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BMC Oral Health Oct 2023Type 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to... (Meta-Analysis)
Meta-Analysis
Evaluating the effect of mechanical debridement with adjunctive antimicrobial photodynamic therapy in comparison with mechanical debridement alone on the peri-implant parameters in type 2 diabetic mellitus patients with peri-implantitis: a systematic review and meta-analysis.
BACKGROUND
Type 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to evaluate the effect of mechanical debridement (MD) + antimicrobial photodynamic therapy (a-PDT) in patients with peri-implantitis who have T2DM in terms of bleeding on probing (BOP) and probing depth (PD) as primary outcomes and plaque index (PI) and crestal bone loss (CBL) as secondary outcomes.
METHODS
Publications compared outcomes between MD + aPDT and MD alone in T2DM patients with peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. Literature until July 2023 using MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science, and Google Scholar were collected.
RESULTS
Two randomized controlled trials (RCTs, 88 individuals) and one controlled clinical trial (CCT, 67 individuals) with follow-up periods ranged from 3 to 12 months were recruited. All studies used diode laser with wavelengths ranged from 660 to 810 nm. The results demonstrated that the MD + aPDT group showed significant benefits for BOP reduction after 6 months (SMD = -2.15, 95% CI: -3.78 to -0.51, p = 0.01). However, a great amount of heterogeneity was observed (I = 91.52%, p < 0.001). Moreover, there was a significant difference between MD + aPDT and MD alone groups in CBL (SMD = -0.69, 95% CI: -1.07 to -0.30, p < 0.001). In addition, homogeneity assumption was satisfied (I = 22.49%, p = 0.28). Significant differences in PD and PI reduction were not found except for PI reduction after 3 months (SMD = -0.79, 95% CI: -1.24 to -0.33, p < 0.001. Also, no heterogeneity was observed (I = 0.00%, p = 0.47).
CONCLUSION
Given that high heterogeneity in BOP and PD outcome was found in this systematic review, future long-term CTs with MD + aPDT should be examined to arrive at a firm conclusion.
Topics: Humans; Peri-Implantitis; Debridement; Diabetes Mellitus, Type 2; Dental Implants; Photochemotherapy; Anti-Infective Agents
PubMed: 37828479
DOI: 10.1186/s12903-023-03337-9 -
International Journal of Molecular... Mar 2022Considering the challenges related to antimicrobial resistance, other strategies for controlling infections have been suggested, such as antimicrobial photodynamic... (Meta-Analysis)
Meta-Analysis Review
Considering the challenges related to antimicrobial resistance, other strategies for controlling infections have been suggested, such as antimicrobial photodynamic therapy (aPDT) and antimicrobial peptides (AMP). This study aims to perform a systematic review and meta-analysis to obtain evidence on the antimicrobial effectiveness of aPDT associated with AMP and establish in vitro knowledge on this topic for further study designs. The PubMed, Scopus, Web of Science, Science Direct, Scielo, and Cochrane Library databases were searched. Two independent and calibrated researchers (Kappa = 0.88) performed all the systematic steps according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The odds ratio (OR) was used as the effect measure. The Peto method was used to perform the meta-analysis due to the sparse data. Twenty studies were included in the present review. The result was significant (OR = 0.14/ = 0.0235/I-squared = 0%), showing better outcomes of aPDT associated with peptides than those of aPDT alone for controlling the microbial load. Only 20% of the studies included evaluated this approach in a biofilm culture. Combined treatment with aPDT and AMP highly increased the ability of microbial reduction of Gram-positive and Gram-negative bacteria. However, additional blind studies are required to evaluate the efficacy of this therapy on microbial biofilms.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antimicrobial Peptides; Biofilms; Gram-Negative Bacteria; Gram-Positive Bacteria; Photochemotherapy; Photosensitizing Agents
PubMed: 35328647
DOI: 10.3390/ijms23063226 -
Journal of Alternative and... Apr 2021Vitiligo is an autoimmune skin condition that affects people globally anywhere, from <0.1% to more than 8% of individuals. The disease destroys skin melanocytes,...
