scholarly journals Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

2020 ◽  
Author(s):  
yuhan xiao ◽  
Yichun Qin ◽  
Haiyang Yu
Keyword(s):  
Photodynamic Therapy ◽  
Meta Analysis ◽  
Cost Effective ◽  
Systemic Review ◽  
Cochrane Library ◽  
Enamel Matrix Derivative ◽  
Local Antibiotics ◽  
Significant Difference ◽  
Systemic Antibiotics

Abstract Background Peri-implant diseases are caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement (MD) with different adjunctive therapies has been applied in the treatment of peri-implant diseases. This systematic review aimed to deduce the optimal adjunctive therapy.Methods Two independent authors screened the literature using MEDLINE and Cochrane Library. Only clinical randomized controlled trials (RCTs) about adjunctive therapies for non-surgical treatment of peri-implant diseases were included in this review. Studies selected were published before February 2020. The clinical outcomes were compared in this meta-analysis.Results: A total of 31 RCTs met the inclusion criteria. The following adjunctive interventions were compared in the included studies: modification of the prosthesis; air abrasive; Er:YAG laser; diode laser; photodynamic therapy; local antibiotics; system antibiotics; probiotics; and enamel matrix derivative. Follow-up ranged from 3 months to 1 year. A statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). However, such a difference was not detected between MD with chlorhexidine and MD alone at 3 months follow-up ( P = 0.61), between MD with probiotics and MD alone ( P = 0.47), and between systemic antibiotics and MD alone ( P = 0.96).Conclusion Currently, the optimal non-surgical intervention is not known. Also, among the interventions with similar efficiency, that with fewer side effects, easy to use, and cost-effective is yet to be identified. Thus, well-designed RCTs with prolonged follow-ups to assess the accurate effectiveness of therapies are imperative.

scholarly journals Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

2020 ◽  
Author(s):  
yuhan xiao ◽  
Yichun Qin ◽  
Haiyang Yu
Keyword(s):  
Photodynamic Therapy ◽  
Meta Analysis ◽  
Cost Effective ◽  
Systemic Review ◽  
Cochrane Library ◽  
Enamel Matrix Derivative ◽  
Local Antibiotics ◽  
Significant Difference ◽  
Systemic Antibiotics

Abstract Background Peri-implant diseases are caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement (MD) with different adjunctive therapies has been applied in the treatment of peri-implant diseases. This systematic review aimed to deduce the optimal adjunctive therapy. Methods Two independent authors screened the literature using MEDLINE and Cochrane Library. Only clinical randomized controlled trials (RCTs) about adjunctive therapies for non-surgical treatment of peri-implant diseases were included in this review. Studies selected were published before February 2020. The clinical outcomes were compared in this meta-analysis. Results: A total of 31 RCTs met the inclusion criteria. The following adjunctive interventions were compared in the included studies: modification of the prosthesis; air abrasive; Er:YAG laser; diode laser; photodynamic therapy; local antibiotics; system antibiotics; probiotics; and enamel matrix derivative. Follow-up ranged from 3 months to 1 year. A statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). However, such a difference was not detected between MD with chlorhexidine and MD alone at 3 months follow-up ( P = 0.61), between MD with probiotics and MD alone ( P = 0.47), and between systemic antibiotics and MD alone ( P = 0.96). Conclusion Currently, the optimal non-surgical intervention is not known. Also, among the interventions with similar efficiency, that with fewer side effects, easy to use, and cost-effective is yet to be identified. Thus, well-designed RCTs with prolonged follow-ups to assess the accurate effectiveness of therapies are imperative.

scholarly journals Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

2020 ◽  
Author(s):  
yuhan xiao ◽  
Yichun Qin ◽  
Haiyang Yu
Keyword(s):  
Photodynamic Therapy ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Enamel Matrix Derivative ◽  
Local Antibiotics ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Systemic Antibiotics

