Hyaluronic Acid Fillers for Midface Augmentation: A Systematic Review

2021 ◽  
Author(s):  
Lily N. Trinh ◽  
Amar Gupta
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Subcutaneous Tissue ◽  
Age Groups ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Full Text Review ◽  
Filler Injections ◽  
Subjective Measurements ◽  
Meta Analyses

AbstractInjectable fillers represent one of the most requested minimally invasive treatments to rejuvenate the aging face, and its popularity is steadily rising. A vast majority of filler treatments are with hyaluronic acid (HA). The aim of this systematic review is to evaluate patient outcomes, safety profile, and administration techniques of various HA fillers for malar augmentation. A systematic review of the published literature was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included PubMed, Embase, and Science Direct databases. Medical Subject Headings (MeSH) terms used were “cheek” OR “midface” OR “malar” and “filler” OR “hyaluronic acid” OR “Juvederm” OR “Restylane” OR “Perlane” OR “Belotero.” The initial search identified 699 articles; 256 duplicates were removed. Additional 12 studies were identified from reference lists. A total of 455 were screened by title and abstract and 387 studies were eliminated based on criteria. Also, 68 articles underwent full-text review, and 18 articles were included in the final review and involved seven different HA formulations. Men and women from many age groups were highly satisfied with their results following HA treatment for midface augmentation up to 24 months. The most common adverse events included bruising, swelling, and tenderness, and typically lasted no more than 2 weeks. Upper cheek filler injections near the zygoma should be placed in the submuscular plane while lower cheek injections should be placed in the subcutaneous tissue. HA is an attractive choice for midface augmentation due to its high patient satisfaction, long-lasting effects, and low side-effect profile. Due to the variability in technique, level of expertise, and subjective measurements across studies, one optimal regimen could not be concluded. However, midface augmentation treatment should be personalized to each patient. Additional clinical trials are required to more conclusively determine the most appropriate approach for this procedure.

Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review

2021 ◽  
Author(s):  
Lily Nguyen Trinh ◽  
Kelly C. McGuigan ◽  
Amar Gupta
Keyword(s):  
Systematic Review ◽  
Final Analysis ◽  
Dermal Filler ◽  
Accurate Information ◽  
Medical Subject Headings ◽  
Tear Trough ◽  
Tear Trough Deformity ◽  
Mesh Terms ◽  
Filler Injections ◽  
Delayed Complications

AbstractTear trough deformity is a popular target for the treatment with filler injections. The side effects are generally mild and transient. However, delayed complications may occur. We aim to perform a thorough systematic review of the published literature related to delayed complications after tear trough filler injections. A search of published literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in June 2021 and included PubMed, ScienceDirect, and Embase databases. The Medical Subject Headings (MeSH) terms used included the following terms: delayed complications, nodules, granulomas, swelling, discoloration, dermal filler, hyaluronic acid (HA), polyacrylamide, calcium hydroxyapatite (CaHA), poly-L-lactic acid (PLLA), eyelid, periorbital, periocular, and tear trough. Twenty-eight articles consisting of 52 individual cases were included in the final analysis. 98% (51/52) of patients were female and had an average age of 48.3 years. HA was the most reported product (71.2%, 37/52), followed by PLLA (4/52, 7.7%), and CaHA (4/52, 7.7%). The most common delayed complication with any dermal filler was swelling (42.3%, 22/52) followed by lumps or nodules (25.0%, 13/52). Xanthelasma-like reaction (17.3%, 9/52), migration (7.7%, 4/52), discoloration (3%, 3/52) also occurred. The average time of onset of any complication was 16.8 months with xanthelasma-like reaction appearing soonest (mean: 10 months) and discoloration appearing latest (mean: 52 months). Most swelling cases were caused by HA. Semi-permanent fillers such as PMMA and synthetic fillers such as PLLA were more likely to be associated with lumps and nodules than other complications. It is important that clinicians who perform tear trough augmentation with dermal fillers have a thorough understanding of the risks of the procedure to diagnose and manage them promptly as well as provide patients with accurate information regarding the potential adverse effects.

