scholarly journals Four-Rooted Maxillary First Molars: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Gabriel Magnucki ◽  
Sven V. K. Mietling
Keyword(s):  
Case Reports ◽  
Meta Analysis ◽  
Population Based ◽  
Occurrence Rate ◽  
Type I ◽  
Root Canals ◽  
Anatomical Anomaly ◽  
Maxillary Molars ◽  
Significant Difference ◽  
Dental Professionals

Objectives. The majority of human maxillary first molars is usually described as having three roots, but different morphologies were documented in several studies and case reports. One very rare and less investigated anatomical anomaly is the occurrence of four radicular structures in the upper first molars. This communication aimed to define the prevalence of four-rooted maxillary first molars on a meta-analytical basis. The external and internal morphology of these teeth was described by the collection of published case reports. Materials and Methods. Six electronic databases were accessed to collect case reports dealing with four-rooted maxillary first molars, as well as population-based cone-beam computed tomography (CBCT) studies. Afterward, the publications were selected according to predefined inclusion/exclusion criteria and evaluated using the Joanna Briggs Institute Critical Appraisal tool. The teeth of the chosen case reports were then independently analyzed by two dental professionals according to different dental classifications. Furthermore, the population studies were meta-analyzed to calculate the global and regional prevalence of four-rooted maxillary molars. Results. Included were forty-nine population-based CBCT studies containing 26663 maxillary first molars. Upon these data, the global incidence of four-rooted maxillary molars was meta-analytically determined as 0.047% (95%-CI:0.011–0.103%). In combination with the case reports, it was pointed out that this anomaly is distributed worldwide. Furthermore, forty-eight case reports were included containing fifty-three maxillary molars with four roots. The analyzed teeth exhibited Versiani´s pulpal chamber floor Types A and B. The majority of four-rooted maxillary first molars were classified as Type I regarding Christie's configuration. But, also 7.54% of the altered teeth could not be described by this classification. 62.34% exhibited four root canals, but also variations with five, six, or seven canals were identified. Furthermore, a significant difference was found in the occurrence rate between male and female patients. Conclusion. Due to the worldwide occurrence, dental professionals should be aware of this rare anomaly to avoid treatment errors, especially during endodontic or surgical therapies.

Close Reduction Percutaneous Pinning (CRPP) versus Open Reduction Internal Fixation (ORIF) for Pediatric Supracondylar Humerus Fractures Gartland Type II and III: A Systematic Review and Meta-analysis

2021 ◽  
Vol 71 (4) ◽  
pp. 187-193
Author(s):  
Putu Astawa ◽  
Made Agus Maharjana ◽  
Surya Adisthanaya ◽  
Made Winatra Satya Putra ◽  
Agus Suarjaya Putra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Cosmetic Outcome ◽  
Type I ◽  
Type Ii ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Humerus Fractures

Introduction: Displaced supracondylar fracture in children is a challenging injury that may result in impaired functional and cosmetic outcome if not well-treated. Utilization of Closed Reduction and Percutaneus Pinning (CRPP) increased for this pathology, some authors believe ORIF results better anatomical reduction and lower rate of loss of reduction. Study aims to compare CRPP and ORIF for pediatric supracondylar humerus fracture. Method: Systematic review was conducted based on PRISMA guideline. Inclusion criteria were age <18 years old, comparing CRPP and ORIF for Supracondylar Humerus Fractures Gartland Type II, II.Studies of one surgical technique, Gartland type I, case reports were excluded. For meta-analysis, 6 studies were included and fixed effect model used to pool the result. In each study, mean difference (MD) with 95% confidence interval (CI) was calculated for dichotomous outcomes using Review Manager. Result: Total of 252 patients aged 0-15 years old were included. CRPP more often performed than ORIF. Satisfactory outcomes measured by Flynn’s criteria were achieved in 87.74% in CRPP and 86.73% in ORIF patient group, indicating significant difference (Heterogeneity, I2 = 23%; WMD, 1.26; 0.58 to 2.73; P =0.56). Conclusion: Current systematic review and meta-analysis suggest that for displaced supracondylar humerus fractures, ORIF offers a comparable functional and cosmetic outcome compared to CRPP.

