A systematic review and meta-analysis of the association between fluoride exposure and neurological disorders

AbstractDifferent studies have suggested that fluoride is related to neurological disorders in children and adolescents, but clinical evidences of which neurological parameters associated to fluoride exposure are, in fact, still controversial. In this way, this systematic review and meta-analysis aimed to show if there is an association between fluoride exposure from different sources, doses and neurological disorders. Terms related to “Humans”; “Central nervous system”; “Fluorides”; and “Neurologic manifestations” were searched in a systematic way on PubMed, Scopus, Web of Science, Lilacs, Cochrane and Google Scholar. All studies performed on humans exposed to fluoride were included on the final assessment. A meta-analysis was then performed and the quality level of evidence was performed using the GRADE approach. Our search retrieved 4,024 studies, among which 27 fulfilled the eligibility criteria. The main source of fluoride was naturally fluoridated water. Twenty-six studies showed alterations related to Intelligence Quotient (IQ) while only one has evaluated headache, insomnia, lethargy, polydipsia and polyuria. Ten studies were included on the meta-analysis, which showed IQ impairment only for individuals under high fluoride exposure considering the World Health Organization criteria, without evidences of association between low levels and any neurological disorder. However, the high heterogeneity observed compromise the final conclusions obtained by the quantitative analyses regarding such high levels. Furthermore, this association was classified as very low-level evidence. At this time, the current evidence does not allow us to state that fluoride is associated with neurological damage, indicating the need for new epidemiological studies that could provide further evidences regarding this possible association.

Download Full-text

Vitamin D in Basketball Players: Current Evidence and Future Directions

Sports Health A Multidisciplinary Approach ◽

10.1177/19417381211019343 ◽

2021 ◽

pp. 194173812110193

Author(s):

Emilija Stojanović ◽

Dragan Radovanović ◽

Tamara Hew-Butler ◽

Dušan Hamar ◽

Vladimir Jakovljević

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Body Composition ◽

Physical Performance ◽

Bone Health ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Current Evidence ◽

Basketball Players ◽

Level Of Evidence

Context: Despite growing interest in quantifying and correcting vitamin D inadequacy in basketball players, a critical synthesis of these data is yet to be performed to overcome the low generalizability of findings from individual studies. Objective: To provide a comprehensive analysis of data in basketball pertaining to (1) the prevalence of vitamin D inadequacy; (2) the effects of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] concentration (and its association with body composition), bone health, and performance; and (3) crucial aspects that warrant further investigation. Data Sources: PubMed, MEDLINE, ERIC, Google Scholar, SCIndex, and ScienceDirect databases were searched. Study Selection: After screening, 15 studies were included in the systematic review and meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3. Data Extraction: The prevalence of vitamin D inadequacy, serum 25(OH)D, body composition, stress fractures, and physical performance were extracted. Results: The pooled prevalence of vitamin D inadequacy for 527 basketball players in 14 studies was 77% ( P < 0.001; 95% CI, 0.70-0.84). Supplementation with 4000 IU/d and 4000 IU/wk (absolute mean difference [AMD]: 25.39 nmol/L; P < 0.001; 95% CI, 13.44-37.33), as well as 10,000 IU/d (AMD: 100.01; P < 0.001; 95% CI, 70.39-129.63) vitamin D restored 25(OH)D to normal concentrations. Body composition data revealed inverse correlations between changes in serum 25(OH)D (from pre- to postsupplementation) and body fat ( r = −0.80; very large). Data concerning positive impacts of vitamin D supplementation on bone health and physical performance remain sparse. Conclusion: The high proportion of vitamin D inadequacy underscores the need to screen for serum 25(OH)D in basketball players. Although supplementation restored vitamin D sufficiency, the beneficial effects on bone health and physical performance remain sparse. Adiposity can modulate 25(OH)D response to supplementation.

