Effects of non-surgical periodontal therapy on periodontal clinical data in periodontitis patients with rheumatoid arthritis: a meta-analysis

Abstract Backgrounds To date, there is still no consensus about the clinical efficacy of non-surgical periodontal therapy in rheumatoid arthritis (RA) patients with periodontitis. Therefore, the aim of this study was to summarize clinical data regarding the efficacy of scaling and root planing (SRP) in patients with RA and periodontitis compared to non-RA periodontitis patients. Methods We selected randomized controlled trials (RCTs) that compared periodontal clinical data in RA as compared to non-RA periodontitis patients by searching Embase, PubMed and Cochrane Central Register of Controlled Trials and by manually retrieving from the earliest records to March 8, 2021. The overall effect size of plaque index (PI), gingival index (GI), attachment loss (AL), probing depth (PD) and bleeding on probing (BOP) were calculated by either a fixed or random-effect model, and subgroup analyses were conducted according to the different time points of follow-up. Two investigators extracted the data and assess the accuracy of the obtained results with 95% of Confidence Intervals (CI). Cochrane Collaboration's tool was responsible for the evaluation of the literature quality and the inter-study heterogeneity was evaluated by Q test and I2 statistic. Sensitivity analyses were applied for results with heterogeneity. Publication bias was determined by Begg's test, Egger's test and the trim-and-fill method. Results Seven RCTs including 212 patients eventually met the inclusion criteria for the study. As the primary results, the change of PD was not statistically significant and in the secondary results changes of PI, GI, AL and BOP were also not statistically significant in RA patients with periodontitis compared to non-RA periodontitis patients. In subgroup analysis, a larger BOP reduction at 3 months, PI and AL reduction at 6 months were observed in patients with RA and periodontitis group. The results of sensitivity analyses had no significant effect. No evidence of potential publication bias was tested. There were some limitations due to the small number of eligible RCTs. Conclusions SRP is equally effective in RA as compared to non-RA periodontitis patients. It suggests RA does not affect the clinical efficacy of non-surgical periodontal therapy. These results could serve evidence-based practice.

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Effects of Non-surgical Periodontal Therapy on Periodontal Clinical Data in Periodontitis Patients With Rheumatoid Arthritis: a Meta-analysis

10.21203/rs.3.rs-173708/v1 ◽

2021 ◽

Author(s):

Yu Huang ◽

Zheng Zhang ◽

Youli Zheng ◽

Zhulan Zhao ◽

Yang Zhong ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Publication Bias ◽

Clinical Efficacy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Periodontal Therapy ◽

Sensitivity Analyses ◽

Cochrane Central Register ◽

Randomized Controlled Clinical Trials

Abstract Backgrounds: To date, there is still no consensus about the clinical efficacy of non-surgical periodontal therapy in rheumatoid arthritis (RA) patients with periodontitis. Therefore, the overall aim of this study was to summarize available data regarding the clinical efficacy of scaling and root planing (SRP) in patients with RA and periodontitis compared to patients with periodontitis alone.Methods: A meta-analysis of existing randomized controlled clinical trials (RCTs) was conducted. The eligible RCTs were selected through Embase, PubMed and Cochrane Central Register of Controlled Trials and manual retrieval from the earliest records to March 15, 2020 to extract data. The overall effect size of plaque index (PI), gingival index (GI), attachment loss (AL), probing depth (PD) and bleeding on probing (BOP) were calculated by either a fixed or random-effect model, and subgroup analyses were conducted according to the different time points of follow-up. Cochrane Collaboration's tool was responsible for the evaluation of the literature quality and the inter-study heterogeneity was evaluated by Q test and I2 statistic. The authors applied sensitivity analysis for results with heterogeneity. Publication bias was determined by Begg's test, Egger's test and the trim-and-fill method.Results: Eight RCTs eventually met the inclusion criteria for the study. The overall outcomes concerned PI, GI, PD, Al and BOP were 0.42(95% CI 0.02, 0.81), 0.03(95% CI -0.03, 0.10),-0.06mm (95% CI -0.18, 0.06), 0.16mm (95% CI-0.03, 0.36) and 4.15(95% CI -0.26, 8.55), respectively. In subgroup analysis, a larger BOP reduction at 3 months, PI and AL reduction at 6 months were observed in patients with RA and periodontitis group. The results of sensitivity analyses had no significant effect. No evidence of potential publication bias was tested.Conclusions: The authors conclude that SRP is equally effective in patients with periodontitis and RA than in periodontitis ones. This result suggests RA does not affect the clinical efficacy of non-surgical periodontal therapy.

