scholarly journals Investigation of the Effectiveness of Surgical Treatment on Maxillary Medication-Related Osteonecrosis of the Jaw: A Literature Review

2021 ◽  
Vol 10 (19) ◽  
pp. 4480
Author(s):  
Kun-Jung Hsu ◽  
Szu-Yu Hsiao ◽  
Ping-Ho Chen ◽  
Han-Sheng Chen ◽  
Chun-Ming Chen
Keyword(s):  
Elderly Patients ◽  
Safety Management ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Osteonecrosis Of The Jaw ◽  
Cochrane Library ◽  
Antiangiogenic Agents ◽  
Disease Occurrence ◽  
Medical Teams

Aim: Medication-related osteonecrosis of the jaw (MRONJ) occurs after exposure to medication (antiresorptive or antiangiogenic agents) for bone-related complications. It is more common in the mandible than in the maxilla. The present study investigated maxillary MRONJ in elderly patients through a meta-analysis. Methods: Keywords, including “MRONJ”, “maxilla”, and “surgery”, were entered into databases, including Embase, PubMed/MEDLINE, Cochrane Library, and ProQuest, which were searched systematically. Results: Investigating 77 studies, we found that 18 (2 case reports and 16 case series) papers conformed to the standards. The results revealed a 2.6:1 female-to-male ratio of disease occurrence. The average age of patients was 70.6 ± 5.5 years, and most patients were in the third stage (43.6%). The average time of medication usage was 50.0 ± 20.1 months. The pooled proportion of clinical efficacy of surgery was 86%. Conclusion: To prevent and manage MRONJ, all elderly patients should maintain proper oral hygiene and receive dental examinations regularly. Risk assessment and safety management of MRONJ should be performed by medical teams.

scholarly journals Return to Sport after Anatomic and Reverse Total Shoulder Arthroplasty in Elderly Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1576
Author(s):  
Rocco Papalia ◽  
Mauro Ciuffreda ◽  
Erika Albo ◽  
Chiara De Andreis ◽  
Lorenzo Alirio Diaz Balzani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Shoulder Arthroplasty ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Return To Sport ◽  
Rate Of Return ◽  
Cochrane Library

The aim of this systematic review and meta-analysis was to evaluate the rate of return to sport in elderly patients who underwent anatomic (ATSA) and reverse (RTSA) total shoulder arthroplasty, to assess postoperative pain and functional outcomes and to give an overview of postoperative rehabilitation protocols. A systematic search in Pubmed-Medline, Cochrane Library, and Google Scholar was carried out to identify eligible randomized clinical trials, observational studies, or case series that evaluated the rate of return to sport after RTSA or ATSA. Six retrospective studies, five case series, and one prospective cohort study were included in this review. The overall rate of return to sport was 82% (95% CI 0.76–0.88, p < 0.01). Patients undergoing ATSA returned at a higher rate (90%) (95% CI 0.80–0.99, p < 0.01) compared to RTSA (77%) (95% CI 0.69–0.85, p < 0.01). Moreover, the results showed that patients returned to sport at the same or a higher level in 75% of cases. Swimming had the highest rate of return (84%), followed by fitness (77%), golf (77%), and tennis (69%). Thus, RTSA and ATSA are effective to guarantee a significative rate of return to sport in elderly patients. A slightly higher rate was found for the anatomic implant.

scholarly journals Repurposing of drugs for Covid-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Pinky Kotecha ◽  
Alexander Light ◽  
Enrico Checcucci ◽  
Daniele Amparore ◽  
Cristian Fiori ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Clinical Improvement ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference

AbstractObjectiveThe aim of this systematic review is to evaluate the data currently available regarding the repurposing of different drugs for Covid-19 treatment. Participants with suspected or diagnosed Covid-19 will be included. The interventions being considered are drugs being repurposed, and comparators will include standard of care treatment or placebo.MethodsWe searched Ovid-MEDLINE, EMBASE, Cochrane library, clinical trial registration site in the UK(NIHR), Europe (clinicaltrialsregister.eu), US (ClinicalTrials.gov) and internationally (isrctn.com), and reviewed the reference lists of articles for eligible articles published up to April 22, 2020. All studies in English that evaluated the efficacy of the listed drugs were included. Cochrane RoB 2.0 and ROBINS-I tool were used to assess study quality. This systematic review adheres to the PRISMA guidelines. The protocol is available at PROSPERO (CRD42020180915).ResultsFrom 708 identified studies or clinical trials, 16 studies and 16 case reports met our eligibility criteria. Of these, 6 were randomized controlled trials (763 patients), 7 cohort studies (321 patients) and 3 case series (191 patients). Chloroquine (CQ) had a 100% discharge rate compared to 50% with lopinavir-ritonavir at day 14, however a trial has recommended against a high dosage due to cardiotoxic events. Hydroxychloroquine (HCQ) has shown no significant improvement in negative seroconversion rate which is also seen in our meta-analysis (p=0.68). Adverse events with HCQ have a significant difference compared to the control group (p=0.001). Lopinavir-ritonavir has shown no improvement in time to clinical improvement which is seen in our meta-analyses (p=0.1). Remdesivir has shown no significant improvement in time to clinical improvement but this trial had insufficient power.DiscussionDue to the paucity in evidence, it is difficult to establish the efficacy of these drugs in the treatment of Covid-19 as currently there is no significant clinical effectiveness of the repurposed drugs. Further large clinical trials are required to achieve more reliable findings. A risk-benefit analysis is required on an individual basis to weigh out the potential improvement in clinical outcome and viral load reduction compared to the risks of the adverse events. (1-16)

625 EFFICACY OF MYOTOMY IN PATIENTS WITH SIGMOID MEGAESOPHAGUS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Marina Orlandini ◽  
Maria Carolina Serafim ◽  
Letícia Datrino ◽  
Clara Santos ◽  
Luca Tristão ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heller Myotomy ◽  
Selection Process ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Manual Search ◽  
The Mean

Abstract   Megaesophagus progress to sigmoid megaesophagus (SM) in 10–15% of patients, presenting tortuosity and sigmoid colon aspect. Esophagectomy is the choice treatment but is associated with high complications and mortality rates. To avoid the esophagectomy inherent morbidity, several authors recommend Heller myotomy (HM) with pull-down technique for SM, mainly for patients with comorbidities and the elderly. This systematic review and meta-analysis is the first to analyze the effectiveness of HM for treating SM. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, Lilacs (BVS), and manual search of references. Inclusion criteria were: a) clinical trials, cohort studies, case series; b) patients with SM and esophageal diameter ≥ 6 cm; and c) patients undergoing primary myotomy. The exclusion criteria were: a) reviews, case reports, cross-sectional studies, editorials, letters, congress abstracts, full-text unavailability; b) animal studies, c) previous surgical treatment for achalasia; and d) pediatric studies. There were no restrictions on language or date of publication, and no filters were applied for the selection process. Random model and a 95% confidence interval (CI) were used. Results Sixteen articles were selected, encompassing 231 patients. The mean age ranged from 36 to 61 years old, and the mean follow-up ranged from 16 to 109 months. The analyzed outcomes include mortality, complications (pneumonia, pneumothorax, gastroesophageal reflux), need for reintervention (remyotomy, dilation and esophagectomy), and results classified as ‘good’ and ‘excellent’. Mortality rate was 0.035 (CI: 0.017–0.07; p &lt; 0.01). Complications rate was 0.08 (CI: 0.04–0.153; p = 0.01). Need for retreatment rate was 0.161 (CI: 0.053–0.399; p &lt; 0.01). Probability of good or excellent outcomes after myotomy was 0.762 (CI: 0.693–0.819; p &lt; 0,01). Conclusion Heller myotomy is an option for avoiding esophagectomy in achalasia, with a low morbimortality rate and good results. It is effective for most patients but will fail in a minority of patients and demand retreatment, be it a remyotomy, endoscopic treatment or esophagectomy.

