Titanium Mesh Exposure After Bone Grafting: Treatment Approaches—A Systematic Review

2021 ◽  
pp. 194338752110461
Author(s):  
Giovanni Cunha ◽  
Pedro Henrique de Azambuja Carvalho ◽  
Lílian Caldas Quirino ◽  
Luiz Henrique Soares Torres ◽  
Valfrido Antônio Pereira Filho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Case Series ◽  
Primary Treatment ◽  
Mesh Exposure ◽  
Titanium Mesh ◽  
Mesh Removal ◽  
Eligibility Criteria ◽  
Oral Hygiene Instructions

Study Design: A systematic review according to PRISMA statement has been designed to answer the preliminary question: “ In titanium mesh exposures, is there a treatment alternative which leads to an increased graft maintenance?” and fill the PICO assessment out. Objective: To review studies published in the past 20 years (1999-2019) in which mesh exposure has occurred, detecting the suitable approaches to treat exposure allowing the graft maintenance. Methods: Initial search on PUBMED, SCOPUS, and COCHRANE databases resulted in 777 articles, and hand-searching identified 6 articles. After removing duplicates and unrelated articles, eligibility criteria were applied, and 31 studies were selected (randomized clinical trials, retrospective/prospective clinical trials, and case series). Results: A total of 677 surgical sites and 225 cases of mesh exposure were identified. Eleven treatments have been identified. Chlorhexidine was the primary approach in 46% of cases, followed by oral hygiene instructions and follow-up with 22.5% of occurrences. In 21% of clinical situations, titanium mesh removal was the treatment of choice, associated with other measures (i.e., antibiotic prescription). There seems to be a consensus in cases of infection. When this complication was associated with tissue dehiscence, the primary treatment was mesh removal. The same does not occur when the site needs to be cleaned for long-term periods. Conclusion: In 2 decades of use of titanium meshes, the available treatments do not seem to have evolved, and there is not enough data to establish a guideline.

scholarly journals Vitamin D Food Fortification and Nutritional Status in Children: A Systematic Review of Randomized Controlled Trials

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2766 ◽  
Author(s):  
Paula Nascimento Brandão-Lima ◽  
Beatriz da Cruz Santos ◽  
Concepción Maria Aguilera ◽  
Analícia Rocha Santos Freire ◽  
Paulo Ricardo Saquete Martins-Filho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Nutritional Status ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Hypovitaminosis D ◽  
Food Fortification ◽  
Fortified Foods ◽  
Eligibility Criteria

Children are in the risk group for developing hypovitaminosis D. Several strategies are used to reduce this risk. Among these, fortification of foods with vitamin D (25(OH)D) has contributed to the achievement of nutritional needs. This systematic review aims to discuss food fortification as a strategy for maintenance or recovery of nutritional status related to vitamin D in children. The work was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International prospective register of systematic reviews (PROSPERO) database (CRD42018052974). Randomized clinical trials with children up to 11 years old, who were offered vitamin D-fortified foods, and who presented 25(OH)D concentrations were used as eligibility criteria. After the selection stages, five studies were included, totaling 792 children of both sexes and aged between two and 11 years. Interventions offered 300–880 IU of vitamin D per day, for a period of 1.6–9 months, using fortified dairy products. In four of the five studies, there was an increase in the serum concentrations of 25(OH)D with the consumption of these foods; additionally, most children reached or maintained sufficiency status. Moreover, the consumption of vitamin D-fortified foods proved to be safe, with no concentrations of 25(OH)D > 250 nmol/L. Based on the above, the fortification of foods with vitamin D can help maintain or recover the nutritional status of this vitamin in children aged 2–11 years. However, it is necessary to perform additional randomized clinical trials in order to establish optimal doses of fortification, according to the peculiarities of each region.

Intervention Therapies to Reduce Pain-Related Fear in Fibromyalgia Syndrome: A Systematic Review of Randomized Clinical Trials

Pain Medicine ◽  
2020 ◽  
Author(s):  
Javier Martinez-Calderon ◽  
Mar Flores-Cortes ◽  
Jose Miguel Morales-Asencio ◽  
Alejandro Luque-Suarez
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Full Detail ◽  
Eligibility Criteria ◽  
Fear Avoidance Beliefs