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Effects of music therapy on depression: A meta-analysis of randomized controlled trials

PLoS ONE ◽

10.1371/journal.pone.0240862 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0240862

Author(s):

Qishou Tang ◽

Zhaohui Huang ◽

Huan Zhou ◽

Peijie Ye

Keyword(s):

Depressive Symptom ◽

Music Therapy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Music Medicine ◽

Effect Model

Background We aimed to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect. Methods PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies evaluating the effectiveness of music-based intervention on depression from inception to May 2020. Standardized mean differences (SMDs) were estimated with random-effect model and fixed-effect model. Results A total of 55 RCTs were included in our meta-analysis. Music therapy exhibited a significant reduction in depressive symptom (SMD = −0.66; 95% CI = -0.86 to -0.46; P<0.001) compared with the control group; while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P<0.001). Among the specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P<0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P<0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P<0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively. Music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods. Conclusions A different effect of music therapy and music medicine on depression was observed in our present meta-analysis, and the effect might be affected by the therapy process.

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Cerebrospinal Fluid and Serum d-Serine Levels in Patients with Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9123840 ◽

2020 ◽

Vol 9 (12) ◽

pp. 3840

Author(s):

Chun-Hung Chang ◽

Hsiao-Lun Kuo ◽

Wei-Fen Ma ◽

Hsin-Chi Tsai

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebrospinal Fluid ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Cochrane Database

Objective: Alzheimer’s disease (AD) is a complex and severe neurodegenerative disease and still lacks effective methods of diagnosis. Dysfunction of the N-methyl-D-aspartate receptor (NMDAR) has been found to be involved in synapse dysfunction and neurotoxicity of AD mechanisms. d-Serine, an NMDAR receptor coagonist, is reported as a potential new biomarker for AD. However, the results of serum and cerebrospinal fluid (CSF) d-serine levels are conflicting. We conducted a meta-analysis to investigate the serum and CSF d-serine levels in patients with AD. Methods: We searched PubMed, the Cochrane central register of controlled trials, and the Cochrane database of systematic reviews for trials that measured d-serine levels both in patients with AD and in controls. We included controlled trials that analyzed d-serine levels in human samples (e.g., serum and CSF). Studies were pooled using a random-effect model for comparisons between AD and control group. We used effect size (ES; expressed as d-serine levels) in each selected meta-analysis to calculate standardized mean difference (SMD). Positive values indicated increased d-serine levels in AD group. We presented results with 95% confidence intervals (CIs). The heterogeneity of the included trials was evaluated through visually inspecting funnel plots and using the I2 statistic. Moderators of effects were explored using metaregression. Results: Seven trials with more than 1186 participants were included in this meta-analysis. d-serine levels in patients with AD were significantly higher than those in controls (SMD = 0.679, 95% CI = 0.335 to 1.022, p < 0.001). Subgroup analyses showed that the AD group had significantly higher d-serine levels in serum and CSF compared with the control group (SMD = 0.566 (serum) and 1.008 (CSF); 95% CI = 0.183 to 0.948 (serum) and 0.168 to 1.849 (CSF)). Moreover, a metaregression revealed a significant negative association between ES and mean mini-mental state examination score in AD group (slope = −0.1203, p = 0.0004). Conclusions: Our results revealed higher d-serine levels in the serum and CSF of patients with AD relative to the controls. Further studies with a larger sample size and longer follow-up are recommended to clarify this association.

