scholarly journals Use of Platelet-Rich Fibrin in the Treatment of Grade 2 Furcation Defects: Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 2104
Author(s):  
Francesco Tarallo ◽  
Leonardo Mancini ◽  
Luciano Pitzurra ◽  
Sergio Bizzarro ◽  
Michele Tepedino ◽  
...  

In periodontitis patients, furcation defects are crucial sites to regenerate due to their complex anatomy. Various modern surgical techniques and use of biomaterials have been suggested in the literature. Among all, platelet-rich fibrin (PRF) has potential in tissue regeneration thanks to its role in the release of growth factors. Therefore, the purpose of this study was to evaluate the beneficial effect of the addition of PRF to open flap debridement (OFD) or as an adjuvant to other biomaterials such as bone grafts in the treatment of grade 2 mandibular furcation defects. Systematic research was carried out on the databases Medline, Scopus, Embase, and Cochrane Library and registered on PROSPERO (CRD42020167662). According to the PICO guidelines by Cochrane, randomized trials and prospective non-randomized trials were evaluated, with a minimum follow-up period of 6 months. The inclusion criteria were the absence of systemic diseases, non-smoking patients, and a population aged from 18 to 65 years. Vertical pocket probing depth (PPD), vertical clinical attachment level (VCAL), and gingival recession (REC) were the primary outcomes. Vertical furcation depth (VFD), and the percentage of bone defect fill (%v-BDF) were considered as secondary outcomes. A meta-analysis of the primary and secondary outcomes was performed. Publication bias was assessed through a funnel plot. Eighty-four articles were initially extracted. Eight randomized clinical trials were analyzed according to the exclusion and inclusion criteria. The Quality assessment instrument (QAI) revealed four articles at low risk of bias, one at moderate, and three at high risk of bias. The metanalysis showed significant data regarding PPD, VCAL, VFD and %v-BDF in the comparison between PRF + OFD vs. OFD alone. The adjunct of PRF to a bone graft showed a significant difference for VCAL and a not statistically significant result for the other involved parameters. In conclusion, the adjunctive use of PRF to OFD seems to enhance the periodontal regeneration in the treatment of grade 2 furcation defects. The combination of PRF and bone graft did not show better clinical results, except for VCAL, although the amount of literature with low risk of bias is scarce. Further well-designed studies to evaluate the combination of these two materials are therefore needed.

2020 ◽  
Vol 27 (3) ◽  
pp. 246-258
Author(s):  
Yeoungsuk Song ◽  
Seurk Park

Purpose: The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing student nurses’ critical thinking, problem solving, and self-directed learning.Methods: To conduct the meta-analysis, 1,963 studies were retrieved from eight databases (Pubmed, EMbase, CINAHL, Cochrane Library, KERIS, KISS, NDSL, KoreaMed) without restriction on publication year. Articles published up to March 2019 were selected for this study. Fourteen studies were selected for meta-analysis based on satisfaction of inclusion criteria and low risk of bias. Baseline demographic data, exercise features, and outcome data were extracted from all trials included. The data was analyzed using the RevMan 5.3 program.Results: Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students’ critical thinking (ES=0.29, 95% Cl=0.04~0.54, <i>p</i>=.002), problem solving (ES=0.39, 95% Cl=-0.09~0.87, <i>p</i>=.11), and self-directed learning (ES=0.35, 95% Cl=-0.22~0.91, <i>p</i>=.23) compared with traditional lectures.Conclusion: PBL help improve the critical thinking in nursing students. Although problem solving and self directed learning were not affected, more research with a larger sample size and repeated meta-analysis of PBL are required.


