scholarly journals Wear in Antagonist Teeth Produced by Monolithic Zirconia Crowns: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (4) ◽  
pp. 997 ◽  
Author(s):  
María Fernanda Solá-Ruíz ◽  
Alejandra Baima-Moscardó ◽  
Eduardo Selva-Otaolaurruchi ◽  
José María Montiel-Company ◽  
Rubén Agustín-Panadero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Model ◽  
Meta Analysis ◽  
Fixed Base ◽  
Zirconia Crowns ◽  
Monolithic Zirconia ◽  
Fixed Prosthesis ◽  
Meta Regression ◽  
Meta Analyses ◽  
Enamel Wear

Background: The aim of this systematic review and meta-analysis was to determine the wear sustained in the natural antagonist tooth in cases of full-coverage fixed-base prosthetic restorations or monolithic zirconia tooth-supported crowns, as well as to determine the wear in the restoration itself, both in the short- and medium-term and considering the factors that may influence wear. Material and methods: A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated wear in antagonist teeth in relation to fixed-prosthesis monolithic zirconia crowns. A total of 5 databases were consulted in the literature search: Pubmed-Medline, Cochrane, Scopus, Embase and Web of Science (WOS). After eliminating duplicated articles and applying the inclusion criteria, eight articles were selected for the qualitative analysis and four for the quantitative analysis. Results: Mean maximum wear of the antagonist tooth in relation to monolithic zirconia crowns of magnitude 95.45 µm (CI at 95% 79.57–111.33) was observed. By using a meta-regression model (R2 = 0.92) the significant effect of time in maximum wear rate (p < 0.001) was observed, estimated at 6.13 µm per month (CI at 95% 3.99–8.27). Furthermore, monolithic zirconia crowns are subject to a mean maximum wear of 58.47 µm (CI 95% 45.44–71.50). By using a meta-regression model (R2 = 0.53) the significant effect of time in the maximum wear value was observed (p = 0.053), estimated at 3.40 µm per month (CI al 95% −0.05–6.85). Conclusions: Monolithic zirconia crowns lead to a progressive maximum wear of the antagonist tooth over time which is greater than the maximum wear sustained in the crown itself. It is not possible to establish an objective and quantitative objection in relation to natural enamel wear or metal–ceramic crowns.

scholarly journals Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis

2020 ◽  
Vol 75 (12) ◽  
pp. 2461-2470
Author(s):  
Benjamin Kye Jyn Tan ◽  
Ryan Eyn Kidd Man ◽  
Alfred Tau Liang Gan ◽  
Eva K Fenwick ◽  
Varshini Varadaraj ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Longitudinal Studies ◽  
Meta Analysis ◽  
Sensory Loss ◽  
Cross Sectional ◽  
Sensory Impairments ◽  
Subgroup Analyses ◽  
Meta Regression ◽  
Meta Analyses

Abstract Background Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty. Methods In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments—vision (VI), hearing (HI), smell (SI), and taste (TI)—and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger’s test. Results We included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI–frailty relationships. Conclusions Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty.

The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression

2021 ◽  
pp. 193229682110646
Author(s):  
Stine Hangaard ◽  
Sisse H. Laursen ◽  
Jonas D. Andersen ◽  
Thomas Kronborg ◽  
Peter Vestergaard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Sufficient Information ◽  
Meta Regression ◽  
Meta Analyses

Background: Previous systematic reviews have aimed to clarify the effect of telemedicine on diabetes. However, such reviews often have a narrow focus, which calls for a more comprehensive systematic review within the field. Hence, the objective of the present systematic review, meta-analysis, and meta-regression is to evaluate the effectiveness of telemedicine solutions versus any comparator without the use of telemedicine on diabetes-related outcomes among adult patients with type 2 diabetes (T2D). Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We considered telemedicine randomized controlled trials (RCT) including adults (≥18 years) diagnosed with T2D. Change in glycated hemoglobin (HbA1c, %) was the primary outcome. PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) were searched on October 14, 2020. An overall treatment effect was estimated using a meta-analysis performed on the pool of included studies based on the mean difference (MD). The revised Cochrane risk-of-bias tool was applied and the certainty of evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: The final sample of papers included a total of 246, of which 168 had sufficient information to calculate the effect of HbA1c%. The results favored telemedicine, with an MD of −0.415% (95% confidence interval [CI] = −0.482% to −0.348%). The heterogeneity was great (I2 = 93.05%). A monitoring component gave rise to the higher effects of telemedicine. Conclusions: In conclusion, telemedicine may serve as a valuable supplement to usual care for patients with T2D. The inclusion of a telemonitoring component seems to increase the effect of telemedicine.

scholarly journals Hypertension prevalence among indigenous populations in Brazil: a systematic review with meta-analysis