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Clinical effects of piribedil in adjuvant treatment of Parkinson’s Disease: A meta-analysis

Open Medicine ◽

10.1515/med-2018-0041 ◽

2018 ◽

Vol 13 (1) ◽

pp. 270-277 ◽

Cited By ~ 3

Author(s):

Lu Peihua ◽

Wang Jianqin

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Efficacy ◽

Adjuvant Treatment ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Controlled Trials ◽

Clinical Effects ◽

Effect Model

AbstractObjective. To evaluate the clinical effects of piribedil in adjuvant treatment of Parkinson’s Disease (PD) by pooling previously openly published studies. Methods. The related electronic databases of Medline (1960~2017.5), Cochrane central register of controlled trials (CENTRAL), EMBASE (1980~2017.5) and Wanfang (1986~20175.5) were searched by two reviewers (Lu Peihua and Wang Jianqian) independently for publications including the topic of prospective randomized controlled trials about clinical effects of piribedil in adjuvant treatment of PD. The data of each included study was extracted and pooled by Stata11.0 software (for meta-analysis). The statistical heterogeneity across the studies was evaluated by I2 test and the publication bias was calculated by begg’s funnel plot and Egger’s line regression test. Results. After searching the related electronic databases of Medline, CENTRAL, EMBSE and Wanfang databases, 11 clinical studies were included in this meta-analysis. The pooled RR (random effect model) of clinical efficacy was 1.29 (95%CI:1.18~1.41, P=4×10-3) indicating the clinical efficacy of piribedil group was signficat higher than those of control group. The standard mean difference (SMD) for UPDRS score changed before and after treatment was pooled by random effect model. The combined SMD was -0.41 (95%CI:-0.75~-0.06). For piribedil related side effects, the combined data indicated that there was no statistical difference for nausea and vomiting (RR=0.43, 95%CI:0.41~1.69, P=0.61), mental disorders (RR=0.85, 95%CI:0.45~1.59, P=0.61) and other toxicities (RR=0.32, 95%CI:0.09~1.16, P=0.08). Conclusion. Piribedil combined with Levodopa in adjuvant treatment of PD is more effective than Levodopa alone without increasing the drug related toxicity.

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Effect of restrictive versus liberal red cell transfusion strategies on haemostasis: systematic review and meta-analysis

Thrombosis and Haemostasis ◽

10.1160/th17-01-0015 ◽

2017 ◽

Vol 117 (05) ◽

pp. 889-898 ◽

Cited By ~ 6

Author(s):

Katherine Colman ◽

Babette Prick ◽

Johannes Duvekot ◽

Connor Sweeney ◽

Ayodele Odutayo ◽

...

Keyword(s):

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Red Cells ◽

Controlled Trials ◽

Cochrane Central Register ◽

Red Cell ◽

Risk Of Bleeding ◽

Red Cell Transfusion ◽

Liberal Transfusion

SummaryRed cells play a key role in normal haemostasis in vitro but their importance clinically is less clear. The objective of this meta-analysis was to assess if correction of anaemia by transfusing red cells at a high haemoglobin threshold (liberal transfusion) is superior to transfusion at a lower haemoglobin threshold (restrictive transfusion) for reducing the risk of bleeding or thrombotic events. We searched for randomised controlled trials in any clinical setting that compared two red cell transfusion thresholds and investigated the risk of bleeding. We searched for studies published up to October 19, 2016 in The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Embase, and the Transfusion Evidence Library and ISI Web of Science. Relative risks (RR) or Peto Odds Ratios (pOR) were pooled using a random-effect model. Nineteen randomised trials with 9852 participants were eligible for inclusion in this review. Overall there was no difference in the risk of any bleeding between transfusion strategies (RR 0.91, 95 % confidence interval [CI] 0.74 to 1.12). The risk of severe or life-threatening bleeding was lower with a restrictive strategy (RR 0.75, 95 % CI 0.57 to 0.99). There was no difference in the risk of thrombotic events (RR 0.83, 95 % CI 0.61 to 1.13). The risk of any bleeding was not reduced with liberal transfusion and there was no overall difference in the risk of thrombotic events. Data from the included trials do not support aiming for a high haemoglobin threshold to improve haemostasis. PROSPERO registration number CRD42016035519.Supplementary Material to this article is available online at www.thrombosis-online.com.