Abstract Objective This systematic review aimed to evaluate the effectiveness of different interventions at reducing pain-related fear in people with fibromyalgia and to analyze whether the included trials reported their interventions in full detail. Design Systematic review. Setting No restrictions. Methods The Cochrane Library, CINAHL, EMBASE, PsycINFO, PubMed, and Scopus were searched from their inception to April 2020, along with manual searches and a gray literature search. Randomized clinical trials were included if they assessed pain-related fear constructs as the primary or secondary outcome in adults with fibromyalgia. Two reviewers independently performed the study selection, data extraction, risk-of-bias assessment, Template for Intervention Description and Replication (TIDieR) checklist assessment, and grading the quality of evidence. Results Twelve randomized clinical trials satisfied the eligibility criteria, including 11 cohorts with a total sample of 1,441 participants. Exercise, multicomponent, and psychological interventions were more effective than controls were in reducing kinesiophobia. However, there were no differences in decreasing kinesiophobia when self-management and electrotherapy were used. There were also no differences between groups with regard to the rest of the interventions and pain-related constructs (fear-avoidance beliefs, fear of pain, and pain-related anxiety). However, a serious risk of bias and a very serious risk of imprecision were detected across the included trials. This caused the overall certainty of the judged evidence to be low and very low. Additionally, the included trials reported insufficient details to allow the full replication of their interventions. Conclusions This systematic review shows that there are promising interventions, such as exercise, multicomponent, and psychological therapies, that may decrease one specific type of fear in people with fibromyalgia, i.e., kinesiophobia. However, because of the low–very low certainty of the evidence found, a call for action is needed to improve the quality of randomized clinical trials, which will lead to more definitive information about the clinical efficacy of interventions in this field.

scholarly journals Mouth-rinses and SARS-CoV-2 viral load in saliva: A living systematic review

2021 ◽  
Author(s):  
Akram Hernández-Vásquez ◽  
Antonio Barrenechea-Pulache ◽  
Daniel Comandé ◽  
Diego Azañedo
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Viral Load ◽  
Randomized Clinical Trials ◽  
Risk Of Bias ◽  
Control Group ◽  
Sterile Water ◽  
Eligibility Criteria ◽  
Mouth Rinses ◽  
Number Of Patients

ABSTRACTObjectiveTo conduct a living systematic review of the clinical evidence regarding the effect of different mouth-rinses on the viral load of SARS-CoV-2 in the saliva of infected patients. The viral load in aerosols, the duration of the reduction in viral load, viral clearance, SARS-CoV-2 cellular infectivity, and salivary cytokine profiles were also evaluated.Materials and methodsThis study was reported using the PRISMA guidelines. An electronic search was conducted in seven databases and in preprint repositories. We included human clinical trials that evaluated the effect of mouth-rinses with antiseptic substances on the viral load of SARS-CoV-2 in the saliva of children or adults that tested positive for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR). Risk of bias was assessed using the ROBINS-I tool. PROSPERO registration number CRD42021240561.ResultsFour studies matching eligibility criteria were selected for evaluation (n=32 participants). Study participants underwent oral rinses with hydrogen peroxide (H2O2) at 1 %, povidone–iodine (PI) at 0.5% or 1%, chlorhexidine gluconate (CHX) at 0.2% or 0.12% or cetylpyridinium chloride (CPC) at 0.075%. Only one study included a control group with sterile water. Three of the studies identified a significant reduction in viral load up to 3, 4, and 6 hours after the use of mouthwashes with PI, CHX, and CPC or PI vs. sterile water, respectively, while one study did not identify a significant reduction in viral load after the use of H2O2 rinses.ConclusionsAccording to the present systematic review, the effect of the use of mouth-rinses on SARS-CoV-2 viral load in the saliva of COVID-19 patients remains uncertain. This is mainly due to the limited number of patients included and a high risk of bias present in the studies analyzed. Evidence from well-designed randomized clinical trials is required for further and more objective evaluation of this effect.

PP107 Amiodarone For Arrhythmia In Chagas Patients: A Systematic Review

2017 ◽  
Vol 33 (S1) ◽  
pp. 121-122
Author(s):  
Luciane Cruz ◽  
Cinara Stein ◽  
Celina Borges Migliavaca ◽  
Verônica Colpani ◽  
Sandro Miguel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Ventricular Tachycardia ◽  
Adverse Effects ◽  
Sudden Death ◽  
Chagas Disease ◽  
Antiarrhythmic Drug ◽  
Case Series ◽  
Health Concern ◽  
Eligibility Criteria

