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Dental Traumatology : Official... Apr 2021Sports-related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well-being and psychological status. Such injuries may also...
BACKGROUND/AIMS
Sports-related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well-being and psychological status. Such injuries may also lead to the fear of re-injury and other problems. Since a delay in adequate emergency treatment can have adverse effects, it is imperative that athletes and coaches have sufficient awareness of emergency treatment options. Hence, the aim of this systematic review was to evaluate the global status of knowledge among athletes and coaches regarding the prevention and emergency management of traumatic dental injuries.
METHODS
The protocol was designed using the PRISMA guidelines and registered in PROSPERO (CRD42020184956). A broad-based search using text words and MeSH terms was performed in established databases according to a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity, and reliability were excluded. Data extraction was performed and risk-of-bias assessment was done by means of the Joanna Briggs Institute's critical appraisal tool.
RESULTS
Nine studies published between 2005 and 2020 were included for qualitative synthesis. They were primarily from Asia with none from North America and Australia. Most of them were cross-sectional, used convenience sampling, and were interview-based. Less than 10% of the participants in two studies had adequate knowledge of the immediate emergency management of tooth avulsion, while only 2.4% of basketball players and coaches knew that it was necessary to collect the avulsed tooth or broken tooth fragments. The overall level of knowledge was reported as poor or insufficient in all studies, with moderate or high risk-of-bias in six studies.
CONCLUSION
The knowledge regarding emergency management of TDI was found to be low globally. Along with the choice of the sport, there was a high level of variability in the study design and sampling characteristics.
Topics: Athletic Injuries; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Humans; Reproducibility of Results; Tooth Avulsion; Tooth Injuries
PubMed: 33220152
DOI: 10.1111/edt.12629 -
Health Policy and Planning Nov 2020The incidence of chemical assault is increasing globally. In response, a number of countries are proposing legislation. However, current legislative initiatives are...
The incidence of chemical assault is increasing globally. In response, a number of countries are proposing legislation. However, current legislative initiatives are uncoordinated and do not address the spectrum of activities to prevent and care for victims of chemical assaults. To fill this gap, we aimed to review legislation, policies and regulations relevant to chemical assault to classify and catalogue current strategies into a legislative framework. Terms related to chemical assault were used to systematically search the academic, lay and legal literatures. Chemical assault was defined as the use of acid or another caustic or corrosive substance or vitriol by one person against another with the intent to injure or disfigure. Reports that described the use of chemical weapons in warfare were excluded. A second search of national legislations of countries with reports of chemical assaults was performed to identify enacted laws and gaps in legislative approaches to chemical assault control. Data regarding relevant laws, policies and regulations were extracted. The findings were used to classify and catalogue current strategies into a legislative framework using content analysis. The search returned 3769 records. Chemical assaults were reported from 104 countries. Using legislation from those countries, a framework consisting of five legislative priorities was developed: (a) apply a public health approach; (b) adopt legal definitions specific to chemical assault; (c) control chemical supply, sales and procurement; (d) facilitate justice; and (e) support survivors. Although many countries have implemented one or more of these legislative priorities, no country has a comprehensive address to chemical assault control. Comparative policy analysis and assessments of the impacts of legislative efforts may further inform strategies to prevent, prosecute and mitigate the impact of chemical assaults. In the meantime, advocacy groups and governments might consider implementation and enforcement of one or more components of this legislative framework to control the growing epidemic of chemical assault.
Topics: Crime Victims; Humans; Internationality; Policy; Policy Making; Public Health
PubMed: 33450768
DOI: 10.1093/heapol/czaa031 -
Journal of Health Psychology Sep 2017Noma disease often results in impairment, morbidity and severe facial disfigurement. This article reports a systematic review of literatures published between 2006 and... (Review)
Review
Noma disease often results in impairment, morbidity and severe facial disfigurement. This article reports a systematic review of literatures published between 2006 and 2015 to establish existing knowledge about social stigma associated with facial disfigurements. Five databases were searched and 114 citations were screened, of which only 15 met the relevant criteria. Titles and abstracts of the retrieved articles were independently reviewed. The research was heterogeneous; therefore, overall synthesis using meta-analysis was inappropriate. It can be seen that the review demonstrates that facial disfigurements are far more complex than was previously thought.
Topics: Humans; Noma; Social Stigma
PubMed: 26837690
DOI: 10.1177/1359105315624751 -
Pediatric Hematology and Oncology Nov 2022Infantile hemangiomas (IH) are the most common benign tumors of childhood. Timely diagnosis and management of higher-risk IH is key in avoiding permanent disfigurement,...
