Antibiotic cement coating in orthopedic surgery: a systematic review of reported clinical techniques

Abstract Background Antibiotic-containing cement and bone graft substitute-coated orthopedic implants provide the advantages of simultaneous local antibiotic delivery and internal stable fixation, aiding in both infection eradication and osseous healing. Standardized protocols pertaining to implant coating techniques in various clinical and particularly intraoperative settings are scarce, and available literature is limited. This systematic review aims to provide a summary of the available current literature reporting on custom-made coating techniques of orthopedic implants, indications, outcomes, and associated complications in clinical use. Methods A systematic search of the literature in PubMed, Medline, Embase, and Cochrane Library databases was performed in accordance with PRISMA guidelines. Articles reporting specifically on custom-made coating techniques of orthopedic implants in a clinical setting were eligible. Results A total of 41 articles with a cumulative total number of 607 cases were included. Indications for treatment mostly involved intramedullary infections after previous plate osteosynthesis or nailing. A variety of implants ranging from intramedullary nails, plates, wires, and rods served as metal cores for coating. Polymethylmethacrylate (PMMA) bone cement was most commonly used, with vancomycin as the most frequently added antibiotic additive. Chest tubes and silicone tubes were most often used to mold. Common complications are cement debonding and breakage of the metallic implant. Conclusion Adequate coating techniques can reduce the burden of treatment and be associated with favorable outcomes. Lack of general consensus and heterogeneity in the reported literature indicate that the perfect all-in-one implant coating method is yet to be found. Further efforts to improve implant coating techniques are warranted. Level of evidence III.

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Infrared Thermography for the Evaluation of Inflammatory and Degenerative Joint Diseases: A Systematic Review

Cartilage ◽

10.1177/19476035211063862 ◽

2021 ◽

Vol 13 (2_suppl) ◽

pp. 1790S-1801S

Author(s):

Guglielmo Schiavon ◽

Gianluigi Capone ◽

Monique Frize ◽

Stefano Zaffagnini ◽

Christian Candrian ◽

...

Keyword(s):

Systematic Review ◽

Disease Progression ◽

Infrared Thermography ◽

Rheumatic Diseases ◽

English Language ◽

Response To Treatment ◽

Cochrane Library ◽

Joint Diseases ◽

Level Of Evidence ◽

Post Evaluation

Objective Inflammation plays a central role in the pathophysiology of rheumatic diseases as well as in osteoarthritis. Temperature, which can be quantified using infrared thermography, provides information about the inflammatory component of joint diseases. This systematic review aims at assessing infrared thermography potential and limitations in these pathologies. Design A systematic review was performed on 3 major databases: PubMed, Cochrane library, and Web of Science, on clinical reports of any level of evidence in English language, published from 1990 to May 2021, with infrared thermography used for diagnosis of osteoarthritis and rheumatic diseases, monitoring disease progression, or response to treatment. Relevant data were extracted, collected in a database, and analyzed for the purpose of this systematic review. Results Of 718 screened articles 32 were found to be eligible for inclusion, for a total of 2094 patients. Nine studies reported the application to osteoarthritis, 21 to rheumatic diseases, 2 on both. The publication trend showed an increasing interest in the last decade. Seven studies investigated the correlation of temperature changes with osteoarthritis, 16 with rheumatic diseases, and 2 with both, whereas 2 focused on the pre-post evaluation to investigate treatment results in patients with osteoarthritis and 5 in patients with rheumatic diseases. A correlation was shown between thermal findings and disease presence and stage, as well as the clinical assessment of disease activity and response to treatment, supporting infrared thermography role in the study and management of rheumatic diseases and osteoarthritis. Conclusions The systematic literature review showed an increasing interest in this technology, with several applications in different joints affected by inflammatory and degenerative pathologies. Infrared thermography proved to be a simple, accurate, noninvasive, and radiation-free method, which could be used in addition to the currently available tools for screening, diagnosis, monitoring of disease progression, and response to medical treatment.

