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BMC Musculoskeletal Disorders May 2023Periprosthetic joint infection (PJI) is a serious complication with total joint arthroplasty (TJA), that necessitates reoperation. Pre-closure irrigation with dilute... (Meta-Analysis)
Meta-Analysis
PURPOSE
Periprosthetic joint infection (PJI) is a serious complication with total joint arthroplasty (TJA), that necessitates reoperation. Pre-closure irrigation with dilute povidone-iodine (PI) is among the preventive measures, but its efficiency is still controversial. As a result, the focus of this systematic review and meta-analysis is on the effect of dilute PI wound irrigation in the prevention of PJI following TJA.
METHODS
We systematically reviewed and analyzed articles that compared PI with other agents in terms of PJI rate after TJA, searching Medline, Scopus, Web of science, and Cochrane databases. A number of 13 papers including 63,950 patients in total, were finally considered in qualitative and quantitative assessments. We have also further assessed review articles.
RESULTS
In comparison with normal saline (NS), PI reduced post-operative infection rate (OR: 0.44; CI 95%: 0.34-0.56). However, there was no difference between PI and chlorhexidine (CHG) (OR: 1.61; CI 95%: 0.83-3.09)) or undetermined comparators (OR: 1.08; CI 95%: 0.67-1.76).
CONCLUSION
PI irrigation seems an efficient preventive measure for post-operative PJI and would seem to be the most feasible for TJA protocol.
Topics: Humans; Povidone-Iodine; Arthroplasty, Replacement, Hip; Prosthesis-Related Infections; Arthritis, Infectious; Surgical Wound Infection; Retrospective Studies
PubMed: 37231378
DOI: 10.1186/s12891-023-06548-x -
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 -
Obstetrical & Gynecological Survey Apr 2021Postpartum hemorrhage (PPH) is an emergent obstetric complication and the leading cause of maternal mortality. Pelvic arterial embolization (PAE) is an effective... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Postpartum hemorrhage (PPH) is an emergent obstetric complication and the leading cause of maternal mortality. Pelvic arterial embolization (PAE) is an effective treatment for intractable PPH. However, a unique protocol has not been accepted in obstetrical practice.
OBJECTIVE
To evaluate its efficiency, safety, complications, and outcomes, we conducted a systematic review and meta-analysis of PAE for PPH in the literature.
EVIDENCE ACQUISITION
The Medline, the database of abstract of reviews, the index to allied health literature, and the Chinese database Sino-Med were searched on March 31, 2020, for studies on PAE for PPH. The data for PAE indication, agents, arteries, success rate, complications, and outcomes were extracted and syncretized for meta-analysis.
RESULTS
From 1075 identified articles, 113 abstracts or full articles were retrieved and 43 studies were finally identified as meeting the including criteria. The results demonstrated that the indications for PAE were as follows: uterine atony, placental abnormality, delivery tract injury, disseminated intravascular coagulation, arteriovenous malformation, and vaginal hematoma. The embolization agents mostly in order were gelatin sponge particles, polyvinyl alcohol particles, Gelfoam, -butyl cyanoacrylate, microcoil, and glue; for arteries, they were mostly uterine artery and internal iliac artery. The clinical success rate was 90.5%, whereas the technical success rate was 99.3%. The most common complications of PAE were postembolization syndrome and menstrual abnormality.
CONCLUSIONS AND RELEVANCE
The emergent PAE is a safe and effective method with high success rate in life-threatening PPH management. Gelatin sponge granules measuring 500 to 1000 μm in diameter have safe results. Pelvic arterial embolization may affect the recovery of menses and increase PPH in the subsequent pregnancy, but there was no noted correlation with fetal growth restriction.
