scholarly journals NSAID Use and Effects on Pediatric Bone Healing: A Review of Current Literature

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 821
Author(s):  
Stephanie Choo ◽  
Julia A. V. Nuelle
Keyword(s):  
Systematic Review ◽  
Bone Healing ◽  
Clinical Studies ◽  
Pain Control ◽  
Bone Fractures ◽  
Long Bone ◽  
Evidence Based ◽  
Skeletally Immature ◽  
Inflammatory Drugs ◽  
The Impact

This systematic review evaluates and synthesizes the available peer-reviewed evidence regarding the impact of non-steroidal anti-inflammatory drugs (NSAIDs) on fracture healing in skeletally immature patients. Evidence supports the use of NSAIDs in this patient population for adequate pain control without increasing the risk of nonunion, particularly in long bone fractures and pseudoarthrosis after spine fusion. However, further clinical studies are needed to fill remaining gaps in knowledge, specifically with respect to the spectrum of available NSAIDs, dosage, and duration of use, in order to make broad evidence-based recommendations regarding the optimal use of NSAIDs during bone healing in skeletally immature patients.

scholarly journals Non-Steroidal Anti-Inflammatory Drugs and Bone Healing in Animal Models – A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Haider Al-Waeli ◽  
Ana Paula Reboucas ◽  
Alaa Mansour ◽  
Martin Morris ◽  
Faleh Tamimi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Animal Models ◽  
Bone Healing ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Biomechanical Properties ◽  
Extensive Literature ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Background: Non-steroidal anti-inflammatory drugs (NSAID) have excellent anti-inflammatory and analgesic properties and are extensively used to treat post-traumatic or surgical musculoskeletal pain. Although an extensive literature exists on the administration of NSAID on animal bone healing, no systematic review and meta-analysis have yet been conducted to on the subject. Such work is important as it can identify the key histomorphometric and biomechanics characteristics during the process of fracture healing and provide comparative information regarding different factors that may affect this process after NSAID administration.Methods: We performed a systematic review and meta-analysis of animal studies to estimate the effect of NSAID administration after bone fracture on healing outcomes. We searched eight databases without limiting the search to starting date up to August 1, 2017 for articles on fractured bone healing in animal models in which NSAID were administered.Results: Out of 5,818 articles screened, 45 were included and three common bone healing outcomes were analysed: biomechanical properties (maximum force to break, stiffness, and work-to-failure), micro-computed tomography (µ-CT), and histomorphometric measurements. The studies were generally of low-quality scores because crucial information, especially concerningrandomization, blinding, and allocation concealment, was poorly reported. Our results show that the negative effects of NSAID after bone fracture on certain biomechanical properties of the healing bones was not statistically significant in mice compared with other animals, in females compared with males, and in younger compared with older animals.Conclusion: The findings suggest that NSAID should be administered with caution in patients with bone fractures or in those who undergo certain orthopedic surgical procedures until prospective human clinical studies can be conducted.Systematic review registration: the protocol published and registered in SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) in 2017, https://www.radboudumc.nl/getmedia/757ec408-7a9e-4635-8233-ae951effea54/Non-Steroidal-Anti-inflammatory-Drugs-and-bone-healing-in-animal-Models-Systematic-Review-and-Meta-Analysis.aspx

Systematic review methodology for development: An example from microfinance

2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet
Keyword(s):  
Systematic Review ◽  
International Development ◽  
Health Sector ◽  
Evidence Based ◽  
Systematic Review Methodology ◽  
Development Interventions ◽  
The Us ◽  
Sub Saharan ◽  
The Impact ◽  
Evidence Based Decision Making

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.

scholarly journals Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 351
Author(s):  
Massimiliano Creta ◽  
Giuseppe Celentano ◽  
Luigi Napolitano ◽  
Roberto La Rocca ◽  
Marco Capece ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Relative Risk ◽  
Clinical Studies ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Bladder Tumour ◽  
Signalling Pathways ◽  
Reductase Inhibitors ◽  
The Impact

Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.

scholarly journals Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele: Executive Summary

Neurosurgery ◽  
2019 ◽  
Vol 85 (3) ◽  
pp. 299-301 ◽  
Author(s):  
Catherine A Mazzola ◽  
Nadege Assassi ◽  
Lissa C Baird ◽  
David F Bauer ◽  
Alexandra D Beier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spina Bifida ◽  
Task Force ◽  
The United States ◽  
Folic Acid Deficiency ◽  
Evidence Based ◽  
Executive Summary ◽  
Full Text Review ◽  
Level I ◽  
The Impact

