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Journal of Clinical Periodontology Jun 2023The aim of this systematic review was to evaluate the efficacy of patient-performed or administered adjunctive measures to non-surgical peri-implantitis therapy in terms... (Review)
Review
AIM
The aim of this systematic review was to evaluate the efficacy of patient-performed or administered adjunctive measures to non-surgical peri-implantitis therapy in terms of probing depth (PD) and/or bleeding on probing (BoP) reductions.
MATERIALS AND METHODS
Randomized and controlled clinical trials with at least 6 months of follow-up were searched in three databases. Secondary outcomes included implant loss, disease resolution, recurrence of peri-implantitis, need of re-treatment, changes in marginal bone levels, patient-reported outcomes and adverse effects.
RESULTS
Of 567 titles, 10 publications, reporting 9 investigations, were included. Three types of adjunctive measures were found (local/systemic antimicrobials and probiotics). Four studies evaluated the effects of local antimicrobials (i.e., minocycline microspheres, chlorhexidine chips or a metronidazole + amoxicillin gel), three studies evaluated systemic antimicrobials (either amoxicillin + metronidazole or metronidazole alone) and two studies evaluated probiotics (Lactobacillus reuteri strains). The addition of local antimicrobials led to modest improvements in PD reduction. Systemic antimicrobials showed significantly greater reductions in PD and BoP, especially at initially deep sites (PD > 6 mm). Due to the large heterogeneity among included studies, no meta-analyses were performed.
CONCLUSIONS
Different adjunctive measures in the non-surgical treatment of peri-implantitis have different impact in terms of PD and BoP reductions. Improved PD reductions result after the use of systemic antimicrobials, and to a lesser extent, after the use of local antimicrobials.
Topics: Humans; Peri-Implantitis; Anti-Bacterial Agents; Metronidazole; Minocycline; Amoxicillin; Anti-Infective Agents; Dental Implants
PubMed: 37143407
DOI: 10.1111/jcpe.13821 -
International Journal of Infectious... Aug 2016De-escalation therapy is a strategy used widely to treat infections while avoiding the use of broad-spectrum antimicrobials. However, there is a paucity of clinical... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
De-escalation therapy is a strategy used widely to treat infections while avoiding the use of broad-spectrum antimicrobials. However, there is a paucity of clinical evidence to demonstrate the effectiveness and safety of de-escalation therapy compared to conventional therapy.
METHODS
A systematic review and meta-analysis was conducted on de-escalation therapy for a variety of infections. A search of the MEDLINE (via PubMed), EMBASE, and Cochrane Library databases up to July 2015 for relevant studies was performed. The primary outcome was relevant mortality, such as 30-day mortality and in-hospital mortality. A meta-analysis was to be conducted for the pooled odds ratio using the random-effects model when possible. Both randomized controlled trials and observational studies were included in the analysis.
RESULTS
A total of 23 studies were included in the analysis. There was no difference in mortality for most infections, and some studies favored de-escalation over non-de-escalation for better survival. The quality of most studies included was not high.
CONCLUSIONS
This review and analysis suggests that de-escalation therapy is safe and effective for most infections, although higher quality studies are needed in the future.
Topics: Anti-Infective Agents; Community-Acquired Infections; Cross Infection; Hospital Mortality; Humans; Infections; Intensive Care Units; Pneumonia; Pneumonia, Ventilator-Associated; Sepsis
PubMed: 27292606
DOI: 10.1016/j.ijid.2016.06.002 -
Journal of Materials Chemistry. B Jan 2023Due to the increasing bacterial resistance to conventional antibiotics, developing safe and effective approaches to combat infections caused by bacteria and biofilms has... (Review)
Review
Due to the increasing bacterial resistance to conventional antibiotics, developing safe and effective approaches to combat infections caused by bacteria and biofilms has become an urgent clinical problem. Recently, carbon dots (CDs) have received great attention as a promising alternative to conventional antimicrobial agents due to their excellent antimicrobial efficacy and biocompatibility. Although CDs have been widely used in the field of antibacterial applications, their antibacterial and antibiofilm mechanisms have not been systematically discussed. This review provides a systematic overview on the complicated mechanisms of antibacterial and antibiofilm CDs based on recent development.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bacteria; Biofilms; Carbon
PubMed: 36602120
DOI: 10.1039/d2tb01977a -
Clinical Oral Investigations May 2023Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products... (Review)
Review
CONTEXT
Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored.
AIMS
This systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite.
SETTINGS AND DESIGN REGISTRATION
This systematic review was registered with PROSPERO (2018 CRD42018112837) METHODS AND MATERIAL: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence.