scholarly journals Effectiveness of Different Modalities of Lip Repositioning Surgery for Management of Patients Complaining of Excessive Gingival Display: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Shima Younespour ◽  
Siamak Yaghobee ◽  
Hoori Aslroosta ◽  
Neda Moslemi ◽  
Elham Pourheydar ◽  
...  
Keyword(s):  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Clinical Trial Registry ◽  
Display Change ◽  
Patient’S Satisfaction ◽  
Partial Thickness ◽  
Flap Thickness ◽  
Meta Analyses

Purpose. This study is aimed at synthesizing the available evidence regarding effectiveness of various modalities (combinations of LRS tasks) and comparison between each two modalities in terms of gingival display reduction, success rate, stability of the results, patient’s satisfaction, and postoperative morbidity. Materials and Methods. The electronic databases including PubMed, Scopus, Web of Science Cochrane Library, Google Scholar databases, ClinicalTrials.gov, and WHO International Clinical Trial Registry Platform were searched up to 27th June 2020 regarding lip repositioning surgery. The modalities were defined as the combinations of the following tasks: frenectomy (yes/no), flap thickness (full/partial), and myotomy (yes/no). Meta-analyses were performed on gingival display change from baseline to months 3, 6, and 12 in each modalities using Stata (v.16). Results. 38 studies (including three clinical trials, two quasiexperimental studies, seven case series, and 26 case reports) met the criteria for final inclusion. The mean gingival display reduced from baseline to 6 months ( WMD = − 2.90 , 95% CI: -4.85 to -0.95) in the patients undergoing the “frenectomy + full-thickness flap + myotomy” modality. This parameter decreased from baseline to 6 and 12 months, respectively ( WMD = − 2.68 , 95% CI: -3.49 to -1.86; WMD = − 2.52 , 95% CI: -4.40 to -0.64), in patients undergoing the “frenectomy + partial-thickness flap + without myotomy” modality. In patients who undergone the “without frenectomy + partial-thickness flap + without myotomy” modality, gingival display reduced from baseline to 6 months ( WMD = − 3.22 , 95% CI: -5.61 to -0.84). Almost 83% of patients with modality 1 had satisfaction. Conclusions. Gingival display within the 6 months after LRS could be reduced with all modalities. Descriptively, the greatest reduction was observed in patients with the modality not including the frenulum.

scholarly journals Influence of Radiofrequency Electromagnetic Fields on the Fertility System: Protocol for a Systematic Review and Meta-Analysis (Preprint)

2017 ◽  
Author(s):  
Nasibeh Roozbeh ◽  
Fatemeh Abdi ◽  
Azadeh Amraee ◽  
Zahra Atarodi Kashani ◽  
Leili Darvish
Keyword(s):  
Systematic Review ◽  
Electromagnetic Fields ◽  
Mobile Phones ◽  
Reproductive System ◽  
Case Reports ◽  
Meta Analysis ◽  
Harmful Effect ◽  
Case Series ◽  
Cochrane Library ◽  
Evidence Based