scholarly journals A short review on the root canal configuration of primary maxillary molars

2020 ◽  
Vol 16 (12) ◽  
pp. 1033-1036
Author(s):  
Deepa Gurunathan ◽  
Keyword(s):  
Root Canal ◽  
Short Review ◽  
Type I ◽  
Cochrane Central Register ◽  
Population Number ◽  
Second Molar ◽  
Root Canals ◽  
Maxillary Molars ◽  
Root Canal Morphology ◽  
Canal Morphology

It is of interest to compile available information on the root canal morphology of primary maxillary molars from known literature. The literature resources used to collect data include Medline/PubMed, The Cochrane Central Register of Clinical Trials, SIGLE and Science Direct. Data consists of type of population, number of teeth per study, number of root canals, canal length and type of root canal configuration. We used data from a total of 13 studies (951 primary maxillary molars). Maxillary molars (1st and 2nd) are dominant for two roots variant. The first molar the mean root length ranges from 7.9mm – 8.1mm. The second molar ranges from 7.2mm-8.5mm. Type I (explain in a phrase) canal morphology is the common variant in both the molars. Data shows that Root Canal morphology shows variations with the diagnostic aid (example micro CT) used and in different ethnic populations.

scholarly journals Treatment of Glucocorticoid-Induced Osteoporosis with Bisphosphonates Alone, Vitamin D Alone or a Combination Treatment in Eastern Asians: A Meta-Analysis

2019 ◽  
Vol 25 (14) ◽  
pp. 1653-1662
Author(s):  
Junjie Wang ◽  
Hongzhuo Li
Keyword(s):  
Vitamin D ◽  
Femoral Neck ◽  
Combination Treatment ◽  
Type I Collagen ◽  
Meta Analysis ◽  
Type I ◽  
Mineral Density ◽  
Bone Specific Alkaline Phosphatase ◽  
Asian Populations ◽  
Significant Difference

Background: Glucocorticoid (GC)-induced osteoporosis and fractures have become a serious problem for Eastern Asians. Bisphosphonates (BPs), vitamin D and a combination treatment are effective methods to prevent and treat GC-induced osteoporosis. Objective: The study aimed to compare the efficacy of BPs, vitamin D and a combination treatment for preventing and managing GC-induced osteoporosis in Eastern Asians. Methods: A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane CENTRAL databases was undertaken for randomized controlled trials (RCTs) on the effect of BPs, vitamin D and the combination treatment on GCs-induced osteoporosis in Eastern Asian populations. Primary outcome measures were the change in bone mineral density (BMD) and bone turnover markers. The final search was performed in March 2019. Results: Nine RCTs were included. A total of 545 patients met the inclusion criteria. Compared with vitamin D, BPs and the combination treatment significantly alleviated osteoporosis of the spine and femoral neck in Eastern Asians with GC-induced osteoporosis. At the same time, the change in serum bone-specific alkaline phosphatase (BAP) and serum C-telopeptide of type I collagen (CTX) levels was observed to be significantly less with BPs and the combination treatment with vitamin D alone. No significant difference was found between BPs and the combination treatment in the markers mentioned above. Conclusion: Compared with vitamin D alone, BPs alone and the combination treatment were significantly effective on Eastern Asians with GC-induced osteoporosis. Compared with the combination treatment, BPs alone were observed to be effective enough to increase the BMDs of the spine and femoral neck on both sides and thus prevent GC-induced osteoporosis in Eastern Asians.

scholarly journals Factors Influencing Risk of Premature Mortality in Community Cases of Depression: A Meta-Analytic Review

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Amanda J. Baxter ◽  
Andrew Page ◽  
Harvey A. Whiteford
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Excess Mortality ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Premature Mortality ◽  
Population Based ◽  
Clinical Depression ◽  
Risk Estimates ◽  
Significant Difference