Infantile hemangiomas (IH) are the most common benign tumors of childhood. Timely diagnosis and management of higher-risk IH is key in avoiding permanent disfigurement, visual impairment, and life-threatening airway compromise. Here, we identify and critically appraise existing clinical practice guidelines (CPGs) for IH diagnosis and management. A systematic search of MEDLINE, SCOPUS, and EMBASE was conducted until August 2021. Four independent reviewers assessed each CPG utilizing the Appraisal of Guidelines for Research and Evaluation, 2 edition (AGREE II). An scaled domain score of ≥60% demonstrated adequacy in a given domain. Intraclass correlation coefficients (ICC) assessed agreement and scoring consistency between the reviewers. Eight CPGs were eligible and included for critical appraisal. Only one CPG was classified as 'high quality', with the remaining seven guidelines being 'average' ( = 3) or 'low' ( = 4) quality. Six guidelines (75.0%) were conducted via nonsystematic literature searches. The 'Applicability' (40.4%±14.0) and 'Rigor of development' (46.9%±17.3) domains achieved the lowest scores, while the highest average scores were in 'Scope and purpose' (76.7%±11.3) and 'Editorial independence' (90.8%±13.0). We found high consistency between the four independent reviewers, with 'very good' ( = 5) or 'good' ( = 1) interrater reliability in all six AGREE II domains. Based on the AGREE II instrument, there is only one available high-quality consensus statement on the diagnosis and management of IH. Low scores in 'Rigor of development' and 'Applicability' suggest notable weaknesses in the development process and reporting quality of existing IH CPGs. Future guidelines should be backed by systematic literature searches and focus on guideline clinical translation.
Topics: Hemangioma; Humans; Infant; Practice Guidelines as Topic; Reproducibility of Results
PubMed: 35468033
DOI: 10.1080/08880018.2022.2062502 -
Plastic and Reconstructive Surgery.... Oct 2019Currently, there are more than 40 cases of facial allotransplantation performed by 13 different groups in 10 countries. Although it has become a potential option to...
BACKGROUND
Currently, there are more than 40 cases of facial allotransplantation performed by 13 different groups in 10 countries. Although it has become a potential option to reconstruct and restore the function and appearance of severely facially disfigured individuals, the ethical concerns of facial allotransplantation remain unsolved. We conducted a systematic review to better understand the ethical concerns on facial allotransplantation and the changing trends of the ethical debate over time.
METHODS
A systematic review of 3 databases was performed to identify articles related to ethical topics on facial allotransplantation. The inclusion criteria were peer-reviewed articles written since 1995 on the topics of ethics and facial allotransplantation in English, French, and Chinese languages. The ethical concerns extracted from the included articles were categorized into 4 core principles of ethics: autonomy, beneficence, nonmaleficence, and justice. The different themes under these 4 principles were extracted and subgrouped. The positions of the included articles were collected. Joinpoint regression was applied to compare the frequency of themes and positions by publication year. We presented the main topics on ethical concerns and the changing trends in ethical themes and principles of facial allotransplantation.
RESULTS
There were 889 articles identified initially. After excluding 265 duplicated articles, 624 articles were included for title/abstract review process, and 148 articles were included in final data analysis. The publication year was from 2002 to 2018 with 136 articles in English, 11 in French, and 1 in Chinese. The most addressed principle was nonmaleficence (117/148, 79.1%), followed by beneficence (116/148, 78.4%), justice (103/148, 69.6%), and autonomy (86/148, 58.1%). The themes on immunosuppression/rejection, quality of life, and identity were the top 3 addressed ethical concerns. Twelve of 13 most addressed ethical themes demonstrated a decreasing trend after 2004. The themes of identity under beneficence showed a significant decrease after 2004. Ethical concerns on the cost/financial topic were the only one showing consistently increase trends from 2002 to 2018. There was a significant increase of the papers in favor of facial allotransplantation procedure comparing to those were against or neutral before and after 2008.
CONCLUSIONS
More and more articles support facial allotransplantation as a feasible option to reconstruct and restore the function and appearance of severely facially disfigured individuals. The requirement of life-long immunosuppression therapy, quality of life, and identity center the ethical debates. Supported by favorable short-term results, 12 of 13 most addressed ethical concerns have trended down. The theme of cost/financial topic becomes more frequently addressed in recent years.
PubMed: 31772878
DOI: 10.1097/GOX.0000000000002425 -
EClinicalMedicine Sep 2020Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been...
BACKGROUND
Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis.
METHODS
We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability.
FINDINGS
A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction.
INTERPRETATION
A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred.
FUNDING
No funding was received.
PubMed: 33089121
DOI: 10.1016/j.eclinm.2020.100506 -
Cutis Aug 2014Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments... (Review)
Review
Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments available, no consistently effective therapies have been established. In this systematic review, we evaluate 8 randomized controlled trials (RCTs) to assess the efficacy and safety of currently available therapies for the treatment of stretch marks. Due to the limited number of patients and high or unclear risk of bias in the studies included in this assessment, the evidence from this review is insufficient to provide clear guidelines for practice. Therefore, more high-quality RCTs are needed.
