-
The Journal of Prosthetic Dentistry Sep 2023High-level evidence concerning the restoration of endodontically treated posterior teeth by means of direct composite resin or indirect restorations is lacking. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
High-level evidence concerning the restoration of endodontically treated posterior teeth by means of direct composite resin or indirect restorations is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to analyze the current literature on the direct and indirect restoration of endodontically treated posterior teeth.
MATERIAL AND METHODS
Databases MEDLINE, CENTRAL, and EMBASE were screened. Risk of bias was assessed by using the ROB2 tool for RCTs and the ROBINS-I tool for prospective and retrospective clinical studies. Randomized clinical trials (RCTs) and prospective and retrospective studies comparing direct composite resin and indirect restorations on endodontically treated posterior teeth were included. Outcomes were tooth and restoration survival. A meta-analysis was conducted for tooth retention and restorative success.
RESULTS
Twenty-two studies were included (2 RCTs, 3 prospective, and 17 retrospective). Over the short term (2.5 to 3 years), low-quality evidence suggested no difference in tooth survival. For the prospective and retrospective clinical trials, the overall risk of bias was serious to critical from the risk of confounding because of a difference in restorative indication: Direct restorations were fabricated when one marginal ridge remained or when tooth prognosis was unfavorable. For short-term restorative success, low-quality evidence suggested no difference between the direct and indirect restorations.
CONCLUSIONS
For the short term (2.5 to 3 years), low-quality evidence suggests no difference in tooth survival or restoration quality. To assess the influence of the type of restoration on the survival and restorative success of endodontically treated posterior teeth, clinical trials that control for the amount of coronal tooth tissue and other baseline characteristics are needed.
Topics: Humans; Composite Resins; Dental Restoration, Permanent; Molar; Retrospective Studies; Dental Restoration Failure; Tooth, Nonvital
PubMed: 34980474
DOI: 10.1016/j.prosdent.2021.11.009 -
Journal of Gastrointestinal Surgery :... Aug 2023Postoperative ileus is common after gastrointestinal surgery. This network meta-analysis aimed to compare the effectiveness of gum chewing and coffee and caffeine intake... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Postoperative ileus is common after gastrointestinal surgery. This network meta-analysis aimed to compare the effectiveness of gum chewing and coffee and caffeine intake on ileus-related outcomes.
METHODS
A systematic literature review was performed to identify randomized controlled trials (RCTs) comparing noninvasive treatments for ileus after gastrointestinal surgery. The main analyses included random effects network meta-analyses using frequentist methods with simultaneous direct and indirect comparisons of time to first flatus, time to first defecation, and length of stay. Bayesian network meta-analysis using Markov chains was also used.
RESULTS
A total of 32 RCTs comparing 4999 patients were included in this network meta-analysis. Time to flatus was reduced by gum chewing (mean difference compared to control (MD): -11 h, 95% confidence interval (95% CI) - 16 to - 5 h, P < 0.001). Time to defecation was reduced by gum chewing and coffee, with MDs of -18 h (95% CI - 23 to - 13 h, P < 0.001) and -13 h (95% CI - 24 to - 1 h, P < 0.001), respectively. Length of stay was reduced by coffee and gum chewing with MDs of - 1.5 days (95% CI: - 2.5 to - 0.6 days, P < 0.001) and - 0.9 days (95% CI: - 1.3 to - 0.4 days, P < 0.001), respectively.
CONCLUSION
Coffee and gum chewing were proven to be effective noninvasive approaches for shortening the postoperative length of hospital stay and time to first defecation, especially in open gastrointestinal surgery; thus these actions should be recommended after gastrointestinal surgery.
Topics: Humans; Defecation; Coffee; Network Meta-Analysis; Mastication; Flatulence; Ileus; Postoperative Complications; Digestive System Surgical Procedures; Chewing Gum; Length of Stay; Gastrointestinal Motility
PubMed: 37277676
DOI: 10.1007/s11605-023-05702-z -
BMC Oral Health Aug 2023Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root...
