scholarly journals Activation and installation of orthodontic appliances temporarily impairs mastication: A systematic review with meta-analysis

2021 ◽  
Author(s):  
Laís Duarte ◽  
Adriana Pinto Bezerra ◽  
Carlos Flores-Mir ◽  
Graziela De Luca Canto ◽  
Luciano José Pereira ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Bite Force ◽  
Orthodontic Appliances ◽  
Masticatory Performance ◽  
Levels Of Evidence ◽  
Assessment Development ◽  
Evidence Quality ◽  
Quality Grading ◽  
Low Levels ◽  
Clear Aligner

ABSTRACT Objectives To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners). Materials and Methods Six electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed. Results Of 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: -4.867 to -0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P > .05). The swallowing threshold remained constant (P > .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P < .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P < .001). Low to very low levels of evidence were found. Conclusions Based on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.

A Systematic Review and Meta-analysis of the Effect of Oral Exercises on Masticatory Function

2021 ◽  
pp. 002203452110503
Author(s):  
X. Shu ◽  
S. He ◽  
E.C.M. Lo ◽  
K.C.M. Leung
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Bite Force ◽  
Mean Difference ◽  
Masticatory Performance ◽  
Masticatory Function ◽  
Assessment Development ◽  
Study Selection ◽  
Longitudinal Comparison

The aim of the current systematic review was to summarize and to evaluate the available information on the effectiveness of oral exercise in improving the masticatory function of people ≥18 y. Electronic databases (Medline, Embase, CENTRAL) and gray literatures were searched (up to December 2020) for relevant randomized and nonrandomized controlled clinical trials. Two reviewers independently conducted the study selection, data extraction, and quality assessments. Meta-analysis was conducted for the comparison of bite force and masticatory performance using mean difference (MD) and standardized mean difference (SMD), respectively. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment was adopted for collective grading of the overall body of evidence. Of the 1,576 records identified, 18 studies (21 articles) were included in the analysis. Results of meta-analysis indicated that oral exercise could significantly improve the mean bite force of the participants (parallel comparison: MD, 41.2; 95% CI, 11.6–70.7, P = 0.006; longitudinal comparison: MD, 126.5; 95% CI, 105.2–144.9, P < 0.001). However, the improvement in masticatory performance was not significant (parallel comparison: SMD, 0.11; 95% CI, –0.20 to 0.42, P = 0.48; longitudinal comparison: SMD, 0.4; 95% CI, –0.11 to 0.91, P = 0.13). Results of meta-regression showed that greater improvements in bite force can be achieved among younger adults and with more intensive exercise. Chewing exercise is the most effective oral exercise, followed by clenching exercise, while simple oral exercise may not have a significant effect. Based on the results of the meta-analysis and GRADE assessment, a weak recommendation for people with declined masticatory function to practice oral exercise is made.

Childhood adversity in schizophrenia: a systematic meta-analysis

2012 ◽  
Vol 43 (2) ◽  
pp. 225-238 ◽  
Author(s):  
S. L. Matheson ◽  
A. M. Shepherd ◽  
R. M. Pinchbeck ◽  
K. R. Laurens ◽  
V. J. Carr
Keyword(s):  
Longitudinal Design ◽  
Meta Analysis ◽  
Childhood Adversity ◽  
Interactive Effects ◽  
Current Evidence ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Assessment Development ◽  
Evidence Quality ◽  
Putative Risk Factor