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The effect of hemodilution on free flap survival: A systematic review of clinical and experimental studies

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-200832 ◽

2020 ◽

Vol 75 (4) ◽

pp. 457-466

Author(s):

Matteo Amoroso ◽

Peter Apelgren ◽

Anna Elander ◽

Karin Säljö ◽

Lars Kölby

Keyword(s):

Systematic Review ◽

Literature Search ◽

Experimental Studies ◽

Free Flaps ◽

Risk Of Bias ◽

Cochrane Library ◽

Level Of Evidence ◽

Grade Scale ◽

Reconstructive Microsurgery ◽

The Cochrane Library

BACKGROUND: Acute normovolemic hemodilution (ANH) has been proposed as a microsurgical technique to improve blood flow in free flaps. OBJECTIVE: Here, we present the first systematic review of clinical and experimental studies on the effect of ANH. METHODS: We performed a systematic literature search of PubMed, Medline, the Cochrane Library, Google Scholar, and ClinicalTrials.gov using search strategies and a review process in agreement with the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions. PICO criteria were defined before bibliometric processing of the retrieved articles, which were analyzed with the SYRCLE RoB tool for risk of bias and the GRADE scale for level of evidence. RESULTS: We retrieved 74 articles from the literature search, and after processing according to PICO criteria, only four articles remained, all of which were experimental. The rating for risk of bias was uncertain according to SYRCLE RoB results, and the level of evidence was low according to GRADE evaluation. CONCLUSIONS: There is no clinical evidence for the effect of ANH on microcirculation in free flaps, and experimental studies provide weak evidence supporting the use of hemodilution in reconstructive microsurgery.

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Occult Metastasis in Laryngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420937744 ◽

2020 ◽

Vol 130 (1) ◽

pp. 67-77

Author(s):

Daniel D. Sharbel ◽

Mary Abkemeier ◽

Michael W. Groves ◽

William G. Albergotti ◽

J. Kenneth Byrd ◽

...

Keyword(s):

Systematic Review ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Distant Metastasis ◽

Laryngeal Squamous Cell Carcinoma ◽

Cochrane Library ◽

Elective Neck Dissection ◽

Occult Metastasis ◽

Level Of Evidence

Objective: The incidence of occult metastasis (OM) in laryngeal squamous cell carcinoma (SCC) is still widely debated. In this systematic review, we aim to determine the rate of OM in laryngeal SCC, its impact on recurrence, and the role of elective neck dissection (END) in the management of the clinically negative neck. Methods: A systematic review of the English-language literature in Web of Science, PubMed, MEDLINE, and Cochrane Library databases on occult metastasis in laryngeal SCC from 1977 to 2018 was conducted. Studies evaluating occult metastasis (OM) in patients with laryngeal SCC with clinically negative necks undergoing surgery were included. Studies evaluating other head and neck subsites, clinically node positive, and salvage patients were excluded. Results: Twenty-one articles with a total of 5630 patients were included. The overall rate of OM was 20.5% and was 23% and 12.2% in supraglottic and glottic tumors, respectively. The OM rate in T1-T2 tumors was 13% and 25% in T3-T4 tumors. T3-T4 tumors had significantly greater odds of developing OM compared to T1-T2 tumors (Odds Ratio [OR] = 2.61, 95% Confidence Interval [CI] = 1.92-3.55, P < .00001). Patients with OM were more likely to develop distant metastasis (OR = 5.65, 95% CI = 3.36-9.51, P < .00001). Conclusions: Patients with advanced T-stage laryngeal SCC should undergo elective neck treatment. More aggressive treatment for patients with history of OM should be considered due to the risk of subsequent regional and distant metastasis. Level of Evidence: II

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Safety and Efficacy of Therapeutic Taping in Primary Dysmenorrhea: a Systematic Review and Meta-analysis

10.21203/rs.3.rs-827953/v1 ◽

2021 ◽

Author(s):

