The effectiveness of exercise therapy for temporomandibular dysfunction: a systematic review and meta-analysis

2016 ◽  
Vol 31 (8) ◽  
pp. 1039-1048 ◽  
Author(s):  
Shantil M Dickerson ◽  
Jarod M Weaver ◽  
Ashley N Boyson ◽  
Jared A Thacker ◽  
Andrew A Junak ◽  
...  

Objective: To investigate the effectiveness of exercise therapy on pain, function, and mobility outcomes in patients with temporomandibular joint dysfunction. Study design: Systematic review with meta-analysis. Methods: A systematic review and meta-analysis undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that met the inclusion criteria: (1) randomized controlled trials; (2) a population with the diagnosis of temporomandibular joint dysfunction; and (3) interventions that included exercise therapy were considered for review. When studies demonstrated homogeneity on outcome measures, the mean differences or standardized mean differences with 95% confidence interval were calculated and pooled in a meta-analysis for pooled synthesis. Results: Six articles with a total of 419 participants were included in the review and only four studies were included in the meta-analysis. Mobility and mixed exercise therapy approaches appear to be the most common exercise approaches utilized for management of temporomandibular joint dysfunction. Exercise therapy and the associated dosage provide moderate short-term and varying long-term benefits in reduction of pain and improvement of range of motion of the in patients with temporomandibular joint dysfunction. Conclusion: Included studies suggest a mobility or a mixed approach to exercise therapies have impact on reducing pain, significant impact for increasing range of motion, but lack a significant impact for functional improvement. Level of evidence: Therapy, level 1a-.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).


2020 ◽  
Author(s):  
Nasrin Amiri Dashatan ◽  
Marzieh Ashrafmansouri ◽  
Mehdi Koushki ◽  
Nayebali Ahmadi

Abstract Background Leishmaniasis is one of the most important health problems worldwide. The evidence has suggested that resveratrol and its derivatives have anti-leishmanial effects; however, the results are inconsistent and inconclusive. The aim of this study was to assess the effect of resveratrol and its derivatives on the Leishmania viability through a systematic review and meta-analysis of available relevant studies. Methods The electronic databases PubMed, ScienceDirect, Embase, Web of Science and Scopus were queried between October 2000 and April 2020 using a comprehensive search strategy. The eligible articles selected and data extraction conducted by two reviewers. Mean differences of IC50 (concentration leading to reduction of 50% of Leishmania) for each outcome was calculated using random-effects models. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity and the stability of the pooled results. Publication bias was evaluated using the Egger’s and Begg’s tests. We also followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for this review. Results Ten studies were included in the meta-analysis. We observed that RSV and its derivatives had significant reducing effects on Leishmania viability in promastigote [24.02 µg/ml; (95% CI 17.1, 30.8); P < 0.05; I2 = 99.8%; P heterogeneity = 0.00] and amastigote [18.3 µg/ml; (95% CI 13.5, 23.2); P < 0.05; I2 = 99.6%; P heterogeneity = 0.00] stages of Leishmania. A significant publication bias was observed in the meta-analysis. Sensitivity analyses showed a similar effect size while reducing the heterogeneity. Subgroup analysis indicated that the pooled effects of leishmanicidal of resveratrol and its derivatives were affected by type of stilbenes and Leishmania species. Conclusions Our findings clearly suggest that the strategies for the treatment of leishmaniasis should be focused on natural products such as RSV and its derivatives. Further study is needed to identify the mechanisms mediating this protective effects of RSV and its derivatives in leishmaniasis.


Author(s):  
Mariana Feijó ◽  
Roberta V L Martins ◽  
Sílvia Socorro ◽  
Luísa Pereira ◽  
Sara Correia

Abstract Endocrine-disrupting chemicals have become an issue of scientific and public discussion. Vinclozolin (VNZ) is a fungicide that competitively antagonizes the binding of natural androgens to their receptor, disturbing the function of tissues that are sensitive to these hormones, as is the case of the male reproductive organs. A systematic review with meta-analyses of rodent studies was conducted to answer the following question: Does exposure to VNZ affect sperm parameters and testicular/epididymal weight? The methodology was prespecified according to the Cochrane Handbook for Systematic Reviews and PRISMA recommendations. Sixteen articles met the inclusion criteria, comprising a total of 1189 animals. The risk of publication bias was assessed using the Trim and Fill adjustment, funnel plot, and Egger regression test. Heterogeneity and inconsistency across the findings were tested using the Q-statistic and I2 of Higgins, respectively. Sensitivity was also analyzed. Statistical analysis was performed on Comprehensive Meta-Analysis software (Version 2.0), using random models and weighted mean differences along with a 95% confidence interval. Sperm motility, counts, daily sperm production (evidence of publication bias), and epididymis weight were decreased in VNZ-treated animals. Exposure length and dose, as well as the time point of exposure, influenced the obtained results. Despite the moderate/high heterogeneity observed, the sensitivity analysis overall demonstrated the robustness of the findings. The quality scores of the included studies were superior to 4 in a total of 9, then classified as good. The obtained data corroborate the capability of VNZ exposure to disrupt spermatogenic output and compromise male fertility.