Background. Depressive disorders are associated with substantial risk of premature mortality. A number of factors may contribute to reported risk estimates, making it difficult to determine actual risk of excess mortality in community cases of depression. The aim of this study is to conduct a systematic review and meta-analysis of excess mortality in population-based studies of clinically defined depression. Methods. Population-based studies reporting all-cause mortality associated with a clinically defined depressive disorder were included in the systematic review. Estimates of relative risk for excess mortality in population-representative cases of clinical depressive disorders were extracted. A meta-analysis was conducted using Stata to pool estimates of excess mortality and identify sources of heterogeneity within the data. Results. Twenty-one studies reporting risk of excess mortality in clinical depression were identified. A significantly higher risk of mortality was found for major depression (RR 1.92 95% CI 1.65–2.23), but no significant difference was found for dysthymia (RR 1.37 95% CI 0.93–2.00). Relative risk of excess mortality was not significantly different following the adjustment of reported risk estimates. Conclusion. A mortality gradient was identified with increasing severity of clinical depression. Recognition of depressive symptoms in general practice and appropriate referral for evidence-based treatment may help improve outcomes, particularly in patients with comorbid physical disorders.

scholarly journals Repurposing of drugs for Covid-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Pinky Kotecha ◽  
Alexander Light ◽  
Enrico Checcucci ◽  
Daniele Amparore ◽  
Cristian Fiori ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Clinical Improvement ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference

AbstractObjectiveThe aim of this systematic review is to evaluate the data currently available regarding the repurposing of different drugs for Covid-19 treatment. Participants with suspected or diagnosed Covid-19 will be included. The interventions being considered are drugs being repurposed, and comparators will include standard of care treatment or placebo.MethodsWe searched Ovid-MEDLINE, EMBASE, Cochrane library, clinical trial registration site in the UK(NIHR), Europe (clinicaltrialsregister.eu), US (ClinicalTrials.gov) and internationally (isrctn.com), and reviewed the reference lists of articles for eligible articles published up to April 22, 2020. All studies in English that evaluated the efficacy of the listed drugs were included. Cochrane RoB 2.0 and ROBINS-I tool were used to assess study quality. This systematic review adheres to the PRISMA guidelines. The protocol is available at PROSPERO (CRD42020180915).ResultsFrom 708 identified studies or clinical trials, 16 studies and 16 case reports met our eligibility criteria. Of these, 6 were randomized controlled trials (763 patients), 7 cohort studies (321 patients) and 3 case series (191 patients). Chloroquine (CQ) had a 100% discharge rate compared to 50% with lopinavir-ritonavir at day 14, however a trial has recommended against a high dosage due to cardiotoxic events. Hydroxychloroquine (HCQ) has shown no significant improvement in negative seroconversion rate which is also seen in our meta-analysis (p=0.68). Adverse events with HCQ have a significant difference compared to the control group (p=0.001). Lopinavir-ritonavir has shown no improvement in time to clinical improvement which is seen in our meta-analyses (p=0.1). Remdesivir has shown no significant improvement in time to clinical improvement but this trial had insufficient power.DiscussionDue to the paucity in evidence, it is difficult to establish the efficacy of these drugs in the treatment of Covid-19 as currently there is no significant clinical effectiveness of the repurposed drugs. Further large clinical trials are required to achieve more reliable findings. A risk-benefit analysis is required on an individual basis to weigh out the potential improvement in clinical outcome and viral load reduction compared to the risks of the adverse events. (1-16)

scholarly journals Agreement between results of meta-analyses from case reports and clinical studies, regarding efficacy and safety of idursulfase therapy in patients with mucopolysaccharidosis type II (MPS-II). A new tool for evidence-based medicine in rare diseases