BackgroundChildhood adversity is a putative risk factor for schizophrenia, although evidence supporting this suggestion is inconsistent and controversial. The aim of this review was to pool and quality assess the current evidence pertaining to childhood adversity in people with schizophrenia compared to other psychiatric disorders and to non-psychiatric controls.MethodIncluded were case-control, cohort and cross-sectional studies. Medline, EMBASE and PsycINFO databases were searched. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and pooled evidence quality was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsTwenty-five studies met inclusion criteria. Moderate to high quality evidence suggests increased rates of childhood adversity in schizophrenia compared to controls [odds ratio (OR) 3.60, p < 0.00001]. Increased childhood adversity was also reported in schizophrenia compared to anxiety disorders (OR 2.54, p = 0.007), although the effect was not significant in the subgroup analysis of five studies assessing only sexual abuse. No differences in rates of childhood adversity were found between schizophrenia and affective psychosis, depression and personality disorders whereas decreased rates of childhood adversity were found in schizophrenia relative to dissociative disorders and post-traumatic stress disorder (OR 0.03, p < 0.0001).ConclusionsThis is the first meta-analysis to report a medium to large effect of childhood adversity in people with schizophrenia and to assess specificity for schizophrenia. Further research is required that incorporates longitudinal design and other potentially causal variables to assess additive and/or interactive effects.

scholarly journals Two-dose varicella vaccine effectiveness in China: a meta-analysis and evidence quality assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhujiazi Zhang ◽  
Luodan Suo ◽  
Jingbin Pan ◽  
Dan Zhao ◽  
Li Lu
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Varicella Vaccine ◽  
Vaccine Effectiveness ◽  
Healthy Children ◽  
Quality Of Evidence ◽  
Assessment Development ◽  
Significant Difference ◽  
Evidence Quality

Abstract Background The objectives of this review were to evaluate the vaccine effectiveness (VE) of the two-dose varicella vaccine for healthy children in China and explore the application of the approach of Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) in observational studies on VE. Methods We searched for observational studies on two-dose varicella VE for children in China aged 1–12 years that were published from 1997 to 2019, and assessed the quality of each study using the Newcastle Ottawa Scale (NOS). We used meta-analysis models to obtain the pooled two-dose VE, and the studies were divided into subgroups and analysed according to whether or not it was an outbreak investigation and its NOS score. The quality of evidence of VEs were rated by approach of the GRADE system. Results A total of 12 studies and 87,196 individuals were included. The pooled two-dose VE was 90% (95% confidence interval [CI]: 69–97%). The VE of outbreak studies (87% [95% CI: 76–93%]) was lower than non-outbreak studies (99% [95% CI: 98–99%]). There was no significant difference in VEs by different NOS quality. The quality of the evidence assessment of pooled two-dose VE was “low”, which was rated down by one category in limitations and publication bias respectively and rated up by two category in large effect. The quality of evidence assessment in subgroup of NOS score ≥ 7 was “moderate”. Conclusions The VE of two-dose varicella vaccine is relatively high in preventing varicella, and is recommended for countries which need further control for varicella. However, higher quality evidence is needed as a supplement for stronger recommendations. The approach of GRADE could be applied for rating the quality of evidence in observational study.

scholarly journals Effectiveness of Auricular Acupuncture for Insomnia: An Overview of Systematic Reviews

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jinke Huang ◽  
Min Shen ◽  
Xiaohui Qin ◽  
Yong Huang
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Descriptive Analysis ◽  
Relevant Literature ◽  
Poor Quality ◽  
Auricular Acupuncture ◽  
Assessment Development ◽  
Evidence Quality

Objectives. The effectiveness of auricular acupuncture (AA) for insomnia is far from uniform. The aim of this overview was to summarize and critically evaluate the evidence from systematic reviews (SRs)/meta-analysis (MAs) and provide an overall verdict about the therapeutic value of AA for insomnia. Methods. A search of relevant literature for SRs/MAs was performed on major medical databases. The methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results. Seven SRs/MAs were deemed eligible for the present overview. According to the evaluation results of AMSTAR-2, the methodological quality of all included SRs/MAs was critically low. Consistent methodological deficiencies were item 2 (the lack of a protocol), item 4 (the lack of a specific search strategy), item 7 (the lack of a list of excluded studies), and item 15 (the lack of an assessment of publication bias). For GRADE, of the 17 outcomes, only 1 (5.9%) was rated of high-quality, 4 (23.5%) were rated of moderate-quality, and the remaining 12 (70.6%) were rated of low-or critically low-quality. Descriptive analysis of the outcomes reveals a positive effect of AA for insomnia. Conclusions. AA may be beneficial for insomnia, but the evidence is plagued by important limitations, e.g., the poor quality of SRs/MAs and primary studies.