Bandara EMIA ◽

Kularathne WNI ◽

K Brain ◽

Weerasekara I

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

Adult Women ◽

Primary Dysmenorrhea ◽

Level Of Evidence ◽

Effective Measure ◽

Safety And Efficacy ◽

Pain Anxiety

Abstract Primary dysmenorrhea (PD) is a common gynecological complaint among adolescents and adult women. Various pharmacological and alternative therapies such as therapeutic taping have been used as a treatment of PD. Although several studies have been conducted to evaluate the safety and efficacy of therapeutic taping in PD, these studies have not provided adequate level of evidence related to the safety and efficacy of therapeutic taping in PD. Hence, a systematic review and meta-analysis was performed to evaluate the safety and efficacy of therapeutic taping in PD. The following databases; Medline, Cochrane Library, Embase, PEDro, CINAHL and any other gray literature sources were searched for randomized controlled trials (RCTs) that used therapeutic taping to treat PD from inception to June 2021 with the language restricted to English. Independently screened articles by two reviewers were extracted according to the study objectives. A total of nine studies were included in the systematic review, involving 577 participants. Three studies were eligible for meta-analysis to find the pooled effect of taping on pain intensity. The review indicates that therapeutic taping is an effective measure in improving pain, anxiety and quality of life of women with PD. Meta-analysis conducted to compare the effect of elastic therapeutic taping (ETT) to sham taping showed that the ETT is an effective measure in improving pain among women with PD (MD = -3.12 (95% CI -5.64, -0.60); p=0.02; I2=95 %). The quality of the studies was assessed using the PEDro scale and the included RCTs indicated a fair to good level of quality. Our systematic review and meta-analysis demonstrated that therapeutic taping is an effective intervention for PD. However, RCTs with higher quality and larger sample sizes are necessary to verify the current results of the review.

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Efficacy and safety of microbiota transfer therapy for the management of autism spectrum disorder in children: a systematic review

F1000Research ◽

10.12688/f1000research.21525.1 ◽

2020 ◽

Vol 9 ◽

pp. 48

Author(s):

Pablo Daniel Estrella Porter ◽

Luis Eduardo Guzmán Freire ◽

Joseth Paulina Adatty Molina ◽

María Verónica Burneo Raza ◽

Henry Alejandro Carrión Celi ◽

...

Keyword(s):

Systematic Review ◽

Autism Spectrum Disorder ◽

Intervention Group ◽

Autism Spectrum ◽

Nervous System Development ◽

Spectrum Disorder ◽

Current Evidence ◽

Cochrane Library ◽

Efficacy And Safety ◽

Level Of Evidence

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with an unclear etiologic mechanism. Following suggestions in the literature of a close relation between the gut microbiota and the central nervous system development, neuroimmune and neuroendocrine systems, new theories and strategies of the management of ASD in children focus on the brain-gut axis via microbiota transfer therapy. Despite the regular appearance in the news, the level of evidence supporting this intervention is unclear and to this date, no systematic review on this issue has been published. Methods: We conducted a systematic literature review of the efficacy and safety of microbiota transfer therapy for the management of ASD in children. MEDLINE via PubMed, LILACS IBECS via BVS, EMBASE via Ovid, Scopus and Cochrane Library were searched on 19th April 2018. Results: One single study published in 2017 was identified. The intervention group included 18 patients and showed significant clinical improvements in the gastrointestinal and ASD-related symptoms. The clinical procedure was reported as safe and well-tolerated with some transitory adverse effects. Conclusions: The causality and correlation of the intervention and the expected outcomes cannot be assumed with current evidence. In addition, recommendations about the effectiveness or safety of microbiota transfer therapy in children with ASD cannot be currently issued. Randomized controlled trials and clinical protocols for the intervention are needed.

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Dental implants survival after nasal floor elevation: a systematic review

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-21-00219 ◽

2021 ◽

Author(s):

Eduardo Anitua ◽

Beatriz Anitua ◽

Mohammad Hamdan Alkhraisat ◽

Laura Piñas ◽

Asier Eguia ◽

...

