scholarly journals Periodontal effects of maxillary expansion in adults using non-surgical expanders with skeletal anchorage vs. surgically assisted maxillary expansion: a systematic review

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
José Antonio Vidalón ◽  
Ismael Loú-Gómez ◽  
Aldo Quiñe ◽  
Karla T. Diaz ◽  
Carlos Liñan Duran ◽  
...  
Keyword(s):  
Randomized Trials ◽  
Grey Literature ◽  
Extraction Process ◽  
Current Evidence ◽  
Skeletal Anchorage ◽  
Maxillary Expansion ◽  
Different Types ◽  
Process Risk ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Abstract Objectives Describe and compare harmful periodontal effects as a consequence of maxillary expansion in adult patients with different types of anchorage devices in non-surgical expanders with skeletal anchorage and surgically assisted maxillary expansion. Materials and methods An exhaustive search was carried out on the electronic databases PubMed (MEDLINE), Embase, Cochrane and LILACS. Additionally, journal references and grey literature were searched without any restrictions. After the selection and extraction process; risk of bias was assessed by the ROB-1 Cochrane tool and Newcastle-Ottawa Scale (NOS) for randomized trials and cohort studies, respectively. Results Of 621 studies retrieved from the searches, six were finally included in this review. One of them presented a low risk bias, while five were excellent respective to selection, comparability and outcomes. Results showed that maxillary expansion in adults using non-surgical expanders (bone-borne or tooth-bone-borne with bicortical skeletal anchorage) produce less harmful periodontal effects, such as: alveolar bending with an average range from 0.92° to 2.32°, compared to surgically assisted maxillary expansion (tooth-borne) of 6.4°; dental inclination with an average range from 0.07° to 2.4°, compared to surgically assisted maxillary expansion (tooth-borne) with a range from 2.01° to 5.56°. Conclusions Although limited, the current evidence seems to show that the bone-borne or tooth-bone-borne with bicortical skeletal anchorage produces fewer undesirable periodontal effects.

scholarly journals Prevalence of Dental Caries among Children of Aged 6-12 Years in Tamilnadu - A Systematic Review

2021 ◽  
Vol 6 (4) ◽  
pp. 177-185
Author(s):  
Suganya. P ◽  
Rajmohan. M ◽  
Bharathwaj. V. V
Keyword(s):  
Systematic Review ◽  
Dental Caries ◽  
Literature Search ◽  
Grey Literature ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Extensive Literature ◽  
High Prevalence ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background: Dental caries is a serious public health problem in developed as well as developing nations, with high prevalence among children around the world. This systematic review of literature was undertaken to document the prevalence of dental caries. Aims and Objectives: This study aims to evaluate the prevalence of dental caries among children of aged 6-12 years in Tamilnadu by conducting a systematic review. Materials and Method: Studies evaluating the prevalence of dental caries among children of aged 6-12 years in the Tamilnadu were investigated. An extensive literature search was done in the following databases: Prospero, Grey literature, Science Direct, Cochrane library, Wiley online library, Lilacs and PubMed. The articles were retrieved from each database based on the MeSH representation. A modified version of the Newcastle-Ottawa Scale for cross-sectional studies was used for assessment of the quality of the studies. A systematic literature search yielded 1034 publications from the various databases searched. According to the Preferred Reporting Items for systematic Reviews and Meta-Analyses and based on the inclusion and exclusion criteria, the final number of included studies was fifteen. Results: Among the included studies, five studies were carried out in the Chennai district. Erode district was found to have the highest prevalence of dental caries at 89.3%. Conclusion: This review has reported a high prevalence of dental caries in Tamilnadu. None of the states reported prevalence below 30%. The government should identify dental caries as a national priority which requires significant attention. Keywords: Dental caries, Prevalence, Tamilnadu, Newcastle-Ottawa Scale.

