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Journal of Oral Biology and... 2023Platelet-rich plasma is considered an effective modality to promote bone regeneration, improve hard and soft tissue healing in surgical procedures including sinus... (Review)
Review
BACKGROUND
Platelet-rich plasma is considered an effective modality to promote bone regeneration, improve hard and soft tissue healing in surgical procedures including sinus augmentation. However, the survival of dental implants in sinus augmented sites with platelet-rich plasma has shown equivocal results in recent studies.
PURPOSE
In this systematic review, data on dental implants' survival in sinus augmentation sites with platelet-rich plasma were examined.
MATERIALS AND METHODS
Randomized controlled trials on the topic with a minimum mean follow-up of 6 months with no language restriction were considered. Other study designs on the topic were excluded. Accordingly, relevant articles were searched in Clinicaltrials.gov, Cochrane databases, PubMed/Medline, and Scopus up to April 2021. Using the Cochrane risk of bias assessment tool, the listed studies' risk of bias was evaluated. From the included studies, the pertinent information was taken and pooled for qualitative and quantitative analysis using R software 4.1.1.
RESULTS
Six randomized controlled trials involving 188 patients who underwent sinus augmentation with and without platelet-rich plasma, and 781 implants were included for qualitative and quantitative analysis. Four hundred and eleven implants were placed in the intervention group (with platelet-rich plasma) and 370 implants were placed in the control group (without platelet-rich plasma). The pooled estimate (OR 0.84, 95% CI 0.37 to 1.91; I = 0%) indicated that there was no statistically significant difference observed between the groups. The test for subgroup differences showed no statistically significant differences between the subgroups (p = 0.45) with no heterogeneity (I = 0%).
CONCLUSION
The bias associated with selective reporting of outcome data was considered as some concern for bias. This systematic review revealed that the effect of platelet-rich plasma is uncertain on the survival of dental implants.
PubMed: 36465890
DOI: 10.1016/j.jobcr.2022.11.002 -
Frontiers in Cardiovascular Medicine 2023Pre-eclampsia (PE) is a severe pregnancy complication. Thrombocytopenia and platelet dysfunction are common hematology disorders in PE. Previous studies considered mean... (Review)
Review
BACKGROUND
Pre-eclampsia (PE) is a severe pregnancy complication. Thrombocytopenia and platelet dysfunction are common hematology disorders in PE. Previous studies considered mean platelet volume (MPV), a functional marker of platelets, as a potentially useful predictor for the diagnosis of PE.
METHODS
PubMed, China Biomedical Literature Database, Chinese National Knowledge Infrastructure, Embase, Wanfang, VIP, and Cochrane Library databases were searched to gather diagnostic trials evaluating the diagnosis of PE using MPV, from their inception to 13 March 2023. We also searched Google Scholar and Baidu.
RESULTS
A total of 22 studies from 20 articles were found. The pooled diagnostic accuracy of the MPV for PE recognition was as follows: sensitivity (SEN) 0.676 [95% confidence interval (CI) (0.658-0.694)], specificity (SPE) 0.710 [95% CI (0.703-0.717)], and diagnostic odds ratio (DOR) 7.012 [95% CI (4.226-11.636)], and the SROC-AUC and Q* indices were 0.7889 and 0.7262, respectively. The pooled SEN, SPE, and DOR of the diagnostic accuracy of MPV for PE before 16 weeks of gestation were 0.707 [95% CI (0.670-0.743)], 0.639 [95% CI (0.611-0.667)], and 4.026 [95% CI (2.727-5.943)], and the SROC-AUC and Q* indices were 0.7278 and 0.6753, respectively. For the interval of truncation values between 9 and 10 fl, the SROC-AUC and Q* indices for MPV were 0.8856 and 0.8162, respectively.
CONCLUSIONS
Available evidence suggests that MPV has a moderate predictive and diagnostic value for PE, particularly in diagnosing after 20 weeks of gestation. The diagnostic accuracy is higher when the MPV cut-off falls between 9 and 10 fl. The sensitivity of MPV alone in diagnosing PE is not high, and the combination of other markers for predictive diagnosis may better differentiate PE.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023425154, identifier: CRD42023425154.