2015 ◽  
Vol 49 (6) ◽  
pp. 1012-1022 ◽  
Author(s):  
Zilmar Augusto de Souza Filho ◽  
Alaidistânia Aparecida Ferreira ◽  
Bernardo dos Santos ◽  
Angela Maria Geraldo Pierin
Keyword(s):  
Systematic Review ◽  
Regression Model ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Indigenous Populations ◽  
Cultural Economic ◽  
Constant Increase ◽  
Hypertension Prevalence ◽  
Meta Regression ◽  
Indigenous Society

Abstract OBJECTIVE Evaluating the evidence of hypertension prevalence among indigenous populations in Brazil through a systematic review and meta-analysis. METHODS A search was performed by two reviewers, with no restriction of date or language in the databases of PubMed, LILACS, SciELO, Virtual Health Library and Capes Journal Portal. Also, a meta-regression model was designed in which the last collection year of each study was used as a moderating variable. RESULTS 23 articles were included in the review. No hypertension was found in indigenous populations in 10 studies, and its prevalence was increasing and varied, reaching levels of up to 29.7%. Combined hypertension prevalence in Indigenous from the period of 1970 to 2014 was 6.2% (95% CI, 3.1% - 10.3%). In the regression, the value of the odds ratio was 1.12 (95% CI, 1.07 - 1.18; p <0.0001), indicating a 12% increase every year in the probability of an indigenous person presenting hypertension. CONCLUSION There has been a constant increase in prevalence despite the absence of hypertension in about half of the studies, probably due to changes in cultural, economic and lifestyle habits, resulting from indigenous interaction with non-indigenous society.

scholarly journals 1245. Does Complexity of Infection Prevention Bundles Matter in Colorectal Surgery? A Systematic Review and Meta-Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S448-S448
Author(s):  
Aurora E Pop-Vicas ◽  
Cybele Lara R Abad ◽  
Fay Osman ◽  
Kelsey Baubie ◽  
Nasia Safdar
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Meta Analysis ◽  
Cost Effective ◽  
Effective Manner ◽  
Meta Regression ◽  
Bundle Size ◽  
Mechanical Bowel Prep ◽  
Meta Analyses ◽  
Dressing Change

Abstract Background Surgical site infection (SSI) prevention bundles in colorectal surgery are common. The optimal bundle composition and impact of increasingly complex and resource-intensive bundled interventions on SSI remain unclear. Methods (1) A systematic review and meta-analysis of randomized and observational trials with pre-post implementation data for colorectal SSI prevention bundles to study their effect on superficial, deep, and organ-space SSI. (2) A meta-regression to determine whether the bundle size (number of different bundle elements) affects SSI. (3) A correlation analysis to identify individual bundle elements with greatest SSI reduction. We used the METAN, METAEFF, and METAREG packages in STATA SE 15 for analysis. Results We included 38 studies in the systematic review, and 29 studies (49,589 patients) in the meta-analysis. Bundle composition was highly variable, ranging from 3 – 13 guideline-recommended elements per bundle. Meta-analyses showed bundles to be associated with relative risk reductions of 43% for any SSI (RR 0.57 [95% CI 0.48–0.67]; 44% for superficial SSI (RR 0.56 [95% CI 0.42–0.75]; 33% for deep SSI (RR 0.67 [95% CI 0.45–0.98], and 37% for organ/space SSI (RR 0.63 [95% CI 0.49 – 0.81]). On meta-regression, bundle size, especially ≥10 elements, was significantly associated with SSI reduction for any SSI (P = 0.04) and for superficial SSI (P = 0.005). Individual bundle elements correlated with strongest SSI reductions were mechanical bowel prep combined with oral antibiotics (R = −0.68, P = 0.0028) and pre-operative chlorhexidine showers (R = −0.49, P = 0.04) for organ/space SSI. Protocols including separate instrument trays and glove ± gown change prior to surgical wound closure (R = −0.55, P = 0.009), and standardized postoperative wound dressing change at 48 hours (R = −30.59, P = 0.005) correlated with highest superficial SSI reductions. Conclusion Complex colorectal bundles with ≥10 clinical guideline-recommended prevention elements are associated with higher reductions in any SSI and in superficial SSI. Further research should evaluate how complex SSI prevention colorectal bundles can be implemented and sustained with high fidelity in the clinical setting in a cost-effective manner. Disclosures All authors: No reported disclosures.