INTRODUCTION:Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a neglected chronic condition with a high burden of morbidity and mortality. It affects about 6 million people in twenty-one countries of Latin America, and has recently become a global health concern (1), especially due to immigration from endemic areas into the developed world. Cardiac arrhythmias are common in patients with Chagas cardiomyopathy and amiodarone has been widely used as an antiarrhythmic drug. Amiodarone has been recommended as the treatment of choice for all patients with sustained ventricular tachycardia (2). The objective of this systematic review is to evaluate the effect of amiodarone in arrhythmia patients with the cardiac form of chronic Chagas disease.METHODS:Searches was conducted in MEDLINE (PubMed), EMBASE and LILACS from the inception to December 2016. Studies regarding the use of amiodarone to treat arrhythmia in patients affected by Chagas disease were included, and the outcomes were arrhythmia, adverse effects and sudden death. Selection of articles and data extraction were made by two independent reviewers.RESULTS:The database search found 378 articles but only 9 studies with 373 subjects fulfilled the eligibility criteria. The nine studies selected were composed of case series (two), crossover clinical trials (two), and clinical trials (five). Results showed that amiodarone reduced ventricular extrasystoles in all studies and ventricular tachycardia in eight studies. During treatment with amiodarone, patients in eight studies had side effects. Corneal microdeposits and gastric discomfort were the most common adverse effects present in studies. Three studies reported sudden death during follow-up.CONCLUSIONS:Amiodarone seems to be an effective antiarrhythmic drug for Chagasic patients, reducing uncomfortable symptoms such as tachycardia. This information can be useful in the primary care context, supporting general practitioners to manage Chagas cardiopathy, mainly when specialized cardiologic consultants are not available.

scholarly journals Efficacy of topical hyaluronic acid for symptomatic oral lichen planus: A systematic Review.

2021 ◽  
Vol 10 (4) ◽  
pp. 1-7
Author(s):  
Sadeq A. Al-Maweri ◽  
◽  
Rawan Alanazi ◽  
Mohammed Nasser Alhajj ◽  
Ammar Daer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Hyaluronic Acid ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Clinical Signs ◽  
Case Series ◽  
Oral Lichen

Background: Oral lichen planus (OLP) is a chronic inflam-matory disorder with a potential of malignant transformation. Despite the extensive research on the topic, the management of OLP is still quite challenging, with no definitive cure. Objective: The present systematic review assessed the efficacy of topical hyaluronic acid in the management of OLP. Material and Methods: A comprehensive search of PubMed, Scopus, Web of Science and Google Scholar was carried out by two independent investigators. All randomized clinical trials that compared the efficacy of hyaluronic acid with other interventions and/or placebo in the management of OLP and fulfilled the following criteria were included: 1) OLP diagnosis was confirmed clinically and histopathologically, 2) the study included systemically healthy patients aged 15 years and older, 3) a minimum sample size of 10, and 4) reporting the main outcomes including pain, erythema, and ulcer size. Case reports, case series, reviews, animal studies, uncontrolled trials were excluded. Results: Four clinical trials involving 234 patients were included. Two studies compared hyaluronic acid with a topical corticosteroid, and two studies compared it with placebo. Only one of the four included studies was at low risk of bias. Overall, topical hyaluronic acid showed good efficacy in alleviating the signs and symptoms of OLP. Two studies found hyaluronic acid significantly more effective in reducing pain and improving clinical signs of OLP compared to placebo. Compared to topical corticosteroids, one study reported comparable results; and one study found hyaluronic acid to be superior to triamcinolone in reducing pain but inferior to triamcinolone in improving the healing time. Conclusion: The limited available evidence suggests that hyaluronic acid may have some benefits in the management of OLP. Further well-designed studies with adequate follow-up periods are highly recommended.

scholarly journals Regenerative endodontic treatment performed with platelet-rich plasma presents better periapical healing than only induced blot clot: a systematic review

2021 ◽  
Vol 10 (13) ◽  
pp. e147101321219
Author(s):  
Christine Men Martins ◽  
Milena Filippini Knecht ◽  
Larissa dos Santos de Moraes ◽  
Victor Eduardo de Souza Batista
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Primary Outcome ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Periapical Healing ◽  
Regenerative Endodontic Treatment