Vitiligo is an autoimmune skin condition that affects people globally anywhere, from <0.1% to more than 8% of individuals. The disease destroys skin melanocytes, resulting in a patchy depigmentation of the skin. About 50% of all patients develop the disease before their 20s. We systematically searched the literature and reviewed the evidence for the use of nutritional supplements and diet in the management of vitiligo. Embase and Medline were searched for diet, herbal, and nutrition-based clinical studies. Additional filters were applied that looked for controlled trial or randomized controlled trial and article or article in press or letter and English and clinical study. We selected clinical studies in humans that showed how diet or natural supplements can improve the symptoms of vitiligo in all of our searches. There were 62 manuscripts that resulted from the PubMed search and 259 from the Embase search. A final of 26 studies were reviewed, and other supplemental case and case-control studies were used to introduce diet components that may influence either exacerbation or amelioration of vitiligo. Possible mechanisms of action are introduced for natural and supplemental interventions. Some of the supplements reviewed include , oral , alpha lipoic acid, vitamins B12, D, and E, folic acid, phenylalanine, canthaxanthin, oil, and other combined herbal bio-actives. Overall, the growing evidence is promising, but more studies are needed in this area to further explore the impact that supplements and diet can have on vitiligo management. The most promising therapies included oral phenylalanine as adjuvant therapy with UVA therapy, oral as monotherapy, both of which can be used with other traditional therapies, and oral with phototherapy or photochemotherapy.
Topics: Adolescent; Adult; Child; Dietary Supplements; Female; Humans; Male; Phytotherapy; Plant Preparations; Vitiligo; Young Adult
PubMed: 33337930
DOI: 10.1089/acm.2020.0292 -
Photodiagnosis and Photodynamic Therapy Dec 2021We sought to conduct a systematic review and meta-analysis of randomized and non-randomized clinical trials to assess the efficacy of photodynamic therapy (PDT) in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We sought to conduct a systematic review and meta-analysis of randomized and non-randomized clinical trials to assess the efficacy of photodynamic therapy (PDT) in cervical epithelial neoplasia (CIN) and early-stage cervical cancer. Additionally, according to the results, we tried to consider which stage of CIN is more sensitive to PDT.
METHODS
A systematic search was conducted using electronic databases including PubMed, ClinicalTrials.gov, the Cochrane Library, and Google Scholar.
INCLUSION CRITERIA
all patients had confirmed low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or an early-stage cervical cancer - the cancer is less than 3 mm deep into the cervix -IA; type of photosensitizer and any type of wavelength.
EXCLUSION CRITERIA
women who were previously treated with PDT; Risk of bias assessment was carried out for each study included in the systematic review using the Cochrane Handbook for Systematic Reviews of Interventions: RoB-2 was used to assess the risk of bias in randomized studies, while ROBINS-I - in non-randomized ones.
RESULTS
We identified 2213 publications, but only 6 met the inclusion criteria and were included in the synthesis. PDT is most effective when patients have CIN 2 or photosensitizer is administered intravenously.
CONCLUSION
Based on our systematic review and meta-analysis, it could be concluded that photodynamic therapy may be a practical approach in CIN (LSIL) regression compared with placebo. Nevertheless, we need more evidence and long-term follow-up to answer all questions thoroughly.
Topics: Carcinoma, Squamous Cell; Female; Humans; Photochemotherapy; Photosensitizing Agents; Squamous Intraepithelial Lesions; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 34534688
DOI: 10.1016/j.pdpdt.2021.102530 -
Photodermatology, Photoimmunology &... Jan 2015Localized phototherapy including topical psoralen plus ultraviolet A (PUVA) and targeted ultraviolet B (UVB), and photodynamic therapy (PDT) have been increasingly used... (Comparative Study)
Comparative Study Meta-Analysis Review
Localized phototherapy including topical psoralen plus ultraviolet A (PUVA) and targeted ultraviolet B (UVB), and photodynamic therapy (PDT) have been increasingly used in the treatment of localized psoriasis. Yet, there are no systematic reviews or meta-analyses that scientifically evaluated the pooled efficacy of these treatments in psoriasis. We searched Medline, Embase, and Cochrane databases during the period of January 1980 to June 2012. Our systematic search resulted in 765 studies, 23 of them were included in the review. The primary outcome was 75% reduction in severity score from baseline. A meta-analysis using random effect model found topical PUVA to be more effective than non-laser targeted UVB [odds ratio: 3.48 (95% confidence interval 0.56-21.84), P = 0.183]. The pooled effect estimate of the efficacy (75% reduction in severity score) of topical PUVA, targeted UVB, and PDT were as follows: 77% (topical PUVA), 61% (targeted UVB), and 22% (PDT). Topical PUVA and targeted UVB phototherapy are very effective in the treatment of localized psoriasis. Topical PUVA seems more effective than non-laser targeted UVB phototherapy. On the other hand, PDT has low efficacy and high percentage of side effects in treating localized psoriasis.
Topics: Humans; MEDLINE; PUVA Therapy; Photochemotherapy; Psoriasis
PubMed: 24283358
DOI: 10.1111/phpp.12092 -
Cornea Dec 2018To compare surgical sequences of combined intracorneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in keratoconus and corneal ectasia in... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To compare surgical sequences of combined intracorneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in keratoconus and corneal ectasia in terms of visual, refractive, and keratometric outcomes.