Topics: Glycolates; Humans; Keratolytic Agents; Laser Therapy; Ointments; Randomized Controlled Trials as Topic; Striae Distensae; Treatment Outcome; Tretinoin
PubMed: 25184641
DOI: No ID Found -
Expert Review of Clinical Immunology Aug 2020Thyroid eye disease is a debilitating, disfiguring, and potentially blinding periocular condition. Teprotumumab is a human insulin-like growth factor-I receptor...
INTRODUCTION
Thyroid eye disease is a debilitating, disfiguring, and potentially blinding periocular condition. Teprotumumab is a human insulin-like growth factor-I receptor monoclonal inhibitor antibody which indicated for treating thyroid eye disease.
AREAS COVERED
The authors performed a systematic review of the literature using the PubMed database, and the following keywords were used: 'teprotumumab,' 'thyroid eye disease,' and 'insulin-like growth factor I receptor.' The chemical property, mechanism of action, pharmacokinetics, clinical efficacy, and safety of teprotumumab were introduced in this paper.
EXPERT OPINION
Teprotumumab is a human monoclonal antibody targeting insulin-like growth factor-I receptor. Clinical trials indicated that proptosis response of teprotumumab was 83%, and clinical activity score, diplopia, and quality of life were also better than placebo. Teprotumumab was well tolerated, common adverse reactions included muscle spasm, nausea, alopecia, diarrhea, fatigue, hyperglycemia, hearing impairment, dysgeusia, headache, and dry skin.
Topics: Antibodies, Monoclonal, Humanized; Clinical Trials as Topic; Graves Ophthalmopathy; Humans
PubMed: 32707005
DOI: 10.1080/1744666X.2020.1801421 -
Burns : Journal of the International... Mar 2021Burn injury can cause abnormal healing and pathologic scar formation that significantly impairs patients' ability to return to baseline levels of functioning. Quality of... (Meta-Analysis)
Meta-Analysis
Burn injury can cause abnormal healing and pathologic scar formation that significantly impairs patients' ability to return to baseline levels of functioning. Quality of life can be significantly diminished due to pain, stiffness, contracture, and the psychological burden of disfigurement. Traditional scar therapies such as silicone sheeting and compression garments are highly reliant on patient compliance, and have not demonstrated satisfactory efficacy. Even more invasive therapies such as intralesional medication delivery or surgical contracture release have high recurrence rates. Recently, fractional CO laser therapy has emerged as a promising treatment modality for burn scars, but there is a lack of recent studies that aggregates extant data to demonstrate outcomes after laser therapy. To address this, we conducted a systematic review and meta-analysis to determine the efficacy of fractional CO lasers in treating burn scars, and found that laser therapy alone yielded statistically significant improvements in scar profiles. There were very few reports of adverse effects, most treatments were provided as outpatient, and both patient and burn practitioners reported high satisfaction. By sharing our findings, we hope that more burn practitioners will consider adopting laser therapy as a safe and cost-effective first-line therapy for burn scar management.
Topics: Burns; Carbon Dioxide; Cicatrix; Cicatrix, Hypertrophic; Contracture; Humans; Laser Therapy; Lasers, Gas; Quality of Life; Treatment Outcome
PubMed: 33288326
DOI: 10.1016/j.burns.2020.10.026 -
Dermatologic Surgery : Official... Nov 2020Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease....
BACKGROUND
Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease. Topical treatments often yield ineffective and temporary results.
OBJECTIVE
The objective of this article is to review and assess all the studies that used light and laser devices to treat KP and its variants.
MATERIAL AND METHODS
On January 15, 2017, an online search of the MEDLINE, Embase, and Cochrane databases was performed using the following combination of keywords: "keratosis pilaris" and "treatment."
RESULTS
Seventeen studies related to light and laser treatments were retained for analysis. The total number of treated patients was 175. Of which, 22 patients had KP atrophicans faciei, 17 patients had KP rubra, and 136 patients had KP.
CONCLUSION
Light and laser devices have been emerging as promising therapeutic options for a disfiguring disease that still lacks, until today, an effective long-term treatment.
Topics: Abnormalities, Multiple; Clinical Trials as Topic; Darier Disease; Eyebrows; Humans; Intense Pulsed Light Therapy; Lasers, Dye; Lasers, Gas; Lasers, Semiconductor; Lasers, Solid-State; Low-Level Light Therapy; Severity of Illness Index; Treatment Outcome
PubMed: 32804891
DOI: 10.1097/DSS.0000000000002441