scholarly journals The efficacy of Botulinum Toxin A on improving ease of care in the upper and lower limbs: a systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation approach

2014 ◽  
Vol 29 (8) ◽  
pp. 731-740 ◽  
Author(s):  
Jennifer A Baker ◽  
Gavin Pereira
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Upper Limb ◽  
Lower Limb ◽  
Botulinum Toxin A ◽  
Meta Analysis ◽  
Lower Limbs ◽  
Toxin A ◽  
Assessment Development ◽  
Evidence Quality

Objectives: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach; evaluating Botulinum Toxin type A efficacy on improving ease of care in the upper/lower limb. Data sources: Pubmed, Cinahl, Amed, Embase and Cochrane databases. English Language. Search to July 2014. Review methods: All randomized, placebo controlled trials on adults with difficulty in caring for the upper/lower limb resulting from spasticity of any origin and treated with a single dose of Botulinum Toxin A. Evidence quality was assessed by GRADE. Results: A total of 32 studies were reviewed. Meta-analysis was carried out on 11 upper limb and three lower limb studies. Evidence quality for the upper limb was moderate. A significant result for Botulinum Toxin A was found at four to 12 weeks for the upper limb (SMD 0.80, CI 0.55, 1.06, p < 0.0001). The effects were maintained for up to six months (SMD 0.48, CI 0.34, 0.62, p < 0.0001). Evidence quality was very low for the lower limb. Meta-analysis was only possible for global assessment of benefit. No significant effect was found. (Patient: RR 1.37 CI (0.94, 2.00) p = 0.11; clinician: RR 1.06 (0.84, 1.34) p = 0.60.) Conclusion: Botulinum Toxin A improves ease of care in the upper limb for up to six months. No conclusion can be drawn for the lower limb.

Plasma Ablation vs Other Hot Techniques for Tonsillectomy: A Meta-analysis

2020 ◽  
Vol 163 (5) ◽  
pp. 860-869
Author(s):  
Guo Liu ◽  
Ciyun Xiao ◽  
Xu Zhou ◽  
Feng Liu
Keyword(s):  
Postoperative Pain ◽  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Normal Diet ◽  
Current Evidence ◽  
Assessment Development ◽  
Plasma Ablation ◽  
Evidence Quality ◽  
The Difference

Objective To evaluate whether plasma ablation tonsillectomy is superior to other hot techniques in reducing postoperative morbidity. Data Sources The databases of PubMed, EMBASE, and Web of Science were used to search the literature, from inception to January 2, 2020. Randomized controlled trials (RCTs) that compared plasma ablation tonsillectomy with any other hot techniques were eligible. Review Methods A modified Cochrane tool was used to assess the risk of bias. The standardized mean difference (SMD) and 95% confidence interval (CI) were used to estimate pooled effects of postoperative pain, and the risk ratio (RR) was used for postoperative bleeding. Subgroup analysis was prespecified to explore the source of heterogeneity. The evidence quality of each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results A total of 15 RCTs were included (n = 1293). Comparing with other hot techniques, plasma ablation tonsillectomy may cause less pain on postoperative day 7 (SMD, −0.53; 95% CI, −0.84 to −0.23). However, the magnitude of the difference may be clinically meaningless. There were no significant differences not only in terms of postoperative pain on day 1 and day 3 but also in the incidence of postoperative bleeding, reoperation hemostasis, and return to normal diet and activities between the 2 groups. Conclusion There is still substantial uncertainty on postoperative pain, bleeding, and recovery. The current evidence is insufficient to demonstrate that plasma ablation is superior to other hot techniques for tonsillectomy.