Topics: Adult; Embolization, Therapeutic; Female; Humans; Iliac Artery; Pelvis; Postpartum Hemorrhage; Pregnancy; Treatment Outcome; Uterine Artery
PubMed: 33908615
DOI: 10.1097/OGX.0000000000000887 -
BMC Oral Health Jul 2023Polyvinyl ether siloxane (PVES) possesses ideal characteristics for making precise and accurate dental impressions. PVES dimensional stability owes to its better... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Polyvinyl ether siloxane (PVES) possesses ideal characteristics for making precise and accurate dental impressions. PVES dimensional stability owes to its better polymeric properties derived from its parent materials poly ethers and polyvinyl siloxanes. As recommended use of chemical disinfecting agents is getting more popular, there is a growing concern associated with the effect of disinfectants on PVES dimensional stability. This study was aimed to understand the PVES behavior when subjected to chemical disinfectants.
MATERIALS AND METHODOLOGY
The data was collected from research studies retrieved from Google Scholar, Scopus, and PubMed using MeSH terms of keywords "vinyl polyether siloxane AND Disinfection" or (Vinyl polyether siloxane OR polyvinyl siloxane ether OR PVES) AND (disinfectant OR disinfection)" without any restriction to publication date. The PRISMA (Preferred Reporting Items for Systemic Review and Meta-Analysis) directions were observed during the data collection, screening of studies, and meta-analysis. The primary data were retrieved, and batch exported from databases using Harzing's Publish or Perish software; primary analysis was performed in Microsoft Excel, while statistical analysis for effect size, two-tailed p-values, and heterogeneity among studies was performed using Meta Essentials. The effect size was calculated using Hedge's g values at the 95% confidence level using the random-effects model. Heterogeneity among studies was measured using the Cochrane Q and I.
RESULTS AND CONCLUSION
Dental impressions made from the PVES elastomeric impression materials showed no significant changes in dimensional stability. Immersion in the chemical disinfectant for 10 min was associated with clinically irrelevant changes in the dimensions of the PVES impressions. Disinfection with sodium hypochlorite was associated with clinically significant changes in dimensions, with a two-tailed p-value of 0.049. Disinfection with 2-2.5% glutaraldehyde solution was not associated with any significant dimensional variability.
Topics: Humans; Disinfectants; Disinfection; Ether; Ethers; Ethyl Ethers; Polyvinyls; Siloxanes
PubMed: 37430254
DOI: 10.1186/s12903-023-03168-8 -
Journal of the American Dental... Jul 2022Considering that the oral cavity is a major entryway and reservoir for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aim of the authors was to... (Review)
Review
BACKGROUND
Considering that the oral cavity is a major entryway and reservoir for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aim of the authors was to perform a systematic review of in vivo and in vitro studies to assess the effectiveness of mouthrinses on SARS-CoV-2 viral load.
TYPES OF STUDIES REVIEWED
The authors searched PubMed, Web of Science, Scopus, MedRxiv, and bioRxiv databases, including in vitro and in vivo studies assessing the virucidal effect of mouthrinses on SARS-CoV-2 or surrogates. From a total of 1,622 articles retrieved, the authors included 39 in this systematic review.
RESULTS
Povidone-iodine was the most studied mouthrinse (14 in vitro and 9 in vivo studies), frequently showing significant reductions in viral load in in vitro assays. Similarly, cetylpyridinium chloride also showed good results, although it was evaluated in fewer studies. Chlorhexidine gluconate and hydrogen peroxide showed conflicting results on SARS-CoV-2 load reduction in both in vitro and in vivo studies.
PRACTICAL IMPLICATIONS
Povidone-iodine-based mouthrinses appear to be the best option as an oral prerinse in the dental context for SARS-CoV-2 viral load reduction. Although the results of primary studies are relevant, there is a need for more in vivo studies on mouthrinses, in particular, randomized controlled clinical trials, to better understand their effect on SARS-CoV-2 viral load and infection prevention.
