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Ozone for the treatment of temporomandibular joint disorders: a systematic review and meta-analysis.Medical Gas Research 2023Temporomandibular joint disorders (TMD) generate pain and difficulties for mouth opening affecting the patients' quality of life. Ozone is an emerging therapy that has... (Meta-Analysis)
Meta-Analysis
Temporomandibular joint disorders (TMD) generate pain and difficulties for mouth opening affecting the patients' quality of life. Ozone is an emerging therapy that has been proposed as a potential treatment, due to that, the evidence about its efficacy should be reviewed. Therefore, this work aimed to conduct a comprehensive systematic review to address the efficacy of ozone therapy for the treatment of pain and limited mouth opening in patients with TMD. The design of the included studies was clinical trials and observational studies, whereas, a series of cases, in vivo, and in vitro studies were excluded. The search was performed in PubMed, ClinicalTrials, Web of Science, and Scopus. Gray literature was searched at Google Scholar. Relevant data of all included studies were recorded. The risk of bias (using RoB 2) and the quality (using Grading of Recommendations Assessment, Development, and Evaluation) assessments were carried out. Meta-analyses using random-effects models of pain and maximal mouth opening data were performed. This review included 8 studies with 404 participants suffering limited function and pain related to TMD. At the overall bias of the studies, 25% exhibited some concerns and 75% had high risk; and the quality of the studies was low. The analysis of the included studies suggests that ozone therapy can diminish pain and improve the maximal mouth opening in TMD patients. However, there is no conclusive evidence of ozone therapy as a superior treatment for TMD compared with occlusal splint and pharmacotherapy.
Topics: Humans; Ozone; Quality of Life; Treatment Outcome; Pain; Temporomandibular Joint Disorders
PubMed: 36571381
DOI: 10.4103/2045-9912.345174 -
The Lancet. Planetary Health Nov 2023High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017.
METHODS
We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure-response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure-response relationships and sufficient exposure data were finally targeted: PM, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach.
FINDINGS
From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070-5040) to 3700 (3210-4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3-15·6) of total DALYs and 3·45% (3·01-3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins.
INTERPRETATION
DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China.
FUNDING
The National Key Research and Development Program of China and the National Natural Science Foundation of China.
Topics: Humans; Air Pollutants; Carbon Monoxide; Sulfur Dioxide; Benzene; Nitrogen Dioxide; Formaldehyde; Cost of Illness; Particulate Matter; Radon; Ozone; Toluene
PubMed: 37940210
DOI: 10.1016/S2542-5196(23)00215-2 -
Frontiers in Immunology 2023With the continuous development of clinical medicine, an increasing number of non-pharmacological interventions have been applied for the treatment of knee... (Meta-Analysis)
Meta-Analysis
Effects of externally-applied, non-pharmacological Interventions on short- and long-term symptoms and inflammatory cytokine levels in patients with knee osteoarthritis: a systematic review and network meta-analysis.
BACKGROUND
With the continuous development of clinical medicine, an increasing number of non-pharmacological interventions have been applied for the treatment of knee osteoarthritis (KOA), with the results of several recent randomized controlled trials (RCTs) showing that a variety of externally-applied, non-pharmacological interventions (EANPI) can improve symptoms and inflammation in patients with KOA. However, the relative benefits and disadvantages of non-drug therapies remain uncertain, and an optimal treatment strategy has not yet been determined.
OBJECTIVE
This study applied network meta-analysis (NMA) to compare and rank the effectiveness of EANPI on the short- and long-term clinical symptoms and inflammatory cytokine levels in patients with KOA.
METHODS
Two independent researchers searched online databases and performed manual retrieval of related citations to identify RCTs that met the selection criteria for the network meta-analysis. These researchers retrieved studies indexed from database inception to August 2023 and performed data extraction and assessment of the risk of bias.