2021 ◽  
Author(s):  
Marianna Rosso ◽  
Robin Wirz ◽  
Ariane Vera Loretan ◽  
Nicole Alessandra Sutter ◽  
Charlène Tatiana Pereira da Cunha ◽  
...  

Animal research on anxiety and anxiety disorders relies on valid animal models of anxiety. However, the validity of widely used rodent behavioural tests of anxiety has repeatedly been questioned, as they often fail to produce consistent results across independent replicate studies using different study populations or different anxiolytic compounds. In this study, we assessed the sensitivity of behavioural tests of anxiety in mice to detect anxiolytic effects of drugs prescribed to treat anxiety in humans. To this end, we conducted a pre-registered systematic review of studies reporting tests of anxiolytic compounds against a control treatment using common behavioural tests of anxiety in mice. PubMed and EMBASE were searched on August 21 st 2019 for studies published in English and 814 papers were identified for inclusion. Risk of bias was assessed based on Syrcle’s risk of bias tool and the Camarades study quality checklist on a randomly selected subsample of 180 papers. Meta-analyses on effect sizes of treatments using standardized mean differences (Hedges’ g) showed that only two of 17 test measures reliably detected effects of anxiolytic compounds other than diazepam. Further, we report considerable variation in both direction and size of effects of most anxiolytics on most outcome variables, indicating poor replicability of test results. This was corroborated by high heterogeneity in most test measures. Finally, we found an overall high risk of bias. Our findings indicate a general lack of sensitivity of common behavioural tests of anxiety in mice to anxiolytic compounds and cast serious doubt on both construct and predictive validity of most of those tests. The use of animals to model human conditions can be justified only if the expected results are informative, reproducible, and translatable. In view of scientifically valid and ethically responsible research, we call for a revision of behavioural tests of anxiety in mice and the development of more predictive tests .


2020 ◽  
Vol 13 (1) ◽  
pp. 71-77
Author(s):  
Yilin Xu ◽  
Peng Yuan ◽  
Ran Wang ◽  
Dan Wang ◽  
Jia Liu ◽  
...  

Content: Distance running is one of the most popular physical activities, and running-related injuries (RRIs) are also common. Foot strike patterns have been suggested to affect biomechanical variables related to RRI risks. Objective: To determine the effects of foot strike techniques on running biomechanics. Data Sources: The databases of Web of Science, PubMed, EMBASE, and EBSCO were searched from database inception through November 2018. Study Selection: The initial electronic search found 723 studies. Of these, 26 studies with a total of 472 participants were eligible for inclusion in this meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 4. Data Extraction: Means, standard deviations, and sample sizes were extracted from the eligible studies, and the standard mean differences (SMDs) were obtained for biomechanical variables between forefoot strike (FFS) and rearfoot strike (RFS) groups using a random-effects model. Results: FFS showed significantly smaller magnitude (SMD, −1.84; 95% CI, −2.29 to −1.38; P < 0.001) and loading rate (mean: SMD, −2.1; 95% CI, −3.18 to −1.01; P < 0.001; peak: SMD, −1.77; 95% CI, −2.21 to −1.33; P < 0.001) of impact force, ankle stiffness (SMD, −1.69; 95% CI, −2.46 to −0.92; P < 0.001), knee extension moment (SMD, −0.64; 95% CI, −0.98 to −0.3; P < 0.001), knee eccentric power (SMD, −2.03; 95% CI, −2.51 to −1.54; P < 0.001), knee negative work (SMD, −1.56; 95% CI, −2.11 to −1.00; P < 0.001), and patellofemoral joint stress (peak: SMD, −0.71; 95% CI, −1.28 to −0.14; P = 0.01; integral: SMD, −0.63; 95% CI, −1.11 to −0.15; P = 0.01) compared with RFS. However, FFS significantly increased ankle plantarflexion moment (SMD, 1.31; 95% CI, 0.66 to 1.96; P < 0.001), eccentric power (SMD, 1.63; 95% CI, 1.18 to 2.08; P < 0.001), negative work (SMD, 2.60; 95% CI, 1.02 to 4.18; P = 0.001), and axial contact force (SMD, 1.26; 95% CI, 0.93 to 1.6; P < 0.001) compared with RFS. Conclusion: Running with RFS imposed higher biomechanical loads on overall ground impact and knee and patellofemoral joints, whereas FFS imposed higher biomechanical loads on the ankle joint and Achilles tendon. The modification of strike techniques may affect the specific biomechanical loads experienced on relevant structures or tissues during running.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Alireza Yargholi ◽  
Mohammad Hasan Najafi ◽  
Mohammad Ali Zareian ◽  
Jessie Hawkins ◽  
Laila Shirbeigi ◽  
...  

