Digital Pulmonology Practice with Phonopulmography Leveraging Artificial Intelligence: Future Perspectives Using Dual Microwave Acoustic Sensing and Imaging.

Respiratory disorders, being one of the leading causes of disability worldwide, account for constant evolution in management technologies, resulting in the incorporation of artificial intelligence (AI) in the recording and analysis of lung sounds to aid diagnosis in clinical pulmonology practice. Although lung sound auscultation is a common clinical practice, its use in diagnosis is limited due to its high variability and subjectivity. We review the origin of lung sounds, various auscultation and processing methods over the years and their clinical applications to understand the potential for a lung sound auscultation and analysis device. Respiratory sounds result from the intra-pulmonary collision of molecules contained in the air, leading to turbulent flow and subsequent sound production. These sounds have been recorded via an electronic stethoscope and analyzed using back-propagation neural networks, wavelet transform models, Gaussian mixture models and recently with machine learning and deep learning models with possible use in asthma, COVID-19, asbestosis and interstitial lung disease. The purpose of this review was to summarize lung sound physiology, recording technologies and diagnostics methods using AI for digital pulmonology practice. Future research and development in recording and analyzing respiratory sounds in real time could revolutionize clinical practice for both the patients and the healthcare personnel.

Practicing Digital Gastroenterology through Phonoenterography Leveraging Artificial Intelligence: Future Perspectives Using Microwave Systems.

Production of bowel sounds, established in the 1900s, has limited application in existing patient-care regimes and diagnostic modalities. We review the physiology of bowel sound production, the developments in recording technologies and the clinical application in various scenarios, to understand the potential of a bowel sound recording and analysis device-the phonoenterogram in future gastroenterological practice. Bowel sound production depends on but is not entirely limited to the type of food consumed, amount of air ingested and the type of intestinal contractions. Recording technologies for extraction and analysis of these include the wavelet-based filtering, autoregressive moving average model, multivariate empirical mode decompression, radial basis function network, two-dimensional positional mapping, neural network model and acoustic biosensor technique. Prior studies evaluate the application of bowel sounds in conditions such as intestinal obstruction, acute appendicitis, large bowel disorders such as inflammatory bowel disease and bowel polyps, ascites, post-operative ileus, sepsis, irritable bowel syndrome, diabetes mellitus, neurodegenerative disorders such as Parkinson's disease and neonatal conditions such as hypertrophic pyloric stenosis. Recording and analysis of bowel sounds using artificial intelligence is crucial for creating an accessible, inexpensive and safe device with a broad range of clinical applications. Microwave-based digital phonoenterography has huge potential for impacting GI practice and patient care.

Prospect of Alpha-Synuclein (A-Syn) Isolation From Saliva as a Promising Diagnostic Biomarker Alternative in Parkinson's Disease (PD): A Systematic Review.

Neurodegenerative diseases, in particular Parkinson's disease (PD), a disabling disorder, require early attention due to the course the diseases take. By the time of clinical manifestation, dopaminergic neuron death would have already exceeded a damaging level. Therefore, the discovery of biomarkers that will effectively diagnose PD at an early stage and help monitor disease advancement is crucial. Out of the available biomarkers and bodily sources from which these can be isolated; alpha-synuclein (a-syn) from saliva seems to be a promising and easily accessible option. This has been further investigated in this systematic review. A comprehensive literature search on PubMed, PubMed Central (PMC), and Science Direct resulted in 1,439 articles. After screening and exclusion, 12 relevant articles were derived. In many of the studies, there was a decrease in total salivary a-syn in PD patients compared to healthy controls (HC), with an increase in oligo a-syn and oligo a-syn/total a-syn ratio as a rather consistent finding amongst the studies reviewed. On the other hand, a few studies revealed no significant difference in a-syn levels between the controls and PD patients. Another common finding was the lack of disease severity correlation with the marker, probably due to the scarcity of longitudinal studies conducted and smaller cohorts recruited in the studies. Overall, the total a-syn did show a genetic and phenotypic association, whilst oligo a-syn had the potential to serve as a biomarker for disease diagnosis. With the standardization of sample collection methods and diagnostic tools, and the accomplishment of longitudinal studies, further importance of salivary a-syn as a biomarker in PD could be established, utilizing the already existing data as an encouraging foundation for future research.

Role of Metformin in the Management of Polycystic Ovarian Syndrome-Associated Acne: A Systematic Review.