BACKGROUND
Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance.
OBJECTIVE
The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites.
METHODOLOGY
The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed.
RESULTS
The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth.
CONCLUSION
According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.
Topics: Humans; Tooth, Nonvital; Dental Materials; Crowns; Tooth Fractures; Composite Resins; Dental Stress Analysis
PubMed: 37574536
DOI: 10.1186/s12903-023-03217-2 -
Environmental Pollution (Barking, Essex... Sep 2023Phthalates are chemicals widely used in plastic-based consumer products, and human exposure is universal. They are classified as endocrine disruptors, and specific... (Meta-Analysis)
Meta-Analysis Review
Phthalates are chemicals widely used in plastic-based consumer products, and human exposure is universal. They are classified as endocrine disruptors, and specific phthalate metabolites have been associated with an increased risk of cardiometabolic diseases. The aim of this study was to assess the association between phthalate exposure and the metabolic syndrome in the general population. A comprehensive literature search was performed in four databases (Web of Science, Medline, PubMed, and Scopus). We included all the observational studies that evaluate the association between phthalate metabolites and the metabolic syndrome available until January 31st, 2023. Pooled Odds Ratios (OR) and their 95% confidence intervals were calculated by using the inverse-variance weighted method. Nine cross-sectional studies and 25,365 participants aged from 12 to 80 were included. Comparing extreme categories of phthalate exposure, the pooled ORs for the metabolic syndrome were: 1.08 (95% CI, 1.02-1.16, I = 28%) for low molecular weight phthalates, and 1.11 (95% CI, 1.07-1.16, I = 7%) for high molecular weight phthalates. For individual phthalate metabolites, the pooled ORs that achieved statistical significance were: 1.13 (95% CI, 1.00-1.27, I = 24%) for MiBP; 1.89 (95% CI, 1.17-3.07, I = 15%) for MMP in men; 1.12 (95% CI, 1.00-1.25, I = 22%) for MCOP; 1.09 (95% CI, 0.99-1.20, I = 0%) for MCPP; 1.16 (95% CI, 1.05-1.28, I = 6%) for MBzP; and 1.16 (95% CI, 1.09-1.24, I = 14%) for DEHP (including ΣDEHP and its metabolites). In conclusion, both low molecular weight and high molecular weight phthalates were associated with an 8 and 11% higher prevalence of the MetS, respectively. The exposure to six specific phthalate metabolites was associated with a higher prevalence of the MetS.
Topics: Male; Humans; Metabolic Syndrome; Environmental Pollutants; Cross-Sectional Studies; Phthalic Acids; Plastics; Environmental Exposure
PubMed: 37328121
DOI: 10.1016/j.envpol.2023.121957 -
The Journal of Hospital Infection Sep 2023This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in reducing the viral load/infectivity of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in reducing the viral load/infectivity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (Part I), alleviating clinical symptoms or severity of disease (Part II), and decreasing the incidence of SARS-CoV-2 infection (Part III).
METHODS
Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) with restrictions were searched up to 3 March 2023. Twenty-three studies (22 RCTs and one NRCT) met the inclusion criteria for this systematic review.
RESULTS
Five RCTs (454 patients and nine interventions) in Part I were eligible for NMA. The NMA results showed that, in comparison with no rinse, sodium chloride (NaCl) was the most effective mouth rinse for reducing the viral load, followed by povidone-iodine (PVP-I), ß-cyclodextrin + citrox (CDCM), hydrogen peroxide (HP), chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), placebo and hypochlorous acid (HClO). However, these results were not significant. Based on surface under the cumulative ranking curve scores, PVP-I was likely to be the most efficacious mouth rinse for reducing SARS-CoV-2 viral load, followed by CDCM, HP, NaCl, CHX, CPC, placebo, no rinse and HClO.
CONCLUSION
Due to heterogeneity of the primary studies, the effectiveness of different mouth rinses to reduce viral infectivity, improve clinical symptoms or prevent SARS-CoV-2 infection remains inconclusive.
