Longevidade de dentes tratados endodonticamente e restaurados com pinos metálicos e de fibra de vidro: uma revisão integrativa da literatura

OBJECTIVE: Review the literature in an integrative way, regarding a clinical longevity of endodontically treated teeth restored with fiberglass and metallic pins and with fixed crowns, based survival factors and failure mode. METHODOLOGY: A search was carried out in the Lilacs and Pubmed databases, with the following descriptors: dental restoration (dental restoration; restauración dental), dental pins (dental pins; pins dentales), clinical study (clinical study; estudio clínico). The inclusion criteria were: articles that addressed the variables of clinical longevity, survival rate and failure mode of metallic pins and fiberglass, in Portuguese, English and Spanish, published between 2010 and 2020, such as clinical trials with or without randomization and systematic reviews with or without meta-analysis. And, the exclusion criteria were: narrative literature reviews, clinical cases, in vitro and silico studies , letters to the editor and opinion articles. RESULTS: Combining the search methods, 06 articles were identified, of which 04 articles were randomized clinical trials and 02 articles were systematic reviews. The included studies show a high level of scientific evidence. FINAL CONSIDERATIONS: The present integrative literature review, regarding the clinical longevity of teeth endodontically treated and restored with metal and fiberglass pins, observed that the clinical results are still conflicting in relation to the factors of survival and failure mode. And that, the remaining coronary structure seems to be more important for the success of the rehabilitation than the material of the pin, however the supporting evidence is limited.

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A Systematic Review and Network Meta-Analysis on the Efficacy of Medications in the Treatment of Chronic Idiopathic Constipation in Japan

Gastroenterology Research and Practice ◽

10.1155/2021/5534687 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Atsushi Nakajima ◽

Ayako Shoji ◽

Kinya Kokubo ◽

Ataru Igarashi

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Bayesian Network ◽

Systematic Reviews ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Relative Efficacy ◽

Idiopathic Constipation ◽

Chronic Idiopathic Constipation ◽

Meta Analyses

Background. In the 2010s, medications with new mechanisms were introduced in Japan for the treatment of chronic idiopathic constipation (CIC). A few systematic reviews have compared medications’ relative efficacy, but the reviews included studies on patients from various races, even though the mechanism of CIC is considered to differ between races. The aim of this study was to use a systematic review and network meta-analysis to compare the relative efficacy of these medications in Japanese patients. Methods. We conducted a meta-analysis and report it here according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified studies by searching MEDLINE (via the PubMed interface) and the Cochrane Library and ICHUSHI databases and included randomized clinical trials that compared medications for CIC with placebo in Japanese adults. Two reviewers independently screened and assessed articles, abstracted data, and assessed the risk of bias. We pooled data by random-effects meta-analyses and also performed a Bayesian network meta-analysis to indirectly compare data. Results. The present systematic review and meta-analyses included 1460 patients in 6 randomized clinical trials: 2 on linaclotide, 3 on elobixibat, 2 on lubiprostone, and 1 on lactulose. The results of direct comparisons showed that linaclotide, elobixibat, and lubiprostone were superior to placebo in the change of spontaneous bowel movements (SBMs) within 1 week: linaclotide, 1.95 (95% CI, 1.51-2.39); elobixibat, 5.69 (95% CI, 3.31-8.07); and lubiprostone, 2.41 (95% CI, 0.82-4.01). The Bayesian network meta-analysis showed consistent results. Elobixibat 10 mg was ranked first for the increase in SBMs and complete SBMs within 1 week and the time to first SBM. Lubiprostone 48 μg was ranked first for the proportion of patients with SBM within 24 hours. Conclusion. Our direct and indirect meta-analyses revealed that the new CIC medications available in Japan have equal efficacy but that elobixibat and lubiprostone are highly likely to be more efficacious.

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Safety of Cerebrolysin for Neurorecovery after Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Twelve Randomized-Controlled Trials

Pharmaceuticals ◽

10.3390/ph14121297 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1297

Author(s):

Stefan Strilciuc ◽

László Vécsei ◽

Dana Boering ◽

Aleš Pražnikar ◽

Oliver Kaut ◽

...