scholarly journals Chloroquine and Hydroxychloroquine for the treatment of COVID-19: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Arunmozhimaran Elavarasi ◽  
Manya Prasad ◽  
Tulika Seth ◽  
Ranjit Kumar Sahoo ◽  
Karan Madan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Efficacy And Safety ◽  
Quality Of Evidence ◽  
Newcastle Ottawa Scale ◽  
Ecg Abnormalities ◽  
Ottawa Scale

Background: There is no effective therapy for COVID-19. Hydroxychloroquine (HCQ) and chloroquine (CQ) have been used for its treatment but their safety and efficacy remain uncertain. Objective: We performed a systematic review to synthesize the available data on the efficacy and safety of CQ and HCQ for the treatment of COVID-19. Methods: Two reviewers searched for published and pre-published relevant articles between December 2019 to 8th June 2020. The data from the selected studies were abstracted and analyzed for efficacy and safety outcomes. Critical appraisal of the evidence was done by Cochrane risk of bias tool and Newcastle Ottawa scale. The quality of evidence was graded as per the GRADE approach. Results: We reviewed 12 observational and 3 randomized trials which included 10659 patients of whom 5713 received CQ/HCQ and 4966 received only standard of care. The efficacy of CQ/HCQ for COVID-19 was inconsistent across the studies. Meta-analysis of included studies revealed no significant reduction in mortality with HCQ use [RR 0.98 95% CI 0.66-1.46] , time to fever resolution [mean difference -0.54 days (-1.19-011)] or clinical deterioration/development of ARDS with HCQ [RR 0.90 95% CI 0.47-1.71]. There was a higher risk of ECG abnormalities/arrhythmia with HCQ/CQ [RR 1.46 95% CI 1.04 to 2.06]. The quality of evidence was graded as very low for these outcomes. Conclusions: The available evidence suggests that CQ or HCQ does not improve clinical outcomes in COVID-19. Well-designed randomized trials are required for assessing the efficacy and safety of HCQ and CQ for COVID-19.

scholarly journals Surgical margins for borderline and malignant phyllodes tumours

2020 ◽  
Vol 102 (3) ◽  
pp. 165-173 ◽  
Author(s):  
A Thind ◽  
B Patel ◽  
K Thind ◽  
J Isherwood ◽  
B Phillips ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Distant Metastasis ◽  
Breast Conservation ◽  
Current Evidence ◽  
Malignant Tumours ◽  
Recurrence Rates ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
Phyllodes Tumours ◽  
Ottawa Scale

Background Phyllodes tumours represent less than 1% of all UK breast neoplasms. Histological features allow classification into benign, borderline or malignant, which has a significant impact on prognosis and recurrence. Currently, there is no consensus for the optimal surgical excision margin. This systematic review aims to provide a comparative summary of outcomes (local recurrence, metastasis and survival) for borderline and malignant phyllodes tumours resected with either ≥1cm or <1cm margins. Methods MEDLINE and Embase were systematically searched (1990 to July 2019), in line with PRISMA guidelines. Study quality was assessed using the Newcastle–Ottawa scale. Results Ten retrospective studies were included (Newcastle–Ottawa scale mean score: 5.6, range: 8–4). Nine reported local recurrence rates, four reported distant metastasis and four reported survival. Meta-analysis pooling demonstrated no statistically significant difference between <1cm and ≥1cm margins in terms of local recurrence rates (relative risk [RR] 1.43, 95% confidence interval [95% CI] 0.70 – 2.93; p=0.33, n=456), distant metastasis (RR 1.93, 95% CI 0.35 – 10.63; p=0.45, n=72) or mortality (RR 1.93, 95% CI 0.42 – 8.77; p=0.40, n=58) for borderline and malignant tumours. Additionally, two studies demonstrated no significant difference in local recurrence for borderline tumours excised with <0.1cm margins compared to ≥1cm. Conclusion Current evidence suggests that margins <1cm may provide adequate tumour excision. This could enable breast conservation in patients with smaller breast-to-tumour volume ratios, with improved cosmetic outcomes and patient satisfaction. A prospective, multi-institutional trial would be appropriate to further elucidate the safety of smaller margins.