scholarly journals Nudging toward vaccination: a systematic review

2021 ◽  
Vol 6 (9) ◽  
pp. e006237
Author(s):  
Mark Donald C Reñosa ◽  
Jeniffer Landicho ◽  
Jonas Wachinger ◽  
Sarah L Dalglish ◽  
Kate Bärnighausen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vaccine Coverage ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Medical Subject Headings ◽  
Assessment Development ◽  
Mesh Terms ◽  
Registration Number ◽  
Vaccine Confidence ◽  
Meta Analyses

BackgroundVaccine hesitancy (VH) and the global decline of vaccine coverage are a major global health threat, and novel approaches for increasing vaccine confidence and uptake are urgently needed. ‘Nudging’, defined as altering the environmental context in which a decision is made or a certain behaviour is enacted, has shown promising results in several health promotion strategies. We present a comprehensive synthesis of evidence regarding the value and impact of nudges to address VH.MethodsWe conducted a systematic review to determine if nudging can mitigate VH and improve vaccine uptake. Our search strategy used Medical Subject Headings (MeSH) and non-MeSH terms to identify articles related to nudging and vaccination in nine research databases. 15 177 titles were extracted and assessed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The final list of included articles was evaluated using the Mixed Methods Appraisal Tool and the Grading of Recommendations, Assessment, Development and Evaluations framework.FindingsIdentified interventions are presented according to a framework for behaviour change, MINDSPACE. Articles (n=48) from 10 primarily high-income countries were included in the review. Nudging-based interventions identified include using reminders and recall, changing the way information is framed and delivered to an intended audience, changing the messenger delivering information, invoking social norms and emotional affect (eg, through storytelling, dramatic narratives and graphical presentations), and offering incentives or changing defaults. The most promising evidence exists for nudges that offer incentives to parents and healthcare workers, that make information more salient or that use trusted messengers to deliver information. The effectiveness of nudging interventions and the direction of the effect varies substantially by context. Evidence for some approaches is mixed, highlighting a need for further research, including how successful interventions can be adapted across settings.ConclusionNudging-based interventions show potential to increase vaccine confidence and uptake, but further evidence is needed for the development of clear recommendations. The ongoing COVID-19 pandemic increases the urgency of undertaking nudging-focused research.PROSPERO registration numberCRD42020185817.

Structural and Functional MRI Brain Changes in Patients with Schizophrenia Following Electroconvulsive Therapy: A Systematic Review

2021 ◽  
Vol 19 ◽  
Author(s):  
Yuchao Jiang ◽  
Mingjun Duan ◽  
Hui He ◽  
Dezhong Yao ◽  
Cheng Luo
Keyword(s):  
Systematic Review ◽  
Functional Mri ◽  
Electroconvulsive Therapy ◽  
Brain Regions ◽  
Parahippocampal Gyrus ◽  
Medical Subject Headings ◽  
Therapeutic Mechanisms ◽  
Brain Changes ◽  
Meta Analyses ◽  
Induced Changes

Background: Schizophrenia (SZ) is a severe psychiatric disorder typically characterized by multidimensional psychotic syndromes. Electroconvulsive therapy (ECT) is a treatment option for medication-resistant patients with SZ or to resolve acute symptoms. Although the efficacy of ECT has been demonstrated in clinical use, its therapeutic mechanisms in the brain remain elusive. Objective: This study aimed to summarize brain changes on structural magnetic resonance imaging (sMRI) and functional MRI (fMRI) after ECT. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was carried out. The PubMed and Medline databases were systematically searched using the following medical subject headings (MeSH): (electroconvulsive therapy OR ECT) AND (schizophrenia) AND (MRI OR fMRI OR DTI OR DWI). Results: This review yielded 12 MRI studies, including 4 with sMRI, 5 with fMRI and 3 with multimodal MRI. Increases in volumes of the hippocampus and its adjacent regions (parahippocampal gyrus and amygdala) as well as insula and frontotemporal regions were noted after ECT. fMRI studies found ECT-induced changes in different brain regions/networks, including the hippocampus, amygdala, default model network, salience network and other regions/networks that are thought to highly correlate with the pathophysiologic characteristics of SZ. The results of the correlation between brain changes and symptom remissions are inconsistent Conclusion: Our review provides evidence supporting ECT-induced brain changes on sMRI and fMRI in SZ and explores the relationship between these changes and symptom remission.