PubMed: 37868773
DOI: 10.3389/fcvm.2023.1251304 -
Regenerative Medicine Jun 2023We aimed to expound upon previous research examining the effect of platelet rich plasma in the treatment of sacroiliac joint (SIJ) dysfunction and pain. A systematic... (Review)
Review
We aimed to expound upon previous research examining the effect of platelet rich plasma in the treatment of sacroiliac joint (SIJ) dysfunction and pain. A systematic review was employed in conjunction with a pooled analysis of the efficacy of platelet-rich plasma (PRP) in SIJ dysfunction and pain. A total of 259 articles were retrieved following database systematic review. As a result, four clinical trials and two case studies were subjected to full text appraisal. The dates of publication ranged from 2015 to 2022. Although a unique modality, there is not enough evidence to support the employment of PRP injections over current steroid standard of care. Further double-blinded, randomized control trials are required to elucidate PRP role in SIJ dysfunction.
Topics: Humans; Sacroiliac Joint; Low Back Pain; Platelet-Rich Plasma; Injections, Intra-Articular; Databases, Factual; Treatment Outcome
PubMed: 37199253
DOI: 10.2217/rme-2022-0211 -
Phytomedicine : International Journal... Jan 2023Cardiovascular disease is one of the most concerning chronic diseases in the world. Many studies have shown that platelet overactivation is a very important factor in...
BACKGROUND
Cardiovascular disease is one of the most concerning chronic diseases in the world. Many studies have shown that platelet overactivation is a very important factor in the occurrence and development of cardiovascular diseases. At present, the widely used antiplatelet drugs have some defects, such as drug resistance and adverse reactions.
PURPOSE
The purpose of this article is to summarize the main mechanisms and pathways of platelet activation, the main targets of antiplatelet aggregation, and the antiplatelet aggregation components of natural drugs and their mechanisms of action to provide new research ideas for the development and application of antiplatelet drugs.
STUDY DESIGN AND METHODS
In this review, we systematically searched the PubMed, Google Scholar, Web of Science, and CNKI databases and selected studies based on predefined eligibility criteria. We then assessed their quality and extracted data.
RESULTS
ADP, AA, THR, AF, collagen, SDF-1α, and Ca can induce platelet aggregation and trigger thrombosis. Natural drugs have a good inhibitory effect on platelet activation. More than 50 kinds of natural drugs and over 120 kinds of chemical compounds, including flavonoids, alkaloids, saponins, terpenoids, coumarins, and organic acids, have significantly inhibited platelet activation activity. The MAPK pathway, cGMP-PKG pathway, cAMP-PKA pathway, PI3K-AKT pathway, PTK pathway, PLC pathway, and AA pathway are the main mechanisms and pathways of platelet activation.
CONCLUSION
Natural drugs and their active ingredients have shown good activity and application prospects in anti-platelet aggregation. We hope that this review provides new research ideas for the development and application of antiplatelet drugs.
Topics: Humans; Platelet Aggregation Inhibitors; Phosphatidylinositol 3-Kinases; Platelet Activation; Platelet Aggregation; Blood Platelets; Cardiovascular Diseases
PubMed: 36347177
DOI: 10.1016/j.phymed.2022.154463 -
European Journal of Pediatrics Mar 2021Patent ductus arteriosus (PDA), one of the most common disorders in newborns, is associated with many complications in premature infants such as respiratory distress... (Meta-Analysis)
Meta-Analysis Review
Patent ductus arteriosus (PDA), one of the most common disorders in newborns, is associated with many complications in premature infants such as respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD). However, the diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA) is still an ongoing debate. The relationship between platelet parameters and hsPDA has been explored in many studies over the last decade, but there is still no definite conclusion. We aim to explain the relationship between platelet parameters and hsPDA through this meta-analysis. Therefore, we used PubMed, Embase, the Cochrane Library, and Web of Science databases as well as the Google Scholar to search for studies up to May 2020. Three reviewers independently screened the articles, evaluated the quality of the articles, and collected the data. The random-effects model and fixed-effects model were used to evaluate pooled results. We used the I-square (I) test to examine heterogeneity and the funnel plot; Egger's test and meta-regression analysis were used to test for publication bias. Influence analysis was also carried out in this study. Stata version 12.0 software was used for data analysis. Fourteen studies, which included 3330 newborns, were extracted from 986 studies. The weighted mean difference (WMD) of the platelet count was - 17.98 (p < 0.001), the platelet distribution width (PDW) was 0.27 (p = 0.266), the mean platelet volume (MPV) was 0.01 (p = 0.958), the plateletcrit (PCT) was - 0.03 (p < 0.001), and the platelet mass was - 150.10 (p = 0.001).Conclusion: Platelet count, PCT, and platelet mass of the first 3 days of life are potentially helpful in identifying premature infants at risk of hsPDA. More prospective studies on the relationship between different degrees of thrombocytopenia and platelet function and hsPDA should be conducted. What is Known: • Platelets are involved in the formation of thrombi during closure of the arterial duct. • The diagnosis of hsPDA by Doppler echocardiography and clinical signs is not precise enough. What is New: • Preterm newborns with hsPDA in the first week of life demonstrated a significant reduction in platelet count, platelet mass, and plateletcrit in the first 3 days of life. • No significant difference was shown between hsPDA and non-hsPDA infants in platelet distribution width and mean platelet volume in the first 3 days of life.