Topics: Humans; COVID-19; Mouthwashes; Povidone-Iodine; SARS-CoV-2; Sodium Chloride; Network Meta-Analysis; Hydrogen Peroxide; Mouth
PubMed: 37419189
DOI: 10.1016/j.jhin.2023.06.022 -
Circulation Jan 2024Hypertrophic cardiomyopathy (HCM) is characterized by unexplained left ventricular hypertrophy and is classically caused by pathogenic or likely pathogenic variants... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hypertrophic cardiomyopathy (HCM) is characterized by unexplained left ventricular hypertrophy and is classically caused by pathogenic or likely pathogenic variants (P/LP) in genes encoding sarcomere proteins. Not all subclinical variant carriers will manifest clinically overt disease because penetrance (proportion of sarcomere or sarcomere-related P/LP variant carriers who develop disease) is variable, age dependent, and not reliably predicted.
METHODS
A systematic search of the literature was performed. We used random-effects generalized linear mixed model meta-analyses to contrast the cross-sectional prevalence and penetrance of sarcomere or sarcomere-related genes in 2 different contexts: clinically-based studies on patients and families with HCM versus population or community-based studies. Longitudinal family/clinical studies were additionally analyzed to investigate the rate of phenotypic conversion from subclinical to overt HCM during follow-up.
RESULTS
In total, 455 full-text manuscripts and articles were assessed. In family/clinical studies, the prevalence of sarcomere variants in patients diagnosed with HCM was 34%. The penetrance across all genes in nonproband relatives carrying P/LP variants identified during cascade screening was 57% (95% CI, 52%-63%), and the mean age at HCM diagnosis was 38 years (95% CI, 36%-40%). Penetrance varied from ≈32% for (myosin light chain 3) to ≈55% for (myosin-binding protein C3), ≈60% for (troponin T2) and (troponin I3), and ≈65% for (myosin heavy chain 7). Population-based genetic studies demonstrate that P/LP sarcomere variants are present in the background population but at a low prevalence of <1%. The penetrance of HCM in incidentally identified P/LP variant carriers was also substantially lower at ≈11%, ranging from 0% in Atherosclerosis Risk in Communities to 18% in UK Biobank. In longitudinal family studies, the pooled phenotypic conversion across all genes was 15% over an average of ≈8 years of follow-up, starting from a mean of ≈16 years of age. However, short-term gene-specific phenotypic conversion varied between ≈12% for and ≈23% for .
CONCLUSIONS
The penetrance of P/LP variants is highly variable and influenced by currently undefined and context-dependent genetic and environmental factors. Additional longitudinal studies are needed to improve our understanding of true lifetime penetrance in families and in the community and to identify drivers of the transition from subclinical to overt HCM.
Topics: Humans; Adult; Penetrance; Mutation; Cross-Sectional Studies; Pedigree; Cardiomyopathy, Hypertrophic; Troponin T
PubMed: 37929589
DOI: 10.1161/CIRCULATIONAHA.123.065987 -
European Review For Medical and... Oct 2023There is an abundance of information on facelifts, blepharoplasties, rhinoplasty, and other cosmetic surgical procedures for the upper third of the face, but little is...
OBJECTIVE
There is an abundance of information on facelifts, blepharoplasties, rhinoplasty, and other cosmetic surgical procedures for the upper third of the face, but little is known about perioral lip rejuvenation. The aim of this article is to examine the existing literature on lip rejuvenation and perioral procedures related to lip rejuvenation. Additionally, this article aims to highlight the importance of addressing perioral areas alongside lip rejuvenation procedures, rather than solely focusing on lip rejuvenation. We also discussed the extensive procedures and materials used for lip rejuvenation, such as hyaluronic acid, botulinum toxin A, abobotulinum, onabotulinum, incobotulinum, prabobotulinum, fat grafts, silicone fillers, human collagen, collagen stimulating procedures such as derma pens and derma rolls, radiation frequency, stem cells, and plasma therapy, as well as the underlying factors that contribute to varying success rates.