Objectives. In recent years, diabetes has become a global health problem that creates a tremendous economic burden for many countries. Clinical trials evaluating the hypoglycemic effects of sesame consumption have produced conflicting results. This systematic review and meta-analysis was conducted to evaluate the effectiveness of sesame as a popular natural herb on glycemic indices in adults. Methods. The search for related articles in PubMed, Scopus, Google Scholar, and Cochrane library was conducted through May 2021. Results were reported as weighted mean differences (WMD) with 95% confidence intervals (CI) using a random-effects model. Results. A total of 605 studies were identified through online searching, and a total of eight RCTs representing 382 participants were included in this study. The meta-analyses revealed that sesame consumption significantly decreases serum fasting blood sugar (FBS): (WMD: −28.23 mg/dl; 95% CI (−39.16, −17.13), I2 = 97.6%; 95% CI (96, 98)), and hemoglobin A1c (HbA1c): (WMD: −1.00%; 95% CI (−1.11, −0.88), I2 = 0%; 95% CI (0, 79)) as compared to the control group. Conclusion. This study provides evidence of the hypoglycemic effects of sesame consumption, particularly in diabetic patients. Additional RCTs on sesame and its preparations should be conducted in different populations to increase generalizability.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250929
Author(s):  
Chun-Shan Hung ◽  
Yang-Ching Chen ◽  
Ten-Fang Yang ◽  
Fu-Huan Huang

Background Primary spontaneous pneumothorax (PSP) prevalence is typically higher in juvenile patients than in adults. We aimed to evaluate the optimal treatment for primary spontaneous pneumothorax and its efficacy and safety in juveniles. Materials and methods We searched PubMed, Embase, and Cochrane databases for eligible studies published from database inception to October 10, 2020, and conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary and secondary outcomes were recurrence rate and hospital stay length, respectively. Odds ratios (OR) and mean differences were used for quantitatively analyzing binary and continuous outcomes, respectively. In total, nine retrospective studies with 1,452 juvenile patients (aged <21) were included for the quantitative analysis. The surgical approach led to a lower recurrence rate than did conservative approaches (OR: 1.95, 95% confidence interval: 1.15–3.32). Moreover, the recurrence rate was low in patients who underwent conservative treatment first and received surgery later. Conclusions Surgical approach for first-line management might have a greater effect on recurrence prevention than do conservative approaches. An upfront surgery might be an optimal choice for juvenile primary spontaneous pneumothorax.


2021 ◽  
Vol 7 ◽  
Author(s):  
Alanna C. Cote ◽  
Riley J. Phelps ◽  
Nina Shaafi Kabiri ◽  
Jaspreet S. Bhangu ◽  
Kevin “Kip” Thomas

Background: The objective of this analysis was to systematically review studies employing wearable technology in patients with dementia by quantifying differences in digitally captured physiological endpoints.Methods: This systematic review and meta-analysis was based on web searches of Cochrane Database, PsycInfo, Pubmed, Embase, and IEEE between October 25–31st, 2017. Observational studies providing physiological data measured by wearable technology on participants with dementia with a mean age ≥50. Data were extracted according to PRISMA guidelines and methodological quality assessed independently using Downs and Black criteria. Standardized mean differences between cases and controls were estimated using random-effects models.Results: Forty-eight studies from 18,456 screened abstracts (Dementia: n = 2,516, Control: n = 1,224) met inclusion criteria for the systematic review. Nineteen of these studies were included in one or multiple meta-analyses (Dementia: n = 617, Control: n = 406). Participants with dementia demonstrated lower levels of daily activity (standardized mean difference (SMD), −1.60; 95% CI, −2.66 to −0.55), decreased sleep efficiency (SMD, −0.52; 95% CI, −0.89 to −0.16), and greater intradaily circadian variability (SMD, 0.46; 95% CI, 0.27 to 0.65) than controls, among other measures. Statistical between-study heterogeneity was observed, possibly due to variation in testing duration, device type or patient setting.Conclusions and Relevance: Digitally captured data using wearable devices revealed that adults with dementia were less active, demonstrated increased fragmentation of their sleep-wake cycle and a loss of typical diurnal variation in circadian rhythm as compared to controls.


