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BMC Women's Health Sep 2023Genitourinary syndrome of menopause (GSM) is a common and disturbing issue in the postmenopausal period. Unlike vasomotor symptoms, it has a progressive trend. Our study... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Genitourinary syndrome of menopause (GSM) is a common and disturbing issue in the postmenopausal period. Unlike vasomotor symptoms, it has a progressive trend. Our study aims to evaluate the efficacy and safety of oxytocin gel versus placebo gel in postmenopausal women with GSM.
METHODS
A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs) from Web of Science, SCOPUS, PubMed, and Cochrane Central Register of Controlled Trials databases on January 18, 2023. Keywords such as "oxytocin," "intravaginal," "vaginal," "atrophic," and "atrophy" were used. We used Review Manager (RevMan) version 5.4 in our analysis. We used the risk ratio (RR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes; both were presented with the corresponding 95% confidence interval (CI) and were calculated with the Mantel-Haenszel or inverse variance statistical method. Cochrane's Q test and the I statistic were used as measures of statistical inconsistency and heterogeneity. The Cochrane Risk of Bias Tool for RCTs was used for the quality assessment of the included studies.
RESULTS
Seven studies with 631 patients were included. Regarding the maturation index, there was a statistically insignificant increase in the oxytocin arm (MD = 12.34, 95% CI (-12.52-37.19), P = 0.33). Clinically assessed vaginal atrophy showed a statistically significant reduction in the oxytocin group (RR = 0.32, 95% CI (0.23 - 0.10), P < 0.00001). For dyspareunia, vaginal pH, and histological evaluation of vaginal atrophy, there was a statistically insignificant difference between the two groups (RR = 1.02, 95% CI (0.82-1.27), P = 0.84), (MD = -0.74, 95% CI (-1.58-0.10), P = 0.08), and (MD = -0.38, 95% CI (-0.82-0.06), P = 0.09), respectively. There was no significant difference in the safety profile between the two groups as measured by endometrial thickness (MD = 0.00, 95% CI (-0.23-0.23), P = 0.99).
CONCLUSIONS
Although oxytocin has been proposed as a viable alternative to estrogen in the treatment of GSM, our findings show the opposite. Larger, high-quality RCTs are needed to confirm or refute our results.
TRIAL REGISTRATION
PROSPERO registration number CRD42022334357.
Topics: Female; Humans; Oxytocin; Postmenopause; Atrophy; Databases, Factual; Dyspareunia
PubMed: 37716966
DOI: 10.1186/s12905-023-02645-0 -
Journal of Clinical Medicine Jul 2023This study aims to systematise subfoveal choroidal thickness (SFCT) measured using optical coherence tomography (OCT) in patients with different severities of thyroid... (Review)
Review
A Comparison of Observational Studies on Subfoveal Choroidal Thickness Measured with OCT according to the Level of Thyroid Eye Disease Activity-Systematic Review and Meta-Analysis.
This study aims to systematise subfoveal choroidal thickness (SFCT) measured using optical coherence tomography (OCT) in patients with different severities of thyroid eye disease (TED) compared with healthy subjects. The PubMed, Web of Science and Scopus databases were searched for the following terms: ((Graves' ophthalmopathy) OR (thyroid eye disease) OR (Graves' orbitopathy) OR (thyroid-associated orbitopathy)) AND (choroidal thickness) AND ((optical coherence tomography) OR (OCT)). The pool of papers was narrowed down to articles published until 31 January 2023 (26, 26 and 96 papers, respectively). Twenty-five (25) articles were taken into consideration, which were original papers and included the choroidal thickness measurements among TED patients in their results. Finally, eight papers were included in the comparative analysis of the SFCT parameter in TED patients and a group of healthy controls, and seven papers in the comparative analysis of the same parameter between active and inactive TED patients. The mean value of the difference between the TED group and the healthy group was 38.79 μm, with a confidence interval (CI) from 0.09 to 77.49 μm ( = 0.0495). The mean difference between the active TED group and inactive TED group was 38.02 μm, with a CI from 8.62 to 67.42 μm ( = 0.0113). All the results were statistically significant.