Abstract Background Peri-implant diseases are caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE and Cochrane Library. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of experimental peri-implant mucositis with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before February 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of thirty-one RCTs met the inclusion criteria. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; Er:YAG laser; diode laser; photodynamic therapy; local antibiotics; system antibiotics; probiotics; enamel matrix derivative. Follow-up ranged from 3 months to 1 years. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up (P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone at 3 months follow-up (P = 0.61), so is MD with probiotics and MD alone (P = 0.47), and so is systemic antibiotics and MD alone (P = 0.96). Conclusion.At present, we do not know which non-surgical intervention is superior to any other, and for the interventions having similar degrees of effectiveness we do not know which one has less side effects, is simpler and cheaper to use. It is necessary to conduct well-designed RCTs with longer follow-ups to assess the accurate effectiveness of therapies.

scholarly journals Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

2020 ◽  
Author(s):  
yuhan xiao ◽  
Yichun Qin ◽  
Haiyang Yu
Keyword(s):  
Photodynamic Therapy ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Local Antibiotics ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Systemic Antibiotics ◽  
Non Surgical Treatment

Abstract Background Peri-implant diseases are mainly caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE, Cochrane Library and Science Direct. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of peri-implant diseases with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before June 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of eighteen RCTs met the inclusion criteria, of which 13 articles were included in the meta-analysis. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; photodynamic therapy; local antibiotics; systemic antibiotics; probiotics. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone in the treatment of peri-implant diseases at 3 months follow-up ( P = 0.84), so is MD with probiotics and MD alone ( P = 0.96), and so is systemic antibiotics and MD alone ( P = 0.47). Conclusion. MD adjunct with PDT is an effective treatment for peri-implant mucositis. However, there is still no effective non-surgical treatment for peri-implantitis.

Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 372-381
Author(s):  
Junhong Wang ◽  
Hua Zhang ◽  
Zongxuan Zhao ◽  
Kaifeng Wen ◽  
Yaoke Xu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Significant Difference ◽  
Bystander Cardiopulmonary Resuscitation ◽  
The Impact ◽  
Hospital Cardiac Arrest

AbstractObjective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

scholarly journals Partial Versus Total Omentectomy in Patients with Gastric Cancer: A Systemic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4971
Author(s):  
Shion Wei Chai ◽  
Suo-Hsien Wang ◽  
Chih-Yuan Wang ◽  
Yi-Chan Chen ◽  
Ruey-Shyang Soong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Systemic Review ◽  
Cochrane Library ◽  
Free Survival ◽  
Significant Difference ◽  
Hospital Stays ◽  
Disease Free

Background: Surgical treatment is the key to cure localized gastric cancer. There is no strong evidence that supports the value of omentectomy. Thus, a meta-analysis was conducted to compare the safety and efficiency of partial and total omentectomy in patients with gastric cancer. Methods: PubMed, Embase, and Cochrane Library databases were searched. All studies that compared total and partial omentectomy as treatments for gastric cancer were included. The primary outcomes were patients’ overall survival and disease-free survival, while the secondary outcomes were perioperative outcome and postoperative complications. Results: A total of nine studies were examined, wherein 1043 patients were included in the partial omentectomy group, and 1995 in the total omentectomy group. The partial omentectomy group was associated with better overall survival (hazard ratio: 0.80, 95% CI: 0.66 to 0.98, p = 0.04, I2 = 0%), shorter operative time, and lesser blood loss than the total omentectomy group. In addition, no statistically significant difference was observed in the number of dissected lymph nodes, length of hospital stays, complication rate, and disease-free survival. Conclusions: Our results show that, compared with total omentectomy in gastric cancer surgery, partial omentectomy had non-inferior oncological outcomes and comparable safety outcomes.

scholarly journals Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan Chen ◽  
Xinlei Chen ◽  
Yali Zhang ◽  
Fangjie Zhou ◽  
Jiaxin Deng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Mineral Trioxide Aggregate ◽  
Systemic Review ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Success Rates ◽  
The Cochrane Library

Abstract Background Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. Methods Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. Results Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. Conclusions Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

