scholarly journals Risk of aspiration pneumonia in paediatric patients with dysphagia who were found to have laryngeal penetration on the instrumental swallow evaluation: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048422
Author(s):  
Vaishali Adlakha ◽  
Leona Ramos ◽  
Abigail Smith ◽  
Olivia Tsistinas ◽  
Emily Tanner-Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aspiration Pneumonia ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Swallowing Function ◽  
Assessment Development ◽  
Increased Risk ◽  
Laryngeal Penetration ◽  
Risk Of Aspiration ◽  
Tracheal Aspiration

IntroductionDysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.Methods and analysisThis study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.Ethics and disseminationThis study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.PROSPERO registration numberCRD42020222145.

scholarly journals Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3179 ◽  
Author(s):  
Daniel Cabanillas-Balsera ◽  
Juan J. Segura-Egea ◽  
María C. Jiménez-Sánchez ◽  
Victoria Areal-Quecuty ◽  
Benito Sánchez-Domínguez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Smoking Habits ◽  
Assessment Development ◽  
Negative Prognostic Factor ◽  
Reported Data ◽  
Teeth Extraction

Aim: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. Material and Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17–10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. Conclusions: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution.

scholarly journals Association between a soy-based infant diet and the onset of puberty: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251241
Author(s):  
Flávia Ramos Kazan Oliveira ◽  
Ana Flora Silva e Gustavo ◽  
Renan Braga Gonçalves ◽  
Fernanda Bolfi ◽  
Adriana Lúcia Mendes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Age At Menarche ◽  
Random Effects Model ◽  
Voice Change ◽  
Assessment Development ◽  
Infant Diet ◽  
Age Range ◽  
Menarche Age

The objective of this systematic review was to evaluate the association between a soy-based infant diet and the onset of puberty. We included studies in which children were fed a soy-based diet, and we compared them with those who were not. The primary outcomes were the onset of puberty in girls (thelarche, pubarche, and menarche age), boys (pubarche, voice change, testicular and penis enlargement age), and both (risk of delayed and precocious puberty [PP]). Search strategies were performed in PubMed, Embase, LILACS, and CENTRAL databases. Two reviewers selected eligible studies, assessed the risk of bias, and extracted data from the included studies. The odds ratio (OR) and mean difference (MD) were calculated with a 95% confidence interval (CI) as a measure of the association between soy consumption and outcomes. We used a random-effects model to pool results across studies and the Grading of Recommendations Assessment, Development, and Evaluation to evaluate the certainty of evidence. We included eight studies in which 598 children consumed a soy-based diet but 2957 did not. The primary outcomes that could be plotted in the meta-analysis were the risk of PP and age at menarche. There was no statistical difference between groups for PP (OR: 0.51, 95% CI: 0.09 to 2.94, 3 studies, 206 participants, low certainty of evidence). No between-group difference was observed in menarche age (MD 0.14 years, 95% CI -0.16 to 0.45, 3 studies, 605 children, low certainty of evidence). One study presented this outcome in terms of median and interquartile range, and although the onset of menarche was marginally increased in girls who received a soy-based diet, the reported age was within the normal age range for menarche. We did not find any association between a soy-based infant diet and the onset of puberty in boys or girls. Trial Registration: PROSPERO registration: CRD42018088902.

scholarly journals Use of convalescent plasma in patients with coronavirus disease (Covid-19): Systematic review and meta-analysis

2021 ◽  
Author(s):  
Fernando Tortosa ◽  
Gabriela Carrasco ◽  
Martin Ragusa ◽  
Pedro Haluska ◽  
Ariel Izcovich
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Standard Of Care ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Assessment Development ◽  
Treatment Standard ◽  
Study Selection

AbstractObjetivesTo assess the effects of convalescent plasma treatment in patients with coronavirus disease (COVID-19).Study designSystematic review and Meta-analysisData sourcesA systematic search was carried out on the L · OVE (Living OVerview of Evidence) platform for COVID-19 until October 31, 2020Study selectionRandomized clinical trials in which people with probable or confirmed COVID-19 were randomized to drug treatment, standard care, or placebo. Pairs of reviewers independently screened potentially eligible articles.MethodsThe PRISMA guidelines were followed for conducting a systematic review and meta-analysis. The risk of bias of the included studies was assessed using the Cochrane risk of bias tool 2.0, and the certainty of the evidence using the recommendation assessment, development and evaluation (GRADE) approach. For each outcome, the interventions were classified into groups, from most to least beneficial or harmful.ResultsWe identified 10 RCTs (randomized controlled trials) involving 11854 patients in which convalescent plasma was compared with standard of care or other treatments. The results of five RCTs that evaluated the use of convalescent plasma in patients with COVID-19 did not show significant differences in the effect on mortality and the need for invasive mechanical ventilation.ConclusionsCurrent evidence is insufficient to recommend the use of convalescent plasma in the treatment of moderate or severe COVID-19.Contribution of the authors