PubMed: 37510836
DOI: 10.3390/jcm12144720 -
BMC Oral Health Oct 2023Concentrated growth factor (CGF), a new autologous platelet concentrate, has been widely investigated to the adjunctive treatment of oral diseases. This study aims to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Concentrated growth factor (CGF), a new autologous platelet concentrate, has been widely investigated to the adjunctive treatment of oral diseases. This study aims to evaluate the efficacy of CGF in the surgical treatment of oral diseases.
METHODS
MEDLINE, Web of Science, Scopus, Cochrane, and EMBASE databases were searched up to July 2023. Only randomized clinical trials were included. The methodologic quality was evaluated by the Cochrane Risk of Bias Tool. RevMan 5.4 software was used for data analysis.
RESULTS
In the treatment of periodontal intrabony defects, bone graft combined with CGF was significantly superior to bone graft (P < 0.01), with mean intrabony defect depth reduction of 1.41 mm and mean clinical attachment level gain of 0.55 mm. In the regenerative surgery of furcation defects, the effect of CGF group was significantly better than control group (P < 0.0001), with mean probing depth reduction of 0.99 mm, vertical bone gain of 0.25 mm, and horizontal bone gain of 0.34 mm. CGF combined with coronally advanced flap (CAF) was more effective than CAF alone (mean keratinized tissue width increase of 0.41 mm, mean gingival thickness increase of 0.26 mm, P < 0.00001), but less effective than connective tissue graft (CTG) combined with CAF (mean root coverage difference of -15.1%, mean gingival thickness difference of -0.5 mm, P < 0.0001). In the alveolar ridge preservation, additional use of CGF reduced horizontal bone resorption by 1.41 mm and buccal vertical bone resorption by 1.01 mm compared to control group (P < 0.0001). The VAS score of CGF group was significantly lower than that of the control group at the 1st and 7th day after oral surgery (P < 0.0001).
CONCLUSIONS
CGF can exert a positive adjunctive effect for the regenerative surgery of periodontal intrabony defects, furcation defects, and alveolar ridge preservation procedure. CGF combined with CAF has a better therapeutic effect on gingival recession compared to CAF alone, although it is not as effective as CTG combined with CAF. CGF could promote postoperative healing and pain relief in oral surgery within a week. There is currently not enough evidence to support the clinical benefits of CGF in other oral surgeries.
Topics: Humans; Surgical Flaps; Gingival Recession; Gingiva; Intercellular Signaling Peptides and Proteins; Furcation Defects; Bone Resorption; Treatment Outcome; Tooth Root
PubMed: 37794381
DOI: 10.1186/s12903-023-03357-5 -
Journal of Clinical Medicine Aug 2023Peripartum cardiomyopathy (PPCM) is a form of new-onset heart failure that has a high rate of maternal morbidity and mortality. This was the first study to... (Review)
Review
Analysis of Clinical Profiles and Echocardiographic Cardiac Outcomes in Peripartum Cardiomyopathy (PPCM) vs. PPCM with Co-Existing Hypertensive Pregnancy Disorder (HPD-PPCM) Patients: A Systematic Review and Meta-Analysis.
Peripartum cardiomyopathy (PPCM) is a form of new-onset heart failure that has a high rate of maternal morbidity and mortality. This was the first study to systematically investigate and compare clinical factors and echocardiographic findings between women with PPCM and co-incident hypertensive pregnancy disorders (HPD-PPCM) and PPCM-only women. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) framework. We used four databases and a single search engine, namely PubMed/Medline, Scopus, Web of Science, and Cochrane. We used Cochrane Risk of Bias (RoB) 2.0 for quality assessment. Databases were searched for relevant articles published from 2013 to the end of April 2023. The meta-analysis used the DerSimonian-Laird random-effects model to analyze the pooled mean difference (MD) and its -value. We included four studies with a total of 64,649 participants and found that systolic blood pressure was significantly more likely to be associated with the PPCM group than the HPD-PPCM group (SMD = -1.63) (95% CI; -4.92,0.28, = 0.01), while the other clinical profiles were not significant. HPD-PPCM was less likely to be associated with LVEF reduction (SMD = -1.55, [CI: -2.89, -0.21], = 0.02). HPD-PPCM was significantly associated with less LV dilation (SMD = 1.81; 95% (CI 0.07-3.01), = 0.04). Moreover, HPD-PPCM was less likely to be associated with relative wall thickness reduction (SMD = 0.70; 95% CI (-1.08--0.33), = 0.0003). In conclusion, PPCM and HPD-PPCM shared different clinical profiles and remodeling types, which may affect each disease's response to pharmacological treatment. Patients with HPD-PPCM exhibited less eccentric remodeling and seemed to have a higher chance of recovering their LV ejection fraction, which means they might not benefit as much from ACEi/ARB and beta-blockers. The findings of this study will guide the development of guidelines for women with PPCM and HPD-PPCM from early detection to further management.