Triclosan-Coated Sutures Reduce the Risk of Surgical Site Infections: A Systematic Review and Meta-analysis

2015 ◽  
Vol 36 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Nalini Singh ◽  
Aila Nica Bandong ◽  
Gilbert Madriaga
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Random Effects ◽  
Meta Analysis ◽  
Surgical Site Infections ◽  
Sensitivity Analyses ◽  
Publication Type ◽  
Random Effects Models ◽  
Meta Regression ◽  
Meta Analyses

OBJECTIVETo analyze available evidence on the effectiveness of triclosan-coated sutures (TCSs) in reducing the risk of surgical site infection (SSI).DESIGNSystematic review and meta-analysis.METHODSA systematic search of both randomized (RCTs) and nonrandomized (non-RCT) studies was performed on PubMed Medline, OVID, EMBASE, and SCOPUS, without restrictions in language and publication type. Random-effects models were utilized and pooled estimates were reported as the relative risk (RR) ratio with 95% confidence interval (CI). Tests for heterogeneity as well as meta-regression, subgroup, and sensitivity analyses were performed.RESULTSA total of 29 studies (22 RCTs, 7 non-RCTs) were included in the meta-analysis. The overall RR of acquiring an SSI was 0.65 (95% CI: 0.55–0.77; I2=42.4%, P=.01) in favor of TCS use. The pooled RR was particularly lower for the abdominal surgery group (RR: 0.56; 95% CI: 0.41–0.77) and was robust to sensitivity analysis. Meta-regression analysis revealed that study design, in part, may explain heterogeneity (P=.03). The pooled RR subgroup meta-analyses for randomized controlled trials (RCTs) and non-RCTs were 0.74 (95% CI: 0.61–0.89) and 0.53 (95% CI: 0.42–0.66), respectively, both of which favored the use of TCSs.CONCLUSIONThe random-effects meta-analysis based on RCTs suggests that TCSs reduced the risk of SSI by 26% among patients undergoing surgery. This effect was particularly evident among those who underwent abdominal surgery.Infect Control Hosp Epidemiol 2015;36(2): 1–11

scholarly journals Depression, anxiety, and stress in oral lichen planus: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Teresa De Porras-Carrique ◽  
Miguel Ángel González-Moles ◽  
Saman Warnakulasuriya ◽  
Pablo Ramos-García
Keyword(s):  
Systematic Review ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Meta Analysis ◽  
Current Evidence ◽  
Specific Method ◽  
Prevalence Of Depression ◽  
Meta Regression ◽  
Meta Analyses ◽  
Oral Lichen

Abstract Objectives We present this systematic review and meta-analyses to evaluate current evidence on the prevalence of depression, anxiety, and stress in patients with oral lichen planus and their magnitude of association. Material and methods We searched PubMed, Embase, Web of Science, Scopus, PsycInfo, and Google Scholar for studies published before January 2021. We evaluated the quality of studies using a specific method for systematic reviews addressing prevalence questions, designed by the Joanna Briggs Institute. We carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses. Results Fifty-one studies (which recruited 6,815 patients) met the inclusion criteria. Our results reveal a high prevalence of depression (31.19%), anxiety (54.76%), and stress (41.10%) in oral lichen planus. Furthermore, OLP patients presented a significantly higher relative frequency than control group without OLP for depression (OR = 6.15, 95% CI = 2.73–13.89, p < 0.001), anxiety (OR = 3.51, 95% CI = 2.10–5.85, p < 0.001), and stress (OR = 3.64, 95% CI = 1.48–8.94, p = 0.005), showing large effect sizes. Subgroups meta-analyses showed the relevance of the participation of psychologists and psychiatrists in the diagnosis of depression, anxiety, and stress in patients with OLP. Multivariable meta-regression analysis showed the importance of the comorbidity of depression-anxiety in patients with OLP. Conclusions Our systematic review and meta-analysis show that patients with OLP suffer a higher prevalence of depression, anxiety, and stress, being more frequent than in general population. Clinical relevance In the dental clinic, especially dentists should be aware of depression, anxiety, and stress in OLP patients to achieve a correct referral.

Risk of Depression in Patients With Psoriatic Disease: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 120347542097747
Author(s):  
Aysha Lukmanji ◽  
Robert B. Basmadjian ◽  
Isabelle A. Vallerand ◽  
Scott B. Patten ◽  
Karen L. Tang
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Future Research ◽  
Random Effects Models ◽  
Psoriatic Disease ◽  
Meta Regression ◽  
Meta Analyses ◽  
Psoriasis Severity

