Publications by authors named "Zhen Y Wong"

Introduction: The management of malignant melanomas often involves performing a sentinel lymph node biopsy (SLNB) aided by imaging with lymphoscintigraphy. Whether lymphoscintigraphy should be performed on the same day as the SLNB operation (SD) or the day before (DB) surgery remains debated. This study aims to summarise existing evidence regarding the impact of the relative timings of lymphoscintigraphy and SLNB on clinical outcomes in melanoma.

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Background: Despite extensive discourse on the utilisation of the temporal muscle for facial reanimation, anatomical description regarding the innervation of its motor nerve branches is incomplete and varied. This systematic review aimed to consolidate the existing evidence concerning the distribution and variation in the pattern of temporalis innervation.

Methods: A PRISMA-compliant systematic literature search was conducted in November 2023 and included studies offering anatomical insights into the distribution and variation of temporalis innervation patterns.

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Background: Despite the encouraging findings of temporalis muscle-based facial reanimation surgery without the need for nerve grafting, there is a need for comprehensive evaluation of the impact of temporalis-based facial reanimation surgery on key outcome measures.

Methods: Comprehensive search in Medline and Embase databases were carried out up to 25 February 2023. The articles that examined facial reanimation surgery using the temporalis muscle were included in this study.

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Bariatric surgery (BS) has demonstrated cardiovascular benefits in patients and was previously proven to be associated with an increased natriuretic peptide level without cardiac dysfunction. However, new studies have emerged, which require us to re-examine the relationship and extent of the correlation between BS, weight loss, and cardiac natriuretic peptide levels. A systematic search was conducted.

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Article Synopsis
  • Facial palsy (FP) leads to facial paralysis, impairments, and affects appearance, which can impact quality of life and mental health due to issues like social isolation.
  • A review of 16 studies from 2010 to 2023 found that botulinum toxin injections are effective in improving facial symmetry and aesthetics for long-term FP management, with benefits lasting around 4 months.
  • Although botulinum shows promise for treating FP, especially for long-term effects, more research is needed for its use in acute cases to establish guidelines for timing, dosage, and treatment intervals.
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Background: The General Medical Council (GMC) has made it mandatory to have a chaperone present during intimate examinations, including breast exams, highlighting the importance of medicolegal protection for both patients and clinicians.

Aims: The use of chaperones during breast examinations is logical, especially in an increasingly litigious society. This review aims to summarize current information regarding patients' and clinicians' perspectives on chaperone use in breast examination.

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Background: Faecal haemoglobin (f-Hb) testing is used in colorectal cancer (CRC) screening and increasingly to guide the investigation in patients with symptoms suggestive of CRC. Studies have demonstrated increased mortality with raised f-Hb.

Aims: To assess the association of raised f-Hb with all-cause, non-CRC (any cause excluding CRC) and cause-specific mortality.

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  • Soft tissue facial injuries (STFI) are common in craniofacial trauma, but there's limited data on surgical site infection (SSI) rates and patient-reported outcomes (PROs) after surgery for these injuries.
  • A thorough review of studies from 1990 to 2023 identified 38 relevant studies, revealing a pooled SSI rate of 3.30%, with no significant difference between surgical and non-surgical treatments.
  • The research shows insufficient evidence regarding the benefits of surgical treatment on cosmetic results, quality of life, and psychological effects, highlighting the need for more comprehensive research in this area.
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In this systematic review, we searched electronic databases for literature addressing physician use of chaperones during examinations of patients undergoing plastic surgery from the perspective of the patient, physician, and chaperone from inception of the database until April 2023. After screening 939 articles, we included seven studies in a systematic review. We conducted an inductive thematic analysis of four domains (physician perspective, patient perspective, chaperone perspective, and chaperone documentation).

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  • The study focuses on patients with advanced non-melanoma skin cancer (NMSC) affecting the skull who cannot receive immunotherapy due to health issues.
  • It evaluates the outcomes of eight patients who underwent craniectomy and soft tissue reconstruction between 2016 and 2022, with a median follow-up of 29.7 months.
  • Findings indicate that the procedure is generally safe and effective, achieving lasting disease control, although there were some complications related to the grafts and flaps used for reconstruction.
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  • * Out of 19 studies with nearly 19,000 participants, it was found that 53.8% of individuals practiced alcohol abstinence, which significantly improved their overall survival compared to those who continued drinking.
  • * The research concludes that while abstinence is linked to better health outcomes, only about half of those with this condition manage to stay abstinent.
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Background: High body mass index (BMI) is a major risk factor for cancer development, but its impact on the global burden of cancer remains unclear.