BACKGROUND Due to the increased number of users of mobile phones, tablets, and other devices over the past few years, concerns about the potential impact of mobile phones on health are growing. The influence of mobile phone exposure on male fertility has been studied in recent years. Other research has shown that electromagnetic fields (EMFs) increase macrophages in the corpus luteum and growing follicles. Due to conflicting results among studies and since no systematic review has been performed to analyze the effects of radiofrequency EMF exposure from electronic devices on the fertility system in recent years, this evidence-based study is necessary. OBJECTIVE The main objectives of this study are to determine the best evidence associated with the influence of radiofrequency EMFs on the fertility system and to provide insight into a potential mechanism using our observations. METHODS In this systematic review, the databases and gray literature will be searched with no language and date limitation. The following databases will be searched: Cochrane Library, MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus, Science Direct, Google Scholar, and other Persian databases. The combination of the Medical Subject Heading terms “radiofrequency electromagnetic” and “male reproductive system” or “female reproductive system” will be searched. Observational study designs will be included but case reports, case series, reviews, and letters to the editor will be excluded. Papers selected for retrieval will be evaluated by two independent referees for methodological validation before entering a review using the Newcastle-Ottawa Scale for nonrandomized studies and cohort studies. RESULTS The results of this study will be submitted to a peer-reviewed journal for publication and also presented at PROSPERO. CONCLUSIONS This systematic review will provide evidence-based data on the effect of radiofrequency EMFs on the fertility system. This article will also classify the harmful effect of radiofrequency waves on primary and secondary infertility. This study could be useful for decreasing infertility. This is important because the rate of infertility is growing, leading to negative outcomes for couples and the health care system. CLINICALTRIAL PROSPERO CRD42017072462; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=72462 (Archived by WebCite at http://www.webcitation.org/6wjiE9R2q)

scholarly journals Influence of Chronic Exposure to Exercise on Heart Rate Variability in Children and Adolescents Affected by Obesity: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (21) ◽  
pp. 11065
Author(s):  
Rodrigo M. Dias ◽  
Íbis A. P. Moraes ◽  
Maria T. A. P. Dantas ◽  
Deborah C. G. L. Fernani ◽  
Anne M. G. G. Fontes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Children And Adolescents ◽  
Chronic Exposure ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Mesh Terms

Background: Sedentary lifestyles are increasingly common amongst children, and insufficient physical activity is a global epidemic estimated to contribute to future incapacities and potential deaths. Objective: We aimed to increase the amount of evidence concerning the effect of chronic exposure to exercise on heart rate variability in children and adolescents affected by obesity. Methods: A systematic review commenced following the PRISMA guidelines developed by Web of Science, Virtual Health Library, PubMed, Cochrane Library, Embase, Ovid, Medline Complete, and Scopus using keywords obtained from the Descriptors in Health Sciences and Medical Subject Headlines (MeSH) terms. We considered (1) Population: Pediatric individuals affected by obesity; (2) Intervention: Exercise; (3) Control: Pre-intervention and sedentary; (4) Outcomes: Clearly presented primary parameters; and (5) Studies: Clinical trials, case controls, case reports, and case series. Results: 11 articles were involved and predominantly included procedures observed during approximately 12 weeks with a distribution of three sessions per week, each session being 30–60 min of aerobic exercise; additionally, the exercise grades were typically completed at a percentage of subjects’ maximum heart rates. The meta-analyses displayed a significant effect on the domains of time (R-R interval, SDNN, rMSSD), frequency (HF ms2, HF (n.u.), LF/HF), and the non-linear index (SD1). Conclusion: Chronic exposure to exercise influences heart rate variability in children and adolescents affected by obesity by elevating the variability and parasympathetic activity and improving the sympathetic-vagal balance. Exercises should be recommended for the improvement of cardiac autonomic modulation to prevent the likelihood of further chronic diseases.

scholarly journals Treatment of Laryngoceles: What Is the Progress over the Last Two Decades?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Karol Zelenik ◽  
Lucia Stanikova ◽  
Katarina Smatanova ◽  
Michal Cerny ◽  
Pavel Kominek
Keyword(s):  
Case Reports ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Demographic Data ◽  
Surgical Techniques ◽  
Case Series ◽  
Cochrane Library ◽  
External Approach ◽  
Randomized Controlled ◽  
The Cochrane Library

