scholarly journals Can tooth bleaching agents cause genotoxicity in the oral epithelium? A systematic review with meta-analysis

2022 ◽  
Vol 11 (1) ◽  
pp. e11411124928
Author(s):  
Liciane dos Santos Menezes ◽  
Patrícia Miranda Leite Ribeiro ◽  
Wilton Mitsunari Takeshita
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Research Question ◽  
Tooth Bleaching ◽  
P Value ◽  
Oral Epithelium ◽  
Level Of Evidence ◽  
Before And After ◽  
Tooth Bleaching Agents

Objective: To assess, with a systematic review (SR) with meta-analysis, the occurrence of genotoxic effects on the oral epithelium after exposure to tooth bleaching agents. Material and methods: This review was performed according to the PRISMA protocols. To identify relevant studies, a systematic search was performed in the following electronic databases: PubMed, Scopus, Embase, LILACS, and Google Scholar. The research question was "Can tooth bleaching agents cause genotoxicity in the oral epithelium?”. The treatment effects were defined as the standardized mean difference (SMD) and 95% confidence intervals (CI) were established. Results: 154 studies were selected and, after screening titles and abstracts, seven full-text manuscripts were assessed for eligibility, of which four studies were included in the meta-analysis. There were no statistically significant differences in the frequency of micronuclei before and after exposure (SMD= -0.14, 95% CI, 0.98 to 0.60, p=0.74), with a Tau2 index = 1.00; Chi2 = 70.20; p-value <0.00001; and I² of 93%, indicating high heterogeneity among the studies. Conclusion: Considering the limitations of the present SR, tooth bleaching agents do not lead to genotoxic damage in the oral epithelium but with a small effect and low level of evidence. In this way, the use of tooth bleaching agents is safe on the oral mucosa but randomized clinical trials that are more standardized in all stages are required to produce more robust evidence.

scholarly journals Can reducing the number of stitches compromise the outcome of laparoscopic Burch surgery in the treatment of stress urinary incontinence? Systematic review and meta-analysis

2017 ◽  
Vol 44 (6) ◽  
pp. 649-654 ◽  
Author(s):  
RICARDO JOSÉ SOUZA ◽  
JOSÉ ANACLETO DUTRA RESENDE JÚNIOR ◽  
CLARICE GUIMARÃES MIGLIO ◽  
LEILA CRISTINA SOARES BROLLO ◽  
MARCO AURÉLIO PINHO OLIVEIRA ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
P Value ◽  
Open Technique ◽  
Control Series ◽  
One Year ◽  
Cure Rates

ABSTRACT The retropubic colposuspension in the treatment of stress urinary incontinence has been rescued with the laparoscopic route. Some authors have reduced the number of stitches, from two to one, due to the difficulty of suturing by this route. To what extent can this modification compromise outcome? To answer this question, we performed a systematic review and meta-analysis on the MEDLINE/PubMed and LILACS/SciELO databases between 1990 and 2015. We included randomized clinical trials, cohort studies and case-control series comparing laparoscopic versus open Burch, and two versus one stitch in laparoscopic Burch, with a minimum follow-up of one year. Fourteen studies compared laparoscopic versus open Burch, in which we found no differences between the two techniques using one stitch (Relative Risk - RR - of 0.94, 95% CI 0.79-1.11) and two stitches (RR of 1.03, 95% CI 0.97-1.10). Only one study compared one stitch versus two stitches in laparoscopic Burch, with cure rates of 68% versus 87%, respectively (p-value= 0.02). We did not identify differences when compared open technique with two stitches versus laparoscopic with one stitch and open technique with two stitches versus laparoscopic with two. The study comparing one versus two laparoscopic stitches demonstrated superior results with the latter. Although there is no robust evidence, when Burch surgery is performed laparoscopically, the use of two stitches seems to be the best option.

scholarly journals Acupuncture for Managing Cancer-Related Insomnia: A Systematic Review of Randomized Clinical Trials

2016 ◽  
Vol 16 (2) ◽  
pp. 135-146 ◽  
Author(s):  
Tae-Young Choi ◽  
Jong In Kim ◽  
Hyun-Ja Lim ◽  
Myeong Soo Lee
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Sleep Quality ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Risk Of Bias ◽  
The Other ◽  
Level Of Evidence

