Platform-Switching Concept in Dental Implants: A Systematic Review and Meta-analysis of Randomized Controlled Trials with a Minimum Follow-up of 3 Years

2021 ◽  
Vol 36 (5) ◽  
pp. e97-e109
Author(s):  
Sunil Mishra ◽  
Reetika Gaddale ◽  
Nithin Sonnahalli ◽  
Ramesh Chowdhary
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Dental Implants ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Platform Switching

Mortality Rates After Paclitaxel-Coated Device Use in Patients With Occlusive Femoropopliteal Disease: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 152660282110235
Author(s):  
Krystal Dinh ◽  
Alexandra M. Limmer ◽  
Andy Z. L. Chen ◽  
Shannon D. Thomas ◽  
Andrew Holden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Occlusive Disease ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Increased Risk ◽  
All Cause Mortality

Purpose: A late increased mortality risk has been reported in a summary level meta-analysis of patients with femoropopliteal artery occlusive disease treated with paclitaxel-coated angioplasty balloons and stents. However, at the longer follow up timepoints that analysis was limited by small trial numbers and few participants. The aim of this study was to report an updated summary level risk of all-cause mortality after treatment with paclitaxel-coated devices in that same patient group. Materials and Methods: We performed a systematic review and meta-analysis of randomized controlled trials to investigate the mortality outcomes associated with paclitaxel-coated devices used to treat patients with occlusive disease of femoropopliteal arteries (last search date December 10, 2020). The single primary endpoint was all-cause mortality. Results: We identified 34 randomized controlled trials (7654 patients; 84% intermittent claudication). There were 622 deaths among 4147 (15.0%) subjects in the paclitaxel device group and 475 deaths among 3507 (13.5%) subjects in the noncoated control group [relative risk ratio (RR) 1.07, 95% confidence interval (CI) 0.96 to 1.20, p=0.20, I2=0%). All-cause mortality was similar between groups at 12 months (34 studies, 7654 patients; RR 0.99, 95% CI 0.81 to 1.22, p=0.94, I2=0%), 24 months (20 studies, 3799 patients; RR 1.16, 95% CI 0.87 to 1.55, p=0.31, I2=0%), and 60 months (9 studies, 2288 patients; RR 1.19, 95% CI 0.98 to 1.45, p=0.08, I2=0%). Conclusion: This updated meta-analysis with included additional trials and larger patient numbers shows no evidence of increased risk of all-cause mortality in patients treated with paclitaxel-coated devices, compared with uncoated devices for femoropopliteal disease at all time points to 60 months. There is therefore no justification to limit their use, or alter regulatory body follow-up recommendations in this patient population. Systematic Review Registration: CRD42020216140.

Physiotherapy as an Initial Treatment Option for Femoroacetabular Impingement: A Systematic Review of the Literature and Meta-analysis of 5 Randomized Controlled Trials

2019 ◽  
Vol 48 (8) ◽  
pp. 2042-2050 ◽  
Author(s):  
Graeme Hoit ◽  
Daniel B. Whelan ◽  
Tim Dwyer ◽  
Prabjit Ajrawat ◽  
Jaskarndip Chahal
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Outcome Measures ◽  
Femoroacetabular Impingement ◽  
Meta Analysis ◽  
Hip Pain ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

Background: Femoroacetabular impingement is a common and debilitating source of hip pain in young adults. Although physiotherapy is used as a mainstay of nonoperative care for femoroacetabular impingement, the evidence regarding different physiotherapy practices is poorly understood. Purpose: To collect and synthesize the best available evidence and arrive at a summary estimate of treatment effect for the utility of physiotherapy in the management of femoroacetabular impingement. Study Design: Meta-analysis. Methods: A systematic review was performed on February 2, 2019, of PubMed, EMBASE, and Cochrane Library databases using “femoroacetabular impingement OR hip pain” and “physiotherapy OR nonoperative management” and their synonyms as search terms. Central treatment themes were identified across protocols, and pooled analyses were conducted to assess for differences in patient-reported outcome measures across these themes. Results: A total of 5 randomized controlled trials met our inclusion criteria. The studies included 124 patients with a mean age of 35 years, of whom 24% were male. The average follow-up was 9.4 weeks (range, 6-12 weeks), and the follow-up rate across all participants was 86%. Among these 5 studies, 4 studies used a physiotherapy protocol that focused on core strengthening versus no core strengthening, 4 studies compared active strengthening versus passive modalities, and 3 studies compared supervised versus unsupervised physiotherapy. Pooled analysis across all studies demonstrated improved outcomes in the treatment groups compared with the controls (standardized mean difference [SMD], 0.76; 95% CI, 0.38-1.13; P < .0001). Core strengthening (SMD, 0.82; 95% CI, 0.39-1.26; P = .0002), active physiotherapy (SMD, 0.70; 95% CI, 0.29-1.10; P = .0008), and supervised physiotherapy (SMD, 0.58; 95% CI, 0.14-1.03; P = .01) were found to result in statistically significant improvements in functional outcomes compared with no core strengthening, passive modalities, and unsupervised care, respectively. Conclusion: Supervised physiotherapy programs focusing on active strengthening and core strengthening are more effective than unsupervised, passive, and non–core focused programs. Future studies with longer term follow-up and validated femoroacetabular impingement specific outcome measures are required to determine prognostic factors for success with nonoperative care as well as to determine the ideal patient profile and structured rehabilitation protocol.

scholarly journals Does Minimizing Ventricular Pacing Reduce the Incidence of Atrial Fibrillation? A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 5 (1) ◽  
pp. 1-7
Author(s):  
Ishan Lakhani ◽  
Mengqi Gong ◽  
Cheuk Wai Wong ◽  
George Bazoukis ◽  
Konstantinos P. Letsas ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Ventricular Pacing ◽  
Right Ventricular Pacing ◽  
Randomized Controlled