Metformin, a biguanide hypoglycemic agent that is safe and effective for treating acne in women with the polycystic ovarian syndrome (PCOS), has shown growing evidence of improving insulin resistance, hyperandrogenism, dyslipidemia, overall cardiovascular health, quality of life, psychological wellbeing, and general health outcomes. This study aims to identify and summarize the effects of metformin in patients with PCOS-associated acne. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was done on PubMed, PubMed Central, Cochrane, Google Scholar, and Science Direct databases from 2011 up to 23 February 2022. Randomized controlled trials (RCTs), cross-sectional studies, observational studies, literature reviews, systematic reviews, and meta-analyses published in English were selected. The data was extracted to a predefined template. Each study was individually checked by using a quality assessment. The initial search generated a total of 218 studies. Nine studies were included in the final selection: two RCTs, one hospital-based longitudinal study, one hospital-based clinical trial, three cross-sectional studies, three systematic reviews with meta-analyses, and one narrative review. Metformin is generally effective and safe for improving PCOS-associated acne and the quality of life. More clinical trials are required to determine the indications for prescribing metformin in patients with PCOS-associated acne.

Is Tocilizumab Effective and Safe in Polymyalgia Rheumatica and Giant-Cell Arteritis With Polymyalgia Rheumatica?

Polymyalgia rheumatica (PMR) and giant-cell arteritis (GCA) with symptoms of PMR share some pathophysiologic features. Interleukin 6 (IL-6) levels are elevated in both groups. We investigated the effect of tocilizumab (TCZ), an IL-6 inhibitor, in both populations and whether there were any differences regarding effectiveness and safety between them. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching the following databases: PubMed, PMC, Medline, Scopus, Cochrane Library, and ClincalTrials.gov. We found eight articles including one systematic review, one randomized controlled trial (RCT), one posthoc analysis of an RCT, and five observational studies. A total of 668 patients were included in this study. After a comprehensive analysis, we can only infer that there is insufficient evidence to suggest TCZ as monotherapy. Nevertheless, using TCZ in combination with glucocorticoid can be an effective therapeutic option.

The Effects of Yoga on Bipolar Disorder: A Systematic Review.

Bipolar disorder (BD) is a mood disorder characterized by severe mood swings and or periods of depression. This study examined the role that practicing yoga has on the symptoms of BD. One of the main goals was to identify if patients with BD believe that yoga is a viable treatment option. Six research databases were searched using the keywords "yoga" AND "therapy" AND "BD" AND "bipolar depression." Articles published in 2005 and later were included in the search. After duplicates were removed, and inclusion and exclusion criteria were applied, five articles were analyzed and included in this literature review. Results of this review indicate that yoga has been shown to be associated with both benefits and risks for the treatment of BD. Studies have shown that yoga might relieve some symptoms of BD and depression. However, due to the lack of research on the impact of yoga on BD and the small number of studies included in this review, results should be approached with caution. Overall, yoga was well-tolerated in the studies reviewed in this article. Yoga may relieve the symptoms of depression. Future research should analyze the long-term impact of yoga on bipolar depression. Yoga instructional standards should also be considered.

Ill Effects and Complications Associated to Removable Dentures With Improper Use and Poor Oral Hygiene: A Systematic Review.

The importance of oral care and its relationship with an individual's well-being has been identified over the past few decades. As there is a drastic increase in the aging population, so did the use of removable dentures more than ever before. The use of dentures among the elderly provides functional advantages and esthetic benefits. However, improper use and poor oral hygiene with removable dentures come with complications, including denture stomatitis, ulcerations, pneumonia, and many more. The study aims to determine the complications associated with inappropriate use and poor oral care and bring forth evidence-based dentist-recommended guidelines for denture maintenance. Articles were systematically screened in PubMed/Medline (Medical Literature Analysis and Retrieval System Online), PubMed Central (PMC), and Cochrane Library using keywords. Medical Subject Heading (MeSH) was also utilized to identify relevant articles. Inclusion and exclusion criteria were applied, duplicate articles were discarded, and then the articles were reviewed by title and abstract screening. The remaining articles went through a detailed full-text review. A quality appraisal check was conducted for each unique type of research publication, after which a total of 22 articles were finalized. In this study, we have seen pathological biofilm formation on dentures, life-threatening pneumonia, denture stomatitis, and accidental ingestion/aspiration of dentures amongst the elderly population. The study also identified members with low literacy rates, minorities, and low-income families seem to be at higher risk of poor oral care and denture hygiene. We identified that most of these complications could be prevented with proper guidance and education. In the future, a further detailed study is important as no clear consensus exists in terms of best practices of denture cleaning methods. In addition, measures should be initiated to encourage regular dentist appointments and increase accessibility among members of low socioeconomic status and minorities.