Topics: Ductus Arteriosus, Patent; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Prospective Studies; Respiratory Distress Syndrome, Newborn
PubMed: 32949292
DOI: 10.1007/s00431-020-03802-5 -
Journal of Clinical Medicine Feb 2022Subjective tinnitus is the perception of sound without the presence of an external source. Increasing evidence suggests that tinnitus is associated with inflammation. In... (Review)
Review
Subjective tinnitus is the perception of sound without the presence of an external source. Increasing evidence suggests that tinnitus is associated with inflammation. In this systematic review, the role of inflammation in subjective tinnitus was studied. Nine animal and twenty human studies reporting inflammatory markers in both humans and animals with tinnitus were included. It was established that TNF-α and IL-1β are increased in tinnitus, and that microglia and astrocytes are activated as well. Moreover, platelet activation may also play a role in tinnitus. In addition, we elaborate on mechanisms of inflammation in tinnitus, and discuss potential treatment options targeting inflammatory pathways.
PubMed: 35207270
DOI: 10.3390/jcm11041000 -
Langenbeck's Archives of Surgery Feb 2023Inflammation plays an important role in tumor growth. Novel serum blood biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR),... (Meta-Analysis)
Meta-Analysis Review
Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis.
BACKGROUND
Inflammation plays an important role in tumor growth. Novel serum blood biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), have been proposed as useful prognostic indexes in cancer patients. However, their role in rectal cancer is controversial.
METHODS
A comprehensive literature review was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, and the Cochrane Database of Systematic Reviews through May 2022. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Quality was appraised with the Methodological Index for Non-Randomized Studies (MINORS) tool. Aim of the study was to summarize available literature on PLR, NLR, and LMR in patients with rectal cancer undergoing resection.
RESULTS
Forty-seven observational studies (14,205 patients) were included; there were 42 retrospective and 5 prospective cohort studies with an average MINORS score of 14.6 (range: 12-18). Worse overall survival was associated with high NLR (HR 1.81; 95%CI 1.52-2.15; p < 0.001), high PLR (HR 1.24; 95%CI 1.06-1.46; p = 0.009), and low LMR (HR 0.67; 95%CI 0.49-0.91; p = 0.01). High NLR and low LMR were also associated with disease-free-survival (HR 1.68; 95%CI 1.35-2.08; p < 0.001 and HR 0.71; 95%CI 0.58-0.87; p < 0.001, respectively).
CONCLUSIONS
NLR, PLR, and LMR are independent clinical predictors for overall survival in patients with rectal cancer treated with curative surgery. NLR and LMR are also good predictors for disease free survival. These biomarkers, which are readily available, appear optimal prognostic indexes and may help clinicians predict the prognosis of rectal cancer and develop individualized treatment strategies.
