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Indian Journal of Ophthalmology Mar 2023The extended use of ethambutol beyond 2 months for treating tuberculosis has increased risk of optic neuropathy. We performed a systematic review of studies evaluating... (Review)
Review
The extended use of ethambutol beyond 2 months for treating tuberculosis has increased risk of optic neuropathy. We performed a systematic review of studies evaluating optic neuropathy in extended ethambutol use since 2010 and compared the outcome with a similar systematic review (1965-2010) by Ezer et al. Literature search was conducted in PubMed, Medline, EMBASE, and Cochrane databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Main outcome measures were visual acuity, color vision, visual field defects, optical coherence tomography (OCT), and visual evoked potential (VEP). The JBI Critical Appraisal Checklists were used for quality assessment. Twelve studies were selected (out of 639 studies) for analysis of ethambutol optic neuropathy. Visual acuity improvement after stopping ethambutol was statistically significant. Similar improvement was not noted for other outcome measures. On comparing the results of this review with those by Ezer et al., significant improvement was noted in visual acuity, color vision, and visual field defects. Moreover, more patients reported increased optic nerve toxicity, color vision defects, and visual field defects in the present review. Hence, we conclude that the extended use of ethambutol beyond 2 months results in significant optic nerve toxicity. Further randomized controlled trials with different populations are needed to understand the magnitude of this issue.
Topics: Humans; Ethambutol; Evoked Potentials, Visual; Optic Nerve Diseases; Optic Nerve; Checklist; Rare Diseases
PubMed: 36872667
DOI: 10.4103/ijo.IJO_1920_22 -
Medicine Aug 2015The purpose of this meta-analysis was to compare the diagnostic accuracy of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic... (Meta-Analysis)
Meta-Analysis Review
Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd-EOB-DTPA)-Enhanced Magnetic Resonance Imaging and Multidetector-Row Computed Tomography for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.
The purpose of this meta-analysis was to compare the diagnostic accuracy of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and multidetector-row computed tomography (MDCT) for hepatocellular carcinoma (HCC).Medline, Cochrane, EMBASE, and Google Scholar databases were searched until July 4, 2014, using combinations of the following terms: gadoxetic acid disodium, Gd-EOB-DTPA, multidetector CT, contrast-enhanced computed tomography, and magnetic resonance imaging. Inclusion criteria were as follows: confirmed diagnosis of primary HCC by histopathological examination of a biopsy specimen; comparative study of MRI using Gd-EOB-DTPA and MDCT for diagnosis of HCC; and studies that provided quantitative outcome data. The pooled sensitivity and specificity of the 2 methods were compared, and diagnostic accuracy was assessed with alternative-free response receiver-operating characteristic analysis.Nine studies were included in the meta-analysis, and a total of 1439 lesions were examined. The pooled sensitivity and specificity for 1.5T MRI were 0.95 and 0.96, respectively, for 3.0T MRI were 0.91 and 0.96, respectively, and for MDCT were 0.74 and 0.93, respectively. The pooled diagnostic odds ratio for 1.5T and 3.0T MRI was 242.96, respectively, and that of MDCT was 33.47. To summarize, Gd-EOB-DTPA-enhanced MRI (1.5T and 3.0T) has better diagnostic accuracy for HCC than MDCT.
Topics: Adult; Aged; Carcinoma, Hepatocellular; Contrast Media; Female; Gadolinium DTPA; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Multidetector Computed Tomography; Radionuclide Imaging; Sensitivity and Specificity
PubMed: 26266348
DOI: 10.1097/MD.0000000000001157 -
Renal Failure Feb 2015To assess the effects and safety of iron-based phosphate binders in adult patients receiving dialysis. (Review)
Review
AIM
To assess the effects and safety of iron-based phosphate binders in adult patients receiving dialysis.
METHODS
We electronically searched MEDLINE, EMBASE, CENTRAL, and CBM for randomized controlled trials about iron-based phosphate binders in adult dialysis patients. Study quality was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of intervention. Meta-analysis was conducted by RevMan 5.3.