Background Previous systematic reviews have assessed the prevalence and odds ratio (OR) of depression for patients with psoriatic disease. Due to probable bidirectional effects, prevalence and prevalence ORs are difficult to interpret. No prior reviews have quantified the relative risk (RR) of depression following a diagnosis of psoriatic disease. Objective To estimate the RR of depression in individuals with psoriasis and in psoriatic arthritis (PsA), clear-to-moderate psoriasis, and moderate-to-severe psoriasis subgroups. Methods Observational studies investigating the risk of depression in adults with psoriatic disease were systematically searched for in Medline, EMBASE, PsycINFO, and CINAHL databases; 4989 unique references were screened. Studies that reported measures of incident depression in psoriasis patients were included. Thirty-one studies were included into the systematic review, of which 17 were meta-analyzed. Random effects models were employed to synthesize relevant data. Sources of heterogeneity were explored with subgroup analysis and meta-regression. Results Seventeen studies were included in meta-analyses. The pooled RR of depression in psoriasis patients compared to nonpsoriasis controls was 1.48 (95% CI: 1.16-1.89). Heterogeneity was high (I2 = 99.8%). Subgroup analysis and meta-regression did not indicate that PsA status or psoriasis severity (clear-to-mild, moderate-to-severe) were sources of heterogeneity. No evidence of publication bias was found. Conclusions This review demonstrates that the risk of depression is greater in patients with psoriasis and PsA. Future research should focus on developing strategies to address the mental health needs of this patient population for depression, including primary prevention, earlier detection, and treatment strategies.

scholarly journals Exploring the Role of Persuasive Design in Unguided ICBT for Depression and Anxiety: Systematic Review, Meta-Analysis, and Meta-Regression (Preprint)

2021 ◽  
Author(s):  
Hugh Cameron McCall ◽  
Heather D Hadjistavropoulos ◽  
Christopher Richard Francis Sundström
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Design Principles ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Depression And Anxiety ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Meta Analyses

BACKGROUND Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment that can overcome barriers to care. Various research groups have suggested that unguided ICBT (i.e., ICBT without therapist support) and other eHealth interventions can be designed in ways that enhance user engagement and thus outcomes. The persuasive systems design framework captures most design recommendations for eHealth interventions, but there is little empirical support that persuasive design is related to clinical outcomes in unguided ICBT. OBJECTIVE One objective of this study was to provide an updated meta-analysis of randomized controlled trials of unguided ICBT for depression and anxiety. Another objective was to describe the use of persuasive design in such interventions. A third objective was to employ meta-regression to explore whether a greater number of persuasive design elements predicts efficacy in unguided ICBT for depression and anxiety. METHODS We conducted a systematic review of five databases to find randomized controlled trials of unguided ICBT for depression and anxiety. We conducted separate random-effects meta-analyses and separate meta-regressions for depression and anxiety interventions. Each meta-regression included two steps. The first step included, as a predictor, whether each intervention was transdiagnostic. For the meta-regression of ICBT for depression, the first step also included the type of control condition. The number of persuasive design principles identified for each intervention was added as a predictor in the second step to reveal the additional variance in effect sizes explained by persuasive design. RESULTS We identified 4,471 articles in our search, 46 of which were eligible for inclusion in our analyses. Our meta-analyses showed effect sizes (Hedges’ g) ranging from 0.22 to 0.31 for depression interventions, depending on the measures taken to account for bias in the results. We found a mean effect size of 0.45 for anxiety interventions, with no evidence that results were inflated by bias. Included interventions were identified as employing an average of 4.88 persuasive design principles. The meta-regressions showed that a greater number of persuasive design principles predicted greater efficacy in ICBT for depression (R2 change=.27, B=0.04, P=.02) but not anxiety (R2 change=.05, B=0.03, P=.17). CONCLUSIONS These findings provide preliminary support for the proposition that more persuasively designed ICBT interventions are more efficacious, at least in the treatment of depression. Further research is needed to clarify the role of persuasive design in ICBT. CLINICALTRIAL PROSPERO (https://www.crd.york.ac.uk/prospero/) CRD42020153466

scholarly journals Prevalence of Postural Hypotension in Primary, Community and Institutional Care: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Sinead TJ McDonagh ◽  
Natasha Mejzner ◽  
Christopher E Clark
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Primary Care ◽  
Postural Hypotension ◽  
Meta Analysis ◽  
Blood Pressure Measurement ◽  
Institutional Care ◽  
Consensus Definition ◽  
Meta Regression ◽  
Meta Analyses

Abstract Background: Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care despite these associated risks. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups.Methods: A systematic review, meta-analyses and meta-regression were undertaken. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean prevalence of PH were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment of included studies was undertaken using an adapted version of the Newcastle-Ottawa Scale.Results: 1816 studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14-20%) in the community, 19% (15-25%) in primary care and 31% (15-50%) in residential care or nursing homes (P=0.16 between groups). By condition, prevalences were 20% (16-24%) with hypertension, 21% (16-26%) with diabetes, 25% (18-33%) with Parkinson’s disease and 29% (25-33%) with dementia, compared to 14% (12-17%) without these conditions (P<0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P<0.01, P=0.13, respectively; R2=36%). PH prevalence was not affected by blood pressure measurement device (P=0.65) or sitting or supine resting position (P=0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P=0.01) irrespective of study quality (P=0.04).Conclusions: The prevalence of PH in populations relevant to primary care is substantial. The definition used is important when testing for PH. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of postural hypotension.PROSPERO: CRD42017075423.

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