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Annals of Internal Medicine Jun 2016Theoretically, the everolimus-eluting bioresorbable vascular scaffold (BVS) could eliminate stent thrombosis and improve outcomes in patients having percutaneous... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Theoretically, the everolimus-eluting bioresorbable vascular scaffold (BVS) could eliminate stent thrombosis and improve outcomes in patients having percutaneous coronary intervention.
PURPOSE
To estimate the incidence of stent thrombosis after BVS implantation and to compare the efficacy and safety of BVSs versus everolimus-eluting metallic stents (EESs) in adults having percutaneous coronary intervention.
DATA SOURCES
PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 20 January 2016.
STUDY SELECTION
6 randomized, controlled trials and 38 observational studies, each involving at least 40 patients with BVS implantation.
DATA EXTRACTION
Two reviewers independently extracted study data and evaluated study risk of bias.
DATA SYNTHESIS
The pooled incidence of definite or probable stent thrombosis after BVS implantation was 1.5 events per 100 patient-years (PYs) (95% CI, 1.2 to 2.0 events per 100 PYs) (126 events during 8508 PYs). Six randomized trials that directly compared BVSs with EESs showed a non-statistically significant increased risk for stent thrombosis (odds ratio [OR], 2.05 [CI, 0.95 to 4.43]; P = 0.067) and myocardial infarction (OR, 1.38 [CI, 0.98 to 1.95]; P = 0.064) with BVSs. The 6 observational studies that compared BVSs with EESs showed increased risk for stent thrombosis (OR, 2.32 [CI, 1.06 to 5.07]; P = 0.035) and myocardial infarction (OR, 2.09 [CI, 1.23 to 3.55]; P = 0.007) with BVSs. The relative rates of all-cause and cardiac death, revascularization, and target lesion failure were similar for BVSs and EESs.
LIMITATION
Scarce comparative data, no published data from large trials with long-term follow-up, and limited quality and incomplete reporting of observational studies.
CONCLUSION
Compared with EESs, BVSs do not eliminate and might increase risks for stent thrombosis and myocardial infarction in adults having percutaneous coronary intervention. Results of large trials with long-term follow-up are critically needed to establish the safety or at least the noninferiority of BVSs compared with EESs.
PRIMARY FUNDING SOURCE
None.
Topics: Absorbable Implants; Cardiovascular Agents; Cause of Death; Comparative Effectiveness Research; Coronary Artery Disease; Drug-Eluting Stents; Everolimus; Humans; Myocardial Infarction; Percutaneous Coronary Intervention; Postoperative Complications; Thrombosis; Tissue Scaffolds
PubMed: 27042809
DOI: 10.7326/M16-0006 -
European Journal of Preventive... Jul 2018Aims The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic... (Meta-Analysis)
Meta-Analysis
Aims The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic review and meta-analysis to determine the impact of POC use on cardiometabolic outcomes including venous thromboembolism, myocardial infarction, stroke, hypertension and diabetes. Methods and results Nineteen observational studies (seven cohort and 12 case-control) were included in this systematic review. Of those, nine studies reported the risk of venous thromboembolism, six reported the risk of myocardial infarction, six reported the risk of stroke, three reported the risk of hypertension and two studies reported the risk of developing diabetes with POC use. The pooled adjusted relative risks (RRs) for venous thromboembolism, myocardial infarction and stroke for oral POC users versus non-users based on the random effects model were 1.06 (95% confidence interval (CI) 0.70-1.62), 0.98 (95% CI 0.66-1.47) and 1.02 (95% CI 0.72-1.44), respectively. Stratified analysis by route of administration showed that injectable POC with a RR of 2.62 (95% CI 1.74-3.94), but not oral POCs (RR 1.06, 95% CI 0.7-1.62), was associated with an increased risk of venous thromboembolism. A decreased risk of venous thromboembolism in a subgroup of women using an intrauterine levonorgestrel device was observed with a RR of 0.53 (95% CI 0.32-0.89). No effect of POC use on blood pressure was found, but there was an indication for an increased risk of diabetes with injectable POCs, albeit non-significant. Conclusions This systematic review and meta-analysis suggests that oral POC use is not associated with an increased risk of developing various cardiometabolic outcomes, whereas injectable POC use might increase the risk of venous thromboembolism.