RESULTS
The analysis included 80 RCTs involving 8440 participants and nine externally-applied, non-pharmacological therapies, namely extracorporeal shock wave, radiofrequency, acupotomy, laser therapy, Tuina therapy, kinesio taping, electroacupuncture, platelet-rich plasma injection, and ozone therapy. The treatment courses ranged from 1 to 12 weeks, with follow-up periods ranging from 4 to 24 weeks. The results of the NMA indicated that each non-drug therapy was superior to sham intervention in improving all outcome indicators. Except for the visual analog scale (VAS) and Western Ontario MacMaster (WOMAC) pain outcomes, all non-drug therapies had better efficacy than pharmacological treatments. For short-term VAS and tumor necrosis factor-alpha (TNF-α), extracorporeal shock wave performed better than other therapies (90.2% and 85.2% respectively). Radiofrequency therapy may be the most promising method to reduce long-term VAS, short- and long-term WOMAC pain, and interleukin (IL)-1β level (84.8%, 97.8%, 90.1%, 94.8% respectively). Tuina therapy may be a significant choice for short- and long-term outcomes of WOMAC function and range of motion (ROM).
CONCLUSIONS
The results of the comprehensive comparison of the outcome indicators in 9 different EANPI indicated that radiofrequency and Tuina therapy were more effective and consistently ranked high in improving clinical symptoms in the short and long term. Radiofrequency is effective at relieving pain, and Tuina therapy can be given priority for treatment when hypofunction is the main symptom. EANPI to improve pain symptoms may be related to the regulation of inflammatory cytokine levels, which may be a potential mechanism of action.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?, identifier CRD42023464177.
Topics: Humans; Osteoarthritis, Knee; Cytokines; Network Meta-Analysis; Pain; Acupuncture Therapy
PubMed: 38155966
DOI: 10.3389/fimmu.2023.1309751 -
BMC Pregnancy and Childbirth Dec 2023The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the occurrence of OFCs. However, there are still some controversies about the current research results, and there is no relevant research to review the latest results in recent years.
OBJECTIVE
In this paper, the authors conducted a systematic review and meta-analysis to explore the correlation between ambient air pollution and the occurrence of neonatal OFCs deformity.
METHODS
We searched Pubmed, Web of science, and Embase databases from the establishment of the database to May 2023. We included observational studies on the relationship between prenatal exposure to fine particulate matter 2.5 (PM2.5), fine particulate matter 10 (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO) and the risk of cleft lip (CL), cleft palate (CP), cleft lip with or without palate (CL/P). the Newcastle-Ottawa quality assessment scale (NOS) was used to evaluate the quality of the literature. Funnel plot and Egger's regression were used to verify the publication bias. Random effect model or fixed effect model was used to estimate the combined relative risk (RR) and 95% confidence interval (95%CI).
RESULTS
A total of eleven studies were included in this study, including four cohort studies and seven case-control studies, including 22,453 cases of OFCs. Ten studies had low risk of bias and only one study had high risk of bias. Three studies reported that PM was positively correlated with CL and CP, with a combined RR and 95%CI of 1.287(1.174,1.411) and 1.267 (1.105,1.454). Two studies reported a positive correlation between O and CL, with a combined RR and 95%CI of 1.132(1.047,1.225). Two studies reported a positive correlation between PM and CL, with a combined RR and 95%CI of 1.108 (1.017,1.206). No association was found between SO, CO, NO exposure during pregnancy and the risk of OFCs.
CONCLUSION
The results of this study showed that there was a significant statistical correlation between exposure to PM, PM, O and the risk of OFCs in the second month of pregnancy. Exposure assessment, research methods and mechanisms need to be further explored.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Air Pollutants; Cleft Lip; Cleft Palate; Air Pollution; Particulate Matter; Ozone; Sulfur Dioxide; Nitrogen Dioxide; Environmental Exposure
PubMed: 38041018
DOI: 10.1186/s12884-023-06104-4 -
Cureus May 2024Cervical intervertebral disc herniation is a common condition and most often presents as neck or upper limb pain causing varying levels of disability and dysfunction.... (Review)
Review
Cervical intervertebral disc herniation is a common condition and most often presents as neck or upper limb pain causing varying levels of disability and dysfunction. Percutaneous injection of ozone into the intradiscal space is a novel and minimally invasive technique for managing this condition and can be an effective alternative to surgical management. A literature search was done using the keywords ozone disc nucleolysis of cervical intervertebral lesions, and five studies were selected based on the inclusion and exclusion criteria. Meta-analysis was performed to determine safety, effectiveness, and symptomatic relief (determined based on the visual analog scale (VAS)) with the publication bias being removed. Subjects treated with ozone therapy showed significant reduction (p < 0.0001) in VAS score as compared to baseline VAS score with a standardized mean difference of 2.78 (95% CI = 1.48 to 4.07; Z value = 4.20). Ozone nucleolysis is a minimally invasive, relatively safe, and optimally effective treatment option for reducing the pain related to cervical disc. Intradiscal ozone therapy can be considered an alternative treatment modality, and well-designed, randomized clinical trials are required to confirm the long-term superiority of ozone therapy against other treatment modalities available for cervical disc herniation.