This study comprehensively reviewed two different treatments for regenerative endodontic: platelet-rich plasma and induced blot clot, in regarding to periapical healing.  Two investigators performed a systematic review. MEDLINE/PubMed, Cochrane Library and Scopus supplied relevant data from studies published until December 2020 to answer the PICO question. Primary outcome was periapical healing. Eight randomized clinical trials fulfilled eligibility criteria. Primary outcome indicated that platelet-rich plasma results in similar or better periapical healing compared to blot clot group. The reported failures were related to blot clot group due to incomplete radiographic parameters, pain and reinfection; however, few cases of unsuccess were reported to platelet-rich plasma group. Only two studies observed better results to blot clot group in relation to increase of radiographic area and partial pulp canal obliteration. This review showed that procedures using platelet-rich plasma were successful in treating permanent teeth with root development.

scholarly journals Zidovudine/Lamivudine vs. Abacavir/Lamivudine vs. Tenofovir/Emtricitabine in fixed-dose combinations as initial treatment for HIV patients: a systematic review and network meta-analysis

2017 ◽  
pp. 70-81 ◽  
Author(s):  
Juan Carlos Alzate Angel ◽  
Marcela María Duque Molina ◽  
Héctor Iván García García
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Initial Treatment ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Fixed Dose ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Statistical Heterogeneity

Introduction: Initial treatment of the HIV is based on the use of three drugs, two of which are nucleoside analog reverse-transcriptase inhibitors. There are three combinations of these drugs which have been approved by different guidelines, each with divergent results in terms of efficacy and safety.Objective: To compare the efficacy and safety of these three combinations.Methods: Systematic review and network meta-analysis of randomized clinical trials comparing fixed doses of Tenofovir Disoproxil Fumarate / Emtricitabine (TDF/FTC), Abacavir / Lamivudine (ABC/3TC) and Zidovudine / Lamivudine (ZDV/3TC).Results: Seven clinical trials met the eligibility criteria. The results suggested higher efficacy with TDF/FTC vs. ABC/3TC at 96 weeks and vs. ZDV/3TC at 48 weeks. However, there is clinical and statistical heterogeneity. Subgroup analysis were performed by third drug and by level of viral load prior to treatment, and found no differences in virological control. Network meta-analysis could only be carried out with TDF/FTC vs. ZDV/3TC, and the proportion of patients with virological response, with no differences at 48 weeks nor at 96 weeks. Direct comparisons showed an increased risk of bone marrow suppression of ZDV/3TC vs. TDF/FTC and of ABC/3TC hypersensitivity reactions vs. ZDV/3TCConclusions: The results did not show differences in effectiveness among the interventions. However, due to the heterogeneity of the third drug and the follow-up time between the included studies, this result is not definitive. The results raise the need for further studies to help improve treatment recommendations in patients infected with HIV.

scholarly journals The effect of bracket slot size on the effectiveness of orthodontic treatment: A systematic review

2017 ◽  
Vol 88 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Elma P. Vieira ◽  
Bruna S. D. Watanabe ◽  
Luana F. Pontes ◽  
José N. F. Mattos ◽  
Lucianne C. Maia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Root Resorption ◽  
Treatment Time ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Duration Of Treatment ◽  
Eligibility Criteria ◽  
Slot Size

ABSTRACT Objectives: To assess, by means of a systematic review, the scientific evidence of the influence of 0.018-inch or 0.022-inch bracket slots on treatment time, efficiency of space closure, efficiency of alignment, quality of orthodontic finishing, level of discomfort, and level of root resorption. Materials and Methods: The PubMed, Bireme, Medline, Scopus, Web of Science, Open Grey, and Google Scholar databases were searched, with no date and language restrictions, for randomized clinical trials and controlled clinical trials, using controlled terms related to bracket slots. After the selection and removal of duplicate articles, the risk of bias was assessed, and the data from the included studies were extracted by two independent researchers. Results: The search yielded 2640 studies. After applying the eligibility criteria, eight articles were fully read and four studies were selected for the qualitative systematic review. No randomized clinical trials assessed the duration of treatment in patients treated with 0.018-inch and 0.022-inch bracket slots. Due to heterogeneity of the data available, a meta-analysis could not be conducted. Conclusions: While most studies indicated a shorter duration of treatment in patients with 0.018-inch bracket slots, no available data confirmed the higher efficiency of one system over the other. The biases in the studies did not allow for a reliable conclusion; therefore, new studies with a better methodologic design are needed.

L-arginine effect on inflammatory mediators: A systematic review of randomized controlled clinical trials

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Seyed Reza Mirhafez ◽  
Mitra Hariri
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Inflammatory Mediators ◽  
Randomized Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Patients With Cancer ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Human Adults ◽  
Factor Α

Abstract. L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.

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