RESULTS
Eight studies with 2018 participants were eligible for our meta-analysis. Iron-based phosphate binders were superior to placebo (MD = -2.43 mg/dL, 95% CI: -3.18 to -1.68, p < 0.00001) and as efficient as sevelamer (MD = 0.04 mg/dL, 95% CI: -0.29 to 0.36, p = 0.83) in reducing serum phosphorus in dialysis patients. No significant differences were found in all adverse events (OR = 1.30, 95% CI: 0.77 to 2.20, p = 0.32) between iron-based phosphate binders and placebo. Iron-based phosphate binders were associated with significant higher serum iron (MD = 9.39 ng/mL, 95% CI 1.48 to 17.30, p = 0.02), higher serum transferring saturation (MD = 6.29%, 95% CI 2.72 to 9.87, p = 0.0006) and lower serum total iron binding capacity (MD = -23.13 µg/dL, 95% CI -35.69 to -10.58, p = 0.0003) in comparison to placebo.
CONCLUSION
Iron-based phosphate binders are as effective as sevelamer and well tolerated for hyperphosphatemia in dialysis patients. Iron-based phosphate binders appear to have a beneficial effect on renal anemia in patients receiving dialysis. Therefore, iron-based phosphate binders may represent a new treatment option for dialysis patients.
Topics: Humans; Hyperphosphatemia; Iron; Phosphates; Polyamines; Randomized Controlled Trials as Topic; Renal Dialysis; Sequestering Agents; Sevelamer
PubMed: 25350834
DOI: 10.3109/0886022X.2014.976160 -
Nephrology, Dialysis, Transplantation :... Jan 2017It remains unclear which phosphate binders should be preferred for hyperphosphatemia management in chronic kidney disease (CKD). (Comparative Study)
Comparative Study Meta-Analysis Review
The efficacy and safety of sevelamer and lanthanum versus calcium-containing and iron-based binders in treating hyperphosphatemia in patients with chronic kidney disease: a systematic review and meta-analysis.
BACKGROUND
It remains unclear which phosphate binders should be preferred for hyperphosphatemia management in chronic kidney disease (CKD).
METHODS
We performed a systematic review and meta-analysis of randomized trials comparing sevelamer or lanthanum with other phosphate binders in CKD.
RESULTS
Fifty-one trials (8829 patients) were reviewed. Compared with calcium-based binders, all-cause mortality was nonsignificantly lower with sevelamer {risk ratio [RR] 0.62 [95% confidence interval (CI) 0.35-1.08]} and lanthanum [RR 0.73 (95% CI 0.18-3.00)], but risk of bias was concerning. Compared with calcium-based binders, sevelamer reduced the risk of hypercalcemia [RR 0.27 (95% CI 0.17-0.42)], as did lanthanum [RR 0.12 (95% CI 0.05-0.32)]. Sevelamer reduced hospitalizations [RR 0.50 (95% CI 0.31-0.81)], but not lanthanum [RR 0.80 (95% CI 0.34-1.93)]. The presence/absence of other clinically relevant outcomes was infrequently reported. Compared with calcium-based binders, sevelamer reduced serum calcium, low-density lipoprotein and coronary artery calcification, but increased intact parathyroid hormone. The clinical relevance of these changes is unknown since corresponding clinical outcomes were not reported. Lanthanum had less favorable impact on biochemical parameters. Sevelamer hydrochloride and sevelamer carbonate were similar in three studies. Sevelamer was similar to lanthanum (three studies) and iron-based binders (three studies).
CONCLUSION
Sevelamer was associated with a nonsignificant reduction in mortality and significantly lower hospitalization rates and hypercalcemia compared with calcium-based binders. However, differences in important outcomes, such as cardiac events, fractures, calciphylaxis, hyperchloremic acidosis and health-related quality of life remain understudied. Lanthanum and iron-based binders did not show superiority for any clinically relevant outcomes. Future studies that fail to measure clinically important outcomes (the reason why phosphate binders are prescribed in the first place) will be wasteful.