Download Full-text

Dental implants survival after nasal floor elevation: a systematic review

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-21-00219 ◽

2021 ◽

Author(s):

Eduardo Anitua ◽

Beatriz Anitua ◽

Mohammad Hamdan Alkhraisat ◽

Laura Piñas ◽

Asier Eguia ◽

...

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Case Reports ◽

Meta Analysis ◽

Lateral Approach ◽

Cochrane Library ◽

Good Survival ◽

Quality Level ◽

Level Of Evidence ◽

Nasal Floor

Purpose The aim of this work is to assess the clinical outcomes of implants placed after a nasal floor elevation procedure. Methods A systematic review was conducted using four electronic databases; Medline (Pubmed), Cochrane library, DOAJ and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: “In patients undergoing dental implant placement in the maxillary anterior region (P), Do implants placed after nasal floor elevation (I) have a different survival (O) from those implants placed without grafting procedures (C)?. The study was pre-registered in PROSPERO (CRD42021229479). Included articles quality was assessed using the “NIH quality assessment tool”, “The Newcastle-Ottawa scale” and “JBI critical appraisal tools for case reports''. Results Twelve articles were finally selected, including 151 patients and 460 implants. The weighted mean follow-up was 32.2 months, and the weighted survival rate after this period was 97.64% (range 89.2-100%). No statistical differences could be inferred between the treatments performed in one-stage or two-stage, following a lateral approach or a transcrestal approach or using different grafting materials. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. Conclusion Within the limitations of this study, implants placed after a nasal floor elevation present a good survival and a low range of complications. In absence of randomized studies, the level of evidence was low, attending the GRADE system and based on the study quality level, the strength of evidence attending the SORT taxonomy was B.

Download Full-text

Efficacy of heavy eccentric calf training for treating mid-portion Achilles tendinopathy: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099934 ◽

2019 ◽

Vol 53 (17) ◽

pp. 1070-1077 ◽

Cited By ~ 15

Author(s):

Myles Calder Murphy ◽

Mervyn J Travers ◽

Paola Chivers ◽

James Robert Debenham ◽

Sean Iain Docking ◽

...

Keyword(s):

Systematic Review ◽

Natural History ◽

Small Sample Size ◽

Meta Analysis ◽

Achilles Tendinopathy ◽

Small Sample ◽

Current Evidence ◽

Eligibility Criteria ◽

Exercise Interventions ◽

And Function

ObjectiveTo assess the effectiveness of heavy eccentric calf training (HECT) in comparison with natural history, traditional physiotherapy, sham interventions or other exercise interventions for improvements in pain and function in mid-portion Achilles tendinopathy.DesignA systematic review and meta-analysis were conducted as per the PRISMA guidelines.Data sourcesPUBMED, CINAHL (Ovid) and CINAHL (EBSCO) were searched from inception until 24 September 2018.Eligibility criteriaRandomised controlled trials comparing HECT to natural history, sham exercise, traditional physiotherapy and other exercise interventions were included. Primary outcome assessing pain and function was the Victorian Institute of Sports Assessment-Achilles.ResultsSeven studies met the inclusion criteria. This review suggests HECT may be superior to both natural history, mean difference (MD) (95% CI) of 20.6 (11.7 to 29.5, one study) and traditional physiotherapy, MD (95% CI) of 17.70 (3.75 to 31.66, two studies). Following removal of one study, at high risk of bias, due to pre-planned sensitivity analysis, this review suggests HECT may be inferior to other exercise interventions, MD (95% CI) of −5.65 (-10.51 to −0.79, three studies). However, this difference is unlikely to be clinically significant.ConclusionCurrent evidence suggests that HECT may be superior to natural history and traditional physiotherapy while HECT may be inferior to other exercise interventions. However, due to methodological limitations, small sample size and a lack of data we are unable to be confident in the results of the estimate of the effect, as the true effect is likely to be substantially different.Systematic review registryPROSPERO registration number: CRD4201804493Protocol referenceThis protocol has been published open access: Murphy M, Travers MJ, Gibson, W. Is heavy eccentric calf training superior to natural history, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy? Systematic Reviews 2018; 7: 58

Download Full-text

Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies

BMJ Open ◽

10.1136/bmjopen-2018-028238 ◽

2019 ◽

Vol 9 (11) ◽

pp. e028238 ◽

Cited By ~ 7

Author(s):

Shimels Hussien Mohammed ◽

Tesfa Dejenie Habtewold ◽

Mulugeta Molla Birhanu ◽

Tesfamichael Awoke Sissay ◽

Balewgizie Sileshi Tegegne ◽

...