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Suture choice to reduce occurrence of surgical site infection, hernia, wound dehiscence and sinus/fistula: a network meta-analysis

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0170 ◽

2019 ◽

Vol 101 (3) ◽

pp. 150-161 ◽

Cited By ~ 1

Author(s):

BE Zucker ◽

C Simillis ◽

P Tekkis ◽

C Kontovounisios

Keyword(s):

Surgical Site Infection ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Wound Dehiscence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Site Infection ◽

Suture Materials ◽

Absorbable Sutures

Background There are many options and little guiding evidence when choosing suture types with which to close the abdominal wall fascia. This network meta-analysis investigated the effect of suture materials on surgical site infection, hernia, wound dehiscence and sinus/fistula occurrence after abdominal surgery. The aim was to provide clarity on whether previous recommendations on suture choice could be followed with confidence. Methods and methods In February 2017, the Cochrane Central Register of Controlled Trials, Medline, EMBASE and Science Citation Index Expanded were searched for randomised controlled trials investigating the effect of suture choice on these four complications in closing the abdomen. A reference search of identified trials was performed. Prisma guidelines and the Cochrane risk of bias tool were followed in the data extraction and synthesis. Two review authors screened titles and abstracts of trials identified. A random effect model was used for the surgical site infection network based on the deviance information criterion statistics. Results Thirty-one trials were included (11,533 participants). No suture material reached the predetermined 90% probability threshold for determination of ‘best treatment’ for any outcome. Pairwise comparisons largely showed no differences between suture types for all outcomes measured. However, nylon demonstrated a reduction in the occurrence of incisional hernias with respect to two commonly used absorbable sutures: polyglycolic acid (odds ratio, OR 1.91; 95% confidence interval, CI, 1.01–3.63) and polyglyconate (OR 2.18; 95% CI 1.17–4.07). Conclusions No suture type can be considered the ‘best treatment’ for the prevention of surgical site infection, hernia, wound dehiscence and sinus/fistula occurrence.

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Periodontal therapy on disease activity of Rheumatoid Arthritis. Systematic review and meta-analysis

10.1101/2020.05.25.20111328 ◽

2020 ◽

Author(s):

Francisco Novillo ◽

Shuheng Lai ◽

Geovanna Cárdenas ◽

Francisca Verdugo ◽

Gabriel Rada

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Disease Activity ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Periodontal Therapy ◽

Controlled Trials ◽

Cochrane Central Register ◽

The Impact

AbstractObjectiveThe objective of this systematic review is to assess the impact of periodontal therapy on disease activity of patients with Rheumatoid ArthritisData SourcesWe will conduct a comprehensive search in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH) and grey literature, to identify all relevant randomized controlled trials regardless of language or publication status (published, unpublished, in press and in progress).Elegibility Criteria for Selecting Studies and MethodsWe will include randomised trials evaluating the effect of periodontal therapy on disease activity of rheumatoid arthritis. Two reviewers will independently screen each study for eligibility, data extraction, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome.Ethics and DisseminationNo ethics approval is considered necessary. The results of this review will be disseminated via peer-reviewed publications, social networks and traditional media.PROSPERO Registration IDCRD42020150286.

