Publications by authors named "Ka Wai Tam"
Introduction: The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) that adopts paramedian incisions and tubular retractors to perform the decompression and interbody fusion has been widely used in the surgery for lumber degenerative disease (LDD). Bilateral pedicle screw fixation (BPSF) and unilateral pedicle screw fixation (UPSF) are the primary fixing techniques in MIS-TLIF. We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the efficacy and safety between UPSF and BPSF in patients undergoing MIS-TLIF surgery for LDD.
View Article and Find Full Text PDFObjective: Deep sternal wound infection (DSWI) is a rare but devastating complication that is estimated to occur in 1-2% of patients after median sternotomy. Current standard of care (SoC) comprises antibiotics, debridement and negative pressure wound therapy (NPWT). Hyperbaric oxygen therapy (HBOT) appears to be an effective adjuvant therapy for osteomyelitis.
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- - The study reviews large-scale clinical trials and real-world data on the effectiveness and safety of CDK4/6 inhibitors for breast cancer treatment, addressing potential biases from limited real-world evidence.
- - It analyzed 41 prospective trials and 80 retrospective studies with nearly 70,000 patients, finding that CDK4/6 inhibitors significantly enhance overall survival and progression-free survival rates across different drugs.
- - Adverse effects vary by ethnicity, with Asian patients more prone to specific side effects like neutropenia, while Western patients reported higher rates of severe adverse effects, highlighting the need for personalized treatment approaches.
This meta-analysis investigated therapeautic effects of laser therapies in patients with Bell's palsy (BP). The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases using the following search terms: (facial paralysis OR Bell's palsy OR facial palsy OR idiopathic facial paralysis) AND (laser OR low-level laser OR photobiomodulation OR phototherapy). Relevant studies published before October 29th 2024 were identified.
View Article and Find Full Text PDFBackground And Objectives: Indication for sentinel lymph node (SLN) biopsy in ductal carcinoma in situ (DCIS) patients with high-upstaging risk remains inconsistent. Our previous systematic review and meta-analysis had reported five variables that were significantly higher in the upstaging group. We developed the "high-risk upstaging model" and investigated its predictivity and accuracy.
View Article and Find Full Text PDFBackground: Older patients with breast cancer are often underrepresented in clinical trials, leading to a lack of evidence-based guidelines for surgical treatment in this cohort. Consequently, synthesizing real-world data is crucial for determining the optimal surgical management of geriatric patients with breast cancer.
Methods: A comprehensive search was conducted of the PubMed, Embase, and Cochrane Library databases.
Background: Lag screw fixation (LSF) or locking plate fixation (LPF) are both recommended for the treatment of medial malleolar fractures (MMFs). However, no standard has been established for attaining optimal surgical treatment or functional recovery. We hypothesized that LPF for MMFs would result in superior outcomes compared to LSF.
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- Aromatherapy may help reduce behavioral and psychological symptoms of dementia (BPSD) and improve functional abilities in patients with dementia, as shown in a systematic review and meta-analysis of randomized controlled trials.
- The analysis included 15 trials involving 821 participants, revealing significant reductions in agitation and neuropsychiatric symptoms after 3 to 4 weeks of treatment with aromatherapy compared to control groups.
- While some trials indicated improvements in depressive moods, the study concluded that aromatherapy is a safe non-drug option for managing BPSD, particularly when combined with massage therapy.
Objectives: Stroke is a leading cause of death in Taiwan. Poor public knowledge of stroke may lead to delays in prehospital arrival, resulting in unfavorable prognoses. Studies have investigated public knowledge of stroke and highlighted the importance of stroke education, however, few such studies have been conducted in Taiwan.
View Article and Find Full Text PDFBackground: Insufficient data available for older patients with breast cancer complicates decision-making regarding optimal treatment. A systematic review that uses real-world data is required for assessing the effectiveness and potential adverse effects of various therapies for this age group of patients.
Methods: Databases of PubMed, Embase, and Cochrane Library were searched.
Background: The optimal treatment for malignant gastric outlet obstruction (GOO) remains uncertain. This systematic review aimed to comprehensively investigate the efficacy and safety of four palliative treatments for malignant GOO: gastrojejunostomy, endoscopic ultrasound-guided gastroenterostomy (EUS-GE), stomach-partitioning gastrojejunostomy (PGJ), and endoscopic stenting.