scholarly journals Intensity of Task-Specific Training for Functional Ability Post-stroke: Protocol for a Systematic Review

2021 ◽  
Author(s):  
Rabiu Ibrahim ◽  
Isa Usman Lawal ◽  
Conran Joseph
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Specific Training ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Pubmed Search ◽  
Evidence Database

Abstract Background This study aimed to describe and present detailed protocol of a systematic review aimed at determining available research evidence regarding the intensity, and frequency of task-specific training ( TST ) that can best result in improved motor function and mobility outcomes in both upper and lower extremities in acute, sub-acute and chronic stroke survivors. Methods Literature search strategies were developed using Medical Subject Headings (MeSH) terms and text key words related to stroke rehabilitation and the use of TST to search for relevant randomized controlled trials (RCTs). The Cochrane Central Register of Controlled Trials, MEDLINE (PubMed search engine), Excerpta Medica dataBASE (EMBASE), Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar were searched for eligible articles published from inception to date. Two reviewers independently screened the titles, selected appropriate abstract/studies and extracted relevant data as yielded by the search based on the study inclusion criteria. Assessment of the study risk of bias and quality of included studies were appraised using the Cochrane’s tool for assessing risk of bias or other appropriate tools. Discussion This paper presented the description of the systematic review methods, and it is expected to guide researchers in conducting systematic review in similar fields of research. Sources of literature search terms and reviewers have been determined. Systematic review registration The study protocol has been registered with PROSPERO (130991)

Zirconia Biocompatibility in Animal Studies - A Systematic Review

2017 ◽  
Vol 376 ◽  
pp. 12-28 ◽  
Author(s):  
Sanda Mihaela Popescu ◽  
Horia Octavian Manolea ◽  
Oana Andreea Diaconu ◽  
Veronica Mercuţ ◽  
Monica Scrieciu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dental Implants ◽  
Animal Studies ◽  
Case Reports ◽  
Powder Injection ◽  
Mesh Terms ◽  
Meta Analyses ◽  
Abstract Screening

Zirconia is a metal used in dental implantology. Its biocompatibility was studied in vitro and in vivo, results of the studies being analyzed in reviews and meta analyses. The aim of this systematic review was to evaluate biocompatibility of zirconia in animal studies in vivo expressed as results of histomorphometric tests. Databases were searched from 1980 until February 2016, with different combination of the following MeSH terms: zirconium, biocompatibility, dental implants, in vivo, animal studies. Letters to the editors, case reports, commentaries, review articles and articles published in other languages then English were excluded. The search of PubMed, ScienceDirect and Google Scholar databases yielded 690 titles. After abstract screening and duplicate discarding 50 articles were identified and finally, 40 were included in the review. Most of the studies compared zirconia with titanium, a well established material for dental implants. In majority of the studies zirconia showed a similar osseointegration with titanium. Surface implant treatments, like sandblasted and etched zirconia (ZrO2-SLA), alumina toughed zirconia (ATZ), and powder injection molding (PIM) were used to improve osseointegration of zirconia with good results. In the light of histomorphometric test, zirconia, no matter physical and structural forms tested, is a biocompatible material.

Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review

2020 ◽  
Vol 45 (8) ◽  
pp. 645-655
Author(s):  
Johnny Wei Bai ◽  
Dong An ◽  
Anahi Perlas ◽  
Vincent Chan
Keyword(s):  
Systematic Review ◽  
Postoperative Analgesia ◽  
Full Text ◽  
Subcutaneous Tissue ◽  
Analgesic Efficacy ◽  
Wound Infiltration ◽  
Surgical Wounds ◽  
Full Text Review ◽  
Protocol Registration ◽  
Abstract Screening