Topics: Administration, Oral; Adolescent; Adult; Aged; Cardiovascular Diseases; Contraceptives, Oral, Hormonal; Diabetes Mellitus; Drug Implants; Female; Humans; Injections; Middle Aged; Progestins; Risk Assessment; Risk Factors; Venous Thromboembolism; Young Adult
PubMed: 29745237
DOI: 10.1177/2047487318774847 -
Nutrition Reviews May 2024It is well known that the microbiome undergoes cyclical diurnal rhythms. It has thus been hypothesized that meal timing may affect gut microbial composition, function,...
CONTEXT
It is well known that the microbiome undergoes cyclical diurnal rhythms. It has thus been hypothesized that meal timing may affect gut microbial composition, function, and host health.
OBJECTIVE
This review aims to examine the effects of time-restricted eating (TRE) and Ramadan fasting (RF) on the composition of the gut microbiota in animal and human studies. The associations between composition of microbiota and host metabolic parameters are also examined.
DATA SOURCES
A search was performed on the PubMed, Cochrane, Scopus, and Web of Science databases up to December 31, 2022. The search strategy was performed using the Medical Subject Heading (MeSH) terms "intermittent fasting" and "gastrointestinal microbiome" and the key words "Ramadan fasting" and "microbes."
DATA EXTRACTION
Seven human studies (4 TRE and 3 RF) and 9 animal studies (7 TRE, 2 RF-like) were retrieved.
DATA ANALYSIS
TRE and RF in human studies lead to an increase in gut microbial community alpha-diversity. In animal studies (both TRE and RF-like), fasting is not associated with improved alpha-diversity, but enhancement of microbial fluctuation is observed, compared with high-fat diet ad libitum groups. Within Firmicutes and Bacteroidetes phyla, no specific direction of changes resulting from fasting are observed in both animals and human. After TRE or RF, a greater abundance of the Faecalibacterium genus is observed in human studies; changes in Lactobacillus abundance are found in animal studies; and increases in Akkermansia are seen both in humans and in animals fed a feed-pellet diet. Only 2 human studies show a beneficial correlation between microbiota changes and host metabolic (HDL cholesterol) or anthropometric parameters (body mass index).
CONCLUSIONS
These findings support the importance of both regimens in improving the gut microbiota composition. However, based on results of animal studies, it can be suggested that diet remains the essential factor in forming the microbiota's environment.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42021278918.
Topics: Gastrointestinal Microbiome; Humans; Fasting; Animals; Islam
PubMed: 37528052
DOI: 10.1093/nutrit/nuad093 -
The European Journal of Contraception &... Apr 2017To assess the efficacy and tolerability (side-effects profile), and compliance of the combined contraceptive vaginal ring (CCVR) compared with combined oral hormonal... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the efficacy and tolerability (side-effects profile), and compliance of the combined contraceptive vaginal ring (CCVR) compared with combined oral hormonal contraceptives (COC).
DATA SOURCES
The PubMed, Embase, POPLINE, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, ClinicalTrials.gov, Clinical Trials Registry Platform (ICTRP) and CINAHL databases were searched.
METHODS OF STUDY SELECTION
Electronic databases were searched for randomised clinical trials comparing the CCVR with COC with a duration of at least 3 months between 01 December and 15 December 2015. The primary outcome was efficacy. The secondary outcomes were compliance, absence of withdrawal bleeding, breakthrough bleeding, nausea and headache. Heterogeneity was assessed using I statistic and Cochran's Q statistic. Results were expressed as odds ratios (OR) with 95% confidence intervals (CIs) using random-effects models or fixed-effects models depending on the heterogeneity.
