Preventive Antibiotic Therapy in the Placement of Immediate Implants: A Systematic Review

Immediate implants present a high risk of early failure. To avoid this, preventive antibiotics (PAs) are prescribed; however, their inappropriate administration leads to antimicrobial resistance. The present study aims to clarify whether the prescription of PAs reduces the rate of early failure of immediate implants and to establish guidelines to avoid the overprescription of these drugs. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS and OpenGrey was carried out. The criteria described in the PRISMA® statement were used. The search was temporarily restricted from 2010 to 2021. The risk of bias was analysed using the SIGN Methodological Assessment Checklist for Systematic Reviews and Meta-Analyses and the JBI Prevalence Critical Appraisal Tool. After searching, eight studies were included that met the established criteria. With the limitations of this study, it can be stated that antibiotic prescription in immediate implants reduces the early failure rate. Preoperative administration of 2–3 g amoxicillin one hour before surgery followed by 500 mg/8 h for five to seven days is recommended. It is considered prudent to avoid the use of clindamycin in favour of azithromycin, clarithromycin or metronidazole in penicillin allergy patients until further studies are conducted.

Gambaran Faktor-faktor Yang Mempengaruhi Kualitas Hidup Lansia : Scoping Review

The elderly will experience many changes and problems such as a decrease in biological, psychological, social or economic functions. Thus, it can be affect their quality of life. Quality of life is the level of well-being with events or conditions experienced by the elderly. The purpose of this study was to determine the factors that affect the quality of life of the elderly. The study used a scoping review method. The databases used for article search are PROQUEST, and PUBMED. Articles are selected based on the keywords, topics and inclusion and exclusion criteria that have been determined. There were five articles obtained. STROBE critical appraisal tool was used to examine the quality of the articles. The results show that the quality of life score on the physical health and dimension was the lowest compared to the psychological, social and environmental dimensions. The associated factors related to the quality of life of the elderly are including gender, age, education level, and economic status.Keywords: Elderly, Fakctors Associated Quality of Life AbstrakLansia akan mengalami banyak perubahan dan masalah seperti penurunan fungsi biologis, psikologis, sosial atau ekonomi sehingga perubahan pada lansia akan membawa tekanan dan berpengaruh pada kualitas hidupnya. Penelitian terkait kualitas hidup pada lansia sangat penting dilakukan karena kualitas hidup merupakan tingkat kesejahteraan dengan peristiwa atau kondisi yang dialami lansia. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kualitas hidup lansia. Penelitian menggunakan metode scoping review. Database yang digunakan untuk pencarian artikel adalah PROQUEST, dan PUBMED. Artikel diseleksi berdasarkan kesesuaian dengan kata kunci, topik serta kriteria inklusi dan eksklusi yang telah ditentukan. Hasil penelusuran didapatkan sebanyak lima artikel berbahasa Inggris. Instrumen telaah kritis yang digunakan untuk menelaah kualitas artikel adalah strobe. Hasil penelitian scoping review dari kelima artikel menunjukan skor kualitas hidup pada dimensi kesehatan fisik paling rendah dari pada dimensi psikologis, hubungan sosial dan lingkungan. Faktor yang berhubungan dengan kualitas hidup lansia adalah karakteristik responden yang meliputi (jenis kelamin, usia, pendidikan, dan status ekonomi).Kata Kunci : Lansia, Kualitas Hidup, Faktor-Faktor

P.138 A systematic review of the incidence and prevalence of Neurofibromatosis type 1 and 2

Background: Neurofibromatosis 1 and 2 (NF1 and NF2) are autosomal dominant genetic disorders caused by mutations in tumour suppressor genes. Methods: We conducted a systematic review of the incidence and prevalence of NF1 and NF2 in OVID Medline, OVID Embase, Web of Science, and Cinahl. We included studies until February 19, 2021, that identified cases based on established criteria. Studies were appraised for quality using the Joanna Briggs Institute Prevalence Critical Appraisal tool. Pooled incidence and prevalence rates were estimated through meta-analysis. Results: Of 1,936 studies, 1,866 were irrelevant after title and abstract screening. Sixteen of 69 studies with full text assessment were included for full review: 13 regarding NF1 and 6 regarding NF2. Incidence rates for NF1 and NF2 ranged from 1/11,494 to 1/1,871 and 1/62,185 to 1/33,000 respectively. Prevalence rates for NF1 and NF2 ranged from 1/6,238 to 1/1,001 and 1/600,000 to 1/56,161 respectively. Meta-analysis will be presented at the conference. Conclusions: An accurate estimate of the incidence and prevalence of NF1 and NF2 will offer more insight into health resource allocation. Increased funding and resources for the development of early diagnostic and treatment tools for NF1 and NF2 may improve the quality of life of patients.