Keyword(s):

Systematic Review ◽

Socioeconomic Status ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Epidemiological Studies ◽

Cochrane Library ◽

Eligibility Criteria ◽

Cross Sectional ◽

Neighbourhood Socioeconomic Status

ObjectiveLow neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.Eligibility criteriaEpidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.Data extraction and synthesisData extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.ResultA total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).ConclusionNSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.PROSPERO registration numberCRD42017063889

Download Full-text

Long-Term Growth in Phenylketonuria: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu11092070 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2070 ◽

Cited By ~ 1

Author(s):

Fatma Ilgaz ◽

Alex Pinto ◽

Hülya Gökmen-Özel ◽

Julio César Rocha ◽

Esther van Dam ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Normal Growth ◽

Optimal Growth ◽

Current Evidence ◽

Eligibility Criteria ◽

Dietary Practices ◽

Dietary Treatments ◽

The Impact

There is an ongoing debate regarding the impact of phenylketonuria (PKU) and its treatment on growth. To date, evidence from studies is inconsistent, and data on the whole developmental period is limited. The primary aim of this systematic review was to investigate the effects of a phenylalanine (Phe)-restricted diet on long-term growth in patients with PKU. Four electronic databases were searched for articles published until September 2018. A total of 887 results were found, but only 13 articles met eligibility criteria. Only three studies had an adequate methodology for meta-analysis. Although the results indicate normal growth at birth and during infancy, children with PKU were significantly shorter and had lower weight for age than reference populations during the first four years of life. Impaired linear growth was observed until the end of adolescence in PKU. In contrast, growth impairment was not reported in patients with mild hyperphenylalaninemia, not requiring dietary restriction. Current evidence indicates that even with advances in dietary treatments, “optimal” growth outcomes are not attained in PKU. The majority of studies include children born before 1990s, so further research is needed to show the effects of recent dietary practices on growth in PKU.

Download Full-text

Strength of the association between Turner syndrome and coeliac disease: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-037478 ◽

2020 ◽

Vol 10 (7) ◽

pp. e037478

Author(s):

Ghada S M Al-Bluwi ◽

Asma H Alnababteh ◽

Saif Al-Shamsi ◽

Rami H Al-Rifai

Keyword(s):

Systematic Review ◽

High Risk ◽

Coeliac Disease ◽

Turner Syndrome ◽

Meta Analysis ◽

Healthcare Providers ◽

Autoimmune Disorder ◽

Epidemiological Studies ◽

Eligibility Criteria ◽

Chromosomal Disorders

IntroductionCoeliac disease (CD) is a genetic autoimmune disorder characterised by a permanent sensitivity to the gluten contained in some grains. Certain patient groups are considered high risk for the development of CD, including, but not limited to, those with chromosomal disorders such as Turner syndrome (TS). Here, we present a protocol for a systematic review and meta-analysis that aims to comprehensively summarise the literature, and quantitatively estimate the weighted strength of the association between TS and CD.Methods and analysisOur protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guidelines. We will search PubMed, Scopus, Web of Science and Embase databases for relevant articles. Variant and broad search terms will be selected for identifying epidemiological studies reporting on the crude and/or adjusted association between TS and CD. Retrieved citations will be screened, and data from the eligible research reports against specific eligibility criteria will be extracted. We will then assess the risk of bias associated with the eligible studies using the Newcastle-Ottawa Scale. The overall weighted strength of the pooled association will be quantified using the random-effects model.Ethics and disseminationThis review will use data from published literature; hence, ethical approval will not be needed. The resulting review will be the first to produce a comprehensive synthesis of the strength of the association between TS and CD. The results will be disseminated through a peer-reviewed journal as well as in local and international conferences and symposiums. Results dissemination would help healthcare providers and policy-makers to make informed decisions regarding the diagnosis and management of CD in high-risk individuals.PROSPERO registration numberCRD42019131881, dated 3 September 2019.