METHODS
A comprehensive electronic search (in PubMed, Web of Science, Scopus, Embase, and Cochrane Library) was conducted in accordance with the PRISMA statement to find articles on combined ICRS implantation and CXL in keratoconus and corneal ectasia. The search period was from the inception of the database up to April 2017. Eligible articles were categorized into 3 surgical sequences (same day, ICRS first, and CXL first) and assessed qualitatively. Articles with 12 months of follow-up data after combined surgery were included in the meta-analysis.
RESULTS
The initial search identified 120 related articles, of which 17 were included in the review after screening. The quality assessment showed that visual, refractive, and keratometric improvement was observed in all studies in all 3 groups of combined surgery. Meta-analysis on 6 studies that reported 12-month follow-up outcomes showed no significant differences between the 3 groups regarding uncorrected and best-corrected visual acuity and cylindrical refractive error. However, results with simultaneous surgery were superior to the CXL-first technique in terms of spherical refractive errors and flat-K (P = 0.011 and P = 0.0001, respectively) and to both CXL first and ICRS first in terms of steep-K (P = 0.002 and P = 0.007, respectively).
CONCLUSIONS
Simultaneous ICRS implantation and CXL may provide better outcomes than staged techniques for improving the corneal shape.
Topics: Collagen; Corneal Stroma; Corneal Topography; Cross-Linking Reagents; Humans; Keratoconus; Photochemotherapy; Photosensitizing Agents; Prosthesis Implantation; Refraction, Ocular; Ultraviolet Rays; Visual Acuity
PubMed: 30211742
DOI: 10.1097/ICO.0000000000001740 -
Photodiagnosis and Photodynamic Therapy Sep 2021We aim to evaluate the diagnostic value of autofluorescence laryngoscope (AFL) in early laryngeal carcinoma and precancerous lesions. aWe also assess the value of AFL in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We aim to evaluate the diagnostic value of autofluorescence laryngoscope (AFL) in early laryngeal carcinoma and precancerous lesions. aWe also assess the value of AFL in diagnosis of early laryngeal carcinoma and precancerous lesions in comparison with that of white light laryngoscope (WL).
METHODS
The databases consisting of PubMed, Cochrane Library, Web of science and CNKI were systematically searched to find pertinent literatures of AFL in diagnosing early laryngeal carcinoma and precancerous lesions. We made a quality evaluation of every study we included using the modified Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled sensitivities, specificities were calculated using Meta-Disc 1.4. And we estimated the summary receiver operating characteristic curves (SROC) and area under the curves (AUC).
RESULTS
We finally included 23 studies. The results of AFL in diagnosing early laryngeal carcinoma and precancerous lesions showed higher sensitivity of 0.91 (95%CI: 0.89-0.93; χ²=43.78, p = 0.0025) and specificity of 0.80 (95%CI: 0.77-0.82; χ²=130.64, p = 0.000), and the weighted AUC of AFL was 0.948 ± 0.013 (95%CI: 0.921-0.974) and the diagnostic accuracy (Q*) was 0.887 ± 0.018. The sensitivity and specificity of WL were 0.74 (95%CI: 0.70-0.77; χ²=52.40, p = 0.000) and 0.89 (95%CI: 0.87-0.90; χ²=299.22, p = 0.000), and the weighted AUC of WL was 0.835 ± 0.029 (95%CI: 0.777-0.892) and the diagnostic accuracy (Q*) was 0.767 ± 0.027.
CONCLUSION
The meta-analysis and systematic review suggested that AFL had high diagnostic value in early laryngeal carcinoma and precancerous lesions, and its diagnostic value was higher than that of WL. These results indicated that AFL can provide good guidance for the early detection of laryngeal carcinoma and precancerous lesions.
Topics: Carcinoma; Humans; Laryngoscopes; Photochemotherapy; Photosensitizing Agents; Precancerous Conditions; Sensitivity and Specificity
PubMed: 34329763
DOI: 10.1016/j.pdpdt.2021.102460 -
Medicine May 2018We sought to conduct a systemic review and meta-analysis of randomized clinical trials to assess the efficacy and safety of photodynamic therapy (PDT) in cervical... (Meta-Analysis)
Meta-Analysis Review
Efficacy and safety of photodynamic therapy for cervical intraepithelial neoplasia and human papilloma virus infection: A systematic review and meta-analysis of randomized clinical trials.
BACKGROUND
We sought to conduct a systemic review and meta-analysis of randomized clinical trials to assess the efficacy and safety of photodynamic therapy (PDT) in cervical intraepithelial neoplasia (CIN) and cervical human papilloma virus (HPV) infection.