2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S53-S53
Author(s):  
S A Almuhaidib

Abstract Introduction/Objective Thyroid disorders are considered to have a significant global health impact, affecting around 200 million people, and about 5% of all populations are diagnosed with hypothyroidism. Thyroid problems are mainly diagnosed by the laboratory’s thyroid function tests (TSH, FT4, and FT3), and currently, there is no special guideline for a preferred sample to test the thyroid functions. Aim To investigate whether using a fasting serum sample or postprandial serum sample could affect the results of the thyroid function tests in both euthyroid people and patients with thyroid problems. Methods/Case Report • A systematic search was done on PubMed, EMBASE, Google Scholar, Semantic Scholar, and manual searches with cross-referencing. • PECOS framework was used for developing the research question. • PRISMA guidelines used for the methodology. • Two meta-analyses for TSH and FT4 were done based on the participant’s thyroid status, and one meta-analysis done for the FT3 for all. • Statistical analyses were done using Revman5 software. Results (if a Case Study enter NA) • Ten full-text studies and three abstracts were included for the systematic review, and for meta-analysis, nine full-text studies and two abstracts. • Based on the Cochrane rule of thumbs of the effect size interpretations, the meta-analyses result showed a statistically significant moderate effect for TSH mean differences; Mean of fasting blood sample &gt; mean of the postprandial sample. • TSH effect for euthyroid people based on results of 9 studies from 641 participants (MD, 0.58; Fixed, 95% CI: [0.44 to 0.73], p. &lt;.00001). • TSH results for all based on results of 11 studies from 921 participants (SMD, 0.46; Random, 95% CI: [0.31 to 0.61], p. &lt;.00001). • No statistically significant effect for FT4 and FT3 mean differences results. • Publication bias is suggested for TSH and FT3 results due to the asymmetrical appearance, but not for FT4. Conclusion • In conclusion, the use of fasting blood samples would have a significantly higher TSH result value compared to the postprandial blood samples. Hence, it may help introduce a new guideline to standardize the blood sampling status for the TSH test screening and diagnosis. Alternatively, different reference ranges depending on the sampling status might be suggested, which might help promote the patients’ quality of life and reduce healthcare costs.


2019 ◽  
Vol 33 (06) ◽  
pp. 547-552
Author(s):  
Si Heng Sharon Tan ◽  
Sheng Yang Lim ◽  
Keng Lin Wong ◽  
Chintan Doshi ◽  
Andrew Kean Seng Lim ◽  
...  

AbstractDistal realignment procedures are now commonly performed routinely with proximal realignment procedures. Despite so, only a limited number of publications exist that have looked into the efficacy of isolated distal realignment procedures, and whether there is indeed a need for routine proximal realignment procedures to be added to the distal realignment procedures. The current systematic review and meta-analysis aims to evaluate the outcomes of isolated distal realignment procedures in the management of patellofemoral instability. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that reported the outcomes of isolated distal realignment procedures for patellofemoral instability were included. A total of six publications were included, with 347 knees. All studies consistently reported a decrease in the rates of patellofemoral instability or maltracking (odds ratio [OR]: < 0.01; 95% confidence interval [CI]: < 0.01–0.01) and an increase in the odds of having a good outcome (OR: 0.01; 95% CI: < 0.01–0.02) after distal realignment procedures. A total of 24 out of 306 patients (7.8%) had postoperative instability or maltracking, and a total of 220 out of 303 patients (72.6%) were rated to have good or excellent outcomes postoperatively. Isolated distal realignment procedures can lead to good outcomes when used in the management of patellofemoral instability. These include a significantly decreased rate of patellofemoral instability or maltracking and a significantly increased number of patients with excellent or good outcomes postoperatively. Comparisons between patients with and without additional proximal realignment procedures suggest that additional proximal realignment procedures do not definitely improve the outcomes of distal realignment procedures and, therefore, should not be routinely performed in all patients undergoing distal realignment procedures. The Level of Evidence for this study is IV.


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