PubMed: 37629345
DOI: 10.3390/jcm12165303 -
Journal of Clinical Medicine Nov 2023The purpose of the research project was to extensively review the efficacy and safety of a trehalose tear-substitute treatment in cases of dry eye disease (DED). A... (Review)
Review
The purpose of the research project was to extensively review the efficacy and safety of a trehalose tear-substitute treatment in cases of dry eye disease (DED). A systematic review that included only full-length randomized controlled studies (RCTs) reporting the effects of trehalose tear-substitute treatment in three databases, PubMed, Scopus and Web of Science, was performed according to the PRISMA statement. The search period included papers published before 8 August 2023. The Cochrane risk-of-bias tool was used to analyze the quality of the studies selected. A total of 10 RCTs were included in this systematic review. Trehalose tear-substitute treatments achieved a higher improvement than did control group interventions in all reported variables. The mean differences between both groups were in favor of trehalose, and were as follows: ocular surface disease index (OSDI) questionnaire score of -8.5 ± 7 points, tear film breakup time (TBUT) of 1.9 ± 1 s, tear film thickness (TFT) of 0.25 ± 0.1 μm, tear meniscus height (TMH) of 0.02 ± 0.02 mm, Schirmer test (ST) of 0.8 ± 1.4 mm, corneal fluorescein staining (CFS) of -0.7 ± 0.1 points and visual acuity (VA) of 0.3 ± 2.1 letters. No adverse events after trehalose tear-substitute treatments were reported. Trehalose tear substitutes are a safe and effective treatment for DED. Therefore, trehalose tear substitutes should be recommended for patients with dry eye disease. In addition, there is specific evidence to support its use in the preoperative cataract surgery period.
PubMed: 38068353
DOI: 10.3390/jcm12237301 -
Frontiers in Pharmacology 2023To systematically evaluate the efficacy and safety of the Chinese medicine detoxification and dredging collaterals in treating carotid atherosclerosis (CAS). A...
To systematically evaluate the efficacy and safety of the Chinese medicine detoxification and dredging collaterals in treating carotid atherosclerosis (CAS). A systematic and comprehensive search of nine relevant domestic and international databases were conducted from their inception until June 2022. The methodological quality of the included trials was evaluated, and the efficacy and safety were comprehensively analyzed. After applying the inclusion and exclusion criteria to the randomized controlled trials (RCTs), the research quality evaluation and data extraction were conducted, followed by a meta-analysis of the selected articles. The Cochrane's Bias risk assessment was utilized to evaluate the quality of the evidence. Of the 2,660 studies initially retrieved, 14 studies were included, involving a total of 1,518 patients. The results of the meta-analysis indicated that the clinical efficacy of the Detoxification and Collateral Dredging method in the treatment of CAS was superior to that of western medicine treatment alone, and the difference was statistically significant [RR = 1.23, 95% CI (1.13, 1.34)] Furthermore, carotid intima-media thickness [Mean Difference (MD) = -0.10, 95% CI (-0.13, -0.08)] and Crouse plaque score [MD = -0.54, 95% CI (-0.75, -0.32)] were significantly lower in the Detoxification and Collateral Dredging group compared to the pure western medicine treatment group. The difference was statistically significant. In addition, serum total cholesterol [MD = -0.70, 95% CI (-0.85, -0.55)] and low-density lipoprotein cholesterol [MD = -0.70, 95% CI (-0.85, -0.55)] were lower in the Detoxification and Collateral Dredging group than in the Western medicine group, with all differences being statistically significant. Serum high-density lipoprotein cholesterol was higher in the Detoxification and Collateral Dredging group compared to the pure western medicine group, and the difference was statistically significant [MD = 0.17, 95% CI (0.11, 0.23)]. The use of Chinese medicine Detoxification and Collateral Dredging approach in the treatment of CAS may offer benefits in improving carotid atherosclerotic plaque and reducing blood lipid levels, with a safety profile superior to that of western medicine treatment alone.