Topics: Humans; Prognosis; Neutrophils; Monocytes; Retrospective Studies; Prospective Studies; Lymphocytes; Biomarkers; Rectal Neoplasms
PubMed: 36781510
DOI: 10.1007/s00423-023-02786-8 -
Journal of Clinical Neuroscience :... Jul 2022A potential relationship between poor clinical outcome and mean platelet volume (MPV), platelet distribution width (PDW) have been suggested by previous studies in acute... (Meta-Analysis)
Meta-Analysis Review
A potential relationship between poor clinical outcome and mean platelet volume (MPV), platelet distribution width (PDW) have been suggested by previous studies in acute ischemic stroke (AIS), but the conclusions continued to be controversial. Here, we performed meta-analysis of available studies to explore the effect of MPV, PDW on clinical outcomes in AIS. A systematic literature search was performed in PubMed, EMBASE, and Cochrane Library up to 21 Dec 2021. A total of 10 articles related to MPV and 4 articles related to PDW on the clinical outcome of AIS including 2,390 patients were enrolled in the meta-analysis. The overall result showed that MPV was decreased in favorable outcome group when compared with unfavorable outcome group [SMD (95%CI) = -0.52 (-0.80, -0.24)]. Subgroup analysis indicated that such trend was consistent in the retrospective study, prospective study, non-thrombolytic, EDTA anticoagulants, Sysmax hematology analyzers and detection time within 2 h. In the meta-analysis of PDW, the overall result and subgroup analyses of favorable outcome group did not observe the significant difference compared with unfavorable outcome group. In this meta-analysis, we found remarkable between-study heterogeneity, but Begg's test and Egger's test did not detect publication bias. In conclusion, this meta-analysis result suggested that elevated MPV may be a predictive marker of adverse clinical outcome of AIS, especially in non-thrombolytic patients, while PDW has insufficient value in predicting clinical outcome of AIS. SYSTEMATIC REVIEW REGISTRATION: This meta-analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42022299316. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=299316).
Topics: Blood Platelets; Humans; Ischemic Stroke; Mean Platelet Volume; Platelet Count; Prospective Studies; Retrospective Studies
PubMed: 35636058
DOI: 10.1016/j.jocn.2022.05.019 -
International Journal of Molecular... Dec 2023Platelet concentrates are used for cell induction and stimulation in tissue repair processes. The aim of the present systematic review and meta-analysis was to compare... (Meta-Analysis)
Meta-Analysis Review
Platelet concentrates are used for cell induction and stimulation in tissue repair processes. The aim of the present systematic review and meta-analysis was to compare the biological and cellular properties of advanced platelet-rich fibrin (A-PRF) to those of other platelet concentrates. Searches were conducted on the PubMed/Medline, Scopus, Web of Science, Embase and LILACS databases using a search strategy oriented by the guiding question. A total of 589 records were retrieved. Seven articles of in vitro experimental studies were selected for qualitative data analysis and four were selected for meta-analysis. The release of growth factors, distribution of cells in the fibrin membrane, and cell viability, the fibrin network, and fibroblast migration were investigated. In the final analysis, statistically significant differences were found for the A-PRF group with regard to platelet-derived growth factor, transforming growth factor, epidermal growth factor and vascular endothelial growth factor at all assessment times. A difference was found with regard to bone morphogenetic protein only in the later assessment, and no differences among groups were found with regard to platelet-derived growth factor or insulin-like growth factor. The results of this systematic review and meta-analysis suggest that A-PRF has superior cellular properties and better release of growth factors compared to other platelet concentrates.
Topics: Platelet-Rich Fibrin; Vascular Endothelial Growth Factor A; Cell Movement; Platelet-Derived Growth Factor; Fibrin
PubMed: 38203653
DOI: 10.3390/ijms25010482 -
The Cochrane Database of Systematic... Aug 2016Severe bleeding and coagulopathy are serious clinical conditions that are associated with high mortality. Thromboelastography (TEG) and thromboelastometry (ROTEM) are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Severe bleeding and coagulopathy are serious clinical conditions that are associated with high mortality. Thromboelastography (TEG) and thromboelastometry (ROTEM) are increasingly used to guide transfusion strategy but their roles remain disputed. This review was first published in 2011 and updated in January 2016.
OBJECTIVES
We assessed the benefits and harms of thromboelastography (TEG)-guided or thromboelastometry (ROTEM)-guided transfusion in adults and children with bleeding. We looked at various outcomes, such as overall mortality and bleeding events, conducted subgroup and sensitivity analyses, examined the role of bias, and applied trial sequential analyses (TSAs) to examine the amount of evidence gathered so far.