Local anesthetics (LAs) are commonly infiltrated into surgical wounds for postsurgical analgesia. While many adjuncts to LA agents have been studied, it is unclear which adjuncts are most effective for co-infiltration to improve and prolong analgesia. We performed a systematic review on adjuncts (excluding epinephrine) to local infiltrative anesthesia to determine their analgesic efficacy and opioid-sparing properties. Multiple databases were searched up to December 2019 for randomized controlled trials (RCTs) and two reviewers independently performed title/abstract screening and full-text review. Inclusion criteria were (1) adult surgical patients and (2) adjunct and LA agents infiltration into the surgical wound or subcutaneous tissue for postoperative analgesia. To focus on wound infiltration, studies on intra-articular, peri-tonsillar, or fascial plane infiltration were excluded. The primary outcome was reduction in postoperative opioid requirement. Secondary outcomes were time-to-first analgesic use, postoperative pain score, and any reported adverse effects. We screened 6670 citations, reviewed 126 full-text articles, and included 89 RCTs. Adjuncts included opioids, non-steroidal anti-inflammatory drugs, steroids, alpha-2 agonists, ketamine, magnesium, neosaxitoxin, and methylene blue. Alpha-2 agonists have the most evidence to support their use as adjuncts to LA infiltration. Fentanyl, ketorolac, dexamethasone, magnesium and several other agents show potential as adjuncts but require more evidence. Most studies support the safety of these agents. Our findings suggest benefits of several adjuncts to local infiltrative anesthesia for postoperative analgesia. Further well-powered RCTs are needed to compare various infiltration regimens and agents.Protocol registrationPROSPERO (CRD42018103851) (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103851)

Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review

2020 ◽  
Author(s):  
Ryan P. Roach ◽  
Andrew J. Clair ◽  
Omar A. Behery ◽  
Savyasachi C. Thakkar ◽  
Richard Iorio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Search Terms ◽  
Mesh Terms ◽  
Total Knee ◽  
Meta Analyses ◽  
Revision Tkas

AbstractBone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones. A systematic review was conducted according to the international Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We combined search terms “Total knee arthroplasty” AND/OR “Sleeve,” “Cone” as either keywords or medical subject heading (MeSH) terms in multiple databases according to PRISMA recommendations. All retrieved articles were reviewed and assessed using defined inclusion and exclusion criteria. A total of 27 studies (12 sleeves and 15 cones) of revision TKAs were included. In the 12 studies on sleeve implantation in revision TKAs, 1,617 sleeves were implanted in 1,133 revision TKAs in 1,025 patients. The overall rate of reoperation was 110/1,133 (9.7%) and the total rate of aseptic loosening per sleeve was 13/1,617 (0.8%). In the 15 studies on tantalum cone implantation in revision TKAs, 701 cones were implanted into 620 revision TKAs in 612 patients. The overall rate of reoperation was 116/620 (18.7%), and the overall rate of aseptic loosening per cone was 12/701 (1.7%). Rates of aseptic loosening of the two implants were found to be similar, while the rate of reoperation was nearly double in revision TKAs utilizing tantalum cones. Variability in the selected studies and the likely multifactorial nature of failure do not allow for any definitive conclusions to be made. This review elucidates the necessity for additional literature examining revision TKA implants.

scholarly journals Is the Treatment of the Tear Trough Deformity with Hyaluronic Acid Injections a Safe Procedure? A Systematic Review

2021 ◽  
Vol 11 (23) ◽  
pp. 11489
Author(s):  
Salvatore D’Amato ◽  
Romolo Fragola ◽  
Pierfrancesco Bove ◽  
Giorgio Lo Giudice ◽  
Paolo Gennaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Hyaluronic Acid ◽  
Cochrane Library ◽  
Injection Technique ◽  
Safe Procedure ◽  
Aesthetic Result ◽  
Tear Trough ◽  
Tear Trough Deformity ◽  
Mesh Terms