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Case Reports ◽

Meta Analysis ◽

Lateral Approach ◽

Cochrane Library ◽

Good Survival ◽

Quality Level ◽

Level Of Evidence ◽

Nasal Floor

Purpose The aim of this work is to assess the clinical outcomes of implants placed after a nasal floor elevation procedure. Methods A systematic review was conducted using four electronic databases; Medline (Pubmed), Cochrane library, DOAJ and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: “In patients undergoing dental implant placement in the maxillary anterior region (P), Do implants placed after nasal floor elevation (I) have a different survival (O) from those implants placed without grafting procedures (C)?. The study was pre-registered in PROSPERO (CRD42021229479). Included articles quality was assessed using the “NIH quality assessment tool”, “The Newcastle-Ottawa scale” and “JBI critical appraisal tools for case reports''. Results Twelve articles were finally selected, including 151 patients and 460 implants. The weighted mean follow-up was 32.2 months, and the weighted survival rate after this period was 97.64% (range 89.2-100%). No statistical differences could be inferred between the treatments performed in one-stage or two-stage, following a lateral approach or a transcrestal approach or using different grafting materials. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. Conclusion Within the limitations of this study, implants placed after a nasal floor elevation present a good survival and a low range of complications. In absence of randomized studies, the level of evidence was low, attending the GRADE system and based on the study quality level, the strength of evidence attending the SORT taxonomy was B.

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Oral Status of Elderly Patients in Long-Term Care Facilities: A Systematic Review

10.21203/rs.2.23435/v3 ◽

2020 ◽

Author(s):

Juan Antonio Ruiz-Roca ◽

Dora Martin-Fuentes ◽

Yolanda Martinez-Beneyto ◽

Ricardo Elias Oñate-Sanchez

Keyword(s):

Systematic Review ◽

Health Status ◽

Oral Health ◽

Elderly Patients ◽

Soft Tissues ◽

Oral Health Status ◽

Cochrane Library ◽

Level Of Evidence ◽

Term Care

Abstract Background: elderly patients who spend long periods hospitalised or those who are in a situation of institutionalisation represent a risk group in this regard, since many of them suffer a degree of dependence and need help to perform the basic personal care tasks. It is therefore important to learn more about the oral health status of this group of patients in order to make a proper assessment of the situation as well as to develop protocols for its management. The purpose of this study was to conduct a systematic review to ascertain the oral health status of elderly patients institutionalised or hospitalised for a long period of time.Methods: a systematic review of the literature published in three different databases (PubMed, Embase and Cochrane Library) was conducted, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or care centre for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were assessed in some way. The selected articles were subjected to a thorough analysis.Results: The search strategy covered 1,014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was3, with a sample consisting of 773 patients in which most of them were women with an average age older than 70 years old.Conclusions: the oral health of patients aged more than 65 is worse than that of the rest of the population. Long-term in hospitals or being institutionalised in a retirement home makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programmes for the personnel.

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Global prevalence of hidradenitis suppurativa and geographical variation—systematic review and meta-analysis

Biomedical Dermatology ◽

10.1186/s41702-019-0052-0 ◽

2020 ◽

Vol 4 (1) ◽

Cited By ~ 3

Author(s):

Kevin Phan ◽

Olivia Charlton ◽

Saxon D. Smith

Keyword(s):

Systematic Review ◽

Significant Variation ◽

Hidradenitis Suppurativa ◽

Meta Analysis ◽

Asia Pacific ◽

Cochrane Library ◽

Prevalence Rates ◽

Level Of Evidence ◽

Pooled Prevalence ◽

The Usa

Abstract Background There is a significant variation in the reported prevalence of hidradenitis suppurativa (HS), ranging from 0.03–4%. We hypothesized that this significant variation may be due to different prevalence rates of HS according to geographical location as well as sex. Objective We aimed to perform a meta-analysis to determine pooled overall prevalence of HS, prevalence stratified according to geographical region and sex. Materials and methods A systematic review was performed by searching Ovid Medline, PubMed, Cochrane Library, DARE, and Embase, from inception to August 2018. A systematic review and meta-analysis was performed according to PRISMA guidelines. A meta-analysis of proportions was performed to determined pooled prevalence rates, with meta-regression based on geographic region. Prevalence in males versus females was also performed according to region. Results The overall pooled prevalence rate was 0.3% (0.2–0.6%) based on 118,760,093 HS cases available. Subgroup analysis demonstrated prevalence differences, with the highest being in Europe 0.8% (0.5–1.3%), compared to the USA 0.2% (0.1–0.4%), Asia-Pacific 0.2% (0.01–2.2%), and South America 0.2% (0.01–0.9%). Prevalence in males was lower compared to females in the USA (OR 0.403, 95% CI 0.37–0.439, P < 0.001) as well as in Europe (OR 0.635, 95% CI 0.397–1.015, P = 0.08) but not in the Asia-Pacific region (OR 0.936, 95% CI 0.319–2.751, P = 0.78). Conclusion Prevalence of HS varies significantly according to the geographical population. This variation is likely attributed to different ethnicity distributions amongst different continents. Level of evidence III