Methods: We estimated global and regional temporal trends in the burden of cancer attributable to high BMI, and the contributions of various cancer types using the framework of the Global Burden of Disease Study.

Results: From 2010 to 2019, there was a 35 % increase in deaths and a 34 % increase in disability-adjusted life-years from cancers attributable to high BMI.

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  • The study examined the effects of proton pump inhibitors (PPIs) on adverse events in cirrhotic patients, using data from 28 studies with over 260,000 patients.
  • The analysis found that while short-term mortality was not significantly affected by PPIs, long-term risks, including mortality, hepatic decompensation, and infections, were notably higher in PPI users.
  • Researchers concluded that PPIs should only be prescribed when absolutely necessary and at the lowest effective dose for patients with cirrhosis due to these risks.
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  • The study investigates the long-term risks associated with metabolic dysfunction-associated steatotic liver disease (MASLD) by analyzing data from 129 original studies comparing MASLD patients to those without the condition.* -
  • Results indicate that individuals with MASLD have a higher risk of various complications, including cardiovascular issues, metabolic disorders (like diabetes and hypertension), chronic kidney disease, and certain cancers, with those having advanced liver disease at an even greater risk.* -
  • The findings highlight the need for comprehensive treatment approaches for MASLD due to its serious multisystem effects on health.*
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Background: The purpose of this review is to provide an overview of the available literature assessing the treatment of botulinum toxin injections for the treatment of synkinesis of the buccinator muscle in patients with peripheral facial palsy (PFP).

Materials And Methods: A multi database search was performed, including the following databases: Pubmed, Medline, Embase, and the Cochrane Library. Each database was searched from its earliest date until 8 June 2023.

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Introduction: The etiology of liver diseases has changed significantly, but its impact on the comparative burden of cirrhosis between males and females is unclear. We estimated sex differences in the burden of cirrhosis across 204 countries and territories from 2010 to 2019.

Methods: We analyzed temporal trends in the burden of cirrhosis using the methodology framework of the 2019 Global Burden of Disease study.

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Background: Non-alcoholic fatty liver disease (NAFLD) represents a significant health threat worldwide. The growing trend towards an aging population, along with an alarming rise in obesity and diabetes, may have significant implications for the burden of NAFLD.

Aim: To assess the impact of NAFLD on the elderly.

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Background: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease globally. While the prevalence, impact, and causes of mortality have been described in various meta-analyses, a systematic all-encompassing umbrella review has yet to be conducted to consolidate the evidence on outcomes associated with NAFLD.

Methods: Search was conducted on Medline and Embase for meta-analysis investigating associated complications and causes of mortality in NAFLD patients.

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Background: Liver transplantation (LT) offers patients with decompensated cirrhosis the best chance at long-term survival. With the rising prevalence of diabetes, further clarity is needed on the impact of receiving a liver allograft from a donor with diabetes on post-LT outcomes. This study aims to evaluate the impact of donor diabetes on clinical outcomes after LT.

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Background And Aims: Obeticholic acid (OCA) is a farnesoid X receptor agonist used in primary biliary cholangitis (PBC) treatment. Recent studies have expanded OCA use for NASH treatment and results from phase 3 clinical trial have shown beneficial reduction of ≥1 stage of fibrosis with no NASH worsening. However, safety concerns still preside, thus we systematically examine the safety profile of OCA in chronic liver disease.

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Objective: With rising prevalence of hypertension and obesity, the effect of hypertension in obesity remains an important global issue. The prognosis of the US general population with obesity based on hypertension control was examined.

Methods: This study examined participants from the National Health and Nutrition Examination Survey between 1999 and 2018.

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Background And Aims: Fatty liver is the commonest liver condition globally and traditionally associated with NAFLD. A consensus meeting was held in Chicago to explore various terminologies. Herein, we explore the proposed changes in nomenclature in a population data set from the US.

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This study aims to provide an overview of the facial features and structure after bariatric surgery in the existing literature. A systematic literature search was performed in electronic databases until 15th February 2022. Four cohort studies including 129 patients from 3 countries were included between time period 2011 and 2020.

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