Abstract BACKGROUND The incidence of spina bifida (SB) in the developing world is higher than in the United States because of malnutrition and folic acid deficiency during pregnancy. Advances in technology have made prenatal repair of myelomeningocele (MM) possible. OBJECTIVE The objective of the guidelines are, (1) To create clinical recommendations for best practices, based on a systematic review and analysis of available literature, (2) to obtain multi-disciplinary endorsement of these guidelines from relevant organizations, and (3) to disseminate the educational content to physicians to improve the care of infants with MM. METHODS The Guidelines Task Force developed search terms and strategies used to search PubMed and Embase for literature published between 1966 and September 2016. Strict inclusion/exclusion criteria were used to screen abstracts and to develop a list of relevant articles for full-text review. RESULTS Guidelines authors aimed to systematically review the literature and make evidence based recommendations about the timing of closure after birth, hydrocephalus, the impact of prenatal closure, and the effect of prenatal closure on ambulation ability and tethered spinal cord. Evidence concerning persistent ventriculomegaly and cognitive impairment was also evaluated. Hundreds of abstracts were identified and reviewed for each of the 5 topics. A total of 14 studies met stringent inclusion criteria. CONCLUSION Based on a comprehensive systematic review, a total of 5 clinical practice recommendations were developed, with 1 Level I, 2 Level II and 2 Level III recommendations. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-1.

scholarly journals Effect of GH/IGF-1 on Bone Metabolism and Osteoporsosis

2014 ◽  
Vol 2014 ◽  
pp. 1-25 ◽  
Author(s):  
Vittorio Locatelli ◽  
Vittorio E. Bianchi
Keyword(s):  
Bone Metabolism ◽  
Bone Healing ◽  
Clinical Studies ◽  
Bone Growth ◽  
Bone Fractures ◽  
Human Subjects ◽  
Target Cells ◽  
Clinical Effects ◽  
Gh Treatment ◽  
Gh Secretion

Background. Growth hormone (GH) and insulin-like growth factor (IGF-1) are fundamental in skeletal growth during puberty and bone health throughout life. GH increases tissue formation by acting directly and indirectly on target cells; IGF-1 is a critical mediator of bone growth. Clinical studies reporting the use of GH and IGF-1 in osteoporosis and fracture healing are outlined.Methods. A Pubmed search revealed 39 clinical studies reporting the effects of GH and IGF-1 administration on bone metabolism in osteopenic and osteoporotic human subjects and on bone healing in operated patients with normal GH secretion. Eighteen clinical studies considered the effect with GH treatment, fourteen studies reported the clinical effects with IGF-1 administration, and seven related to the GH/IGF-1 effect on bone healing.Results. Both GH and IGF-1 administration significantly increased bone resorption and bone formation in the most studies. GH/IGF-1 administration in patients with hip or tibial fractures resulted in increased bone healing, rapid clinical improvements. Some conflicting results were evidenced.Conclusions. GH and IGF-1 therapy has a significant anabolic effect. GH administration for the treatment of osteoporosis and bone fractures may greatly improve clinical outcome. GH interacts with sex steroids in the anabolic process. GH resistance process is considered.

scholarly journals Bone Healing and Hormonal Bioassay in Patients with Long-Bone Fractures and Concomitant Head Injury

2016 ◽  
Vol 25 (4) ◽  
pp. 336-342 ◽  
Author(s):  
Fathy G. Khallaf ◽  
Elijah O. Kehinde ◽  
Sundus Hussein
Keyword(s):  
Head Injury ◽  
Bone Healing ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures

scholarly journals The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review

2017 ◽  
Vol 89 (4) ◽  
pp. 2851-2863 ◽  
Author(s):  
ADRIANO S. CORRÊA ◽  
VINÍCIUS L. DE ALMEIDA ◽  
BEATRIZ M.V. LOPES ◽  
ADEMIR FRANCO ◽  
FELIPE R. DE MATOS ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Control ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Metamizole/dipyrone for the relief of cancer pain: A systematic review and evidence-based recommendations for clinical practice

2016 ◽  
Vol 31 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Jan Gaertner ◽  
Ulrike M Stamer ◽  
Constanze Remi ◽  
Raymond Voltz ◽  
Claudia Bausewein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Oral Morphine ◽  
Cochrane Library ◽  
Evidence Based ◽  
Low Doses ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background: Dipyrone (metamizole) is one of the most widely used non-opioid analgesics for the treatment of cancer pain. Aim: Because evidence-based recommendations are not yet available, a systematic review was conducted for the German Guideline Program in Oncology to provide recommendations for the use of dipyrone in cancer pain. Design: First, a systematic review for clinical trials assessing dipyrone in adult patients with cancer pain was conducted. Endpoints were pain intensity, opioid-sparing effects, safety, and quality of life. Data sources: The search was performed in MedLine, Embase (via Ovid), and the Cochrane Library (1948–2013) and additional hand search was conducted. Finally, recommendations were developed and agreed in a formal structured consensus process by 53 representatives of scientific medical societies and 49 experts. Results: Of 177 retrieved studies, 4 could be included (3 randomized controlled trials and 1 cohort study, n = 252 patients): dipyrone significantly decreased pain intensity compared to placebo, even if low doses (1.5–2 g/day) were used. Higher doses (3 × 2 g/day) were more effective than low doses (3 × 1 g/day), but equally effective as 60 mg oral morphine/day. Pain reduction of dipyrone and non-steroidal anti-inflammatory drugs did not differ significantly. Compared to placebo, non-steroidal anti-inflammatory drugs, and morphine, the incidence of adverse effects was not increased. Conclusion: Dipyrone can be recommended for the treatment of cancer pain as an alternative to other non-opioids either alone or in combination with opioids. It can be preferred over non-steroidal anti-inflammatory drugs due to the presumably favorable side effect profile in long-term use, but comparative studies are not available for long-term use.

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