RESULTS
4368 records were identified, 2844 of which were removed after duplicates and 1524 records were screened. Of these, 1503 were excluded and 21 full text articles were assessed for eligibility. After removing another 7 articles, 14 records were finally included in the qualitative and quantitative analysis. The results show a trend to higher efficacy for the CCVR in preventing pregnancy (Peto OR: 0.52 [95% CI: 0.26-1.04]) and a significantly lower presence of nausea (Peto OR: 0.66 [95% CI: 0.46-0.93]). More cycles were compliant in the CCVR group (Peto OR: 1.22 [95% CI: 1.12-1.32]) and fewer women reported breakthrough bleeding (Peto OR: 0.68 [95% CI: 0.51-0.91]).
CONCLUSIONS
Our findings demonstrate that the CCVR is as effective and tolerable as the COC but with a better bleeding profile.
Topics: Contraceptive Agents, Female; Contraceptive Devices, Female; Desogestrel; Drug Implants; Ethinyl Estradiol; Female; Humans
PubMed: 28256919
DOI: 10.1080/13625187.2017.1287351 -
Journal of Advanced Nursing Apr 2018To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home. (Meta-Analysis)
Meta-Analysis Review
AIM
To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home.
BACKGROUND
Inadequate discharge planning for the ageing population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
A systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000-2015.
REVIEW METHODS
Critical appraisal, data extraction and meta-analysis followed the methodology of the Joanna Briggs Institute.
RESULTS
Thirteen studies were included in the review, 2 of 13 were pilot studies and one had a pre-post design. Included studies involved 3,964 participants with a median age of 77 years. Nurse discharge planning did not significantly reduce hospital readmission or quality of life, except readmission was lower across studies conducted in the USA. The overall effect score for nurse discharge planning on length of stay was statistically significant and positive.
CONCLUSION
Nursing discharge planning is a complex intervention and difficult to evaluate. Findings suggest that nursing discharge planning for older inpatients discharged home increases the length of stay yet neither reduces readmission rate nor improves quality of life.
Topics: Aged; Aged, 80 and over; Female; Hospitalization; Humans; Male; Nursing Service, Hospital; Patient Discharge; Patient Outcome Assessment; Patient Transfer
PubMed: 28986920
DOI: 10.1111/jan.13475 -
International Journal of Environmental... Nov 2022The implementation of adjunctive antibiotics has been recommended for the therapy of peri-implantitis (PI). In this review, antibiotic resistance patterns in PI patients... (Review)
Review
The implementation of adjunctive antibiotics has been recommended for the therapy of peri-implantitis (PI). In this review, antibiotic resistance patterns in PI patients were assessed. A systematic scoping review of observational studies and trials was established in conjunction with the PRISMA extension for scoping reviews. The SCOPUS, PubMed/MEDLINE, EMBASE, SCIELO, Web of Science, and LILACS databases were reviewed along with the gray literature. The primary electronic examination produced 139 investigations. Finally, four observational studies met the selection criteria. These studies evaluated 214 implants in 168 patients. and mainly presented high resistance to tetracycline, metronidazole, and erythromycin in PI patients. Similarly, was also highly resistant to clindamycin and doxycycline. Other microorganisms such as , , and also presented significant levels of resistance to other antibiotics including amoxicillin, azithromycin, and moxifloxacin. However, most microorganisms did not show resistance to the combination amoxicillin metronidazole. Although the management of adjunctive antimicrobials in the therapy of PI is controversial, in this review, the resistance of relevant microorganisms to antibiotics used to treat PI, and usually prescribed in dentistry, was observed. Clinicians should consider the antibiotic resistance demonstrated in the treatment of PI patients and its public health consequences.
Topics: Humans; Peri-Implantitis; Aggregatibacter actinomycetemcomitans; Drug Resistance, Microbial; Fusobacterium nucleatum; Porphyromonas gingivalis; Amoxicillin; Metronidazole; Anti-Bacterial Agents
PubMed: 36497685
DOI: 10.3390/ijerph192315609 -
Annals of Internal Medicine Nov 2017Percutaneous coronary interventions to implant bioresorbable vascular scaffolds (BVSs) were designed to reduce the late thrombotic events that occur with metallic stents. (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Percutaneous coronary interventions to implant bioresorbable vascular scaffolds (BVSs) were designed to reduce the late thrombotic events that occur with metallic stents.
