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Asia-Pacific Journal of Public Health Jan 2022This review aimed to investigate national estimates of sugar-sweetened beverage (SSB) consumption in children and adolescents aged two to 18 years, from countries in... (Meta-Analysis)
Meta-Analysis
A Systematic Review of the Recent Consumption Levels of Sugar-Sweetened Beverages in Children and Adolescents From the World Health Organization Regions With High Dietary-Related Burden of Disease.
This review aimed to investigate national estimates of sugar-sweetened beverage (SSB) consumption in children and adolescents aged two to 18 years, from countries in regions particularly burdened by dietary-related chronic illnesses. The most recent studies or reports from included countries (n = 73) with national-level consumption data of SSBs in children and adolescents, collected between January 2010 and October 2019, were considered for inclusion. A random effects meta-analysis was used to calculate pooled estimates of the mean consumption of SSB in millimeters per day. Heterogeneity between national estimates was assessed using the statistic and explored via subgroup analyses by the World Health Organization region, age groups, and country-level income. Forty-eight studies were included in the review reporting national estimates of consumption for 51 countries. The highest estimate of daily consumption was in China at 710.0 mL (95% confidence interval (CI) [698.8, 721.2], while the lowest was in Australia at 115.1 mL (95% CI [111.2, 119.1]). Pooled synthesis of daily SSB consumption of the 51 countries was 326.0 mL (95% CI [288.3, 363.8]), although heterogeneity was high, and was not explained by subgroup analyses. While there is considerable variability between countries, intake of SSB remains high among children and adolescents internationally underscoring the need for public health efforts to reduce SSBs consumption.
Topics: Adolescent; Beverages; Child; Cost of Illness; Diet; Humans; Sugar-Sweetened Beverages; World Health Organization
PubMed: 34013784
DOI: 10.1177/10105395211014642 -
Experimental Neurology Apr 2012In the spinal cord, neuron and glial cells actively interact and contribute to neurofunction. Surprisingly, both cell types have similar receptors, transporters and ion... (Review)
Review
In the spinal cord, neuron and glial cells actively interact and contribute to neurofunction. Surprisingly, both cell types have similar receptors, transporters and ion channels and also produce similar neurotransmitters and cytokines. The neuroanatomical and neurochemical similarities work synergistically to maintain physiological homeostasis in the normal spinal cord. However, in trauma or disease states, spinal glia become activated, dorsal horn neurons become hyperexcitable contributing to sensitized neuronal-glial circuits. The maladaptive spinal circuits directly affect synaptic excitability, including activation of intracellular downstream cascades that result in enhanced evoked and spontaneous activity in dorsal horn neurons with the result that abnormal pain syndromes develop. Recent literature reported that spinal cord injury produces glial activation in the dorsal horn; however, the majority of glial activation studies after SCI have focused on transient and/or acute time points, from a few hours to 1 month, and peri-lesion sites, a few millimeters rostral and caudal to the lesion site. In addition, thoracic spinal cord injury produces activation of astrocytes and microglia that contributes to dorsal horn neuronal hyperexcitability and central neuropathic pain in above-level, at-level and below-level segments remote from the lesion in the spinal cord. The cellular and molecular events of glial activation are not simple events, rather they are the consequence of a combination of several neurochemical and neurophysiological changes following SCI. The ionic imbalances, neuroinflammation and alterations of cell cycle proteins after SCI are predominant components for neuroanatomical and neurochemical changes that result in glial activation. More importantly, SCI induced release of glutamate, proinflammatory cytokines, ATP, reactive oxygen species (ROS) and neurotrophic factors trigger activation of postsynaptic neuron and glial cells via their own receptors and channels that, in turn, contribute to neuronal-neuronal and neuronal-glial interaction as well as microglia-astrocytic interactions. However, a systematic review of temporal and spatial glial activation following SCI has not been done. In this review, we describe time and regional dependence of glial activation and describe activation mechanisms in various SCI models in rats. These data are placed in the broader context of glial activation mechanisms and chronic pain states. Our work in the context of work by others in SCI models demonstrates that dysfunctional glia, a condition called "gliopathy", is a key contributor in the underlying cellular mechanisms contributing to neuropathic pain.