scholarly journals Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients: a meta-analysis

2020 ◽  
Author(s):  
Daniel Martin Simadibrata ◽  
Julius Calvin ◽  
Alya Darin Wijaya ◽  
Naufal Arkan Abiyyu Ibrahim
Keyword(s):  
Regression Analysis ◽  
Inflammatory Marker ◽  
Meta Analysis ◽  
Grey Literature ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Newcastle Ottawa Scale ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Ottawa Scale

The neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, was suggested to be predictive of severity and mortality in COVID-19 patients, thus allowing early risk stratification. In this study, we investigated whether NLR levels on admission could predict the severity and mortality of COVID-19 patients. A literature search was conducted on 23 July 2020 to retrieve all published articles, including grey literature and preprints, investigating the association between on-admission NLR values and severity or mortality in COVID-19 patients. The risk of bias was assessed using the Newcastle Ottawa Scale (NOS). A meta-analysis was performed to determine the overall standardized mean difference (SMD) in NLR values and the pooled risk ratio (RR) for severity and mortality with the 95% Confidence Interval (95%CI). Meta-regression analysis was done to identify potential confounders. A total of 38 articles, including 5699 patients with severity outcomes and 6033 patients with mortality outcomes, were included. The meta-analysis showed that severe and non-survivors of COVID-19 had higher on-admission NLR levels than non-severe and survivors (SMD 0.88; 95%CI 0.72-1.04; I2=75% and 1.68; 95%CI 0.98-2.39; I2=99%, respectively). Regardless of the different NLR cut-off values, the pooled mortality RR in patients with elevated vs. normal NLR levels was 2.75 (95%CI 0.97-7.72). Meta-regression analysis showed that the association between NLR levels on admission and COVID-19 severity and mortality was unaffected by age (p=0.236; p=0.213, respectively). High NLR levels on admission were associated with severe COVID-19 and mortality. Further studies need to focus on determining the optimal cut-off value for NLR before clinical use.

Evaluation of Resistant Starch Quality from Different Types of Banana in Batter Coating Formulation to Reduce Oil Absorption in Fried Food

2019 ◽  
Vol 2 (2) ◽  
pp. 115-120
Author(s):  
Karissha Fritzi Della ◽  
Mutiara Pratiwi ◽  
Purwa Tri Cahyana ◽  
Maria DPT Gunawan-Puteri
Keyword(s):  
Resistant Starch ◽  
Extraction Process ◽  
Fat Content ◽  
Water Retention Capacity ◽  
Oil Absorption ◽  
Retention Capacity ◽  
Fried Food ◽  
Musa Paradisiaca ◽  
Different Types ◽  
Coating Formulation

Fried food is convenient for many people due to its pleasant texture and taste. On the other hand, it comes with the risk of high oil absorption which might lead to certain health problems. Resistant starch (RS) has been known to have a functionality of reducing oil absorption. Three different types of banana: Kepok (Musa paradisiaca formatypica), Raja Bulu (Musa paradisiaca L.) and Ambon (Musa paradisiaca L. var sapientum) were evaluated on its performance when utilized as source of resistant starch especially on their application in reducing oil absorption in fried food. Tempeh was used as the food model. Banana starch (RS2) was isolated through water alkaline extraction process, continued with modification process through three repeated cycles of autoclaving-cooling process to obtain the RS3. RS3 was added into the batter coating formulation at three substitution ratios (10%, 30% and 50%) and then used to coat tempeh before frying. Evaluation of resistant starch in batter and battered productwas conducted on the following parameters: fat content, water retention capacity (WRC), coating pick up and sensory analysis. The result of this study revealed that Raja Bulu showed the most effective result on reducing oil absorption in the food tested. In the three bananas used, the ratio of 50% performed best in coating pick up (highest), WRC (highest) and fat content(lowest) parameters, but not significantly different with the 30% ratio. In terms of sensory acceptance, using Raja Bulu as the selected banana type, 30% of substitution ratio was significantly more preferable by the panelists in crispness, oiliness, and overall acceptance attributes compared to control and other substitution ratios.

Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
High Altitude ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

Hydroxychloroquine prophylaxis for preeclampsia, hypertension and prematurity in pregnant patients with systemic lupus erythematosus: A meta-analysis

Lupus ◽  
2021 ◽  
pp. 096120332110071
Author(s):  
Jiaoniu Duan ◽  
Dan Ma ◽  
Xiaoting Wen ◽  
Qianyu Guo ◽  
Jinfang Gao ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
English Language ◽  
Gestational Hypertension ◽  
Meta Analysis ◽  
Fetal Outcomes ◽  
Pregnancy Hypertension ◽  
Cochrane Database ◽  
Newcastle Ottawa Scale ◽  
Prospective Cohorts ◽  
Ottawa Scale

Objectives This meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE. Methods A literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases’ inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ− group). Two investigators extracted the data and assessed the quality using the Newcastle-Ottawa Scale (NOS) and GRADE criteria independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. All statistical analyses were conducted using the Stata 12.0 software. Results Nine studies involving 1132 pregnancies were included in the study (3 case controls, 2 prospective cohorts, 4 retrospective cohorts). Preeclampsia, gestational hypertension, and prematurity were significantly lower in the HCQ+ group than in the HCQ− group (OR 0.35, 95% CI 0.21–0.59), (OR 0.41, 95% CI 0.19–0.89) and (OR 0.55, 95% CI 0.36–0.86), respectively. There were no significant differences in the rates of HELLP Syndrome (OR 0.88, 95% CI 0.19–3.96), gestational diabetes (OR 2.3, 95% CI 0.44–12.12), thrombotic events (OR 0.26, 95% CI 0.05–1.51), spontaneous abortion (OR 1.77, 95% CI 0.96–3.26), premature rupture of membranes (OR 0.58, 95% CI 0.24–1.39), oligohydramnios (OR 0.90, 95% CI 0.38–2.14), live birth (OR 1.22, 95% CI 0.60–2.47), stillbirth (OR 1.00, 95% CI 0.50–2.00), congenital malformation (OR 0.53, 95% CI 0.14–2.04), low birth weight (OR 0.77, 95% CI 0.43–1.39), intrauterine distress (OR 1.07, 95% CI 0.41–2.76,), intrauterine growth restriction (OR 0.57, 95% CI 0.06–5.43), or five-minute APGAR score <7 (OR 0.72, 95% CI 0.20–2.58) between the two groups. Conclusions HCQ treatment during pregnancy could reduce the risk of preeclampsia, pregnancy hypertension and prematurity in SLE patients. The certainty of evidence is high but majority of the studies included are retrospective studies and not randomized controlled trials. Therefore, the multidisciplinary management of pregnant patients with SLE should promote HCQ use, irrespective of disease activity or severity.

scholarly journals Safety of Systemic Medications Among Older Adults With Psoriasis and Atopic Dermatitis: A Systematic Review of Observational Studies