2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
A. Grabosky ◽  
P. Mackers ◽  
C. Langdon ◽  
I. Alobid

BACKGROUND: Septoplasty is one of the most frequently performed surgeries. However, there remains a question as to the effect of such intervention on the sense of smell. This study aims to examine the available evidence regarding the effect of septoplasty on the sense of smell. METHODS: A database search was performed using PubMed, ScienceDirect, Google Scholar and The Cochrane Library databases from January 1990 to February 2020. Search terms included smell, olfaction, odor, septum, septoplasty, and septorhinoplasty. A meta-analysis was performed with 12 studies that provided sufficient data on change in olfaction. RESULTS: 14 studies met the inclusion criteria, and 2 additional studies were included manually; comprising a total of 996 patients and 25 controls. Significant improvement in olfactory test scores was observed in all tests. Pre- and postoperative differences in means were 0.63 for BSIT, 0.80 for CCCRC test, 1.16 for odor threshold, 1.43 for odor discrimination, and 1.18 for odor identification. CONCLUSIONS: Septoplasty seems to improve olfactory function. However, the outcome of this intervention is discrete and not equal for all patients, so further randomized trials are needed to confirm current findings.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 401-401
Author(s):  
Yue-Heng Yin ◽  
Liu Yat Justina

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.


2021 ◽  
pp. 030157422110195
Author(s):  
Ashish Agrawal ◽  
TM Chou

Introduction: The objective of this systematic review is to assess the effect of vibrational force on biomarkers for orthodontic tooth movement. Methods: An electronic search was conducted for relevant studies (up to December 31, 2020) on the following databases: Pubmed, Google scholar, Web of Science, Cochrane Library, Wiley Library, and ProQuest Dissertation Abstracts and Thesis database. Hand searching of selected orthodontic journals was also undertaken. The selected studies were assessed for the risk of bias in Cochrane collaboration risk of bias tool. The “traffic plot” and “weighted plot” risk of bias distribution are designed in the RoB 2 tool. The 2 authors extracted the data and analyzed it. Results: Six studies fulfilled the inclusion criteria. The risks of biases were high for 4, low and some concern for other 2 studies. The biomarkers, medium, device, frequency and duration of device, as well as other data were extracted. The outcomes of the studies were found to be heterogenous. Conclusion: One study showed highly statistically significant levels of IL-1 beta with <.001. Rate of tooth movement was correlated with levels of released biomarkers under the influence of vibrational force in 3 studies, but it was found to be significant only in 1 study. It was further observed that vibration does not have any significant reduction in pain and discomfort.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.


2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110327
Author(s):  
Weihua Liu ◽  
Wenli Yu ◽  
Hongli Yu ◽  
Mingwei Sheng

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.


Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.


Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.


2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110023
Author(s):  
Qian Zou ◽  
Jiawei Si ◽  
Yatao Guo ◽  
Jiayu Yu ◽  
Huijuan Shi

Objective To determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis. Methods The electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates. Results A total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI ( r = 0.51, 95% CI 0.14, 0.75). Conclusions This meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.


2021 ◽  
pp. 109980042110154
Author(s):  
Seong-Hi Park ◽  
Chul-Gyu Kim

Background: A systematic review was performed to identify the types of physical activities effective as interventions in preventing metabolic syndrome in middle-aged women. Methods: Electronic databases (MEDLINE, EMBASE, the Cochrane Library, and CINAHL) served as the data sources. Cochrane’s Risk of Bias 2 was applied to assess the risk of bias of the randomized controlled trials. Meta-analyses were performed on selected studies using Review Manager 5.3. Thirty-one trials enrolling 2,202 participants were included. Results: Compared to controls, the effects of physical activity were indicated by pooled mean differences, which were −0.57 kg for body weight, −0.43 kg/m2 for body mass index, −1.63 cm for waist circumference, −4.89 mmHg for systolic blood pressure (BP), and −2.71 mmHg for diastolic BP. The effects were greater on the measurements of waist circumference and BP than on body weight and BMI. The types of physical activities were further analyzed according to sub-groups. Only aerobic exercise did not affect body weight and resistance exercise did not significantly change any results. Contrarily, combined exercises significantly reduced measurements of waist circumference and BP. Conclusion: This review can provide valuable information for research and implementation of measures to prevent metabolic syndrome in middle-aged women.


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