MATERIALS AND METHODS
A thorough literature search was done using PubMed, Cochrane, Ebsco search, Google Scholar, Scopus, and Web of Science for the articles pertaining to facial and lip cosmetic surgeries 1995-2020. Keywords for the search included anatomy of the face, facial aging, perioral areas, lip rejuvenation, botox, grafts, facelift, plastic surgery, stem cell therapy, plasma treatment, and cosmetic surgery.
RESULTS
37 articles met the study criteria. 14 out of 37 studies included procedures for lip and perioral region rejuvenation. The remaining 23 studies either involved lip procedures alone or lip procedures in conjunction with facial cosmetic procedures. Lip rejuvenation with perioral enhancement with hyaluronic acid gel demonstrated a 94.3% improvement on the lip fullness scale (LFS) one month after re-treatment. The amalgamation of lip and perioral region rejuvenation produces a synergistic effect. Whereas, sole lip rejuvenation procedures showed short-term results with less patient satisfaction, calling for secondary lip rejuvenation procedures. It was also observed that hyaluronic acid was the most commonly used agent for lip rejuvenation procedures with minimal or no side effects.
CONCLUSIONS
In conjunction with perioral rejuvenation, lip rejuvenation procedures produce more aesthetically appealing results. However, any cosmetic surgical or non-surgical procedure is limited by the nature and composition of the products used. The use of FDA-approved products for rejuvenation is strongly advised to avoid undesirable side effects. Further extensive research is required on the long-term outcomes and adverse effects of stem cell transplants, such as tumor development.
Topics: Humans; Lip; Hyaluronic Acid; Cosmetic Techniques; Rejuvenation; Skin Aging; Collagen
PubMed: 37843317
DOI: 10.26355/eurrev_202310_33929 -
Techniques in Coloproctology Jan 2024This systematic review and meta-analysis aimed to evaluate the safety and efficacy of sclerotherapy methods for hemorrhoidal disease (HD) over the past 40 years. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This systematic review and meta-analysis aimed to evaluate the safety and efficacy of sclerotherapy methods for hemorrhoidal disease (HD) over the past 40 years.
METHODS
The review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive literature search was conducted, including studies reporting the use of sclerotherapy in patients with HD. Study eligibility criteria were defined, and data were extracted independently by the authors. Random-effects meta-analyses were performed to assess outcomes of interest.
RESULTS
Out of 1965 records identified, 44 studies met the inclusion criteria, involving 9729 patients. The majority of studies were conducted in Japan, followed by the UK, Italy, and Portugal. The median age of participants was 52 years, and the majority were male. The Goligher grade distribution indicated varying degrees of HD severity. Sclerotherapy was predominantly administered through anoscopy, with polidocanol being the most commonly used agent. The procedure was generally performed without pre-injection analgesia. The meta-analysis of 14 randomized controlled trials (RCTs) revealed that sclerotherapy was not inferior to control interventions in terms of success rate (risk ratio [RR] 1.00, 95% CI 0.71-1.41) and recurrence rate (RR 1.11, 95% CI 0.69-1.77), while resulting in fewer complications (RR 0.46, 95% CI 0.23-0.92).
CONCLUSIONS
This systematic review highlights the safety and efficacy of sclerotherapy for HD, which yields similar success rates and fewer complications compared to other conservative or surgical approaches. Further research is warranted to optimize sclerotherapy techniques and evaluate long-term outcomes.
REGISTRATION
PROSPERO 2023 CRD42023396910.
Topics: Male; Humans; Female; Middle Aged; Sclerotherapy; Hemorrhoids; Italy; Odds Ratio; Polidocanol
PubMed: 38261136
DOI: 10.1007/s10151-023-02908-w -
Journal of Stroke and Cerebrovascular... Nov 2023Stroke diagnosis is dependent on lengthy clinical and neuroimaging assessments, while rapid treatment initiation improves clinical outcome. Currently, more sensitive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Stroke diagnosis is dependent on lengthy clinical and neuroimaging assessments, while rapid treatment initiation improves clinical outcome. Currently, more sensitive biomarker assays of both non-coding RNA- and protein biomarkers have improved their detectability, which could accelerate stroke diagnosis. This systematic review and meta-analysis compares non-coding RNA- with protein biomarkers for their potential to diagnose and differentiate acute stroke (subtypes) in (pre-)hospital settings.
