-nc-sa 4.0). license (http://creativecommons.org/licenses/by-nc-sa/4.0/). Koziarska-rościszewska M, Piątek a, Kobza-sindlewska K, Krakowiak M, winnicka r, Krakowiak a. dextromethorphan recreational use and poisoning -the social and psychological background. Fam Med Prim Care Rev 2018; 20(2): 139-143, doi: https://
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