Topics: Biomarkers; Calcium Compounds; Chelating Agents; Humans; Hyperphosphatemia; Lanthanum; Phosphates; Renal Insufficiency, Chronic; Safety; Sevelamer; Treatment Outcome
PubMed: 27651467
DOI: 10.1093/ndt/gfw312 -
Metabolites Mar 2022Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer in which the consumption of tobacco and alcohol is considered to be the main aetiological... (Review)
Review
Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer in which the consumption of tobacco and alcohol is considered to be the main aetiological factor. Salivary metabolome profiling could identify novel biochemical pathways involved in the pathogenesis of various diseases. This systematic review was designed to answer the question "Are salivary metabolites reliable for the diagnosis of oral squamous cell carcinoma?". Following the inclusion and exclusion criteria, nineteen studies were included (according to PRISMA statement guidelines). In all included studies, the diagnostic material was unstimulated whole saliva, whose metabolome changes were determined by different spectroscopic methods. At the metabolic level, OSCC patients differed significantly not only from healthy subjects but also from patients with oral leukoplakia, lichen planus or other oral potentially malignant disorders. Among the detected salivary metabolites, there were the indicators of the impaired metabolic pathways, such as choline metabolism, amino acid pathways, polyamine metabolism, urea cycle, creatine metabolism, glycolysis or glycerolipid metabolism. In conclusion, saliva contains many potential metabolites, which can be used reliably to early diagnose and monitor staging in patients with OSCC. However, further investigations are necessary to confirm these findings and to identify new salivary metabolic biomarkers.
PubMed: 35448481
DOI: 10.3390/metabo12040294 -
Molecular imaging for prostate cancer: Performance analysis of Ga-PSMA PET/CT versus choline PET/CT.Actas Urologicas Espanolas Jun 2017There is a need for a precise and reliable imaging to improve the management of prostate cancer. In recent years the PET/CT with choline has changed the handling of... (Comparative Study)
Comparative Study Review
INTRODUCTION
There is a need for a precise and reliable imaging to improve the management of prostate cancer. In recent years the PET/CT with choline has changed the handling of prostate cancer in Europe, and it is commonly used for initial stratification or for the diagnosis of a biochemical recurrence, although it does not lack limitations. Other markers are being tested, including the ligand of prostate-specific membrane antigen (PSMA), that seems to offer encouraging prospects. The goal of this piece of work was to critically review the role of choline and PSMA PET/CT in prostate cancer.
EVIDENCE ACQUISITION
A systematic literature review of databases PUBMED/MEDLINE and EMBASE was conducted searching for articles fully published in English on the PET marker in prostate cancer and its clinical application.
EVIDENCE SYNTHESIS AND DISCUSSION
It seems as 68Ga-PSMA PET/CT is better than PET/CT in prostate cancer to detect primary prostate lesions, initial metastases in the lymph nodes and recurrence. However, further research is required to obtain high-level tests. Also, other PET markers are studied. Moreover, the emergence of a new PET/MR camera could change the performance of PET imaging.
Topics: Choline; Edetic Acid; Gallium Isotopes; Gallium Radioisotopes; Humans; Male; Molecular Imaging; Oligopeptides; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms
PubMed: 27912910
DOI: 10.1016/j.acuro.2016.09.015 -
Odontology Jan 2023This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of... (Review)
Review
This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of different considerations: effect on smear layer removal, influence on sealer bond strength, activation effect by means of sonic or ultrasonic devices, effects on dentine surface, antibacterial activity, and effectiveness boost for regenerative procedures, releasing growth factors from dentin. To evaluate the results of CA as a final irrigant and compare them to other chelating agents. This review followed the PRISMA checklist. An electronic search was conducted in MEDLINE (OVID), Scopus (Elsevier) and the Web of Science (Thomson Reuters) databases. Risk of bias of included studies was evaluated using the modified CONSORT checklist and the PRIRATE checklist 2020 guidelines. 39 studies fulfilled the eligibility criteria to be included in this review: 27 in vitro studies using extracted human teeth, 10 in vitro studies using human dentin disks, and 2 RCT. Citric acid has proven to be effective in smear layer removal, showing better results in coronal and middle root thirds, improving its effect when combined with manual dynamic activation. There is no agreement regarding citric acid effect on sealer adhesion and adaptation to root canal walls due to heterogeneity within studies. Citric acid irrigation can decrease dentine microhardness and cause decalcification and erosion, especially when used before NaOCl. Citric acid has proven to be beneficial in regenerative endodontic procedures due to higher TGF-β1 release.Trial registration: Prospero database CRD42021267055.