Topics: Animals; Gliosis; Neuralgia; Neuroglia; Rats; Spinal Cord; Spinal Cord Injuries
PubMed: 22036747
DOI: 10.1016/j.expneurol.2011.10.010 -
Journal of Cranio-maxillo-facial... Nov 2021A systematic review and network meta-analysis was conducted to compare different bone-substitute materials used for alveolar ridge preservation after tooth extraction.... (Meta-Analysis)
Meta-Analysis
A systematic review and network meta-analysis was conducted to compare different bone-substitute materials used for alveolar ridge preservation after tooth extraction. The electronic search was carried out on Embase, PubMed, Cochrane Library, Web of Science, Scopus, LILACS, and grey literature up to March 22, 2020 (registration number INPLASY202030005). Only randomized controlled trials were included to answer the following PICOS question: 'What grafting materials produce greater alveolar ridge preservation after tooth extraction?' The primary outcomes were the alveolar width resorption 1 mm below the alveolar crest and buccal height resorption in millimeters. Of the 4379 studies initially identified, 31 studies involving 1088 patients were included in the quantitative analyses. Out of 25 revised biomaterials, eight showed a statistically significant difference compared with unassisted healing in both alveolar width and height measurements (mean width differences: ApatosⓇ, 2.27 [1.266-3.28]; Bio-OssⓇ, 0.88 [0.33-1.42]; Bio-Oss CollⓇ, 0.53 [0.04-1.01]; Bond-apatiteⓇ, 2.20 [1.30-3.11]; freeze-dried bone allograft, 1.35 [0.44-2.26]; Gen-OsⓇ, 1.90 [0.60-3.20]; platelet-rich fibrin, 1.66 [0.66-2.67]; and MP3Ⓡ, 2.67 [1.59-3.75]). Overall, xenograft materials should be considered as among the best of the available grafting materials for alveolar preservation after tooth extraction.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Transplantation; Humans; Network Meta-Analysis; Tooth Extraction; Tooth Socket
PubMed: 34176715
DOI: 10.1016/j.jcms.2021.06.005 -
Clinical Journal of the American... Jan 2009Renal pelvis dilatation (RPD) occurs in 1% of fetuses. Severe RPD (>15 mm) is frequently associated with urinary tract pathology. For the majority with mild (5 to 9 mm)... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Renal pelvis dilatation (RPD) occurs in 1% of fetuses. Severe RPD (>15 mm) is frequently associated with urinary tract pathology. For the majority with mild (5 to 9 mm) to moderate (10 to 15 mm) RPD, however, there is uncertainty about the risk of abnormalities and how much postnatal investigation is required.
STUDY DESIGN
Systematic review of cohort studies of fetuses with RPD < or = 15 mm and metaregression to estimate risks of postnatal RPD, obstruction, and VUR.
RESULTS
Of 506 potentially relevant papers, 18 met the inclusion criteria. Risk of postnatal RPD increased with fetal RP size and earlier gestation. Odds ratios for postnatal RPD doubled per millimeter increase in fetal RP size: At 20 wk gestation, for example, 18% of fetuses with mean RP of 6 mm were estimated to have persistent postnatal RPD, compared with 95% of fetuses with 12 mm RPD, but risks were decreased by 16% to 18% per week of presentation gestation. Estimated risks of obstruction and VUR were substantially lower, particularly in the mild group such as the 6 mm example above: obstruction 2%, VUR 4%.
CONCLUSIONS
Our novel risk estimates are useful for antenatal counseling at presentation. The low frequency of obstruction/VUR in mild RPD raises questions over the most appropriate investigation of these cases but further data are required before establishing definitive postnatal management pathways. We suggest the need for a large prospective multicenter study to collect individual patient parameters/results and search for additional prognostic indicators.
Topics: Counseling; Dilatation, Pathologic; Female; Gestational Age; Humans; Kidney Diseases; Kidney Pelvis; Odds Ratio; Pregnancy; Risk Assessment; Risk Factors; Severity of Illness Index; Ultrasonography, Prenatal; Ureteral Obstruction; Vesico-Ureteral Reflux
PubMed: 18987299
DOI: 10.2215/CJN.00810208 -
Oral Surgery, Oral Medicine, Oral... Nov 2015The aim of this systematic review and meta-analysis was to assess the influence of platelet-rich plasma (PRP) on the regeneration of periodontal intrabony defects by... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to assess the influence of platelet-rich plasma (PRP) on the regeneration of periodontal intrabony defects by means of evaluating clinical and radiographic outcomes in prospective human clinical trials.