PURPOSE
To estimate the incidence of scaffold thrombosis after BVS implantation and compare everolimus-eluting BVSs with everolimus-eluting metallic stents (EESs) in terms of safety and efficacy at mid- and long-term follow-up in adults who had a percutaneous coronary intervention.
DATA SOURCES
PubMed, EMBASE, the Cochrane Library, conference proceedings, and relevant Web sites from inception until 20 May 2017, without language restriction.
STUDY SELECTION
7 randomized trials and 38 observational studies (each with a minimum of 6 months and 100 patient-years of follow-up) in adults with coronary artery disease who had a BVS or an EES and reported scaffold or stent thrombosis (main outcome) or other secondary outcomes (such as death, myocardial infarction, or revascularization).
DATA EXTRACTION
2 reviewers independently extracted study data, rated study quality, and assessed strength of evidence.
DATA SYNTHESIS
The pooled incidence of definite or probable scaffold thrombosis after BVS implantation was 1.8% (95% CI, 1.5% to 2.2%) at a median follow-up of 1 year (41 studies, 21 884 patients) and 0.8% (CI, 0.5% to 1.3%) beyond 1 year (14 studies, 4688 patients). Seven trials involving 5578 patients that directly compared BVSs with EESs showed an increased risk for definite or probable scaffold thrombosis (odds ratio [OR], 3.40 [CI, 2.01 to 5.76]) with BVSs at a median follow-up of 25 months. Increased risks were present at early (prominently subacute), late, and very late stages, and odds beyond 1 year were almost double those seen within 1 year. Bioresorbably vascular scaffolds increased risks for myocardial infarction (OR, 1.63 [CI, 1.26 to 2.10]), target lesion revascularization (OR, 1.31 [CI, 1.03 to 1.67]), and target lesion failure (OR, 1.37 [CI, 1.12 to 1.66]); the odds for these 3 end points also increased over time. The incidences of all-cause, cardiac, and noncardiac death and of target vessel and any revascularization did not differ.
LIMITATION
Quality of observational studies was unclear, and some data were unpublished.
CONCLUSION
Compared with EESs, BVSs increased the risks for scaffold thrombosis and other thrombotic events at mid- and long-term follow-up, and risks increased over time.
PRIMARY FUNDING SOURCE
National Natural Science Foundation of China.
Topics: Absorbable Implants; Adult; Coronary Disease; Drug-Eluting Stents; Everolimus; Humans; Incidence; Percutaneous Coronary Intervention; Prosthesis Design; Risk Factors; Thrombosis
PubMed: 29049539
DOI: 10.7326/M17-1101 -
The Laryngoscope Jan 2016Postendoscopic sinus surgery corticosteroid administration reduces polyp formation, inflammation, and adhesions. Steroid-eluting bioabsorbable intranasal devices (SEBID)... (Review)
Review
OBJECTIVES/HYPOTHESIS
Postendoscopic sinus surgery corticosteroid administration reduces polyp formation, inflammation, and adhesions. Steroid-eluting bioabsorbable intranasal devices (SEBID) are novel interventions thought to improve local drug delivery while minimizing systemic side effects. The primary aim of this systematic review is to evaluate the efficacy and safety of bioabsorbable SEBIDs. The secondary aim is to inform clinical recommendations and to introduce clinicians to this novel technology.
STUDY DESIGN
MEDLINE, PubMed, Embase, and Cochrane Database were searched according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.
METHODS
Original articles assessing the efficacy of SEBIDs inserted after endoscopic sinus surgery. For each study, we recorded the efficacy endpoints and safety outcomes.