2021 ◽  
pp. 120347542199377
Author(s):  
Evan Tang ◽  
Talha Maqbool ◽  
Megan Lam ◽  
Gaelen P. Adam ◽  
Mina Tadrous ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Atopic Dermatitis ◽  
Observational Studies ◽  
Relative Effect ◽  
Emergency Department Visits ◽  
Major Cardiovascular Events ◽  
Quantitative Synthesis ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background Psoriasis and atopic dermatitis are common among older adults (≥65 years old), but clinical trials often exclude that population. Objective To synthesize evidence from observational studies on the safety of systemic therapies (conventional or biologic) for psoriasis and atopic dermatitis among older adults in a systematic review. Methods We searched MEDLINE and EMBASE (inception to October 31, 2019) and included observational studies reporting adverse events among older people treated with systemic therapy for psoriasis or atopic dermatitis. Outcomes were death, hospitalization, emergency department visits, infections, major cardiovascular events, renal toxicity, hepatotoxicity, and cytopenias. We assessed study quality using the Newcastle-Ottawa Scale. Results We included 22 studies on treatment for psoriasis and 2 for atopic dermatitis. Most studies were small and non-comparative and 20 of 24 were low quality. Studies comparing safety between medications or medication classes or between older and younger adults did not show apparent differences but had wide confidence intervals around relative effect estimates. Heterogeneity of study design and reporting precluded quantitative synthesis. Conclusions There is scant evidence on the safety of conventional systemic and biologic medications for older adults with psoriasis or atopic dermatitis; older adults and their clinicians should be aware of this evidence gap.

scholarly journals Effects of Polyphenol Intake on Metabolic Syndrome: Current Evidences from Human Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-18 ◽  
Author(s):  
Gemma Chiva-Blanch ◽  
Lina Badimon
Keyword(s):  
Metabolic Syndrome ◽  
Type Ii Diabetes ◽  
Randomized Trials ◽  
Virgin Olive Oil ◽  
Epidemiological Studies ◽  
Current Evidence ◽  
Aromatic Plants ◽  
Polyphenol Intake ◽  
Public Health Strategies

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors which severely increases the risk of type II diabetes and cardiovascular disease. Several epidemiological studies have observed a negative association between polyphenol intake and MetS rates. Nevertheless, there are relatively small numbers of interventional studies evidencing this association. This review is focused on human interventional trials with polyphenols as polyphenol-rich foods and dietary patterns rich in polyphenols in patients with MetS. Current evidence suggests that polyphenol intake has the potential to alleviate MetS components by decreasing body weight, blood pressure, and blood glucose and by improving lipid metabolism. Therefore, high intake of polyphenol-rich foods such as nuts, fruits, vegetables, seasoning with aromatic plants, spices, and virgin olive oil may be the cornerstone of a healthy diet preventing the development and progression of MetS, although there is no polyphenol or polyphenol-rich food able to influence all MetS features. However, inconsistent results have been found in different trials, and more long-term randomized trials are warranted to develop public health strategies to decrease MetS rates.

The promise of Telemedicine in Pakistan: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Syed Sarosh Mahdi ◽  
Franceso Amenta ◽  
Raheel Allana ◽  
Gopi Battineni 3rd ◽  
Tamsal Khalid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rural Areas ◽  
Urban Region ◽  
Middle Income ◽  
Web Based ◽  
Study Characteristics ◽  
Implementation Costs ◽  
Newcastle Ottawa Scale ◽  
Good Support ◽  
Ottawa Scale

BACKGROUND Telemedicine is a medical practice of assisting remote patients and it has great potential in developing countries like Pakistan. Telemedicine solves the logistical barriers, deliver good support to weak health systems and unite worldwide networks of healthcare personals. Because of high implementation costs, yet it is not possible to adopt telehealth systems for low and middle-income nations. OBJECTIVE In this systematic review, we aim to present an update revision of region-based telemedical services in Pakistan. METHODS Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE) and Google Scholar were used for document search. Newcastle Ottawa Scale (NOS) is adopted to conduct study quality. Majority of the studies (n-8) included in the review were of high quality as assessed through the Newcastle Ottawa scale. Selected study characteristics further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation and outcomes. RESULTS Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Majority of studies produced evidence on telehealth interventions by smartphone services like SMS, apps and web-based telemedicine. CONCLUSIONS Telehealth interventions like mHealth, eHealth, telemedicine, and telepharmacy are starting to evaluate for the last two decades but certainly needs to become an integral part of Pakistan's current health infrastructure.

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