Efficacy of Alprostadil in Preventing Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110044
Author(s):  
Hongling Xu ◽  
Hongye Wang ◽  
Chuang Zhang ◽  
Jun Xiao ◽  
Ning Hua ◽  
...  
Keyword(s):  
Meta Analysis ◽  
China National Knowledge Infrastructure ◽  
Contrast Induced Nephropathy ◽  
Serum Cystatin ◽  
Assessment Development ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Knowledge Infrastructure ◽  
Evidence Evaluation ◽  
Biological Medicine ◽  
Neutrophil Gelatinase

This study aimed to determine the efficacy of alprostadil in preventing contrast-induced nephropathy (CIN). Eligible studies were searched using the keywords through the databases of PubMed, Cochrane, Embase, China Biological Medicine Database, China National Knowledge Infrastructure, and Vanfun. Quality evaluation of the included studies was conducted according to international evidence evaluation and recommended Grades of Recommendations Assessment, Development, and Evaluation standards. We included 29 studies with 5623 patients. Compared with hydration, 10 µg/d alprostadil or 20 µg/d alprostadil plus hydration significantly decreased the incidence of CIN. Compared with hydration, alprostadil plus hydration significantly reduced serum creatinine and blood urea nitrogen at 24, 48, and 72 hours and 7 days after coronary angiography (CAG). Alprostadil (20 µg/d) plus hydration significantly decreased serum cystatin versus hydration at 24, 48, and 72 hours after CAG. Compared with hydration, alprostadil plus hydration significantly increased glomerular filtration rate at 24 and 72 hours after CAG. Alprostadil plus hydration significantly decreased neutrophil gelatinase-associated lipocalin levels compared to hydration at 24, 48, and 72 hours after CAG. Alprostadil plus hydration significantly decreased urine macroglobulin versus hydration at 24 and 48 hours after CAG.

scholarly journals Comparative Efficacy of Antifungal Agents Used in the Treatment of Oropharyngeal Candidiasis among HIV-Infected Adults: A Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 7 (8) ◽  
pp. 637
Author(s):  
Shamala Gopal Rajadurai ◽  
Mari Kannan Maharajan ◽  
Sajesh K. Veettil ◽  
Divya Gopinath
Keyword(s):  
Antifungal Agents ◽  
Meta Analysis ◽  
Oropharyngeal Candidiasis ◽  
Mycological Cure ◽  
Comparative Efficacy ◽  
Assessment Development ◽  
Randomized Controlled ◽  
Favorable Safety ◽  
Grade Approach

The objective of this study was to assess the comparative efficacy and safety of different antifungal agents used for the treatment of oropharyngeal candidiasis (OPC) in adult patients with HIV. A systematic search was performed on the four major databases (Medline, Embase, CENTRAL and Scopus) to identify randomized controlled trials (RCTs) that evaluated the efficacy of antifungal agents in HIV patients with OPC. A network meta-analysis was performed from the data extracted from the selected studies. The agents were ranked according using surface under the cumulative ranking (SUCRA). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of evidence. A total of 15 trials were included in the quantitative analysis involving the data from a total of 2883 participants. Fluconazole was ranked as the most effective antifungal agent to achieve clinical cure (SUCRA = 0.87) in OPC followed by posaconazole and itraconazole. Posaconazole was ranked the most efficacious agent in achieving mycological cure (SUCRA = 0.81), followed by fluconazole. While nystatin was ranked the safest, the effect estimates of none of the other systemic antifungal agents were significantly higher than fluconazole. Based on the available evidence, fluconazole can be considered as the most effective drug in the treatment of OPC among HIV-infected adults and has a favorable safety profile, followed by posaconazole.

scholarly journals A living WHO guideline on drugs to prevent covid-19

BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Meta Analysis ◽  
World Health ◽  
Policy And Practice ◽  
Assessment Development ◽  
Research Priority ◽  
Health Organization ◽  
Almost All ◽  
Drug Interventions

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.

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