Background. Insomnia is a prominent complaint of cancer patients that can significantly affect their quality of life and symptoms related to sleep quality. Conventional drug approaches have a low rate of success in alleviating those suffering insomnia. The aim of this systematic review was to assess the efficacy of acupuncture in the management of cancer-related insomnia. Methods. A total of 12 databases were searched from their inception through January 2016 without language restriction. Randomized controlled trials (RCTs) and quasi-RCTs were included if acupuncture was used as the sole intervention or as an adjunct to another standard treatment for any cancer-related insomnia. The data extraction and the risk of bias assessments were performed by 2 independent reviewers. Results. Of the 90 studies screened, 6 RCTs were included. The risk of bias was generally unclear or low. Three RCTs showed equivalent effects on the Pittsburgh Sleep Quality Index and 2 RCTs showed the similar effects on response rate to those of conventional drugs at the end of treatment. The other RCT showed acupuncture was better than hormone therapy in the numbers of hours slept each night and number of times woken up each night. The 3 weeks of follow-up in 2 RCTs showed superior effects of acupuncture compared with conventional drugs, and a meta-analysis showed significant effects of acupuncture. Two RCTs tested the effects of acupuncture on cancer-related insomnia compared with sham acupuncture. One RCT showed favourable effects, while the other trial failed to do so. Conclusion. There is a low level of evidence that acupuncture may be superior to sham acupuncture, drugs or hormones therapy. However, the number of studies and effect size are small for clinical significance. Further clinical trials are warranted.

High Dose Chemotherapy and Autologous Stem Cell Transplantation in the Primary Therapy of Advanced Follicular Lymphoma in Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2314-2314
Author(s):  
Murtadha K. Al-Khabori ◽  
John de Almeida ◽  
Gordon Guyatt ◽  
John Kuruvilla ◽  
Michael Crump
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
P Value ◽  
High Dose ◽  
High Dose Therapy ◽  
Dose Therapy ◽  
American Society

Abstract Abstract 2314 Poster Board II-291 Background: The impact of high dose therapy and autologous stem cell transplantation (ASCT) in the upfront management of adults with advanced follicular lymphoma (FL) on overall survival remains uncertain. A number of randomized clinical trials (RCTs) compared ASCT to conventional dose chemotherapy regimens. We performed a systematic review to address this question. Objective: To compare the overall survival (OS), event free survival (EFS), treatment related mortality (TRM), incidence of secondary myelodysplasia/acute myeloid leukemia (t-MDS/AML) and secondary solid tumors within the ASCT strategy and chemotherapy. Methods: We performed a search of MEDLINE, EMBASE, CENTRAL, American Society of Hematology (ASH), American Society of Clinical Oncology (ASCO), BIOSIS, PAPERSFIRST, PROCEEDINGS, clinical trials registries (National Cancer Institute, clinicaltrials.gov) and bibliographies of relevant studies for randomized controlled trials comparing myelo-ablative chemotherapy with ASCT to any chemotherapy in adults with untreated advanced (Ann Arbor stage III-IV) FL. Two reviewers recorded study characteristics, methodology and outcomes. Disagreement was resolved by discussion. Results: Seven trials were identified and included in the systematic review but only four with available data reporting 941 patients were included in the meta-analysis. Three trials excluded: one was never reported; the second was stopped early due to the increased toxicities in the transplant arm; and the third showed no significant difference in EFS or OS at an interim analysis with insufficient data for the meta-analysis. None of these studies has been published. In one of the 7 trials patients in both arms received rituximab during the induction treatment. High dose therapy and ASCT did not result in improved OS compared to standard therapy, Hazard Ratio (HR) 1.15 (0.85, 1.55). The HR for EFS was 0.61 (0.34, 1.11) with substantial heterogeneity, I2 =91%, Chi2 p value <0.00001. Only the duration of the follow up could explain this heterogeneity with statistically significant subgroup interaction, P <0.00001. The incidence of t-MDS/AML ranged from 1% to 7% in the ASCT arms of the four studies, with a difference in favour of standard chemotherapy, Risk Difference (RD) 4% (95%CI: -1%, 8%), and significant heterogeneity (Chi2 p value of 0.008, I2=75%) due to difference in duration of follow up (p=0.005 for the subgroup differences).There was no increase in mortality directly attributable to treatment (RD 0%, 95%CI: -2%, 1%) nor in secondary solid tumors (RD 1%, 95%CI: -2%, 4%). Conclusions: High dose therapy and ASCT as part of initial does not improve overall survival despite a trend towards better disease control, likely because of the effectiveness of second and subsequent lines of treatment for FL. T-MDS/AML occurs more commonly following ASCT and represents a significant risk to patients. With one exception, these studies were conducted before the introduction of monoclonal B cell antibodies. Future trials of ASCT in the context of current chemo-immunotherapy approaches to FL would further inform this issue. Disclosures: No relevant conflicts of interest to declare.