PubMed: 38854278
DOI: 10.7759/cureus.59855 -
Iranian Journal of Public Health Jan 2024Influenza is the first infectious disease that implements global monitoring and is one of the major public health issues in the world. Air pollutants have become an... (Review)
Review
BACKGROUND
Influenza is the first infectious disease that implements global monitoring and is one of the major public health issues in the world. Air pollutants have become an important global public health issue, in recent years, and much epidemiological and clinical evidence has shown that air pollutants are associated with respiratory diseases.
METHODS
We comprehensively searched articles published up to 15 November 2022 in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Database of Chinese sci-tech periodicals, and Wanfang Database. The search strategies were based on keyword combinations related to influenza and air pollutants. The air pollutants included particulate matter (PM, PM), nitrogen dioxide (NO), sulfur dioxide (SO), carbon monoxide (CO), and ozone (O). Meta-analysis was performed using the R programming language (R4.2.1).
RESULTS
A total of 2926 records were identified and 1220 duplicates were excluded. Finally, 19 studies were included in the meta-analysis according to inclusion and exclusion criteria. We observed a significant association between partial air pollutants (PM, NO, PM and SO) and the incidence risk of influenza. The RRs were 1.0221 (95% CI: 1.0093~1.0352), 1.0395 (95% CI: 1.0131~1.0666), 1.007 (95% CI: 1.0009~1.0132), and 1.0352 (95% CI. 1.0076~1.0635), respectively. However, there was no significant relationship between CO and O exposure and influenza, and the RRs were 1.2272 (95% CI: 0.9253~1.6275) and 1.0045 (95% CI: 0.9930~1.0160), respectively.
CONCLUSION
Exposure to PM, NO, PM, and SO was significantly associated with influenza, which may be risk factors for influenza. The association of CO and O with influenza needs further investigation.
PubMed: 38694869
DOI: 10.18502/ijph.v53i1.14678 -
The Lancet Regional Health. Western... Nov 2023Gaseous emissions have contributed to global warming, an increase in the frequency of extreme weather events and poorer air quality. The associated health impacts have... (Review)
Review
UNLABELLED
Gaseous emissions have contributed to global warming, an increase in the frequency of extreme weather events and poorer air quality. The associated health impacts have been well reported in temperate regions. In Singapore, key climate change adaptation measures and activities include coastal and flood protection, and mitigating heat impacts. We systematically reviewed studies examining climate variability and air quality with population health in Singapore, a tropical city-state in South-East Asia (SEA), with the aim to identify evidence gaps for policymakers. We included 14 studies with respiratory illnesses, cardiovascular outcomes, foodborne disease and dengue. Absolute humidity (3 studies) and rainfall (2 studies) were positively associated with adverse health. Extreme heat (2 studies) was inversely associated with adverse health. The effects of mean ambient temperature and relative humidity on adverse health were inconsistent. Nitrogen dioxide and ozone were positively associated with adverse health. Climate variability and air quality may have disease-specific, differing directions of effect in Singapore. Additional high quality studies are required to strengthen the evidence for policymaking. Research on effective climate action advocacy and adaptation measures for community activities should be strengthened.
FUNDING
There was no funding source for this study.
PubMed: 38116501
DOI: 10.1016/j.lanwpc.2023.100947 -
Healthcare (Basel, Switzerland) Oct 2023The potential influence of environmental factors, particularly air pollutants such as ozone (O), on the dynamics and progression of COVID-19 remains a significant... (Review)
Review
The potential influence of environmental factors, particularly air pollutants such as ozone (O), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00-1.13) compared to the general population (OR: 1.00, 95% CI: 0.98-1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: -0.187) and mortality (coefficient: -0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics.