Topics: Humans; Citric Acid; Edetic Acid; Smear Layer; Dental Pulp Cavity; Root Canal Preparation; Root Canal Irrigants; Dentin; Microscopy, Electron, Scanning; Sodium Hypochlorite
PubMed: 36220913
DOI: 10.1007/s10266-022-00744-2 -
Clinical Imaging Oct 2023To evaluate the value of four indices of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance as a potential imaging... (Meta-Analysis)
Meta-Analysis Review
AIMS
To evaluate the value of four indices of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance as a potential imaging marker of liver functional reserve.
METHODS
PubMed/Medline, Embase, Cochrane Library, and Web of Science were searched for studies concerning the relationship between Gd-EOB-DTPA-enhanced MRI and liver functional reserve estimated by ICG-R15, Pooled correlation coefficient (r) and 95% confidence intervals (CIs) were calculated, Meanwhile, Sensitivity and subgroup analyses were performed along with Egger's test for the estimation of publication bias and potential heterogeneity.
RESULTS
14 publications with 1285 patients were included. The pooled r between relative liver enhancement (RLE), reduction rate of T1 relaxation time of the liver (rrT1), liver-to-spleen ratio (LSR), liver-to-muscle ratio (LMR), and ICG-R15 were -0.49 (95% CI, -0.56 to -0.41, p < 0.05), -0.47 (95% CI, -0.57 to -0.36, p < 0.05), -0.45 (95% CI, -0.55 to -0.34, p < 0.05), -0.50 (95% CI, -0.61 to -0.38, p < 0.05). moderate heterogeneity was observed between studies on rrT1, LSR, LMR, and ICG-R15 (p ≤ 0.05), but no significant heterogeneity was observed between RLE and ICG-R15. Further analysis shows that there was a notable heterogeneity between subgroup analysis of LSR and ICG-R15 stratified by years of publication, as well as rrT1 and LMR stratified by total patients and study design, the distribution funnel plots and the results of Egger's test showed no evidence of publication bias.
CONCLUSIONS
RLE, LSR, LMR, and rrT1 all correlated significantly with ICG-R15-estimated hepatic functional reserve. The four indices represent a promising imaging biomarker in the prediction of liver functional reserve.
Topics: Humans; Liver Function Tests; Contrast Media; Liver; Gadolinium DTPA; Magnetic Resonance Imaging; Liver Neoplasms; Retrospective Studies
PubMed: 37437466
DOI: 10.1016/j.clinimag.2023.06.018 -
Liver Transplantation : Official... Dec 2017Early detection of small hepatocellular carcinoma (HCC) lesions can improve longterm patient survival. A systematic review and meta-analysis of the diagnostic... (Comparative Study)
Comparative Study Meta-Analysis Review
Early detection of small hepatocellular carcinoma (HCC) lesions can improve longterm patient survival. A systematic review and meta-analysis of the diagnostic performance of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and multidetector computed tomography (MDCT) was performed in diagnosing small HCCs measuring up to 2 cm (≤2 cm). Two investigators searched multiple databases for studies in which the performances of either Gd-EOB-DTPA-enhanced MRI or MDCT were reported with sufficient data to construct 2 × 2 contingency tables for diagnosing HCCs up to 2 cm on a per-lesion or per-patient level. Diagnostic performances were quantitatively pooled by a bivariate random-effect model with further meta-regression and subgroup analyses. A total of 27 studies (14 on Gd-EOB-DTPA-enhanced MRI, 9 on MDCT, and 4 on both) were included, enrolling a total of 1735 patients on Gd-EOB-DTPA-enhanced MRI and 1781 patients on MDCT. Gd-EOB-DTPA-enhanced MRI demonstrated significantly higher overall sensitivity than did MDCT (0.96 versus 0.65; P < 0.01), without substantial loss of specificity (0.94 