P563Hemoptysis after cryoablation for atrial fibrillation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
N Kumar ◽  
I Aksoy
Keyword(s):  
Atrial Fibrillation ◽  
Meta Analysis ◽  
Pulmonary Veins ◽  
Systemic Review ◽  
Cochrane Library ◽  
Cryoballoon Ablation ◽  
The Mean ◽  
Lower Temperature ◽  
Severe Type

Abstract Aim Cryoballoon is a widely used tool for ablation for atrial fibrillation (AF). There are several complications after cryoablation. This paper assesses the incidence rate and severity of hemoptysis after cryo ablation for AF. Methods For current systemic review and meta-analysis, literature has been reviewed from 2008 to 2019 focusing on the incidence of hemoptysis after cryoballoon ablation for atrial fibrillation catheter ablation in PubMed, Cochrane library and EMBASE databases. Results This meta-analysis included 3534 patients from 20 studies; of mean age 54.0 ± 10.9 years. All patients had cryoballoon ablation for paroxysmal or persistent AF refractory to treatment and follow up duration for 8.2 ± 5.9 months with mean procedure duration of 153.4± 65.4 minutes. The mean cryoablation duration was 869.4 ± 148 sec with mean temperature of -59.7 ± 5.1 °C and a total of 109 patients (3.08%) had hemoptysis which was mild in the majority of cases (76.1%), mild to moderate in 20.2% and severe in only 3.7%.  Hemoptysis onset was at 29.0 ± 56.5 day with median of 7 days, range (2 hours to 210 days). In 11 studies hemoptysis occurred early in 51 patients (95% CI for I2 was 0.0% to 0.0, P =0.95, I2 was 0.0%), but in 9 studies, hemoptysis occurred late in 58 patients (95% CI for I2 was 0.0% to 0.0, P =0.96, I2 was 0.0%). Conclusion Mild hemoptysis is experienced by significant number of cryoballoon AF ablation patients and severe type in 3.5 % attributed to significantly lower temperature in inferior pulmonary veins and is more often associated with bigger cryoballoon. Abstract Figure. Overview of the manuscripts selection

Impact of spontaneous hepatocellular carcinoma rupture on surgical outcome after liver resection: a systemic review and meta-analysis

2020 ◽  
Author(s):  
Wei Zhang ◽  
Zhi-Yong Huang ◽  
Chang Shu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Recurrence Rate ◽  
Surgical Outcome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Tumor Rupture ◽  
Significant Difference ◽  
The Impact

Abstract Background Spontaneous tumor rupture is a rare but life-threatening complication of hepatocellular carcinoma (HCC). The impact of spontaneous ruptured HCC on long-term survival after liver resection (LR) remains unclear. Our aim was to compare the surgical outcome in patients who underwent LR with ruptured and non-ruptured HCC . Methods A comprehensive search using PubMed, Embase, Cochrane Library and Science Citation Index Expanded databases was performed. The primary outcomes were the hazard ratio (HR) for overall survival ( OS) and disease free survival (DFS). The secondary outcomes included morbidity, hospital mortality and recurrence rate . Results Ten retrospective studies including 3222 patients met the inclusion criteria. Pooled analysis revealed a significantly poorer OS and DFS for patients with ruptured HCC compared to patients with non-ruptured HCC (HR, 2.02; 95% CI, 1.61-2.54; P< 0.00001 and HR, 1.92; 95% CI, 1.56-2.35; P<0.00001, respectively). In the subgroup analysis, both the propensity score matching (PSM) and non-PSM studies demonstrated a significantly poorer OS in the ruptured HCC group (P=0.02 and P<0.00001, respectively). However, meta-analysis of two PSM studies showed that there was not significant difference in the DFS between the two groups (P=0.50). Patients in the ruptured HCC group had a higher mortality and recurrence rate than the non-ruptured HCC group, but the difference was not significant (P = 0.05 and P = 0.06, respectively) Conclusions Surgical outcomes of the patients with the ruptured or non-ruptured HCC undergoing LR were not only affected by tumor rupture itself, but also by the tumor characteristics and liver functional status. Therefore, classifying all ruptured but resectable HCC as T4 stage is unable to accurately represent their true prognosis.