METHODS
The Medline, EMBASE, and Cochrane Central Register databases were searched using relevant keywords for entries up to May 1, 2017, irrespective of year of publication. The language was restricted to English. Randomized clinical trials and qualitative studies comparing PDT and placebo for CIN or HPV-positive patients were included. We assessed the evidence quality using a risk of bias graph in RevMan V5.3 and the Grading of Recommendations Assessment, Development, and Evaluation scoring system.
RESULTS
Of the 168 studies identified, only 4 RCTs met the inclusion criteria for meta-analysis. In all, 292 and 141 patients received PDT or placebo, respectively. PDT significantly increased the complete remission rate (CRR) among those with CIN (odds ratio [OR]: 2.51 [1.23-5.12]; P = .01) and HPV infection (OR: 3.82 [1.91-7.65]; P = .0002). The adverse events rate (AER) for PDT was greater than that for placebo (OR: 13.32 [4.44, 40.02]; P < .00001). The overall evidence quality was very low. Similarly, in a systematic review including 21 qualitative records, the CRRs for CIN patients with PDT and cervical HPV infection patients with PDT were 82.0% and 77.5%, respectively. The AER for PDT was 31.6%, which was lower than that observed in our meta-analysis (74.6%).
CONCLUSIONS
PDT that targets CIN or cervical HPV infection improves the CRR, but slightly compromises safety. Further studies are necessary to identify the most effective and least toxic photosensitizer.
Topics: Adolescent; Adult; Female; Humans; Middle Aged; Papillomaviridae; Papillomavirus Infections; Photochemotherapy; Photosensitizing Agents; Randomized Controlled Trials as Topic; Treatment Outcome; Uterine Cervical Neoplasms; Young Adult; Uterine Cervical Dysplasia
PubMed: 29794788
DOI: 10.1097/MD.0000000000010864 -
Lasers in Medical Science May 2017Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser... (Meta-Analysis)
Meta-Analysis Review
Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser and light modalities in the treatment of DSAP. A systematic review of light and laser treatment modalities was conducted to include 26 cases of patients with DSAP. Systematic review resulted in 14 articles to be included. Photodynamic therapy (PDT) overall was the least successful treatment modality, with clinical improvement seen in a minority of patients (MAL-PDT: N = 9 patients, 33.3% showed improvement; ALA-PDT: N = 3 patients, 0% improvement; hypericin-PDT: N = 2 patients, 0% improvement) after numerous post-procedural side effects of hyperpigmentation, inflammation, erythema, and discomfort. Overall, in the available reports, PDT demonstrates poor outcomes with greater incidence of side effects. The response rates of DSAP lesions treated with lasers were as follows: (Q-switched ruby lasers: N = 2, 100%; CO laser: N = 1, 100%; PDT and CO combination therapy: N = 2, 0-50%; erbium and neodymium YAG lasers: N = 2, 100%; fractional 1927-nm thulium fiber lasers: N = 2, 100%; Grenz rays: N = 1, 100%; and fractional photothermolysis: N = 2, 100%). The side effects of laser therapy were minimal and included mild erythema, slight hyperpigmentation, and moderate edema. Laser therapy is a promising treatment option for DSAP with an excellent side effect profile. However, higher power studies are required to determine optimal guidelines for laser treatment of DSAP.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Laser Therapy; Lasers, Gas; Lasers, Solid-State; Male; Middle Aged; Photochemotherapy; Phototherapy; Porokeratosis; Treatment Outcome
PubMed: 28239750
DOI: 10.1007/s10103-017-2179-9 -
Acta Dermato-venereologica Jan 2021A systematic literature review was conducted to identify and qualitatively assess randomized controlled trials in immunocompetent patients ≥ 18 years with head-... (Meta-Analysis)
Meta-Analysis
A systematic literature review was conducted to identify and qualitatively assess randomized controlled trials in immunocompetent patients ≥ 18 years with head- region lesions of actinic keratoses who were treated with field-directed, lesion-directed and other therapies. Network meta-analysis was used to quantitatively evaluate field-directed therapies (5-fluorouracil formulations, diclofenac sodium, imiquimod, ingenol mebutate, 5-aminolevulinic acid or methyl aminolevulinate plus photodynamic therapy) using complete clearance or partial clearance of actinic keratoses lesions, and adverse event-related withdrawals as a proxy of acceptability. Of 2,863 references identified, 75 trials reported in 151 publications were included. In summary, comparative network meta-analysis evaluation showed that 5-fluorouracil formulations were the most efficacious interventions examined. 5-fluorouracil 4%, which was recently approved, showed a comparable efficacy profile to 5-fluorouracil 5%, and had satisfactory acceptability outcomes.
Topics: Diterpenes; Humans; Imiquimod; Keratosis, Actinic; Network Meta-Analysis; Photochemotherapy; Treatment Outcome
PubMed: 33170301
DOI: 10.2340/00015555-3690