scholarly journals The Impact of Histopathological Features on the Prognosis of Oral Squamous Cell Carcinoma: A Comprehensive Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Eder da Silva Dolens ◽  
Mauricio Rocha Dourado ◽  
Alhadi Almangush ◽  
Tuula A. Salo ◽  
Clarissa Araujo Gurgel Rocha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Histopathological Features ◽  
Increased Risk ◽  
The Impact

ObjectiveOver many decades, studies on histopathological features have not only presented high-level evidence of contribution for treatment directions and prognosis of oral squamous cell carcinoma (OSCC) but also provided inconsistencies, making clinical application difficult. The 8th TNM staging system of OSCC has acknowledged the importance of some histopathological features, by incorporating depth of invasion (DOI) to T category and extranodal extension (ENE) to N category. The aim of this systematic review with meta-analysis is to determine the most clinically relevant histopathological features for risk assessment and treatment planning of OSCC and to elucidate gaps in the literature.MethodsA systematic review was conducted using PRISMA guidelines, and the eligibility criteria were based on population, exposure, comparison, outcome, and study type (PECOS). PubMed, Cochrane, Scopus, and Web of Science were searched for articles exploring the impact of histopathological features on OSCC outcomes with Cox multivariate analysis. Pooled data were subjected to an inverse variance method with random effects or fixed effect model, and the risk of bias was evaluated using quality in prognosis studies (QUIPS). Quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.ResultsThe study included 172 articles published from 1999 to 2021. Meta-analyses confirmed the prognostic potential of DOI, ENE, perineural invasion, lymphovascular invasion, and involvement of the surgical margins and brought promising results for the association of bone invasion, tumor thickness, and pattern of invasion with increased risk for poor survival. Although with a small number of studies, the results also revealed a clinical significance of tumor budding and tumor-stroma ratio on predicted survival of patients with OSCC. Most of the studies were considered with low or moderate risk of bias, and the certainty in evidence varied from very low to high.ConclusionOur results confirm the potential prognostic usefulness of many histopathological features and highlight the promising results of others; however, further studies are advised to apply consistent designs, filling in the literature gaps to the pertinence of histopathological markers for OSCC prognosis.Systematic Review RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42020219630.

scholarly journals Feeding in neonates with antenatal doppler abnormalities- a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rajendra Prasad Anne ◽  
Abhishek S Aradhya ◽  
Srinivas Murki
Keyword(s):  
Meta Analysis ◽  
Risk Of Bias ◽  
Preterm Neonates ◽  
Study Objective ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Increased Risk ◽  
Late Initiation ◽  
Hospital Acquired ◽  
The Impact

Abstract Preterm neonates with antenatal doppler abnormalities are at increased risk of necrotizing enterocolitis (NEC). In these neonates, we did a meta-analysis to compare the impact of early versus late initiation of feeding, and slow versus rapid feed advancement on the important neonatal outcomes. The databases of PubMed, Embase, Cochrane central, CINAHL and google scholar were searched on 6th September 2020. We included all randomized controlled trials addressing the study objective(s). The risk of bias was assessed using the Risk of Bias tool, version 2. Certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Early feeding did not increase the incidence of NEC stage 2 or more (odds ratio/OR 1.27, 95% confidence interval/CI 0.83, 1.96; 6 studies, 772 participants) and mortality (OR 0.79, 95% CI 0.4, 1.57; 3 studies, 498 participants). A trend was noted towards an increased incidence of feeding intolerance (OR 1.37, 95% CI 0.98, 1.92). There was a significant reduction in time to reach full feeds, duration of total parental nutrition, duration of hospital stay, and rates of hospital-acquired infections. The time to regain birth weight was not different. Rapid feed advancement decreased the time to reach full feeds, without affecting other outcomes. The overall certainty of the evidence was rated low. Heterogeneity was not significant. Conclusion: There is low-certainty evidence to recommend early feed initiation in preterm neonates with antenatal doppler abnormalities. The data is insufficient to make a recommendation on the rapidity of feed advancement.