PubMed: 37830707
DOI: 10.3390/healthcare11192670 -
Toxics Mar 2024The effects of air pollution on physical health are well recognized, with many studies revealing air pollution's effects on vision disorder, yet no relationship has been... (Review)
Review
The effects of air pollution on physical health are well recognized, with many studies revealing air pollution's effects on vision disorder, yet no relationship has been established. Therefore, a meta-analysis was carried out in this study to investigate the connection between vision disorder and ambient particles (diameter ≤ 2.5 µm (PM), diameter ≤ 10 µm (PM)) and gaseous pollutants (nitrogen dioxide (NO), sulfur dioxide (SO), carbon monoxide (CO), Ozone (O)). Twelve relevant studies published by 26 February 2024 were identified in three databases. A pooled odds ratios (ORs) of 95% confidence intervals (CIs) were obtained using random-effects meta-analysis models. Meta-analysis results revealed that for every 10 µg/m increase in PM and NO exposure, a substantially higher incidence of vision disorder was observed (OR = 1.10; 95% CI: 1.01, 1.19; OR = 1.08, 95% CI: 1.00, 1.16). No significant correlation existed between exposure to PM, SO and CO and vision disorder. However, O exposure was negatively associated with vision disorder. In addition, subgroup analyses revealed that PM exposure was significantly correlated with the risk of glaucoma and age-related macular degeneration and that children and adolescents were more susceptible to NO and PM than adults. Overall, exposure to air pollutants, especially PM and NO, may increase the incidence of vision disorder.
PubMed: 38535942
DOI: 10.3390/toxics12030209 -
The Science of the Total Environment Jan 2024Low- and middle-income countries (LMIC) are disproportionately affected by air pollution and its health burden, representing a global inequity. The COVID-19 pandemic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Low- and middle-income countries (LMIC) are disproportionately affected by air pollution and its health burden, representing a global inequity. The COVID-19 pandemic provided a unique opportunity to investigate the impact of unprecedented lockdown measures on air pollutant concentrations globally. We aim to quantify air pollutant concentration changes across LMIC settings as a result of COVID-19 restrictions.
METHODS
Searches for this systematic review and meta-analysis were carried out across five databases on 30th March 2022; MEDLINE, Embase, Web of Science, Scopus and Transport Research Information Documentation. Modelling and observational studies were included, as long as the estimates reflected city or town level data and were taken exclusively in pre-lockdown and lockdown periods. Mean percentage changes per pollutant were calculated and meta-analyses were carried out to calculate mean difference in measured ground-level observed concentrations for each pollutant (PROSPERO CRD42022326924).
FINDINGS
Of the 2982 manuscripts from initial searches, 256 manuscripts were included providing 3818 percentage changes of all pollutants. No studies included any countries from Sub-Saharan Africa and 34 % and 39.4 % of studies were from China and India, respectively. There was a mean percentage change of -37.4 %, -21.7 %, -54.6 %, -39.1 %, -48.9 %, 16.9 %, -34.9 %, -30.6 % and - 14.7 % for black carbon (BC), carbon monoxide (CO), nitric oxide (NO), nitrogen dioxide (NO), oxides of nitrogen (NO), ozone (O), particulate matter 10 (PM) and 2.5 (PM) and sulphur dioxide (SO), respectively. Meta-analysis included 100 manuscripts, providing 908 mean concentration differences, which showed significant reduction in mean concentration in all study settings for BC (-0.46 μg/m, PI -0.85; -0.08), CO (-0.25 mg/m, PI -0.44; -0.03), NO (-19.41 μg/m, PI -31.14; -7.68) and NO (-22.32 μg/m, PI -40.94; -3.70).
INTERPRETATION
The findings of this systematic review and meta-analysis quantify and confirm the trends reported across the globe in air pollutant concentration, including increases in O. Despite the majority of global urban growth occurring in LMIC, there are distinct geographical gaps in air pollution data and, where it is available, differing approaches to analysis and reporting.
Topics: Humans; Developing Countries; Nitrogen Dioxide; Pandemics; COVID-19; Communicable Disease Control; Air Pollution; Air Pollutants; Particulate Matter; Ozone; Nitric Oxide
PubMed: 37884141
DOI: 10.1016/j.scitotenv.2023.168110