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Effect of janus kinase inhibitors and methotrexate combination on malignancy in patients with rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Autoimmunity Highlights ◽

10.1186/s13317-021-00153-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Vinod Solipuram ◽

Akhila Mohan ◽

Roshniben Patel ◽

Ruoning Ni

Keyword(s):

Rheumatoid Arthritis ◽

Combination Therapy ◽

Randomized Controlled Trials ◽

Random Effect ◽

Janus Kinase ◽

Controlled Trials ◽

Randomized Controlled ◽

Increased Risk ◽

Significant Difference ◽

Risk Of Malignancy

Abstract Background Rheumatoid arthritis (RA) is a systemic autoimmune disease. The combination therapy of methotrexate (MTX) and Janus kinase inhibitor (JAKi) is commonly used. Patients with RA are at increased risk of malignancy, however, it remains unclear whether the combination therapy is associated with a higher risk. Objective To assess the malignancy risk among patients with RA receiving combination therapy of JAKi and MTX compared to MTX alone. Methods PubMed, Cochrane and Embase were thoroughly searched for randomized controlled trials (RCTs) in patients with RA receiving JAKi and MTX, from inception to July 2020. Primary endpoints were malignancy events, Non melanomatous skin cancer (NMSC) and malignancy excluding NMSC and secondary endpoints were serious adverse events (SAE), deaths. Risk ratio (RR) and 95% CI were calculated using the Mantel–Haenszel random-effect method. Results 659 publications were screened and 13 RCTs with a total of 6911 patients were included in the analysis. There was no statistically significant difference in malignancy [RR = 1.42; 95% CI (0.59, 3.41)], neither NMSC [RR = 1.44 (0.36, 5.76)] nor malignancies excluding NMSC [RR = 1.12 (0.40, 3.13)]. No statistically significant difference between the two groups for SAE [RR = 1.15 (0.90, 1.47)] and deaths [RR = 1.99 (0.75, 5.27)] was found. Conclusion The adjunction of JAKi to MTX is not associated with an increased risk of malignancy when compared to MTX alone. There is no increased risk of SAE and deaths when compared to MTX alone in patients with RA.

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Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1093 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Giacchetta ◽

M Chiavarini ◽

G Naldini ◽

R Fabiani

Keyword(s):

Systematic Review ◽

Malignant Melanoma ◽

Publication Bias ◽

Oral Contraceptives ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cutaneous Malignant Melanoma ◽

Hormonal Factors ◽

Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

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Interventional radiology versus operative management for splenic injuries: a study protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-028172 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028172

Author(s):

Masahiro Kashiura ◽

Noritaka Yada ◽

Kazuma Yamakawa

Keyword(s):

Systematic Review ◽

Interventional Radiology ◽

Meta Analysis ◽

Operative Management ◽

Sensitivity Analyses ◽

Definitive Treatment ◽

Controlled Trials ◽

Cochrane Central Register ◽

Statistical Heterogeneity ◽

Non Operative Management

IntroductionOver the past decades, the treatment for blunt splenic injuries has shifted from operative to non-operative management. Interventional radiology such as splenic arterial embolisation generally increases the success rate of non-operative management. However, the type of intervention, such as the first definitive treatment for haemostasis (interventional radiology or surgery) in blunt splenic injuries is unclear. Therefore, we aim to clarify whether interventional radiology improves mortality in patients with blunt splenic trauma compared with operative management by conducting a systematic review and meta-analysis.Methods and analysisWe will search the following electronic bibliographic databases to retrieve relevant articles for the literature review: Medline, Embase and the Cochrane Central Register of Controlled Trials. We will include controlled trials and observational studies published until September 2018. We will screen search results, assess the study population, extract data and assess the risk of bias. Two review authors will extract data independently, and discrepancies will be identified and resolved through a discussion with a third author where necessary. Data from eligible studies will be pooled using a random-effects meta-analysis. Statistical heterogeneity will be assessed by using the Mantel-Haenszel χ² test and the I² statistic, and any observed heterogeneity will be quantified using the I² statistic. We will conduct sensitivity analyses according to several factors relevant for the heterogeneity.Ethics and disseminationOur study does not require ethical approval as it is based on the findings of previously published articles. This systematic review will provide guidance on selecting a method for haemostasis of splenic injuries and may also identify knowledge gaps that could direct further research in the field. Results will be disseminated through publication in a peer-reviewed journal and presentations at relevant conferences.PROSPERO registration numberCRD42018108304.

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