Among the various therapeutic options for the treatment of tear trough deformities, the use of hyaluronic acid-based fillers has constantly been increasing. The aim of this research is to conduct a systematic review of the published literature related to the use of hyaluronic acid-based dermal fillers for the treatment of tear trough deformities and possible related complications. A search of the published literature was conducted following the PRISMA guidelines, including PubMed, Cochrane Library, and Ovid databases. Text words and Medical Search Headings (MeSH terms) were used to identify nine articles included in our analysis. The most used filler was Restylane (Galderma). The injection technique was performed through the use of a cannula or, more frequently, with a needle, through the execution of boluses or retrograde release. The injection plane was predominantly the supra-periosteal layer. The most observed side effects were mild and included redness, edema, contour irregularities, bruising, and blue-gray dyschromia. The degree of patient satisfaction was high, with an optimal aesthetic result that was maintained for 6 to 12 months. Although the duration of treatment of tear trough deformities with HA fillers is not comparable to surgical treatment, this is a minimally invasive, safe procedure, quick to perform, and with a high degree of patient satisfaction.

scholarly journals Women’s decision in family planning use and its determinants in Ethiopia. A systematic review and meta-analysis protocol

2021 ◽  
Author(s):  
Etsay Woldu Anbesu ◽  
Setognal Birara Aychiluhm ◽  
Mussie Alemayehu
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Family Planning ◽  
Contraceptive Use ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Grey Literature ◽  
Reproductive Health Services ◽  
Mesh Terms ◽  
Meta Analyses

Abstract Background Low uptake of contraceptive use have much consequence on maternal and child health. Despite this effect, less emphasis was given to women’s decision-making on family planning use in Ethiopia. Though there are studies conducted in different parts of the country on women’s decision-making in family planning use, there are inconsistent findings. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of women’s decision-making in family planning use and its determinants in Ethiopia. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be followed to develop the review protocol. All observational studies will be retrieved using Medical Subject Heading (Mesh) terms or keywords from online databases PubMed, CINAHL, Google Scholar, and unpublished grey literature from May 10-11August/2021. The quality of the studies will be critically assessed using Joanna Briggs Institute checklist. Heterogeneity among studies will be examined using I-squared statistics. Funnel plots and Egger’s test will be used to examine publication bias. The Meta-analysis will be performed using STATA version 14 software. Statistical significance will be determined at 95% CI. Discussion Improving women’s autonomy on decision-making on reproductive health services including contraceptive use has a substantial advantage. There are studies on women’s decision-making in family planning use and this systematic review and meta-analysis will help policymakers to develop appropriate interventions.

scholarly journals What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 551
Author(s):  
Noonan ◽  
Olaussen ◽  
Mathew ◽  
Mitra ◽  
Smit ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Meta Analysis ◽  
Ct Scanning ◽  
Trauma Team ◽  
Team Training ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Mesh Terms

Background and Objectives: Major trauma centres manage severely injured patients using multi-disciplinary teams but the evidence-base that targeted Trauma Team Training (TTT) improves patients’ outcomes is unclear. This systematic review aimed to identify the association between the implementation of TTT programs and patient outcomes. Methods: We searched OVID Medline, PubMed and The Cochrane Library (CENTRAL) from the date of the database commencement until 10 of April 2019 for a combination of Medical Subject Headings (MeSH) terms and keywords relating to TTT and clinical outcomes. Reference lists of appraised studies were also screened for relevant articles. We extracted data on the study setting, type and details about the learners, as well as clinical outcomes of mortality and/or time to critical interventions. A meta-analysis of the association between TTT and mortality was conducted using a random effects model. Results: The search yielded 1136 unique records and abstracts, of which 18 full texts were reviewed. Nine studies met final inclusion, of which seven were included in a meta-analysis of the primary outcome. There were no randomised controlled trials. TTT was not associated with mortality (Pooled overall odds ratio (OR) 0.83; 95% Confidence Interval; 0.64–1.09). TTT was associated with improvements in time to operating theatre and time to first computerized tomography (CT) scanning. Conclusions: Despite few publications related to TTT, its introduction was associated with improvements in time to critical interventions. Whether such improvements can translate to improvements in patient outcomes remains unknown. Further research focusing on the translation of standardised trauma team reception “actions” into TTT is required to assess the association between TTT and patient outcome.

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