PubMed: 38146459
DOI: 10.3389/fphar.2023.1147964 -
Cureus Jan 2024Diabetic macular edema (DME) is a significant condition linked to diabetes that can result in visual loss. In recent times, there has been a notable change in the desire... (Review)
Review
Comparative Efficacy of Anti-vascular Endothelial Growth Factor (Anti-VEGF) Agents and Corticosteroids in Managing Diabetic Retinopathy-Associated Diabetic Macular Edema: A Meta-Analysis and Comprehensive Systematic Review.
Diabetic macular edema (DME) is a significant condition linked to diabetes that can result in visual loss. In recent times, there has been a notable change in the desire for treatment, with a shift toward anti-vascular endothelial growth factor (anti-VEGF) therapy and intravitreal steroids while moving away from conventional laser therapies. This comprehensive meta-analysis explicitly compares the efficacy of two therapies for DME: anti-VEGF therapy and corticosteroid. We conducted a thorough search using PubMed and Google Scholar to identify publications that compare the effects of anti-VEGF therapy and corticosteroid implants on DME. Using Review Manager 5.0 (RevMan), we incorporated data from nine research studies, which involved a total of 877 people. The group was split into two factions: 453 patients were administered corticosteroids, while 466 patients underwent treatment with anti-VEGF therapy. Our investigation demonstrated that both corticosteroid and anti-VEGF therapy positively improved the best-corrected visual acuity (BCVA) and reduced the central macular thickness (CMT). Nevertheless, comparing the mean BCVA on the logarithm of the minimum angle of resolution (logMAR) scale revealed no statistically significant changes between the two treatments. This indicates considerable inconsistency, as evidenced by the weighted mean difference (WMD) of -0.13 (-0.41, 0.16) with a -value of 0.39 and an value of 99%. In addition, both treatments improved BCVA compared to the initial measurement. However, there was no statistically significant benefit for corticosteroid over anti-VEGF therapy, as indicated by the WMD of 0.03 (-0.07, 0.13) with a -value of 0.55 and an value of 80%. The examination of the average CMT also yielded findings that lacked statistical significance, displaying a significant amount of variation (WMD -36.37, 95% confidence interval [-127.52, 54.78], = 0.43, = 98%). Remarkably, there were no significant alterations among the anti-VEGF therapy group despite a rise in CMT from the initial measurement. The main conclusion drawn from our research is that corticosteroid demonstrates encouraging immediate enhancements in BCVA and CMT. However, anti-VEGF therapy seems to provide more significant long-term advantages. Nevertheless, it is crucial to acknowledge that the corticosteroid group had a greater susceptibility to acquiring elevated intraocular pressure (IOP) and the possibility of glaucoma.
PubMed: 38333510
DOI: 10.7759/cureus.51910 -
International Journal of Pharmaceutics:... Dec 2023Electrospun chitosan nanofibers (QSNFs) enhance the healing process by mimicking skin structure and function. The aim of this study was to analyze the therapeutic... (Review)
Review
Electrospun chitosan nanofibers (QSNFs) enhance the healing process by mimicking skin structure and function. The aim of this study was to analyze the therapeutic effects of QSNFs application on animal skin wounds to identify a potential direction for translational research in dermatology. The PRISMA methodology and the PICO scheme were used. A random effects model and mean difference analysis were applied for the meta-analysis. A meta-regression model was constructed, risk of bias was determined, and methodological quality assessment was performed. Of the 2370 articles collected, 54 studies were selected based on the inclusion and exclusion criteria. The wound healing area was used for building models on the 3rd, 7th, and 14th days of follow-up; the results were - 10.4% (95% CI, -18.2% to -2.6%, = 0.001), -21.0% (95% CI, -27.3% to -14.7%, p = 0.001), and - 14.0% (95% CI, -19.1 to -8.8%, p = 0.001), respectively. Antioxidants and synthetic polymers combined with QSNFs further reduced skin wound areas ( < 0.05). The results show a more efficient reduction in wound area percentages in experimental groups than in control groups, so QSNFs could potentially be applied in translational human medicine research.