RESULTS
Ten articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success.
CONCLUSIONS
The studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases.
Topics: Humans; Sodium Hypochlorite; Chloramines; Root Canal Irrigants; Anti-Infective Agents; Dental Pulp Cavity
PubMed: 36808559
DOI: 10.1007/s00784-023-04913-7 -
The Cochrane Database of Systematic... Aug 2017Malignant wounds are a devastating complication of cancer. They usually develop in the last six months of life, in the breast, chest wall or head and neck regions. They... (Review)
Review
BACKGROUND
Malignant wounds are a devastating complication of cancer. They usually develop in the last six months of life, in the breast, chest wall or head and neck regions. They are very difficult to treat successfully, and the commonly associated symptoms of pain, exudate, malodour, and the risk of haemorrhage are extremely distressing for those with advanced cancer. Treatment and care of malignant wounds is primarily palliative, and focuses on alleviating pain, controlling infection and odour from the wound, managing exudate and protecting the surrounding skin from further deterioration. In malignant wounds, with tissue degradation and death, there is proliferation of both anaerobic and aerobic bacteria. The aim of antibiotic therapy is to successfully eliminate these bacteria, reduce associated symptoms, such as odour, and promote wound healing.
OBJECTIVES
To assess the effects of systemic antibiotics for treating malignant wounds.
SEARCH METHODS
We searched the following electronic databases on 8 March 2017: the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library, 2017, Issue 3), Ovid MEDLINE, Ovid Embase and EBSCO CINAHL Plus. We also searched the clinical trial registries of the World Health Organization (WHO) International Clinical Trials Registry Platform (apps.who.int/trialsearch) and ClinicalTrials.gov on 20 March 2017; and OpenSIGLE (to identify grey literature) and ProQuest Dissertations & Theses Global (to retrieve dissertation theses related to our topic of interest) on 13 March 2017.
SELECTION CRITERIA
Randomised controlled trials that assessed the effects of any systemic antibiotics on malignant wounds were eligible for inclusion.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened and selected trials for inclusion, assessed risk of bias and extracted study data. A third reviewer checked extracted data for accuracy prior to analysis.
MAIN RESULTS
We identified only one study for inclusion in this review. This study was a prospective, double-blind cross-over trial that compared the effect of systemic metronidazole with a placebo on odour in malignant wounds. Nine participants with a fungating wound and for whom the smell was troublesome were recruited and six of these completed both the intervention and control (placebo) stages of the trial. Each stage lasted fourteen days, with a fourteen day gap (washout period) between administration of the metronidazole and the placebo.The study, in comparing metronidazole and placebo, reported on two of this review's pre-specified primary outcomes (malodour and adverse effects of the treatment) and on none of the review's pre-specified secondary outcomes.MalodourThe mean malodour (smell) scores for the metronidazole group was 1.17 (standard deviation (SD) 1.60) and the mean for the placebo group was 3.33 (SD 0.82). It is unclear if systemic antibiotics were associated with a difference in malodour (1 study with 6 participants; MD -2.16, 95% CI -3.6 to -0.72) as the quality of the evidence (GRADE) was very low for this outcome. The study was downgraded due to high risk of attrition bias (33% loss to follow-up) and very serious imprecision due to the small sample size.Adverse effectsNo adverse effects of the treatment were reported in either the intervention or control group by the trial authors.
AUTHORS' CONCLUSIONS
It is uncertain whether systemic metronidazole leads to a reduction in malodour in patients with malignant wounds. This is because we were only able to include a single study at high risk of bias with a very small sample size, which focused only on patients with breast cancer. More research is needed to substantiate these findings and to investigate the effects of systemic metronidazole and other antibiotics on quality of life, pain relief, exudate and tumour containment in patients with malignant wounds.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Double-Blind Method; Humans; Metronidazole; Neoplasms; Odorants; Prospective Studies; Soft Tissue Injuries; Wounds and Injuries
PubMed: 28837757
DOI: 10.1002/14651858.CD011609.pub2 -
Mini Reviews in Medicinal Chemistry 2021Herb, Zanthoxylum armatum DC., commonly called Indian prickly ash, and Nepal pepper (family Rutaceae), is widely utilized in the traditional medicinal system. (Review)
Review
INTRODUCTION
Herb, Zanthoxylum armatum DC., commonly called Indian prickly ash, and Nepal pepper (family Rutaceae), is widely utilized in the traditional medicinal system.
OBJECTIVE
The current review provides requisite data for collecting descriptive information on the organoleptic, microscopical, ethnobotanical use, and phytochemicals and pharmacological properties of Z. armatum; therefore, it may help in forming a bridge between research gaps and the upcoming future findings for most of the researches.