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Comparison between Minimally Invasive Plate Osteosynthesis and Conventional Open Plating for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/7081032 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Enzhe Zhao ◽

Rui Zhang ◽

Dou Wu ◽

Yao Guo ◽

Qiang Liu

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Cohort Studies ◽

Functional Outcome ◽

Plate Osteosynthesis ◽

Meta Analysis ◽

Operation Time ◽

Cochrane Library ◽

Minimally Invasive Plate Osteosynthesis ◽

Clavicle Fractures

Objective. The aim of this study was to compare the functional outcome and complications in midshaft clavicle fractures receiving minimally invasive plate osteosynthesis and conventional open plating. Methods. Relevant studies were searched in the databases of Medline, EMBASE, Cochrane Library, Ovid, and Web of Science from inception to March 1, 2019. Pooled data were analyzed with Cochrane Collaboration’s Review Manager 5.3. Results. A total of 7 studies were included, of which 2 were randomized controlled trials, 3 were retrospective cohort studies, and 2 were prospective cohort studies including 316 patients. No statistical differences in functional outcome (weighted mean difference [WMD] = 0.99, P=0.12), operation time (WMD = −10.44, P=0.07) and time to bone union (WMD = −0.23, P=0.70) were observed between the two groups. However, minimally invasive plate osteosynthesis reduced rates of skin numbness (odds ratio (OR) = 0.25, 95% CI : 0.13 to 0.48; P<0.0001) and complications (OR = 0.33, 95% CI : 0.16 to 0.71; P=0.005) compared with conventional open plating. Conclusion. This systematic review and meta-analysis found no differences in terms of functional outcomes, operation time, and fracture healing time between minimally invasive plate osteosynthesis and conventional open plating. However, minimally invasive plate osteosynthesis had apparent advantages in rates of skin numbness and complications.

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Effect of oromotor exercises on feeding in children with cerebral palsy: systematic review

Bulletin of Faculty of Physical Therapy ◽

10.1186/s43161-021-00054-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Rania El Nagar ◽

Alaa AL-Nemr ◽

Faten Abdelazeim

Keyword(s):

Systematic Review ◽

Cerebral Palsy ◽

Descriptive Analysis ◽

Sensory Stimulation ◽

Cochrane Library ◽

Feeding Problems ◽

Level Of Evidence ◽

Weak Evidence ◽

Children With Cerebral Palsy ◽

Meta Analyses

Abstract Background Feeding problems are prevalent in children with cerebral palsy (CP). Oromotor exercises (OME) should be started as soon as possible to enhance chewing and drooling. Oromotor exercises consist of active exercises, passive exercises, and sensory stimulation. The purpose of this review is to evaluate the effectiveness of oromotor exercises on feeding, chewing, and drooling in children with CP. Body The American Academy for Cerebral Palsy and Developmental Medicine and Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology were used to conduct a systematic review. Four databases (PubMed, Cochrane Library, PEDro, and Google Scholar) were searched; this review includes seven articles, participants were 173 participants ranging in age from 18 months to 18 years. Articles were assessed according to their level of evidence and quality assessment was done by AACPDM, PEDro scale, and JBI scale. Due to the heterogeneity across included studies, descriptive analysis was performed on all of them. Primary outcomes were chewing and drooling. Results showed the effectiveness of OME in improving drooling, but with weak evidence while not effective in improving chewing. Conclusion High-quality studies are required to develop a firm judgment on the influence of oromotor exercises on feeding. The current level of evidence to support the effectiveness of oromotor exercises in children with CP is currently insufficient.

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