Download Full-text

Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119877186 ◽

2019 ◽

Vol 11 (6) ◽

pp. 486-491 ◽

Cited By ~ 5

Author(s):

Jennifer Cheng ◽

Brittany Ammerman ◽

Kristen Santiago ◽

Bridget Jivanelli ◽

Emerald Lin ◽

...

Keyword(s):

Systematic Review ◽

Study Design ◽

Rate Ratio ◽

Meta Analysis ◽

Incidence Rates ◽

Ice Hockey ◽

Cochrane Library ◽

Eligibility Criteria ◽

Level Of Evidence ◽

Meta Regression

Context: The incidence of sports-related concussion in females has been increasing in recent years. Objective: To conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression. Data Sources: PubMed (Medline), EMBASE, and Cochrane Library databases were searched from January 2000 to January 2018. Study Selection: Studies reporting sports-related concussion incidence data for both males and females (age ≥10 years) were included. Study Design: Systematic review with meta-analysis and meta-regression. Level of Evidence: Level 4. Methods: The rate ratio was calculated as the concussion rate in females/males. Data were pooled using the DerSimonian-Laird random-effects model. Results: Thirty-eight studies met the eligibility criteria and were included in the meta-analysis. Soccer and basketball demonstrated significantly higher incidence of concussions in females compared with males (rate ratio [95% CI], 1.76 [1.43-2.16] and 1.99 [1.56-2.54], respectively; P < 0.01). Sex-based differences in concussion incidence rates for baseball/softball, ice hockey, lacrosse, swimming/diving, and track and field were not statistically significant. In the meta-regression analysis, there were no significant effects on the rate ratio when evaluating study design, setting, and population. Conclusion: Concussion incidence rates were significantly higher in females than in males for soccer and basketball.

Download Full-text

Favipiravir for treating novcl coronavirus (COVID-19) patients: protocol for a systematic review and meta-analysis of Controlled trials

10.21203/rs.3.rs-23106/v1 ◽

2020 ◽

Author(s):

Morteza Arab-Zozani ◽

Soheil Hassanipour ◽

Djavad Ghoddoosi-Nejad

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Treatment Options ◽

World Health ◽

Eligibility Criteria ◽

Data Synthesis ◽

Clinical Trial Registries ◽

Statistical Heterogeneity ◽

Health Organization

Abstract Background An outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China in mid-December 2019, and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Due to the unknown nature of the disease and the lack of specific drugs, several potential treatments were used for patients. This systematic review and meta-analysis will evaluate studies of the effects of Favipiravir in COVID-19 pneumonia. Methods We will search electronic databases including LitCovid hub, PubMed, Scopus, ISI web of Sciences, Cochrane, and Embase using keywords related to COVID-19 and Favipiravir. We will search the reference lists of all included studies and reviews. We will also search for clinical trial registries, such as clinicaltrial.gov for the ongoing clinical trials. Two investigators (MAZ and SH) will independently screen titles, abstracts, and full-text of included studies based on eligibility criteria. These investigators will also independently extract data and appraise the quality of studies. All potential discrepancies will be resolved through consultation with the third reviewer. Data synthesis will be conducted using the Review Manager software (version 5.3) or CMA (version 2). Statistical heterogeneity will be assessed using a standard I 2 test. A funnel plot, Egger’s test, and Begg’s test will be used for asymmetry to explore possible publication bias. Discussion The findings of this systematic review with proportional meta-analysis will help to identify the safety and efficacy of Favipiravir for COVID-19 patients. Knowledge gained from this research will also assist physicians in selecting better treatment options and developing a guideline in this field.