MATERIALS AND METHODS
The systematic literature survey was conducted using the PRISMA methodology. The collective information was gathered from books, renowned journals, and electronic databases including Science Direct, Web of Science, Scopus and PubMed from 1966 to 2020.
RESULTS
Most of the bioactive metabolites are isolated and characterized till date, such as monoterpenes in essential oil and lignan components are reported to be present in the herbs. Several in vitro and in vivo pharmacological bioassays revealed the potential of Z. armatum having as possessing antimicrobial, antifungal, antibacterial, and hepatoprotective effects and so on.
CONCLUSION
Therefore, the current review summarizes the organoleptic, microscopy, phytochemistry and biological activities of Z. armatum, providing more emphasis on in vitro as well as in-vivo studies along with clinical research, helpful in exploring the potential efficacy of the plant.
Topics: Anti-Infective Agents; Fungi; Gram-Negative Bacteria; Gram-Positive Bacteria; Medicine, Traditional; Oils, Volatile; Phytochemicals; Plant Components, Aerial; Plant Extracts; Zanthoxylum
PubMed: 33390134
DOI: 10.2174/1389557521999201230200503 -
Food and Chemical Toxicology : An... Dec 2017Citrinin (CIT) is a mycotoxin which causes contamination in the food and is associated with different toxic effects. A web search on CIT has been conducted covering the... (Review)
Review
Citrinin (CIT) is a mycotoxin which causes contamination in the food and is associated with different toxic effects. A web search on CIT has been conducted covering the timespan since 1946. The accumulated data indicate that CIT is produced by several fungal strains belonging to Penicillium, Aspergillus and Monascus genera, and is usually found together with another nephrotoxic mycotoxin, ochratoxin A. Although, it is evident that CIT exposure can exert toxic effects on the heart, liver, kidney, as well as reproductive system, the mechanism of CIT-induced toxicity remains largely elusive. It is still controversial what are the genotoxic and mutagenic effects of CIT. Until now, its toxic effect has been linked to the CIT-mediated oxidative stress and mitochondrial dysfunction in biological systems. However, the toxicity strongly depends on its concentration, route, frequency and time of exposure, as well as from the used test systems. Besides the toxic effects, CIT is also reported to possess a broad spectrum of bioactivities, including antibacterial, antifungal, and potential anticancer and neuro-protective effects in vitro. This systematic review presents the current state of CIT research with emphasis on its bioactivity profile.
Topics: Animals; Anti-Infective Agents; Citrinin; DNA Damage; Food Contamination; Humans; Oxidative Stress
PubMed: 28993214
DOI: 10.1016/j.fct.2017.10.002 -
BMJ (Clinical Research Ed.) Apr 2021This is the second version (first update) of the living systematic review, replacing the previous version (available as a data supplement). When citing this paper please... (Meta-Analysis)
Meta-Analysis
UPDATES
This is the second version (first update) of the living systematic review, replacing the previous version (available as a data supplement). When citing this paper please consider adding the version number and date of access for clarity.
OBJECTIVE
To determine and compare the effects of drug prophylaxis on severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (covid-19).
DESIGN
Living systematic review and network meta-analysis (NMA).
DATA SOURCES
World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature to 4 March 2022.
STUDY SELECTION
Randomised trials in which people at risk of covid-19 were allocated to prophylaxis or no prophylaxis (standard care or placebo). Pairs of reviewers independently screened potentially eligible articles.
METHODS
After duplicate data abstraction, we conducted random-effects bayesian network meta-analysis. We assessed risk of bias of the included studies using a modification of the Cochrane risk of bias 2.0 tool and assessed the certainty of the evidence using the grading of recommendations assessment, development and evaluation (GRADE) approach.
RESULTS
The second iteration of this living NMA includes 32 randomised trials which enrolled 25 147 participants and addressed 21 different prophylactic drugs; adding 21 trials (66%), 18 162 participants (75%) and 16 (76%) prophylactic drugs. Of the 16 prophylactic drugs analysed, none provided convincing evidence of a reduction in the risk of laboratory confirmed SARS-CoV-2 infection. For admission to hospital and mortality outcomes, no prophylactic drug proved different than standard care or placebo. Hydroxychloroquine and vitamin C combined with zinc probably increase the risk of adverse effects leading to drug discontinuation—risk difference for hydroxychloroquine (RD) 6 more per 1000 (95% credible interval (CrI) 2 more to 10 more); for vitamin C combined with zinc, RD 69 more per 1000 (47 more to 90 more), moderate certainty evidence.