Methods: We searched PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases, ClinicalTrials.
Background: Chemotherapy-induced nausea and vomiting (CINV) is a prevalent and distressing side effect. Historically, ginger has been explored as a potential remedy for various ailments, including its potential efficacy against CINV.
Objective: The aim of this study was to determine whether taking ginger supplements can relieve CINV.
Background: Patients receiving mechanical ventilation commonly experience sleep fragmentation. The present meta-analysis compared the effects of pressure controlled ventilation (PCV) and pressure support ventilation (PSV) on sleep quality.
Methods: We conducted a search of the PubMed, Embase, and Cochrane Library databases for studies published before November 2023.
Background: The aging population has caused assistive technology (AT) to receive attention. Thus, ensuring accurate user comprehension of AT has become increasingly crucial, and more specialized education for students in relevant fields is necessary. The goal of this study was to explore the learning outcomes in the context of AT for older adults and individuals with disabilities through the use of VR experiential learning.
View Article and Find Full Text PDFThis study compared the ankle-brachial index (ABI) with transcutaneous oxygen pressure (TcPO ) in assessing peripheral vascular disease (PVD) prevalence in 100 diabetic foot ulcer (DFU) patients. Patients were categorized into vascular or nonvascular reconstruction groups and underwent both ABI and TcPO measurements four times over 6 months. Predictive validity for PVD diagnosis was analysed using the area under the receiver-operating characteristic curve (AUC).
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- This study investigated the differences in outcomes between low-dose and standard-dose alteplase in patients with acute ischemic stroke, focusing on bridging therapy for large vessel occlusion.
- The analysis included five studies with 408 patients and measured outcomes like functional independence, successful recanalization, intracerebral hemorrhage, and mortality.
- Results showed that low-dose alteplase did not improve 90-day functional independence compared to standard-dose but had similar rates of successful recanalization, sICH, and mortality, though these results were not statistically significant.
Background: Adhesions within the abdominal cavity develop in as many as 90 % of individuals following abdominal surgery. However, the true adhesive condition of patients can only be ascertained during the second surgery.
Methods: We conducted a prospective, non-randomized study to assess the anti-adhesion properties of purified starch in patients who had undergone colorectal surgery in the past and then needed a subsequent surgical intervention.
Post-operative pain and bleeding are the main complications following hemorrhoidal surgery. This study aimed to investigate whether an absorbable gelatin sponge is a superior hemostatic and analgesic agent compared to gauze soaked in epinephrine for post-hemorrhoidal surgery care. A retrospective study was conducted using data from a single institute.
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- Inflammatory breast cancer (IBC) is a rare and aggressive type of breast cancer, and the study evaluates breast-conserving therapy (BCT) as an alternative to mastectomy for patients responding to neoadjuvant chemotherapy (NAC).
- The analysis reviewed 17 studies, showing similar local recurrence rates and 5-year survival rates for patients undergoing BCT and those undergoing mastectomy.
- Despite promising results for BCT, concerns about the low sentinel lymph node detection rate and high false-negative rate indicate a need for more extensive clinical studies.
Objective: Cancer-related fatigue (CRF) is a common side effect in cancer patients, possibly due to disrupted circadian rhythms. While bright light therapy (BLT) is known to modulate circadian rhythms, its role in mitigating CRF remains unclear. This study examined the impact of BLT on CRF and other related symptoms.
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- - Simulation scenarios were utilized in a Risk-of-Bias 2.0 framework to teach third-year preclinical medical students about biases in randomized controlled trials as part of an evidence-based medicine course.
- - The teaching method included 13 modules where students assessed bias through interactive voting and discussions, emphasizing critical thinking in evaluating research evidence.
- - Feedback from 306 students indicated a high appreciation for the interactive format, although they faced challenges in recognizing certain biases effectively.
Objective: Thyroid nodules are common and sometimes associated with cosmetic issues. Surgical treatment has several disadvantages, including visible scarring. High-intensity focused ultrasound (HIFU) is a recent noninvasive treatment for thyroid nodules.
View Article and Find Full Text PDFDementia is a major cause of disability and dependency. Pharmacological interventions are commonly provided to patients with dementia to delay the deterioration of cognitive functions but cannot alter the course of disease. Nonpharmacological interventions are now attracting increasing scholarly interest.
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