scholarly journals Smoking and Radiolucent Periapical Lesions in Root Filled Teeth: Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (11) ◽  
pp. 3506
Author(s):  
Daniel Cabanillas-Balsera ◽  
Juan J. Segura-Egea ◽  
María Bermudo-Fuenmayor ◽  
Jenifer Martín-González ◽  
María Carmen Jiménez-Sánchez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Smoking Habit ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Periapical Lesions ◽  
Assessment Development ◽  
Negative Prognostic Factor ◽  
Reported Data

Aim: This systematic review and meta-analysis aimed to investigate the association between smoking habits and the prevalence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT). Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was: in adult patients who have RFT, does the absence or presence of a smoking habit affect the prevalence of RPLs associated with RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, Scopus, and PRISMA protocol were used to evaluate and present the results. Studies comparing smokers with control non-smoker subjects, including RFT, and providing data on the prevalence of RFT with RPLs, were included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: Four studies reported data on inclusion criteria, representing data from 9257 root-filled teeth—4465 from non-smokers and 4792 from smoker patients. The meta-analysis provided an odds ratio indicating a significant association between smoking and higher prevalence of root filled teeth with radiolucent periapical lesions (OR = 1.16; 95% CI = 1.07–1.26; p = 0.0004). The certainty of the literature assessment was moderate per GRADE. The ROBINS-I tool classified three studies as low risk of bias, and the fourth as moderate risk of bias. Conclusions: Moderate, quality scientific evidence indicates a weak but significant relationship between smoking and the prevalence of RPLs in RFT. Smoking can be considered a negative prognostic factor for the outcome of root canal treatment. Endodontic providers should be aware of the relationship between smoking and persistent apical periodontitis, assessed as RPLs, in RFT.

Parent–Infant Interventions to Promote Parental Sensitivity During NICU Hospitalization: Systematic Review and Meta-Analysis

2021 ◽  
pp. 105381512199192
Author(s):  
Andréane Lavallée ◽  
Gwenaëlle De Clifford-Faugère ◽  
Ariane Ballard ◽  
Marilyn Aita
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Standard Care ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Parental Sensitivity ◽  
Assessment Development ◽  
Implementation Failure ◽  
Meta Analyses

This systematic review and meta-analysis examined the effectiveness of parent–infant interventions for parents of preterm infants on parental sensitivity compared to standard care or active comparators. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration ID: CRD42016047083). Database searches were performed from inception to 2020 to identify eligible randomized controlled trials. Two review authors independently selected studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias assessment tool and quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) guidelines. A total of 19 studies ( n = 2,111 participants) were included and 14 were suitable to be pooled in our primary outcome meta-analysis. Results show no significant effect of parent–infant interventions over standard care or basic educational programs, on parental sensitivity. Results may not necessarily be due to the ineffectiveness of the interventions but rather due to implementation failure or high risk of bias of included studies.

scholarly journals Association between vision impairment and mortality: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037556
Author(s):  
Joshua R Ehrlich ◽  
Jacqueline Ramke ◽  
David Macleod ◽  
Bonnielin K Swenor ◽  
Helen Burn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Global Health ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Vision Impairment ◽  
Published Data ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Meta Analyses

IntroductionDue to growth and ageing of the world’s population, the number of individuals worldwide with vision impairment (VI) and blindness is projected to increase rapidly over the coming decades. VI and blindness are an important cause of years lived with disability. However, the association of VI and blindness with mortality, including the risk of bias in published studies and certainty of the evidence, has not been adequately studied in an up-to-date systematic review and meta-analysis.Methods and analysisThe planned systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases, including MEDLINE Ovid, Embase Ovid and Global Health, will be searched for relevant studies. Two reviewers will then screen studies and review full texts to identify studies for inclusion. Data extraction will be performed, and for included studies, the risk of bias and certainty of the evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The prognostic factor in this study is visual function, which must have been measured using a standard objective ophthalmic clinical or research instrument. We will use standard criteria from WHO to categorise VI and blindness. All-cause mortality may be assessed by any method one or more years after baseline assessment of vision. Results from included studies will be meta-analysed according to relevant sections of the Meta-analysis Of Observational Studies in Epidemiology checklist.Ethics and disseminationThis review will only include published data; therefore, ethics approval will not be sought. The findings of this review and meta-analysis will be published in an open-access, peer-reviewed journal and will be included in the ongoing Lancet Global Health Commission on Global Eye Health.