Keyword(s):

Clinical Trials ◽

Ischemic Stroke ◽

Adverse Events ◽

Acute Ischemic Stroke ◽

Systematic Reviews ◽

Safety Profile ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Safety Information ◽

High Dose

We perforMed a systematic search and meta-analysis of available literature to determine the safety profile of Cerebrolysin in acute ischemic stroke, filling existing safety information gaps and inconsistent results. We searched EMBASE, PubMed, and Cochrane Databases of Systematic Reviews and Clinical Trials up to the end of February 2021. Data collection and analysis were conducted using methods described in the Cochrane Handbook for Systematic Reviews of Interventions. All safety outcomes were analyzed based on risk ratios (RR) and their 95% confidence intervals. The meta-analysis pooled 2202 patients from twelve randomized clinical trials, registering non-statistically significant (p > 0.05) differences between Cerebrolysin and placebo throughout main and subgroup analyses. The lowest rate of Serious Adverse Events (SAE), as compared to placebo, was observed for the highest dose of Cerebrolysin (50 mL), highlighting a moderate reduction (RR = 0.6). We observed a tendency of superiority of Cerebrolysin regarding SAE in high dose treatment courses for moderate-severe ischemic stroke, suggesting some effect of the agent against adverse events. This comprehensive safety meta-analysis confirms the safety profile for patients treated with Cerebrolysin after acute ischemic stroke, as compared to placebo.

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Safety of Cerebrolysin for Neurorecovery After Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Twelve Randomized-Controlled Trials

10.20944/preprints202109.0446.v2 ◽

2021 ◽

Author(s):

Stefan Strilciuc ◽

László Vécsei ◽

Dana Boering ◽

Aleš Pražnikar ◽

Oliver Kaut ◽

...

Keyword(s):

Clinical Trials ◽

Ischemic Stroke ◽

Adverse Events ◽

Acute Ischemic Stroke ◽

Systematic Reviews ◽

Safety Profile ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Safety Information ◽

High Dose

We performed a systematic search and meta-analysis of available literature to determine the safety profile of Cerebrolysin in acute ischemic stroke, filling existing safety information gaps and inconsistent results. We searched EMBASE, PubMed and Cochrane Databases of Systematic Reviews and Clinical Trials up to the end of February 2021. Data collection and analysis was conducted using methods described in the Cochrane Handbook for Systematic Reviews of Interventions. All safety outcomes were analyzed based on risk ratios (RR) and their 95% confidence intervals. The meta-analysis pooled 2202 patients from twelve randomized clinical trials, registering non-statistically significant (p>0.05) differences between Cerebrolysin and placebo throughout main and subgroup analyses. The lowest rate of Serious Adverse Events (SAE), as compared to placebo, was observed for the highest dose of Cerebrolysin (50 mL), highlighting a moderate reduction (RR = 0.6). We observed a tendency of superiority of Cerebrolysin regarding SAE in high dose treatment courses for moderate-severe ischemic stroke, suggesting some effect of the agent against adverse events. This comprehensive safety meta-analysis confirms the safety profile for patients treated with Cerebrolysin after acute ischemic stroke, as compared to placebo.

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Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab358 ◽

2021 ◽

Author(s):

Andrew Hill ◽

Anna Garratt ◽

Jacob Levi ◽

Jonathan Falconer ◽

Leah Ellis ◽

...

Keyword(s):

Clinical Trials ◽

Randomized Trials ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Severe Infection ◽

Viral Clearance ◽

Reactive Protein ◽

Wide Range ◽

High Concentrations

Abstract Ivermectin is an antiparasitic drug being investigated for repurposing against SARS-CoV-2. Ivermectin showed in-vitro activity against SARS-COV-2 at high concentrations. This meta-analysis investigated ivermectin in 24 randomized clinical trials (3328 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries. Ivermectin was associated with reduced inflammatory markers (C-Reactive Protein, d-dimer and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. In 11 randomized trials of moderate/severe infection, there was a 56% reduction in mortality (Relative Risk 0.44 [95%CI 0.25-0.77]; p=0.004; 35/1064 (3%) deaths on ivermectin; 93/1063 (9%) deaths in controls) with favorable clinical recovery and reduced hospitalization. Many studies included were not peer reviewed and a wide range of doses were evaluated. Currently, WHO recommends the use of ivermectin only inside clinical trials. A network of large clinical trials is in progress to validate the results seen to date.

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