Topics: COVID-19; Humans; Mouthwashes; Povidone-Iodine; SARS-CoV-2; Viral Load
PubMed: 35287944
DOI: 10.1016/j.adaj.2021.12.007 -
Turkish Journal of Obstetrics and... Mar 2023To identify the preferred agent by comparing the therapeutic efficacy, degree of infarction, and side effects of polyvinyl alcohol particles (PVA) and tris-acryl gelatin...
OBJECTIVE
To identify the preferred agent by comparing the therapeutic efficacy, degree of infarction, and side effects of polyvinyl alcohol particles (PVA) and tris-acryl gelatin embolization (TAGM) agents in uterine artery embolization.
MATERIALS AND METHODS
We included available articles comparing PVA with TAGM embolization agents in the management of fibroids. The primary outcomes included the decrease in uterine volume (%), decrease in dominant tumor volume (%), fibroid infarction rate, complete infarction fibroid, complications, pain score after 24 h, procedure time (minutes), duration of hospital stay, fluoroscopy time (minutes), and the change in symptom severity score.
RESULTS
Eight articles that met our inclusion criteria were included in this study. Our analysis yielded an overall superiority of PVA compared to TAGM regarding complete fibroid infarction rate at the first 24 h. However, TAGM was better than PVA concerning <90% infarction rate outcome. While both embolization techniques showed similar effects regarding the change in symptom severity score, the percentage of decrease in uterine volume, percentage of decrease of dominant tumor volume, 90-99% infarction rate, complete infarction rate when assessed after the first 24 h, pain score after the first 24 h, procedure time, fluoroscopy time, minor, and major complications.
CONCLUSION
Both PVA and TAGM embolization agents are effective and safe modalities in treating patients with fibroids, with no significant variation of both agents in most outcomes.
PubMed: 36908106
DOI: 10.4274/tjod.galenos.2023.43778 -
American Journal of Ophthalmology Aug 2022To summarize key findings from a Cochrane systematic review of the effectiveness and safety of topical pharmacologic interventions compared with active control or... (Review)
Review
PURPOSE
To summarize key findings from a Cochrane systematic review of the effectiveness and safety of topical pharmacologic interventions compared with active control or placebo for epidemic keratoconjunctivitis (EKC).
DESIGN
Systematic review.
METHODS
We included randomized controlled trials that compared antiseptic agents, virustatic agents, or immune-modulating topical therapies with placebo or an active control. We adhered to Cochrane methods for trial selection, data extraction, risk of bias evaluation, and data synthesis.
RESULTS
Ten randomized controlled trials with 892 participants with acute or chronic EKC were included. Eight trials compared interventions with artificial tears or saline (n = 4) or with steroids (n = 4); two 3-arm trials contributed data to both comparisons. Estimates suggested that compared with tears, after povidone-iodine (PVP-I) alone (2 studies, 409 participants) more participants with acute EKC had resolution of symptoms (risk ratio [RR] 1.15 [95% confidence interval {CI} 1.07-1.24]) and signs (RR 3.19 [95% CI 2.29-4.45]) within 10 days. In 2 trials comparing treatments with steroid alone or steroid with levofloxacin, fewer eyes treated with PVP-I or polyvinyl alcohol iodine (PVA-I) plus steroid developed subepithelial infiltrates within 21 days (RR 0.08 [95% CI 0.01-0.55]; 69 eyes). No treatment was shown to improve resolution of infiltrates.
CONCLUSIONS
Low- to very low-level certainty of evidence suggested that PVP-I or PVA-I with steroid may confer some benefit in acute EKC, but imprecision from small sample sizes, the potential risk of bias from inadequate reporting or trial design, and variability in participant selection, outcome measurement, and reporting limit the amount and quality of evidence.
Topics: Anti-Infective Agents, Local; Humans; Keratoconjunctivitis; Lubricant Eye Drops; Povidone-Iodine
PubMed: 35331686
DOI: 10.1016/j.ajo.2022.03.018 -
Ultrasound in Medicine & Biology Sep 2020Ischemic stroke is a leading cause of death and disability worldwide, so adequate prevention strategies are crucial. However, current stroke risk stratification is based...