Abstract 1122‐000132: Fuoxetine for Recovery After Stroke: A Pooled Analysis of 7165 Patients

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Mohamed Fahmy Doheim ◽  
Ahmed Elsnhory ◽  
Mohammed Elgammal ◽  
Abdulrahman Ibrahim Hagrass ◽  
Ahmed Hanbal ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Stroke Patients ◽  
Permanent Disability ◽  
Safety And Efficacy ◽  
Nihss Score ◽  
Significant Difference

Introduction : Stroke is one of the predominant causes of permanent disability, mortality, significant cognitive, physical, and psychosocial morbidity in the world. We conducted this systematic review and meta‐analysis to assess the safety and efficacy of fluoxetine for recovery stroke patients through different time points of follow up. Methods : We searched in PubMed, Cochrane Library, Scopus, and Web of Science databases/ search engines until June 2021. Mean difference (MD) with 95% confidence interval (CI) was applied for continuous data, while risk ratio (RR) with 95% CI was used for dichotomous data. Results : Seventeen randomized clinical trials were identified which assessed the safety and efficacy of fluoxetine compared to placebo for stroke patients. Fluoxetine enhances the National Institutes of Health Stroke Scale (NIHSS) score [MD = ‐0.67, 95 % CI (‐1.19 to ‐0.15), P = 0.01] and the Fugl‐Meyer Motor Scale (FMMS) score [MD = 17.36, 95 % CI (12.12 to 22.61), P <0.00001] at three months follow up. However, the NIHSS score showed no significant difference between the two groups at two weeks [MD = ‐0.32, 95% CI (‐0.72 to 0.07), p = 0.11] or at six months [MD = ‐0.17,95% CI (‐0.47 to 0.14), p = 0.29]. Fluoxetine and placebo‐treated patients had the same overall impact on FMMS scores at one month [MD = 7.77, 95 % CI (‐10.57 to 26.11), P = 0.41]. The fluoxetine arm had a higher risk of broken bone (RR = 2.30, 95% CI [1.59, 3.32], p < 0.001) and hyponatremia (RR = 2.12, 95% CI [1.19, 3.76], p = 0.01) with lower risk of new depression (RR = 0.72, 95% CI [0.61, 0.84], p< 0.001) in comparison to the placebo arm. Conclusions : The efficacy of fluoxetine is likely to take time to emerge, and is expected to be transient. The use of fluoxetine increased the incidence of hyponatremia and bone fractures while decreasing the risk of new‐onset depression.

scholarly journals How to Choose Platelet-Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis in Overweight or Obese Patients: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Pan Luo ◽  
Zhencheng Xiong ◽  
Wei Sun ◽  
Lijun Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Obese Patients ◽  
Knee Oa ◽  
Significant Difference ◽  
Better Than

Objective. The purpose of this meta-analysis was to determine whether platelet-rich plasma (PRP) was better than hyaluronic acid (HA) for the treatment of knee osteoarthritis (OA) in overweight or obese patients. Design. Two reviewers independently used the keywords combined with free words to search English-based electronic databases according to Cochrane Collaboration guidelines, such as PubMed, Embase, ScienceDirect, and Cochrane library. The pooled data were analyzed using RevMan 5.3. Results. Ten randomized controlled trials (RCTs) with 1096 patients were included. During the first two months of follow-up, there was no significant difference between the two groups. At the 3rd, 6th, and 12th months of follow-up, the pooled analysis showed that PRP was better than HA for the treatment of knee OA in overweight or obese patients. There were significant differences between the two groups at Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (3 months: MD = −1.35, [95% CI: −2.19 to −0.50], P=0.002, I2 = 0%; 6 months: MD = −7.62, [95% CI: −13.51 to −1.72], P=0.01, I2 = 88%; 12 months: MD = −12.11, [95% CI: −20.21 to −4.01], P=0.003, I2 = 94%). Conclusions. For overweight or obese patients with knee OA, intra-articular injection of PRP in a short time was not necessarily superior to HA, but long-term use was better than HA in pain and functional relief.

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