Efficacy of natural, peroxide‐free tooth‐bleaching agents: A systematic review, meta‐analysis, and technological prospecting

2019 ◽  
Vol 34 (5) ◽  
pp. 1060-1070 ◽  
Author(s):  
Juliana Silva Ribeiro ◽  
Wellington Luiz Oliveira da Rosa ◽  
Adriana Fernandes Silva ◽  
Evandro Piva ◽  
Rafael Guerra Lund
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Tooth Bleaching ◽  
Tooth Bleaching Agents

scholarly journals Erectile dysfunction and penile rehabilitation after pelvic fracture: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045117
Author(s):  
Florian A Schmid ◽  
Ulrike Held ◽  
Daniel Eberli ◽  
Hans-Christoph Pape ◽  
Sascha Halvachizadeh
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Literature Search ◽  
Meta Analysis ◽  
P Value ◽  
Systematic Literature Search ◽  
Rehabilitation Therapy ◽  
Increased Risk ◽  
Before And After ◽  
Penile Rehabilitation

ObjectiveTo investigate the rate of erectile dysfunction (ED) after pelvic ring fracture (PRF).DesignSystematic review and meta-analysis.MethodsA systematic literature search of the Cochrane, EMBASE, MEDLINE, Scopus and Web of Science Library databases was conducted in January 2020. Included were original studies performed on humans assessing ED after PRF according to the 5-item International Index of Erectile Function (IIEF-5) questionnaire and fracture classification following Young and Burgess, Tile or Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association. Furthermore, interventional cohort studies assessing the effect of penile rehabilitation therapy with phosphodiesterase-5-inhibitors (PDE-5-I) on IIEF-5 scores compared before and after treatment were included. Results were presented as forest plots of proportions of patients with ED after PRF or mean changes on IIEF-5 questionnaires before and after penile rehabilitation. Studies not included in the quantitative analysis were narratively summarised. Risk of bias assessment was conducted using the revised tool for the Quality Assessment on Diagnostic Accuracy Studies.ResultsThe systematic literature search retrieved 617 articles. Seven articles were included in the qualitative analysis and the meta-analysis. Pooled proportions revealed 37% of patients with ED after suffering any form of PRF (result on probability scale pr=0.37, 95% CI: 0.26 to 0.50). Patients after 3 months of penile rehabilitation therapy reported a higher IIEF-5 score than before (change score=6.5 points, 95% CI: 2.54 to 10.46, p value=0.0013).ConclusionDespite some heterogeneity and limited high-quality research, this study concludes that patients suffering from any type of PRF have an increased risk of developing ED. Oral intake of PDE-5-I for the purpose of penile rehabilitation therapy increases IIEF-5 scores and may relevantly influence quality-of-life in these patients.PROSPERO registration numberCRD42020169699.

scholarly journals Influence of occlusal reduction on pain after endodontic treatment: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nayane Chagas Carvalho Alves ◽  
Sirley Raiane Mamede Veloso ◽  
Silmara de Andrade Silva ◽  
Andressa Cartaxo de Almeida ◽  
Christianne Tavares Velozo Telles ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Research Question ◽  
Endodontic Treatment ◽  
Cochrane Library ◽  
Endodontically Treated Teeth ◽  
Dichotomous Outcome ◽  
Significant Difference

AbstractThe purpose of this systematic review was to analyze the influence of occlusal reduction on the postoperative pain levels after endodontic treatment (instrumentation and obturation of the root canal system). This review followed the PRISMA statement and was registered at PROSPERO (CRD42018107918). Two independent reviewers searched the Lilacs, Cochrane Library, PubMed (Medline), Web of Science, Scopus, Scielo, and ScienceDirect for articles published until April 2021. The research question was, "Does occlusal reduction decrease postoperative pain in endodontically treated teeth?". Only randomized clinical trials were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (presence or absence of pain). The search strategies retrieved 4114 studies. Twelve studies were included for qualitative analysis and nine for quantitative analysis. The meta-analysis results did not reveal a significant difference in the reduction of postoperative pain levels for endodontic instrumentation at 6, 12, 24, 48 h and for endodontic obturation at 6 or 12 h after occlusal reduction. According to the GRADE tool, the analyzed outcome was classified as having a moderate level of certainty. It is concluded that occlusal reduction does not interfere with postoperative pain levels after endodontic treatment.