BACKGROUND
PRP is a high concentration of platelets suspended in a small volume of plasma and has been used for periodontal tissue regeneration. However, although it has been broadly studied, there is much controversy on its efficacy when used to treat infrabony periodontal defects.
METHODS
An electronic literature search was conducted by two reviewers (AR and AM) in several databases up to February 2014. The PICO question was: Does PRP have a higher or similar efficacy of regenerating periodontal intrabony defects compared with other conventional periodontal regeneration treatments (e.g., bone grafts, barrier membranes)? Articles were included in this systematic review if they were prospective clinical trials with 10 or more human patients, reporting the radiographic and/or clinical outcomes PRP for regeneration intrabony periodontal defects. Random effects meta-analyses of the selected studies were applied to avoid any bias being caused by methodologic differences among studies.
RESULTS
Twenty-two papers were obtained and reviewed. Of these, 21 articles fulfilled the inclusion criteria and subsequently were qualitatively analyzed. Eighteen of these could be meta-analyzed. Fourteen articles were included for evaluating of probing pocket depth (PPD). The weighted mean difference (WMD) was 0.55 mm, with a 95% CI=-0.09 to 1.20 mm (P=.09). For bone level (BL), 2 articles measured BL in millimeters, and the other two articles measured BL in percentage. The WMD was 0.76 mm (95% CI=0.21-1.31 mm; P=.007) and 47.41% (95% CI=32.48%-62.33%; P<.0001), respectively. For attachment level (AL) changes, 12 articles were included. The WMD was 0.58 mm, with a 95% CI=0.24 to 0.91 mm (P=.0008). Sixteen articles were included for evaluation of marginal gingival level (MGL). The WMD -0.10 mm, with a 95% CI=-0.19 to -0.01 (P=.03).
CONCLUSIONS
High heterogeneity among studies made it difficult to draw clear conclusions. Nonetheless, within the limitations of this review, PRP might offer some beneficial effects on clinical and radiographic outcomes for regeneration of periodontal intrabony defects.
Topics: Alveolar Bone Loss; Bone Regeneration; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Diseases; Platelet-Rich Plasma; Prospective Studies
PubMed: 26453383
DOI: 10.1016/j.oooo.2015.06.035 -
Arthroplasty Today Feb 2023Additional distal femoral resection is a common technique to address a flexion contracture during primary total knee arthroplasty (TKA) but can lead to midflexion...
BACKGROUND
Additional distal femoral resection is a common technique to address a flexion contracture during primary total knee arthroplasty (TKA) but can lead to midflexion instability and patella baja. Prior reports regarding the magnitude of knee extension obtained with additional femoral resection have varied. This study sought to systematically review research describing the effect of femoral resection on knee extension and to perform meta-regression to estimate this relationship.
METHODS
A systematic review was conducted using MEDLINE, PubMed, and Cochrane databases by combining the terms ("flexion contracture" OR "flexion deformity") AND ("knee arthroplasty" OR "knee replacement") to identify 481 abstracts. In total, 7 articles reporting change in knee extension after additional femoral resection or augmentation across 184 knees were included. The mean value for knee extension, its standard deviation, and the number of knees tested were recorded for each level. Meta-regression was performed using weighted mixed-effects linear regression.
RESULTS
Meta-regression estimated that each 1mm resected from the joint line produced a 2.5° gain of extension (95% confidence interval, 1.7 to 3.2). Sensitivity analyses excluding outlying observations estimated each 1mm resected from the joint line produced a 2.0° gain of extension (95% confidence interval, 1.9 to 2.2).
CONCLUSIONS
Each millimeter of additional femoral resection is likely to produce only a 2° improvement in knee extension. Thus, an additional resection of 2 mm is likely to improve knee extension by less than 5°. Alternative techniques, including posterior capsular release and posterior osteophyte resection, should be considered in correcting a flexion contracture during TKA.