Objectives. To review surgical techniques used in the treatment of laryngoceles over the last two decades and point out developments and trends.Materials and Methods. PubMed, the Cochrane Library, and the JBI Library of Systematic Reviews were searched using the term “laryngocele.” Demographic data, type of laryngocele, presence of a laryngopyocele, type of treatment and need for a tracheotomy were assessed.Results. Overall, data on 86 patients were analyzed, culled from 50 articles, of which 41 were case reports and 9 were case series. No single systematic review or meta-analysis or randomized controlled trial has been published on the topic. Altogether, 71 laryngoceles in 63 patients met the criteria for further analysis focusing on surgical treatment. An external approach was selected in 25/29 (86.2%) cases of combined laryngoceles. Microlaryngoscopic resection using a CO2laser was performed in three cases and endoscopic robotic surgery in one case. The majority of patients with an internal laryngocele, 31/42 (73.8%), were treated using the microlaryngoscopy approach.Conclusions. Microlaryngoscopy involving the use of a CO2laser has become the main therapeutic procedure for the treatment of internal laryngoceles during the past 20 years. An external approach still remains the main therapeutic approach for the treatment of combined laryngoceles.

scholarly journals Sunitinib Treatment for Advanced Paraganglioma: Case Report of a Novel SDHD Gene Mutation Variant and Systematic Review of the Literature

2021 ◽  
Vol 11 ◽  
Author(s):  
Franz Sesti ◽  
Tiziana Feola ◽  
Giulia Puliani ◽  
Roberta Centello ◽  
Valentina Di Vito ◽  
...  
Keyword(s):  
Systematic Review ◽  
Novel Mutation ◽  
Case Reports ◽  
Therapeutic Option ◽  
Case Series ◽  
Cochrane Library ◽  
Neuroendocrine Neoplasms ◽  
Antiangiogenic Agents ◽  
Review Of The Literature ◽  
Sunitinib Treatment

BackgroundParagangliomas (PGLs) are neuroendocrine neoplasms arising from chromaffin cells of sympathetic or parasympathetic paraganglia. Systemic therapies have been used only in metastatic PGLs. Antiangiogenic agents, such as sunitinib, could be a viable therapeutic choice in the subgroup of patients with SDH-positive PGLs. We describe the case of a man with Familial Paraganglioma Syndrome type 1 (FPGL) related to a novel mutation in SDHD gene treated with sunitinib. Furthermore, we performed a systematic review of the literature aimed to address the following question: is sunitinib treatment effective in patients with advanced/progressive/metastatic PGL?MethodsWe performed a data search using MEDLINE, Cochrane Library, and Scopus between April 2019 and September 2020. We included studies reporting data on clinical or biological characteristics, or clinical outcomes of patients with PGLs treated with sunitinib.ResultsThe search leaded to the selection of 25 publications. Data from case reports and case series showed that disease control rate (DCR = stable disease + partial response + complete response) was achieved in 34.7% of cases under sunitinib treatment. In 39% of patients DCR was followed by progressive disease (PD) or tumor relapse, 26.1% patients showed PD. Data from clinical trials showed that DCR was 83%, and the median progression free survival was 13.4 months.DiscussionData from the present literature review suggested that sunitinib could be a viable therapeutic option in advanced/progressive/metastatic inoperable PGLs. However, further trials on the efficacy of sunitinib in FPGL and sporadic PGL are needed.

scholarly journals What Specimen Urologists Should Be Most Concerned About ? A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
M. Reza Roshandel ◽  
Masoud Nateqi ◽  
Ramin Lak ◽  
Pooya Aavani ◽  
Reza Sari Motlagh ◽  
...  
Keyword(s):  
Case Reports ◽  
Meta Analysis ◽  
Systemic Disease ◽  
Case Series ◽  
Cochrane Library ◽  
List Type ◽  
Viral Shedding ◽  
Negative Results ◽  
Technical Errors ◽  
Preventative Measures