PubMed: 36950662
DOI: 10.1016/j.ijpx.2023.100175 -
Journal of Clinical Medicine Mar 2024Fragile gingival tissue is a risk factor for the development of gingival recessions. Despite the fact that gingival recessions are more commonly seen around anterior... (Review)
Review
Fragile gingival tissue is a risk factor for the development of gingival recessions. Despite the fact that gingival recessions are more commonly seen around anterior mandibular teeth, previous research has predominantly concentrated on the gingival dimensions in the anterior maxilla. The objective was to systematically compare buccal gingival thicknesses between the upper and lower jaws in individuals with healthy gingival conditions in the aesthetic zone. A comprehensive search of three databases was carried out until October 2023. Gingival thickness differences between the maxilla and mandible were evaluated by calculating the mean differences along with the corresponding 95% confidence interval (CI). Subgroup analysis was conducted based on the measurement area, measurement method, and tooth category. A total of seventeen studies were included in this systematic review. Eleven studies were included in the quantitative analysis. Quantitative analysis comparing gingival thickness around 2100 teeth in the anterior mandible to 2056 teeth in the anterior maxilla revealed a statistically significant thinner buccal gingiva in the mandible (mean difference: 0.16 mm; 95% CI [-0.24, -0.07]; = 0.0003). The present systematic review revealed a more delicate buccal gingiva in the anterior mandible. However, further scientific validation is required due to the considerable heterogeneity in study design and the potential presence of confounding variables.
PubMed: 38542013
DOI: 10.3390/jcm13061789 -
BMC Oral Health Dec 2023The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications... (Meta-Analysis)
Meta-Analysis
PURPOSE OF THE STUDY
The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications using conventional impression methods improve the marginal and internal fit?
BACKGROUND
The incorporation of digital technology in the fabrication of fixed partial dentures (FPDs) has accelerated over the past decade. This study is directed at evaluating the marginal and internal fit of FPDs manufactured using digital approaches compared to conventional techniques. The need for updated data has encouraged this review.
MATERIALS AND METHODS
An electronic search was conducted in PubMed, Scopus, Web of Science, and the Grey Database to identify relevant studies. The Modified Methodological Index for Non-Randomized Studies (MINORS) was used to assess the risk of bias in in vitro experiments. The key results of this meta-analysis were the standard mean differences (SMDs) and 95% confidence intervals (CI) of each main variance, marginal fit, and internal fit between the digital and conventional techniques. Additional analyses were performed to assess the significance of three subgroup parameters: method of digitalization, cement spacer thickness, and span length, and their influence on the fit of the FPDs.
RESULTS
Based on predefined criteria, of the seven articles included in this systematic review, only five were selected for the quantitative data analysis. The marginal fit results were (P = 0.06; SMD: -1.88; 95% CI: - 3.88, 0.11) (P > 0.05) and the internal fit results were (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.10) (P < 0.05). Regarding the subgroup analyses, the method of digitalization subgroup results were (P = 0.35; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.80; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively. The span length results were (P = 0.10; SMD: -1.89; 95% CI: - 3.89, 0.11) for marginal fit and (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.11) for internal fit. The cement spacer thickness (P = 0.01; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.04; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively.
CONCLUSION
Tooth-retained fixed partial dentures FPDs produced by digital scanning and computer-aided design/computer-aided manufacturing (CAD/CAM) systems can significantly enhance the internal fit compared with those manufactured by traditional methods. Intraoral scanners can replace conventional impressions for the fabrication of FPDs because they minimize the operating time and reduce patient pain. Further clinical studies are required to obtain more conclusive results.
SYSTEMATIC REVIEW REGISTRATION
This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42021261397.
Topics: Humans; Dental Marginal Adaptation; Denture, Partial, Fixed; Computer-Aided Design; Research Design; Dental Prosthesis Design
PubMed: 38049754
DOI: 10.1186/s12903-023-03628-1