Ischemic stroke is a leading cause of death and disability worldwide, so adequate prevention strategies are crucial. However, current stroke risk stratification is based on epidemiologic studies and is still suboptimal for individual patients. The aim of this systematic review was to provide a literature overview on the feasibility and diagnostic value of vascular shear wave elastography (SWE) using ultrasound (US) in (mimicked) human and non-human arteries affected by different stages of atherosclerotic diseases or diseases related to atherosclerosis. An online search was conducted on Pubmed, Embase, Web of Science and IEEE databases to identify studies using US SWE for the assessment of vascular elasticity. A quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) checklist, and relevant data were extracted. A total of 19 studies were included: 10 with human patients and 9 with non-human subjects (i.e., [excised] animal arteries and polyvinyl alcohol phantoms). All studies revealed the feasibility of using US SWE to assess individually stiffness of the arterial wall and plaques. Quantitative elasticity values were highly variable between studies. However, within studies, SWE could detect statistically significant elasticity differences in patient/subject characteristics and could distinguish different plaque types with good reproducibility. US SWE, with its unique ability to assess the elasticity of the vessel wall and plaque throughout the cardiac cycle, might be a good candidate to improve stroke risk stratification. However, more clinical studies have to be performed to assess this technique's exact clinical value.
Topics: Atherosclerosis; Elasticity Imaging Techniques; Humans; Plaque, Atherosclerotic
PubMed: 32620385
DOI: 10.1016/j.ultrasmedbio.2020.05.013 -
International Journal of Environmental... Mar 2022The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of... (Review)
Review
The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings.
Topics: COVID-19; Humans; Mouthwashes; Povidone-Iodine; Randomized Controlled Trials as Topic; SARS-CoV-2; Viral Load
PubMed: 35270569
DOI: 10.3390/ijerph19052877 -
Medicine Mar 2021The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the effect of a polyurethane (PU) tracheal tube cuff on the prevention of... (Meta-Analysis)
Meta-Analysis
Comparison of polyurethane tracheal tube cuffs and conventional polyvinyl chloride tube cuff for prevention of ventilator-associated pneumonia: A systematic review with meta-analysis.
BACKGROUND
The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the effect of a polyurethane (PU) tracheal tube cuff on the prevention of ventilator-associated pneumonia (VAP).
METHODS
We performed a systematic search using the MEDLINE database through PubMed, Cochrane Central Register of Controlled Trial, SCOPUS, and Web of Science.Randomized controlled trials comparing the incidence of VAP and clinically relevant outcomes between PU cuff tubes and polyvinyl chloride (PVC) cuff tubes in adult patients. Two authors independently extracted study details, patient characteristics, and clinical outcomes such as incidence of VAP, bacterial colonization of tracheal aspirate, duration of mechanical ventilation, ICU stay, and ICU mortality.
RESULTS
From 309 studies identified as potentially eligible, six studies with 1226 patients were included in this meta-analysis. All studies compared the incidence of VAP between PU cuffs and PVC cuffs. Use of a PU cuff was not associated with a reduction in VAP incidence (RR = 0.68; 95% CI, 0.45-1.03) with significant statistical heterogeneity (I2 = 65%). The quality of evidence was "very low." According to the TSA, the actual sample size was only 15.8% of the target sample size, and the cumulative Z score did not cross the trial sequential monitoring boundary for benefit. No positive impact was reported for the other relevant outcomes for PU cuffs.
CONCLUSIONS
The use of a PU cuff for mechanical ventilation did not prevent VAP. Further trials with a low risk of bias need to be performed.
Topics: Equipment Design; Humans; Intensive Care Units; Intubation, Intratracheal; Pneumonia, Ventilator-Associated; Polyurethanes; Polyvinyl Chloride; Respiration, Artificial
PubMed: 33655952
DOI: 10.1097/MD.0000000000024906