Download Full-text

What are the risk factors for injuries and injury prevention strategies for skiers and snowboarders in terrain parks and half-pipes? A systematic review

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099166 ◽

2018 ◽

Vol 53 (1) ◽

pp. 19-24 ◽

Cited By ~ 6

Author(s):

Olivier Audet ◽

Brent E Hagel ◽

Albertro Nettel-Aguirre ◽

Tatum Mitra ◽

Carolyn A Emery ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Injury Prevention ◽

Meta Analysis ◽

Original Data ◽

Current Evidence ◽

Prevention Strategies ◽

Eligibility Criteria ◽

Severe Injuries ◽

Registration Number

ObjectiveTo synthesise the current evidence regarding the risk factors, the injury prevention strategies and the profile of injured skiers and snowboarders in terrain parks (TPs) and half-pipes (HPs).DesignSystematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Data sourcesLiterature searches from six electronic databases and manual searches were performed.Eligibility criteria for selecting studiesInclusion criteria were: (1) publication based on original data; (2) injuries sustained in TPs or HPs; (3) recreational skiing or snowboarding injuries; (4) observational or experimental study design with a comparison group.ResultsNo study explored the risk factors in HPs or the prevention strategies in TPs or HPs. From the literature retrieved, there is strong evidence that skiing or snowboarding in a TP is a risk factor for head, neck, back and severe injuries. Two papers assessed the risk factors for injuries in TPs, mainly demonstrating that features promoting aerial manoeuvres or a large drop to the ground were associated with higher feature-specific injury rates. The profile of injured skiers and snowboarders in TPs described in the literature suggested some evidence of associations between factors including activity, sex, skill level, helmet use, age and TP injuries.Summary/conclusionsThis systematic review demonstrates the need for studies identifying the risk factors for injuries to skiers and snowboarders and on interventions to reduce the risk of injury in TPs and HPs. Studies addressing the issue of TP design should be considered.PROSPERO registration numberCRD42016045206.

Download Full-text

Knee Kinematics During Landing: Is It Really a Predictor of Acute Noncontact Knee Injuries in Athletes? A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120966952 ◽

2020 ◽

Vol 8 (12) ◽

pp. 232596712096695

Author(s):

Natalia Romero-Franco ◽

María del Carmen Ortego-Mate ◽

Jesús Molina-Mula

Keyword(s):

Systematic Review ◽

Sagittal Plane ◽

Meta Analysis ◽

Knee Injuries ◽

Knee Kinematics ◽

Eligibility Criteria ◽

Level Of Evidence ◽

Biomechanical Evaluation ◽

Kinetics Of ◽

Kinematics And Kinetics

Background: Although knee kinematics during landing tasks has traditionally been considered to predict noncontact knee injuries, the predictive association between noncontact knee injuries and kinematic and kinetic variables remains unclear. Purpose: To systematically review the association between kinematic and kinetic variables from biomechanical evaluation during landing tasks and subsequent acute noncontact knee injuries in athletes. Study Design: Systematic review; Level of evidence, 2. Methods: Databases used for searches were MEDLINE, LILACS, IBECS, CINAHL, SPORTDiscus, SCIELO, IME, ScienceDirect, and Cochrane from database inception to May 2020. Manual reference checks, articles published online ahead of print, and citation tracking were also considered. Eligibility criteria included prospective studies evaluating frontal and sagittal plane kinematics and kinetics of landing tasks and their association with subsequent acute noncontact knee injuries in athletes. Results: A total of 13 studies met the eligibility criteria, capturing 333 acute noncontact knee injuries in 8689 participants. A meta-analysis revealed no significant effects for any kinematic and kinetic variable with regard to subsequent noncontact knee injuries. Conclusion: No kinetic or kinematic variables from landing tasks had a significant association with acute noncontact knee injuries. Therefore, the role and application of the landing assessment for predicting acute noncontact knee injuries are limited and unclear, particularly given the heterogeneity and risk of bias of studies to date.

Download Full-text