AbstractObjectiveInvestigating the infectivity of body fluid can be useful for preventative measures in the community and ensuring safety in the operating rooms and on the laboratory practices.MethodsWe performed a literature search of clinical trials, cohorts, and case series using PubMed/MEDLINE, Google Scholar, and Cochrane library, and downloadable database of CDC. We excluded case reports and searched all-language articles for review and repeated until the final drafting. The search protocol was registered in the PROSPERO database.ResultsThirty studies with urinary sampling for viral shedding were included. A total number of 1,271 patients were enrolled initially, among which 569 patients had undergone urinary testing. Nine studies observed urinary viral shedding in urine from 41 patients. The total incidence of urinary SARS-CoV-2 shedding was 8%, compared to 21.3% and 39.5 % for blood and stool, respectively. The summarized risk ratio (RR) estimates for urine positive rates compared to the pharyngeal rate was 0.08. The pertaining RR urine compared to blood and stool positive rates were 0.20 and 0.33 respectively.ConclusionsOur review concludes that not only the SARS-CoV-2 can be excreted in the urine in eight percent of patients but also its incidence may have associations with the severity of the systemic disease, ICU admission, and fatality rates. Moreover, the findings in our review suggest that a larger population size may reveal more positive urinary cases possibly by minimizing biases. However, it is important to notice that it is the naso-pharyngeal specimens, stool, and serum that show more possibilities to became positive, respectively.Take-home bullet points❖The urinary shedding incidence was 8%, compared to 21.3% and 39.5 % for blood and stool, respectively.❖Urinary shedding may have associations with the severity of the systemic disease, ICU admission, and fatality rates.❖Repeat urinary testing is warranted throughout the disease phases, especially in clinically suspected cases with an initially negative results.❖Technical errors in handling samples, as well as different rRT-PCR methods can be responsible for diversity found in results, in part.

scholarly journals Safety and Tolerability of Lacosamide in Patients With Epilepsy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chunsong Yang ◽  
Yuxuan Peng ◽  
Lingli Zhang ◽  
Li Zhao
Keyword(s):  
Adverse Events ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Meta Analysis ◽  
Safety Data ◽  
Case Series ◽  
Cochrane Library ◽  
Total Incidence ◽  
Patients With Epilepsy

Background: As a third-generation antiseizure medication (ASM), lacosamide (LCM) is recommended worldwide for patients with epilepsy. We aimed to provide more conclusive evidence for the safety and tolerability of LCM in patients with epilepsy.Methods: A systematic search was performed on MEDLINE, Embase, Cochrane Library, CBM, CNKI, IDB, VIP Database, and Wanfang Database from inception to 2021 March, and all studies assessing the safety of LCM were included. A meta-analysis was performed for safety data of LCM.Results: Eighty-three studies involving 12268 populations (11 randomized clinical trials (RCTs), 16 cohort studies, 53 case series, and 3 case reports) were included in our study. Meta-analysis of the total incidence of adverse events (AEs) of LCM was 38.7% [95% CI (35.1%, 45.8%); n=75 studies]. Incidence of withdrawal due to AEs was 10.8% [95% CI (9.1%, 12.6%); n=56 studies], and incidence of serious adverse events (SAEs) was 6.5% [95% CI (4.0%, 8.9%); n=13 studies]. Most AEs were in the nervous system and digestive system. The most common AEs were sedation (15.8%), dizziness (15.7%), fatigue (9.4%), and nausea/vomiting (9.3%). For children, the total incidence of AEs of LCM was 32.8% [95% CI (21.6%, 44.0%); n=16 studies], and the most common AEs were dizziness (8.6%), nausea/vomiting (8.6%), and somnolence (6.8%).Conclusion: Lacosamide is generally safe and well tolerated in patients with epilepsy. Common AEs were sedation, dizziness, and fatigue. It is necessary to pay more attention to the prevention and management of these AEs and conduct more large-scale and high-quality studies to update safety data.

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