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Miguel Sampayo-Cordero ◽  
Bernat Miguel-Huguet ◽  
Almudena Pardo-Mateos ◽  
Andrea Malfettone ◽  
José Pérez-García ◽  
...  
Keyword(s):  
Rare Diseases ◽  
Clinical Studies ◽  
Case Reports ◽  
Meta Analysis ◽  
Type I ◽  
Mucopolysaccharidosis Type ◽  
Type Ii ◽  
Mucopolysaccharidosis Type Ii ◽  
Mps Ii ◽  
Meta Analyses

Abstract Background A preliminary exploratory study shows solid agreement between the results of case reports and clinical study meta-analyses in mucopolysaccharidosis Type I (MPS-I) adult patients. The aim of the present study is to confirm previous results in another patient population, suffering from mucopolysaccharidosis Type II (MPS-II). Methods A systematic review and meta-analysis of case reports published by April 2018 was conducted for MPS-II patients treated with enzyme replacement therapy (ERT). The study is reported in accordance with PRISMA and MOOSE guidelines (PROSPERO database code CRD42018093408). The assessed population and outcomes were the same as previously analyzed in a meta-analysis of MPS-II clinical studies. The primary endpoint was the percent of clinical cases showing improvement in efficacy outcome, or no harm in safety outcome after ERT initiation. A restrictive procedure to aggregate case reports, by selecting standardized and well-defined outcomes, was proposed. Different sensitivity analyses were able to evaluate the robustness of results. Results Every outcome classified as “acceptable evidence group” in our case report meta-analysis had been graded as “moderate strength of evidence” in the aforementioned meta-analysis of clinical studies. Sensitivity, specificity, and positive-negative predictive values for results of both meta-analyses reached 100%, and were deemed equivalent. Conclusions Aggregating case reports quantitatively, rather than analyzing them qualitatively, may improve conclusions in rare diseases and personalized medicine. Additionally, we propose some methods to evaluate publication bias and heterogeneity of the included studies in a meta-analysis of case reports.

scholarly journals Comparison of postoperative analgesic effects in response to either dexamethasone or dexmedetomidine as local anesthetic adjuvants: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Zhen-Guo Song ◽  
Shen-Yue Pang ◽  
Gui-Yue Wang ◽  
Zhao Zhang
Keyword(s):  
Randomized Controlled Trials ◽  
Nerve Block ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Type I ◽  
Analgesic Effects ◽  
Randomized Controlled ◽  
Upper Limb Surgery ◽  
Significant Difference

AbstractThis review compares the effects of peripheral dexamethasone and dexmedetomidine on postoperative analgesia. We included six randomized controlled trials (354 patients) through a systematic literature search. We found that analgesia duration was comparable between dexamethasone and dexmedetomidine (58.59 min, 95% CI (confidence interval), −  66.13, 183.31 min) with extreme heterogeneity. Secondary outcome was also compared and no significant difference was observed in sensory block onset and duration and motor block duration and also for postoperative nausea and vomiting. It is noteworthy that dexamethasone reduced analgesic consumption (fentanyl) by 29.12 mcg compared with dexmedetomidine. We performed subgroup analyses and found no significant difference between the following: (1) lidocaine vs ropivacaine (P = 0.28), (2) nerve block vs nerve block + general anesthesia (P = 0.47), and (3) upper limb surgery vs thoracoscopic pneumonectomy (P = 0.27). We applied trial sequential analysis to assess the risks of type I and II errors and concluded that the meta-analysis was insufficiently powered to answer the clinical question, and further analysis is needed to establish which adjuvant is better. In conclusion, we believe that existing research indicates that dexamethasone and dexmedetomidine have equivalent analgesic effects in peripheral nerve blocks.

scholarly journals Circulating Type I Interferon Levels and COVID-19 Severity: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Rafaela Pires da Silva ◽  
João Ismael Budelon Gonçalves ◽  
Rafael Fernandes Zanin ◽  
Felipe Barreto Schuch ◽  
Ana Paula Duarte de Souza
Keyword(s):  
Plasma Protein ◽  
Limit Of Detection ◽  
Meta Analysis ◽  
Clinical Status ◽  
Clinical Manifestations ◽  
Type I Interferons ◽  
Interferon Response ◽  
Type I ◽  
Protein Levels ◽  
Significant Difference

IntroductionCoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, resulting in a range of clinical manifestations and outcomes. Laboratory and immunological alterations have been considered as potential markers of disease severity and clinical evolution. Type I interferons (IFN-I), mainly represented by IFN-α and β, are a group of cytokines with an important function in antiviral responses and have played a complex role in COVID-19. Some studies have demonstrated that IFN-I levels and interferon response is elevated in mild cases, while other studies have noted this in severe cases. The involvement of IFN-I on the pathogenesis and outcomes of SARS-CoV-2 infection remains unclear. In this study, we summarize the available evidence of the association of plasma protein levels of type I IFN with the severity of COVID-19.MethodsThe PRISMA checklist guided the reporting of the data. A systematic search of the MEDLINE (PubMed), EMBASE, and Web of Science databases was performed up to March of 2021, looking for articles that evaluated plasma protein levels of IFN-I in mild, severe, or critical COVID-19 patients. Comparative meta-analyses with random effects were performed to compare the standardized mean differences in plasma protein levels of IFN-I of mild versus severe and mild versus critical patients. Meta-regressions were performed to test the moderating role of age, sex, time that the IFN-I was measured, and limit of detection of the assay used in the difference between the means.ResultsThere was no significant difference in plasma levels of IFN-α when comparing between mild and severe patients (SMD = -0.236, 95% CI -0.645 to 0.173, p = 0.258, I2 = 82.11), nor when comparing between patients mild and critical (SMD = 0.203, 95% CI -0.363 to 0.770, p = 0.481, I2 = 64.06). However, there was a significant difference between healthy individuals and patients with mild disease (SMD = 0.447, 95% CI 0.085 to 0.810, p = 0.016, I2 = 62.89).ConclusionsPeripheral IFN-α cannot be used as a severity marker as it does not determine the clinical status presented by COVID-19 patients.

scholarly journals Presentation and Management of Liraglutide-Related Pancreatitis: Systematic Review of Case Reports

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A418-A418
Author(s):  
Som P Singh ◽  
Fahad Qureshi
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Systematic Reviews ◽  
Serum Amylase ◽  
Age Of Onset ◽  
Case Reports ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Duration Of Treatment ◽  
Significant Difference

Abstract Background: Liraglutide is a glucagon-like peptide-1 (GLP-1 agonist) aimed towards promoting glucose-dependent insulin secretions. This medication is an emerging treatment option for the management of obesity through promoting satiety. However, there are a growing number of cases noting adverse effects of liraglutide. Of note, liraglutide has been seen to elevate serum amylase and lipase levels among users, and therefore promoting acute pancreatitis. Moreover, the overall presentation of liraglutide-related acute pancreatitis can be variable. The aim of this study is to determine qualitative patterns of presentation and meta-analysis of lab changes among acute pancreatitis patients on liraglutide. Methodology: Systematic review of the literature was performed on MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews for liraglutide-related acute pancreatitis case studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. Meta-Analysis performed using Stata. Results: Twenty-one patient cases were identified then contingently evaluated for acute pancreatitis based on presentation, labs, and treatment outcomes. Within the pancreatitis cases, the average age of onset was 59 ± 16.5 (male = 58 ± 24.5; female = 56 ± 24.6). Upon qualitative review, 14.3% of patients were asymptomatic but showed elevated serum amylase and lipase levels following liraglutide administration (p &lt; 0.05). Among the symptomatic group, there was variation in the duration of liraglutide administration and reported compliance. There was no significant difference among treatment regimes between symptomatic and asymptomatic groups. Conclusion: Longer duration of liraglutide treatment without dose adjustment was notable to show elevated rises in both serum amylase and lipase. However, the variation of patient symptoms cannot be determined through the duration of treatment. Patient demographics do not seem to play a role in acute pancreatitis episodes. Future studies ought to focus on larger patient samples to further develop an understanding of treatment duration, presentation, and management of acute pancreatitis management after liraglutide administration.

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