scholarly journals The role of obesity and adipokines in coronary microvascular dysfunction: a systematic review and meta-analysis

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Spezia ◽  
A Bonato ◽  
G De Fortunato ◽  
A Bossi ◽  
M Glauber
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Coronary Flow ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Flow Reserve ◽  
Increased Risk ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Background Patients with obesity present structural and functional changes in the heart and in the coronary circulation, which ultimately leads to an increased risk of cardiovascular disease. Obesity is associated with a low chronic state of inflammation which seems to be linked to a compromised coronary vasoreactivity, which is shown to be a forerunner and a long-term predictor of clinically relevant cardiovascular events. Methods A systematic review was performed by searching PubMed, Embase and Cochrane Library database. Selection criteria were applied leading to the inclusion of studies of any level of evidence published in peer-reviewed journals reporting clinical or preclinical results. Relative data were extracted and critically analysed. PRISMA guidelines were applied and risk of bias was assessed, as well as the methodological quality of the included studies. After this assessment, we excluded all the articles with serious risk of bias and/or low quality. Meta-analysis was conducted on the data collected regarding coronary blood flow (CFR) and hyperemic myocardial blood flow (MBF), while for the other parameters a descriptive analysis was performed. Results After applying the described criteria, we included 15 articles on human and animal literature assessed as medium or high quality. The data of 1399 patients were examined, 456 of which with obesity (BMI ≥ 30). A pooled effect size analysis shows that coronary flow reserve (CFR) is significantly reduced in patients with obesity [Random Effect (RE): -47.7%, 95% confidence interval (CI) -80.2% – -15.2%; n = 422]. Increased BMI is associated with reduced CFR. The same trend is found evaluating pharmacological induced stress MBF, which was reduced in patients with obesity [RE: -47.8%, 95% CI -73.7% – -21.8%; n = 409]. Nevertheless, MBF at rest did not show a significant difference in patients with obesity from our analysis [RE: 15%, 95% CI -24% - 53%; n = 409]. Pro-inflammatory adipokines secretion, as leptin and CRP, seems to correlate with a significant decrease of stress-induced MBF and reduced CFR. Conclusions Obesity is associated with a significant higher risk of coronary microvascular disfunction, which is reflected by diminished CFR and stress MBF. Systemic inflammation and the imbalance of adipokines related to obesity has been closely linked to a blunt coronary flow. CMD is a pre-clinical heart conditions that often remains undiagnosed. Further evidence is required to clear out the role of Obesity from a molecular point of view on the coronary endothelium.

scholarly journals Efficacy of Antimicrobial Photodynamic Therapy Compared to Nystatin Therapy in reducing Candida Colony Count in Patients with Candida-Associated Denture Stomatitis: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Parsa Firoozi ◽  
Nima Farshidfar ◽  
Reza Fekrazad
Keyword(s):  
Systematic Review ◽  
Photodynamic Therapy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Colony Count ◽  
Current Evidence ◽  
Antimicrobial Photodynamic Therapy ◽  
Denture Stomatitis ◽  
Assessment Development

Abstract Purpose: This meta-analysis assessed the efficacy of antimicrobial photodynamic therapy (aPDT) compared to conventional nystatin therapy (NYT) in reducing Candida colony count in patients with Candida-Associated Denture Stomatitis (CADS) and critically appraised the available literature.Methods: This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) updated guidelines. A literature search was performed in four electronic databases to identify relevant articles up to 15 August 2021. Randomized controlled trials (RCTs) that assessed the efficacy of aPDT compared to NYT in reducing Candida colony count in patients with CADS were investigated. The weighted mean difference (MD) and 95% confidence interval were calculated. The I2 statistic was used to determine heterogeneity at the level of α= 0.10. The Cochrane risk of bias (RoB 2) tool was used to assess the risk of bias. Certainty of the evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) ranking system.Results: Only 3 eligible RCTs with 141 participants were included in this systematic review and meta-analysis. Based on the pooled results, NYT compared to aPDT, generally performed better in reducing Candida colony count (Log10 CFU/mL) in patients’ palate and patients’ denture. The included studies had a moderate risk of bias and the certainty of the evidence was low.Conclusion: Although still inconclusive, based on the current evidence aPDT may be effective in reducing Candida colony count, and treating CADS. Nonetheless, it does not appear to be more effective than conventional NYT in this regard. According to the limited number of included studies, more well-designed RCTs with larger sample sizes and standardized methodology should be conducted to validate this conclusion.

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