RESULTS
Seven studies met the inclusion criteria from 737 initial articles identified, including five prospective randomized controlled trials and two prospective single-cohort studies involving 394 sinuses within treatment arms. Patients were followed up for 2 to 6 months. Six studies demonstrated SEBID efficacy with statistical significance (P < 0.05). Steroid-eluting bioabsorbable intranasal devices were effective in reducing adhesion formation, polyp formation, inflammation, Lund-Kennedy scores, and perioperative sinus endoscopy scores. The devices improved patient-reported outcomes and olfaction while reducing postoperative interventions. They were not associated with adverse events and pose no ocular safety risk. Complications in three SEBID applications were reported.
CONCLUSION
There is limited data available on SEBIDS; further studies are required to determine whether they are safe and effective adjuncts postendoscopic sinus surgery. Future studies are needed to optimize the dosing regimen, compare devices, and provide long-term outcomes. Steroid-eluting bioabsorbable intranasal devices may tentatively be incorporated into future evidence-based practice.
Topics: Absorbable Implants; Administration, Intranasal; Adrenal Cortex Hormones; Drug Implants; Endoscopy; Humans; Paranasal Sinus Diseases
PubMed: 26154025
DOI: 10.1002/lary.25460 -
Clinical Implant Dentistry and Related... Jan 2015The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge... (Review)
Review
PURPOSE
The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier when used for alveolar ridge/maxillary sinus augmentation in humans.
MATERIALS AND METHODS
Clinical studies/case series published 1980 through June 2012 using rhBMP-2/ACS were searched. Studies meeting the following criteria were considered eligible for inclusion: >10 subjects at baseline and maxillary sinus or alveolar ridge augmentation not concomitant with implant placement.
RESULTS
Seven of 69 publications were eligible for review. rhBMP-2/ACS yielded clinically meaningful bone formation for maxillary sinus augmentation that would allow placement of regular dental implants without consistent differences between rhBMP-2 concentrations. Nevertheless, the statistical analysis showed that sinus augmentation following autogenous bone graft was significantly greater (mean bone height: 1.6 mm, 95% CI: 0.5-2.7 mm) than for rhBMP-2/ACS (rhBMP-2 at 1.5 mg/mL). In extraction sockets, rhBMP-2/ACS maintained alveolar ridge height while enhancing alveolar ridge width. Safety reports did not represent concerns for the proposed indications.
CONCLUSIONS
rhBMP-2/ACS appears a promising alternative to autogenous bone grafts for alveolar ridge/maxillary sinus augmentation; dose and carrier optimization may expand its efficacy, use, and clinical application.
Topics: Absorbable Implants; Alveolar Ridge Augmentation; Bone Morphogenetic Protein 2; Collagen; Humans; Osteogenesis; Recombinant Proteins; Sinus Floor Augmentation; Transforming Growth Factor beta
PubMed: 24102703
DOI: 10.1111/cid.12156 -
The International Journal, Advanced... 2021This paper presents a systematic review on extrusion additive manufacturing (EAM), with focus on the technological development of screw-assisted systems that can be fed... (Review)
Review
This paper presents a systematic review on extrusion additive manufacturing (EAM), with focus on the technological development of screw-assisted systems that can be fed directly with granulated materials. Screw-assisted EAM has gained importance as an enabling technology to expand the range of 3D printing materials, reduce costs associated with feedstock fabrication, and increase the material deposition rate compared to traditional fused filament fabrication (FFF). Many experimental printheads and commercial systems that use some screw-processing mechanism can be found in the literature, but the design diversity and lack of standard terminology make it difficult to determine the most suitable solutions for a given material or application field. Besides, the few previous reviews have offered only a glimpse into the topic, without an in-depth analysis about the design of the extruders and associated capabilities. A systematic procedure was devised to identify the screw-assisted EAM systems that can print directly from granulated materials, resulting in 61 articles describing different pieces of equipment that were categorized as experimental printheads and commercial systems, for small- and large-scale applications. After describing their main characteristics, the most significant extruder modifications were discussed with reference to the materials processed and performance requirements. In the end, a general workflow for the development of 3D printers based on screw extrusion was proposed. This review intends to provide information about the state-of-the-art screw-assisted EAM and help the academy to identify further research opportunities in the field.
PubMed: 34092883
DOI: 10.1007/s00170-021-07365-z