scholarly journals The Place of Fluvoxamine in the Treatment of Non-critically ill Patients with COVID-19: A Living Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Salah Eddine Oussama Kacimi ◽  
Elona Greca ◽  
Mohamed Amine Haireche ◽  
Ahmed Sallam ElHawary ◽  
Mounir Ould Setti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Critically Ill ◽  
Standard Care ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mortality Rates ◽  
P Value ◽  
Exclusion Criteria ◽  
Significant Difference

Background: Fluvoxamine is a selective serotonin reuptake inhibitor that is known to be used as antidepressant. Repurposing of Fluvoxamine for the treatment of COVID-19 is theorized to help in the prevention of the clinical deterioration of SARS CoV-2 patients. In our systematic review and meta-analysis, we aim to assess the safety and efficacy of the drug under study in terms of its effect on the mortality and the risk of hospitalization and mechanical ventilation in non-critically ill COVID-19 patients. Methods: We performed a systematic search of seven electronic databases. The search results were screened based on the previously determined inclusion and exclusion criteria. We determined the data related to our objectives. The mortality rates, rates of hospitalization, risk of mechanical ventilation and serious side effects were extracted from the studies that successfully met our inclusion and exclusion criteria. Then, the extracted data from the included studies was included in the meta-analysis. Results: Three studies, two randomized clinical trials and one observational cohort study, with 1762 patients, were the final outcome of our search and screening processes. Among all participants, 886 patients received Fluvoxamine while 876 were controls. Follow up periods ranged from 7 days to 28 days. There was no significant difference in the intention-to-treat mortality rates between the two groups (RR = 0.66; 95% CI: 0.36 - 1.21, p-value = 0.18; I2 = 0%). However, Fluvoxamine decreased the per-protocol mortality compared to both placebo alone or placebo/standard care (RR = 0.09; 95% CI: 0.01 - 0.64, p-value = 0.02; I2 = 0% and RR = 0.09; 95% CI: 0.01 - 0.72, respectively). As compared to placebo or standard care, the all-cause hospitalization was significantly reduced in the fluvoxamine group (RR = 0.71; 95% CI: 0.54 - 0.93, p-value = 0.01; I2 = 61%). This risk reduction was not significant when compared to placebo alone (RR = 0.76; 95% CI: 0.57 - 1.00; p-value = 0.051; I2 = 48%). Furthermore, the risk of mechanical ventilation was not improved in the fluvoxamine group as compared to placebo (RR = 0.71; 95% CI: 0.43 - 1.16, p-value = 0.17; I2 = 0%). The serious adverse effects were almost the same in the treatment group and the control (13% and 12% respectively). Conclusion: Fluvoxamine does not significantly reduce the mortality rates or the risk of mechanical ventilation in SARS CoV-2 patients. Nonetheless, it was found to have a good impact on reducing all cause hospitalization among patients with COVID-19 disease. Therefore, further clinical studies are needed to determine the effectiveness of the drug and its mechanisms of action.

Can exposure to panoramic radiographs induce genotoxic effects on the oral epithelium? A systematic review with meta-analysis

2021 ◽  
pp. 20210149
Author(s):  
Marcos Antônio Lima dos Santos ◽  
Graziane Ribeiro Couto ◽  
Mark Jon Santana Sabey ◽  
Danilo de Paula Ribeiro Borges ◽  
Wilton Mitsunari Takeshita
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
P Value ◽  
Oral Epithelium ◽  
Genotoxic Effects ◽  
Quality Of Evidence ◽  
Panoramic Radiographs ◽  
Small Effect Size