METHODS
We performed a systematic review and meta-analysis of studies evaluating diagnostic performance of non-coding RNA- and protein biomarkers to differentiate acute ischemic and hemorrhagic stroke, stroke mimics, and (healthy) controls. Quality appraisal of individual studies was assessed using the QUADAS-2 tool while the meta-analysis was performed with the sROC approach and by assessing pooled sensitivity and specificity, diagnostic odds ratios, positive- and negative likelihood ratios, and the Youden Index.
SUMMARY OF REVIEW
112 studies were included in the systematic review and 42 studies in the meta-analysis containing 11627 patients with ischemic strokes, 2110 patients with hemorrhagic strokes, 1393 patients with a stroke mimic, and 5548 healthy controls. Proteins (IL-6 and S100 calcium-binding protein B (S100B)) and microRNAs (miR-30a) have similar performance in ischemic stroke diagnosis. To differentiate between ischemic- or hemorrhagic strokes, glial fibrillary acidic protein (GFAP) levels and autoantibodies to the NR2 peptide (NR2aAb, a cleavage product of NMDA neuroreceptors) were best performing whereas no investigated protein or non-coding RNA biomarkers differentiated stroke from stroke mimics with high diagnostic potential.
CONCLUSIONS
Despite sampling time differences, circulating microRNAs (< 24 h) and proteins (< 4,5 h) perform equally well in ischemic stroke diagnosis. GFAP differentiates stroke subtypes, while a biomarker panel of GFAP and UCH-L1 improved the sensitivity and specificity of UCH-L1 alone to differentiate stroke.
Topics: Humans; Hemorrhagic Stroke; Stroke; Biomarkers; Ischemic Stroke; Glial Fibrillary Acidic Protein; MicroRNAs; RNA, Untranslated
PubMed: 37778160
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107388 -
Journal of Gastrointestinal and Liver... Sep 2023Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. Studies evaluated the effect of several diets on inflammatory markers...
BACKGROUND AND AIMS
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. Studies evaluated the effect of several diets on inflammatory markers in IBD patients. Nevertheless, the results have been inconsistent. Therefore, we conducted this review to evaluate the effectiveness of dietary interventions on inflammatory markers in IBD.
METHODS
A comprehensive electronic literature search strategy using the PubMed, Embase, and Scopus was conducted in March 2023 and evaluated inflammatory markers included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin (FC), as well as disease severity scores. We included full-text articles that met our inclusion and exclusion criteria. To evaluate the included studies, we used the NHLBI quality evaluation tools.
RESULTS
A total of 16 studies were included in our qualitative synthesis. Elemental and polymeric diets showed similar efficacy in reducing Crohn's disease activity index (CDAI) and CRP levels. On the other hand, most studies evaluating the effects of omega 3 fatty acids reported no significant improvement. Moreover, protein supplementation was not seen to improve ESR or CRP levels. Except for improvements in FC levels with IgG4-guided exclusion diet in CD patients with elevated CDAI levels, restrictive diets were successful in controlling functional abdominal symptoms but did not appear to have an impact on inflammation in most studies. Furthermore, disease severity scores, CRP, ESR, and FC levels did not significantly change when eating a high-fiber, low-refined-carb, low-fat diet.
CONCLUSIONS
Diet plays a vital role in managing IBD by impacting the inflammatory response. Among the interventions studied, enteral nutrition showed the most promising results, improving patients' inflammatory status. Restrictive diets effectively managed symptoms and clinical remission but had limited impact on inflammatory markers. Supplementing the diet with fatty acids, omega 3, or proteins did not definitively improve patients' condition or inflammation.
PubMed: 37494554
DOI: 10.15403/jgld-5090