AMSTAR 2 Appraisal of Systematic Reviews and Meta-analyses in the Field of Heart Failure from High-impact Journals

Background: The MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 is a critical appraisal tool for systematic reviews (SRs) and meta-analyses (MAs) of interventions. We aimed to perform the first AMSTAR 2-based quality assessment of heart failure-related studies. Methods: Eleven high-impact journals were searched from 2009 to 2019. The included studies were assessed on the basis of 16 domains. Seven domains were deemed critical for high-quality studies. On the basis of the performance in these 16 domains with different weights, overall ratings were generated and the quality was determined to be “high,” “moderate,” “low,” or “critically low.” Results: Eighty-one heart failure-related SRs with MAs were included. Overall, 79 studies were of “critically low quality” and two were of “low quality.” These findings were attributed to insufficiency in the following critical domains: a priori protocols (compliance rate, 5%), complete list of exclusions with justification (5%), risk of bias assessment (69%), meta-analysis methodology (78%), and investigation of publication bias (60%).Conclusions: The low ratings for these potential high-quality heart failure-related SRs and MAs challenge the discrimination capacity of AMSTAR 2. In addition to identifying certain areas of insufficiency, these findings indicate the need to justify or modify AMSTAR 2’s rating rules.

Effect of Pharmacogenetic-Based Decision Support Tools in Improving Depression Outcomes: A Systematic Review

Introduction: Evidence supporting pharmacogenetic (PGX) tests utility in depression is scarce. The main objectives of this study were to summarize, update, and assess the quality of the available evidence regarding PGX testing in depression as well as estimating the impact of using PGX testing tools in depression outcomes in the MENA region. Methodology: Scientific databases were systematically searched from inception to March 20, 2020 for systematic reviews (SRs) and randomized controlled trials (RCTs) assessing clinical utility of PGX tests in treatment of depression. Meta-analysis only and RCTs that that were included in eligible SRs were excluded. Quality of the eligible studies were assessed using Crowe Critical Appraisal Tool (CCAT). Results: Six SRs and three RCTs met the inclusion criteria and were included in this study. Results of the SRs have provided weak evidence on the efficacy of PGX testing especially in patients with moderate-severe depression at eight weeks. In addition, there was a lack of evidence regarding safety outcomes. Newer RCTs with better qualities showed clinical promise regarding efficacy outcomes especially in patients with gene-drug interactions. No evidence was found regarding PGX testing impact in the MENA region. Conclusion: This SR summarizes findings, provides an update, and assesses the quality of available SRs on this topic. Findings of this study have demonstrated that PGX testing prior to treatment initiation might improve efficacy outcomes. Further studies are warranted to assess PGX testing impact on safety outcomes.

Liver Impairment—The Potential Application of Volatile Organic Compounds in Hepatology

Liver diseases are currently diagnosed through liver biopsy. Its invasiveness, costs, and relatively low diagnostic accuracy require new techniques to be sought. Analysis of volatile organic compounds (VOCs) in human bio-matrices has received a lot of attention. It is known that a musty odour characterises liver impairment, resulting in the elucidation of volatile chemicals in the breath and other body fluids such as urine and stool, which may serve as biomarkers of a disease. Aims: This study aims to review all the studies found in the literature regarding VOCs in liver diseases, and to summarise all the identified compounds that could be used as diagnostic or prognostic biomarkers. The literature search was conducted on ScienceDirect and PubMed, and each eligible publication was qualitatively assessed by two independent evaluators using the SANRA critical appraisal tool. Results: In the search, 58 publications were found, and 28 were kept for inclusion: 23 were about VOCs in the breath, one in the bile, three in urine, and one in faeces. Each publication was graded from zero to ten. A graphical summary of the metabolic pathways showcasing the known liver disease-related VOCs and suggestions on how VOC analysis on liver impairment could be applied in clinical practice are given.

Anxiety and depression among healthcare workers during the COVID-19 pandemic: a systematic umbrella review of the global evidence

ObjectivesTo summarise the evidence relating to the prevalence of anxiety and depression among healthcare workers (HCWs) during the COVID-19 pandemic.DesignAn umbrella review of systematic reviews was undertaken using the Joanna Briggs Institute (JBI) methods.Data sourcesThe Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, PsycINFO, Embase and CINAHL were searched in March 2021 for reviews published in English.Eligibility criteriaSystematic reviews reporting the prevalence of anxiety and depression among HCWs during the COVID-19 pandemic. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed using the JBI critical appraisal tool for systematic reviews, and the degree of overlap in primary studies was calculated.ResultsTen systematic reviews (100 unique studies), including 169 157 HCWs from 35 countries were included. The prevalence of anxiety among all HCWs ranged from 22.2% (95% CI 21.3% to 23.1%) to 33.0% (95% CI 31.9% to 34.1%). The prevalence of anxiety among physicians (n=5820) was reported to be between 17% and 19.8% and for nurses (n=14 938) between 22.8% and 27%. The prevalence of depression among all HCWs ranged from 17.9% (95% CI 17.1% to 18.8%) to 36% (95% CI 34.9% to 37.1%). The prevalence of depression among physicians (n=643) and nurses (n=8063) was reported to be 40.4% and 28%, respectively.ConclusionsThere is wide variation evident in the presence of anxiety and depression among HCWs. In particular, the prevalence of depression among physicians was high. Strategies to reduce the incidence of anxiety and depression are urgently required.PROSPERO registration numberCRD42021238960.