versus 0.98; P > 0.05). Area under the summary receiver operating characteristic curve was 0.97 with Gd-EOB-DTPA-enhanced MRI and 0.85 with MDCT. Regarding Gd-EOB-DTPA-enhanced MRI, sensitivity was significantly higher for studies from non-Asian countries than Asian countries (0.96 versus 0.93; P < 0.01), for retrospective studies than prospective studies (0.95 versus 0.91; P < 0.01), and for those with Gd-EOB-DTPA injection rate ≥ 1.5 mL/s than that of <1.5 mL/s (0.97 versus 0.90; P < 0.01). In conclusion, Gd-EOB-DTPA-enhanced MRI demonstrated higher sensitivity and overall diagnostic accuracy than MDCT, and thus should be the preferred imaging modality for diagnosing small HCCs measuring up to 2 cm. Liver Transplantation 23 1505-1518 2017 AASLD.
Topics: Carcinoma, Hepatocellular; Contrast Media; Early Detection of Cancer; Gadolinium DTPA; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Multidetector Computed Tomography; ROC Curve
PubMed: 28886231
DOI: 10.1002/lt.24867 -
Microscopy Research and Technique Feb 2024The purpose of this systematic review of meta-analysis was to compare the effectiveness of removing the smearing layer using EDTA versus Chitosan (Ch) and Chitosan... (Meta-Analysis)
Meta-Analysis Review
The comparative of chitosan and chitosan nanoparticle versus ethylenediaminetetraacetic acid on the smear layer removal: A systematic review and meta-analysis of in vitro study.
The purpose of this systematic review of meta-analysis was to compare the effectiveness of removing the smearing layer using EDTA versus Chitosan (Ch) and Chitosan nanoparticles (Ch-NPs). A search was performed in four electronic databases (Web of Science, PubMed, Scopus, and Cochrane). The included studies were assessed by two reviewers using Joanna Briggs Institute's critical appraisal checklist for the quasi-experimental studies. Outcomes obtained by scanning electron microscopy (SEM) and conventional methods were presented as standardized mean differences alongside 95% confidence intervals. Seven investigations employed 212 single-root teeth. In the apical section (p = .317, 95% CI = -0.820 to 0.266, Tau = 0.387), middle segment (p = .914, 95% CI = -1.019 to 0.912, Tau = 1.027), and coronal segment (p = .277, 95% CI = -1.008 to 0.289, Tau = 0.378). This meta-analysis found no difference between Ch, Ch-NPs, and EDTA in removing the smear layer in the three segments. This systematic review is designed to show evidence related to the PICO question, in which our outcome is smear layer removal and not the clinical success of such a treatment. RESEARCH HIGHLIGHTS: The study aimed to compare the effectiveness of chitosan and chitosan nanoparticles with ethylenediaminetetraacetic acid (EDTA) in removing the smear layer, a layer of debris and organic material on the tooth surface, through a systematic review and meta-analysis. The removal of the smear layer is crucial for successful dental treatments, as it enhances the adhesion of restorative materials and improves the penetration of antimicrobial agents into dentinal tubules. The researchers conducted a systematic review and meta-analysis, searching various databases of electron microscopy results for relevant in vitro studies comparing the effects of chitosan or chitosan nanoparticles with EDTA on smear layer removal. The results encourage further exploration of chitosan and chitosan nanoparticles for clinical use in dentistry, while considering their specific applications and long-term effects.
Topics: Humans; Edetic Acid; Chitosan; Smear Layer; Root Canal Preparation; Sodium Hypochlorite; Root Canal Irrigants; Microscopy, Electron, Scanning; Dental Pulp Cavity
PubMed: 37732467
DOI: 10.1002/jemt.24423