PubMed: 36845290
DOI: 10.1016/j.artd.2022.101083 -
Microsurgery Jan 2021Our purpose was to explore a case of a complicated ulnar artery pseudoaneurysm and propose an algorithm to guide physicians in this scenario. We present a case of a... (Review)
Review
BACKGROUND
Our purpose was to explore a case of a complicated ulnar artery pseudoaneurysm and propose an algorithm to guide physicians in this scenario. We present a case of a 5-year-old boy with a pediatric ulnar artery pseudoaneurysm that developed after a wrist laceration from broken glass 6 weeks after the initial injury. The diagnosis of pseudoaneurysm was missed, and the patient was transferred to our facility in urgent need of resection and repair due to profuse bleeding. An ultrasound confirmed the suspected diagnosis of ulnar artery aneurysm with thrombosis within the vessel. An area of skin necrosis was also present. Upon exploration of the wound, the ulnar artery pseudoaneurysm was identified and resected. The defect measured six millimeters and it was repaired primarily, under the microscope, after the proximal and distal portions were freed by dissection. The patient's incision was well healed at six-week follow-up.
METHOD
A systematic literature review of the English literature on ulnar artery aneurysm was conducted on PubMed/Medline, Embase, Cochrane Clinical Answers, and Cochrane Clinical Trials, without timeframe limitations. Finally, we provide an algorithm to assist the decision-making process in similar scenarios.
CONCLUSION
Although ulnar artery aneurysm is rare on a pediatric patient, it should be considered in the differential diagnosis each time a patient presents with a wrist mass. In such cases, a high index of suspicion warrants examination by a hand specialist.
Topics: Aneurysm, False; Child; Child, Preschool; Humans; Lacerations; Male; Ulnar Artery; Wrist; Wrist Joint
PubMed: 33128477
DOI: 10.1002/micr.30676 -
International Journal of Oral and... Jan 2020The aim of this study was to analyse the influence of different loading protocols on marginal bone loss (MBL). The outcomes of different implant loading protocols were... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to analyse the influence of different loading protocols on marginal bone loss (MBL). The outcomes of different implant loading protocols were assessed at 1year after implantation, with focus on MBL; protocols included immediate, immediate non-occlusal, early, and conventional loading. The search strategy resulted in 889 studies. Twenty-two of these studies fulfilled the inclusion criteria. Among the included studies, the lowest MBL was for immediately loaded implants (0.05±0.67mm) and the highest for immediate non-occlusally loaded implants (1.37±0.5mm). The results of the meta-analysis showed an estimated mean MBL of 0.457mm (95% confidence interval (CI) 0.133-0.781) for immediate loading, 0.390mm (95% CI 0.240-0.540) for immediate non-occlusal loading, 0.488mm (95% CI 0.289-0.687) for early loading (>2 days to <3 months), and 0.852mm (95% CI 0.429-1.275) for conventional loading (>3 months) implant protocols. The lowest decrease in 1-year implant survival per millimetre increase in MBL was observed for immediate loading and the highest for conventional loading. Conventional loading showed a significantly higher MBL than the other three loading protocols. This systematic review and meta-analysis indicates that the immediate loading protocol is a reasonable alternative to the conventional loading protocol.
Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Immediate Dental Implant Loading; Time Factors
PubMed: 31255443
DOI: 10.1016/j.ijom.2019.03.965 -
The Cochrane Database of Systematic... Apr 2005Preterm and low birth weight infants are often growth-restricted at hospital discharge. Feeding infants post-hospital discharge with calorie and protein-enriched formula... (Meta-Analysis)
Meta-Analysis Review
Calorie and protein-enriched formula versus standard term formula for improving growth and development in preterm or low birth weight infants following hospital discharge.
BACKGROUND
Preterm and low birth weight infants are often growth-restricted at hospital discharge. Feeding infants post-hospital discharge with calorie and protein-enriched formula milk might facilitate "catch-up" growth and improve development.
OBJECTIVES
To review the evidence from randomised controlled trials that feeding following hospital discharge with calorie and protein-enriched formula compared with standard term formula improves growth and development for preterm or low birth weight infants.