Radiographic examinations combined with clinical and histological tests play an important role in diagnosing changes in the craniofacial region. Considering that X-radiation is a form of ionizing energy capable of damaging the DNA of individuals, it has been the object of studies since its introduction. The micronucleus test is used to quantify this damage, assessing whether or not chromosomal breakage occurs. Objective: To evaluate, through a systematic review (SR) with meta-analysis, the occurrence of genotoxic effects in the oral epithelium after the exposure of patients to panoramic radiographs. Methods: An SR was performed with the PICOS (Population, Intervention, Comparison, Outcome, and Study design) strategy, aiming to answer the following question: “Can panoramic radiographs induce genotoxic effects on the oral epithelium?” The study was registered in the PROSPERO (International prospective register of systematic reviews) platform. A systematic search was performed in the following electronic databases: PubMed (including MedLine), Scopus, Embase, LILACS, Medline EbscoHost, and Google Scholar. Treatment effects were defined as standardized mean difference (SMD), and 95% confidence intervals (CI) were established. The Joanna Briggs Institute questionnaire for observational studies was applied to assess the risk of bias. The GRADE tool was used to assess the quality of evidence of the SR. Results: A total of 251 potentially relevant studies were selected through the search strategy. After screening titles and abstracts, 11 full-text manuscripts were assessed for eligibility and nine observational studies were included in the meta-analysis. The present study showed an increase in micronuclei after the exposure (SMD = 0.21, 95% CI, 0.03 to 0.28, p = 0.02), with a Tau2index = 0.00, Chi2 = 2.35, and p-value = 0.97. Therefore, the articles selected were considered homogeneous and the I² of 0% indicated low heterogeneity. Conclusion: According to the studies analysed, although the quality of evidence was considered low, panoramic radiographs can cause genotoxic damage in the oral epithelium but with a small effect size.

scholarly journals Effect of Photodynamic Therapy on Microorganisms Responsible for Dental Caries: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 20 (14) ◽  
pp. 3585 ◽  
Author(s):  
Analú Barros de Oliveira ◽  
Túlio Morandin Ferrisse ◽  
Raquel Souza Marques ◽  
Sarah Raquel de Annunzio ◽  
Fernanda Lourenção Brighenti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Photodynamic Therapy ◽  
Dental Caries ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Research Question ◽  
Microbial Reduction ◽  
Cochrane Library ◽  
Study Protocols

The aim of this study was to perform a systematic review of the literature followed by a meta-analysis about the efficacy of photodynamic therapy (PDT) on the microorganisms responsible for dental caries. The research question and the keywords were constructed according to the PICO strategy. The article search was done in Embase, Lilacs, Scielo, Medline, Scopus, Cochrane Library, Web of Science, Science Direct, and Pubmed databases. Randomized clinical trials and in vitro studies were selected in the review. The study was conducted according the PRISMA guideline for systematic review. A total of 34 articles were included in the qualitative analysis and four articles were divided into two subgroups to perform the meta-analysis. Few studies have achieved an effective microbial reduction in microorganisms associated with the pathogenesis of dental caries. The results highlight that there is no consensus about the study protocols for PDT against cariogenic microorganisms, although the results showed the PDT could be a good alternative for the treatment of dental caries.

scholarly journals The Effects of Dairy Intake on Insulin Resistance: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2237 ◽  
Author(s):  
Kristen M. Sochol ◽  
Tanya S. Johns ◽  
Rupinder S. Buttar ◽  
Lovepreet Randhawa ◽  
Edeline Sanchez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Clinical Trials ◽  
Body Weight ◽  
Waist Circumference ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
P Value ◽  
Low Fat ◽  
Dairy Intake

The incidence of type 2 diabetes mellitus (DM) has increased in the US over the last several years. The consumption of low-fat dairy foods has been linked with decreasing the risk of DM but studies have yet to show a clear correlation. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effects of dairy intake on homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference, and body weight. In MEDLINE and Embase, we identified and reviewed 49 relevant RCTs: 30 had appropriate data format for inclusion in the meta-analysis. Using the Review Manager 5 software, we calculated the pooled standardized mean differences comparing dairy dietary interventions to control for our outcomes of interest. For HOMA-IR (794 individuals), we found a mean difference of −1.21 (95% CI −1.74 to −0.67; p-value < 0.00001; I2 = 92%). For waist circumference (1348 individuals), the mean difference was −1.09 cm (95% CI 1.68 to −0.58; p-value < 0.00001; I2 = 94%). For body weight (2362 individuals), the dairy intake intervention group weighed 0.42 kg less than control (p-value < 0.00001; I2 = 92%). Our findings suggest that dairy intake, especially low-fat dairy products, has a beneficial effect on HOMA-IR, waist circumference, and body weight. This could impact dietary recommendations to reduce DM risk.

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