CONCLUSIONS
Much of the evidence remains very low certainty and we therefore anticipate future studies evaluating drugs for prophylaxis may change the results for SARS-CoV-2 infection, admission to hospital and mortality outcomes. Both hydroxychloroquine and vitamin C combined with zinc probably increase adverse effects.
SYSTEMATIC REVIEW REGISTRATION
This review was not registered. The protocol established a priori is included as a supplement.
FUNDING
This study was supported by the Canadian Institutes of Health Research (grant CIHR-IRSC:0579001321).
Topics: Anti-Infective Agents; COVID-19; Carrageenan; Chemoprevention; Global Health; Humans; Hydroxychloroquine; Ivermectin; SARS-CoV-2; Treatment Outcome; Uncertainty
PubMed: 33903131
DOI: 10.1136/bmj.n949 -
Expert Reviews in Molecular Medicine Aug 2023Metallic nanoparticles from different natural sources exhibit superior therapeutic options as compared to the conventional methods. species have attracted special... (Review)
Review
BACKGROUND
Metallic nanoparticles from different natural sources exhibit superior therapeutic options as compared to the conventional methods. species have attracted special attention of researchers worldwide due to the presence of bioactive molecules such as flavonoids, biflavonoids, triterpenes, steroids, saponins, tannins and other secondary metabolites that exhibit antimicrobial, antiplasmodial, anticancer and anti-inflammatory activities. Environment friendly green synthesised silver nanoparticles from species provide viable, safe and efficient treatment against different fungal pathogens.
OBJECTIVE
This systematic review aims to summarise the literature pertaining to superior antifungal ability of green synthesised silver nanoparticles using plant extracts of spp. in comparison to both aqueous and ethanolic raw plant extracts by electronically collecting articles from databases.
METHODS
The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis were taken into consideration while preparing this review. The titles and abstracts of the collected data were stored in Endnote20 based on the inclusion and exclusion criteria. The search strategy included literature from established sources like PubMed, Google Scholar and Retrieval System Online using subject descriptors.
RESULTS
The search yielded 60 articles with unique hits. After removal of duplications, 46 articles were identified, 40 were assessed and only seven articles were chosen and included in this review based on our eligibility criteria.
CONCLUSION
The physicochemical and preliminary phytochemical investigations of suggest higher drug potency of nanoparticles synthesised from plant extract against different diseases as compared to aqueous and ethanolic plant extracts. The study holds great promise as the synthesis of nanoparticles involves low energy consumption, minimal technology and least toxic effects.
Topics: Humans; Metal Nanoparticles; Selaginellaceae; Silver; Anti-Infective Agents; Plant Extracts
PubMed: 37534437
DOI: 10.1017/erm.2023.21 -
The Journal of Prosthetic Dentistry Dec 2023Photodynamic therapy is widely used in dentistry, but limited evidence exists regarding its effectiveness in treating denture stomatitis. High resistance to antifungals... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Photodynamic therapy is widely used in dentistry, but limited evidence exists regarding its effectiveness in treating denture stomatitis. High resistance to antifungals has been reported, and photodynamic therapy could be an alternative treatment.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate whether photodynamic therapy is effective in reducing denture stomatitis.
MATERIAL AND METHODS
A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and recorded in the prospective register of systematic reviews (PROSPERO) (CRD42020205589) to answer the population, intervention, control, outcome (PICO) question: "Is photodynamic therapy effective in the treatment of denture stomatitis when compared with the use of antifungal agents?" Electronic searches were performed in databases PubMed/MEDLINE, Cochrane library, and Web of Science for articles published until February 2021 by using the following terms: (denture stomatitis OR oral candidiasis) AND (low-level light therapy OR laser therapy OR lasers OR photodynamic therapies OR photochemotherapy) AND (antifungal drugs OR antifungal agents OR antimicrobial OR treatment). Clinical trials and randomized clinical trials, studies in the English language, and studies comparing antifungal agents with photodynamic therapy were included.
RESULTS
In total, 5 articles were selected for the qualitative analysis and 3 for the meta-analysis. No significant difference was detected between antifungal therapy and photodynamic therapy in the reduction of colony-forming units on the palate. In a subgroup analysis, a significant difference was found in the reduction of colony-forming units on the palate at 15 days and at the denture surface at 30 days.
CONCLUSIONS
Photodynamic therapy is effective in the treatment of denture stomatitis, but after 30 days and 15 days, the antifungals demonstrated better performance.
Topics: Humans; Antifungal Agents; Stomatitis, Denture; Candidiasis, Oral; Photochemotherapy; Anti-Infective Agents
PubMed: 35125209
DOI: 10.1016/j.prosdent.2021.11.028