Background: Right ventricular pacing disrupts atrioventricular synchrony and increases the risk of atrial fibrillation (AF). However, whether algorithms for minimizing ventricular pacing reduce the incidence of AF remains controversial. Therefore, we conducted a systematic review and meta-analysis to compare the incidence of AF between minimizing ventricular pacing and conventional pacing protocols in patients with pacemakers implanted.Methods: The PubMed, Embase, and Cochrane Library databases were searched up to August 1, 2017, for randomized controlled trials that reported the incidence of AF in patients with and without the use of algorithms for minimizing ventricular pacing.Results: Eleven studies comprising 5705 participants (61% males, mean age 71 years [standard deviation 11 years]) were finally included in the analysis. The mean follow-up duration was 24 months. Use of algorithms for minimizing ventricular pacing significantly reduced the incidence of AF, with an odds ratio of 0.74 (95% confidence interval 0.55‐1.00; P<0.05). There was moderate heterogeneity among studies (I2=63%).Conclusions: The incidence of AF was reduced by 26% with use of algorithms for minimizing ventricular pacing. The incorporation of such algorithms in routine clinical practice should in theory lead to a decrease in AF-related morbidity and mortality.

scholarly journals Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096849
Author(s):  
Maria T. Schwabe ◽  
John C. Clohisy ◽  
Abby L. Cheng ◽  
Cecilia Pascual-Garrido ◽  
Marcie Harris-Hayes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Short Term ◽  
Intention To Treat ◽  
Randomized Controlled

Background: Both physical therapy (PT) and surgery are effective in treating femoroacetabular impingement (FAI), but their relative efficacy has not been well established until recently. Several randomized controlled trials (RCTs) comparing the early clinical outcomes of these treatments have been published, with contradictory results. Purpose/Hypothesis: The purpose of this study was to perform a meta-analysis of RCTs that compared early patient-reported outcomes (PROs) of hip arthroscopy versus PT in patients with symptomatic FAI. The hypothesis was that surgical treatment of FAI leads to better short-term outcomes than PT. Study Design: Systematic review; Level of evidence, 1. Methods: In March 2019, a systematic review was performed to identify RCTs comparing hip arthroscopy and PT in patients with symptomatic FAI. A total of 819 studies were found among 6 databases; of these, 3 RCTs met eligibility (Griffin et al, 2018; Mansell et al, 2018; and Palmer et al, 2019). All 3 RCTs reported international Hip Outcome Tool--33 (iHOT-33) scores, and 2 reported Hip Outcome Score (HOS)–Activities of Daily Living (ADL) and HOS-Sport results. In a random-effects meta-analysis, between-group differences in postintervention scores were assessed according to intention-to-treat and as-treated approaches. Quality was assessed with CONSORT, CERT, TiDieR, and the Cochrane Collaboration tool. Results: The 3 RCTs included 650 patients with FAI; the mean follow-up ranged from 8 to 24 months. All studies reported PRO improvement from baseline to follow-up for both PT and surgery. The quality of the Griffin and Palmer studies was good, with minimal bias. In the Mansell study, a 70% crossover rate from PT to surgery increased the risk of bias. The meta-analysis demonstrated improved iHOT-33 outcomes with surgery compared with PT for intention-to-treat (mean difference [MD], 11.3; P = .046) and as-treated (MD, 12.6; P = .007) analyses. The as-treated meta-analysis of HOS-ADL scores favored surgery (MD, 12.0; P < .001), whereas the intention-to-treat analysis demonstrated no significant difference between groups for HOS-ADL (MD, 3.9; P = .571). Conclusion: In patients with FAI, the combined results of 3 RCTs demonstrated superior short-term outcomes for surgery versus PT. However, PT did result in improved outcomes and did not appear to compromise the surgical outcomes of patients for whom therapy failed and who progressed to surgery.

scholarly journals A Systematic Review and Meta-analysis of Randomized Controlled Trials on the Effect of Transcranial Magnetic Stimulation on Tinnitus Management

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Salma Galal ◽  
Naema Ismail ◽  
Ghada Niel
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Randomized Controlled Trials ◽  
Magnetic Stimulation ◽  
Meta Analysis ◽  
Complete Recovery ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Keywords Tinnitus

Introduction: Tinnitus occurs in 10-15% of the world’s population. It may lead to hearing loss, depression, and suicidal tendencies, as well as reduced quality of life. The aim of this study was to assess whether Transcranial Magnetic Stimulation (TMS) effectively reduces tinnitus handicapping after six months or more of follow-up.Methods: A systematic review of randomized controlled trials with follow-up of six months was undertaken. The review took place through searching Medline, Science Direct, and Google Scholar databases using the keywords “tinnitus” and “Transcranial Magnetic Stimulation” and limiting the search results to randomized controlled trials (RCTs) conducted on adults (19 years and older) published between 2005-2015. Meta-analysis was performed on the similarly designed studies.Results: Five RCTs with six month follow-up were found conforming to the inclusion criteria. In total, there were 119 patients in the TMS arms and 115 in the placebo arms. However, designs were different between the studies and were therefore not all comparable. Different parameters were used to measure the severity of tinnitus and depression scores. Tinnitus handicapped inventory (THI) was the common measured outcome parameter used in all studies. THI score decreased after the TMS in four studies. Meta-analysis was performed on three similarly designed RCTs with the overall effect being insignificant.Conclusion: TMS reduced the THI score and decreased the severity of tinnitus in 45% of patients and lead to a complete recovery in 32% of cases in one study. However, the meta-analysis demonstrated lack of significant effect of TMS on tinnitus management.

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