SEARCH STRATEGY
We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2004), MEDLINE (1966 - December 2004), EMBASE (1980 - December 2004), CINAHL (1982 - December 2004), conference proceedings, and previous reviews.
SELECTION CRITERIA
Randomised or quasi-randomised controlled trials that compared the effect of feeding preterm or low birth weight infants post-hospital discharge with calorie and protein-enriched formula compared with standard term formula.
DATA COLLECTION AND ANALYSIS
We extracted data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two authors, and synthesis of data using weighted mean difference and a fixed effects model for meta-analysis.
MAIN RESULTS
We found six trials that were eligible for inclusion. These recruited a total of 424 infants and were generally of good methodological quality. These trials found little evidence that feeding with calorie and protein-enriched formula milk affected growth and development. Because of differences in the way individual trials measured and presented outcomes, data synthesis was limited. Meta-analysis of data from two trials found a statistically significant effect on crown-heel length at 18 months post-term (weighted mean difference 9.7 millimetres (95% confidence interval 3.2 to 16.2)), but not on weight or head circumference. Meta-analysis of data from the two trials that assessed neurodevelopment at 18 months post-term did not reveal a statistically significant difference in either Bayley Mental Development Index (weighted mean difference 0.23 (95% confidence interval -2.99 to 3.45)) or Psychomotor Development Index (weighted mean difference 0.56 (95% confidence interval -1.95 to 3.07)). There are not yet any data on growth or development through later childhood.
AUTHORS' CONCLUSIONS
The limited available data do not provide strong evidence that feeding preterm or low birth weight infants following hospital discharge with calorie and protein-enriched formula compared with standard term formula affects growth rates or development up to 18 months post-term.
Topics: Child Development; Dietary Proteins; Energy Intake; Humans; Infant Formula; Infant Nutritional Physiological Phenomena; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Randomized Controlled Trials as Topic
PubMed: 15846728
DOI: 10.1002/14651858.CD004696.pub2 -
International Journal of Oral and... Mar 2024The objective was to evaluate the efficacy of curcumin in improving mouth opening (MO), burning sensation (BS), and tongue protrusion (TP) symptoms in patients with oral... (Meta-Analysis)
Meta-Analysis Review
The objective was to evaluate the efficacy of curcumin in improving mouth opening (MO), burning sensation (BS), and tongue protrusion (TP) symptoms in patients with oral submucous fibrosis (OSF). An electronic search up to November 2022 was conducted in the PubMed, Web of Science, Embase, EBSCO, ProQuest, and Cochrane Library databases to identify studies using curcumin in the treatment of OSF with comparison to control groups (drugs previously proven to be effective for OSF treatment) or placebo. Only randomized controlled trials (RCTs) were considered. RevMan 5.3 software was used for the meta-analysis. Thirteen RCTs met the eligibility criteria and were included in the analysis. The results showed no significant improvement in MO (in millimetres) for curcumin when compared to control at 1 month (P = 0.91), 2 months (P = 0.54), 3 months (P = 0.56), or 6 months (P = 0.17) of treatment. There was no significant difference in BS (assessed using a visual analogue scale) between curcumin and control after 1 month (P = 0.05), 2 months (P = 0.64), 3 months (P = 0.13), or 6 months (P = 0.56) of treatment. Compared with the control groups, treatment with curcumin for 1 month (P = 0.32), 2 months (P = 0.07), and 3 months (P = 0.14) did not significantly improve the TP (in millimetres) of patients. The administration of curcumin, whether topically applied or taken orally, did not confer statistically significant improvements in MO, BS, or TP in comparison to the control treatments, among patients with OSF. The results of this meta-analysis showed that compared to placebo, the application of curcumin for 6 months markedly alleviated BS (P < 0.001). Curcumin treatment in OSF reaches a clinically effective range, but more bioavailability-centred outcomes should be reported. Robust multicentre RCTs are warranted to elucidate the efficacy of curcumin in improving specific outcomes like MO, BS, and TP in patients with this condition. Defining the therapeutic role of this natural compound may provide an effective botanical alternative for managing OSF.
Topics: Humans; Oral Submucous Fibrosis; Curcumin; Randomized Controlled Trials as Topic; Tongue Diseases
PubMed: 38057194
DOI: 10.1016/j.ijom.2023.11.005