SEARCH METHODS
In this updated review we identified randomized controlled trials (RCTs) from the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1); MEDLINE; Embase; Science Citation Index Expanded; International Web of Science; CINAHL; LILACS; and the Chinese Biomedical Literature Database (up to 5 January 2016). We contacted trial authors, authors of previous reviews, and manufacturers in the field. The original search was run in October 2010.
SELECTION CRITERIA
We included all RCTs, irrespective of blinding or language, that compared transfusion guided by TEG or ROTEM to transfusion guided by clinical judgement, guided by standard laboratory tests, or a combination. We also included interventional algorithms including both TEG or ROTEM in combination with standard laboratory tests or other devices. The primary analysis included trials on TEG or ROTEM versus any comparator.
DATA COLLECTION AND ANALYSIS
Two review authors independently abstracted data; we resolved any disagreements by discussion. We presented pooled estimates of the intervention effects on dichotomous outcomes as risk ratio (RR) with 95% confidence intervals (CIs). Due to skewed data, meta-analysis was not provided for continuous outcome data. Our primary outcome measure was all-cause mortality. We performed subgroup and sensitivity analyses to assess the effect based on the presence of coagulopathy of a TEG- or ROTEM-guided algorithm, and in adults and children on various clinical and physiological outcomes. We assessed the risk of bias through assessment of trial methodological components and the risk of random error through TSA.
MAIN RESULTS
We included eight new studies (617 participants) in this updated review. In total we included 17 studies (1493 participants). A total of 15 trials provided data for the meta-analyses. We judged only two trials as low risk of bias. The majority of studies included participants undergoing cardiac surgery.We found six ongoing trials but were unable to retrieve any data from them. Compared with transfusion guided by any method, TEG or ROTEM seemed to reduce overall mortality (7.4% versus 3.9%; risk ratio (RR) 0.52, 95% CI 0.28 to 0.95; I(2) = 0%, 8 studies, 717 participants, low quality of evidence) but only eight trials provided data on mortality, and two were zero event trials. Our analyses demonstrated a statistically significant effect of TEG or ROTEM compared to any comparison on the proportion of participants transfused with pooled red blood cells (PRBCs) (RR 0.86, 95% CI 0.79 to 0.94; I(2) = 0%, 10 studies, 832 participants, low quality of evidence), fresh frozen plasma (FFP) (RR 0.57, 95% CI 0.33 to 0.96; I(2) = 86%, 8 studies, 761 participants, low quality of evidence), platelets (RR 0.73, 95% CI 0.60 to 0.88; I(2) = 0%, 10 studies, 832 participants, low quality of evidence), and overall haemostatic transfusion with FFP or platelets (low quality of evidence). Meta-analyses also showed fewer participants with dialysis-dependent renal failure.We found no difference in the proportion needing surgical reinterventions (RR 0.75, 95% CI 0.50 to 1.10; I(2) = 0%, 9 studies, 887 participants, low quality of evidence) and excessive bleeding events or massive transfusion (RR 0.38, 95% CI 0.38 to 1.77; I(2) = 34%, 2 studies, 280 participants, low quality of evidence). The planned subgroup analyses failed to show any significant differences.We graded the quality of evidence as low based on the high risk of bias in the studies, large heterogeneity, low number of events, imprecision, and indirectness. TSA indicates that only 54% of required information size has been reached so far in regards to mortality, while there may be evidence of benefit for transfusion outcomes. Overall, evaluated outcomes were consistent with a benefit in favour of a TEG- or ROTEM-guided transfusion in bleeding patients.
AUTHORS' CONCLUSIONS
There is growing evidence that application of TEG- or ROTEM-guided transfusion strategies may reduce the need for blood products, and improve morbidity in patients with bleeding. However, these results are primarily based on trials of elective cardiac surgery involving cardiopulmonary bypass, and the level of evidence remains low. Further evaluation of TEG- or ROTEM-guided transfusion in acute settings and other patient categories in low risk of bias studies is needed.
Topics: Adult; Blood Coagulation Disorders; Cardiac Surgical Procedures; Child; Erythrocyte Transfusion; Hemorrhage; Humans; Liver Transplantation; Outcome Assessment, Health Care; Plasma; Randomized Controlled Trials as Topic; Thrombelastography
PubMed: 27552162
DOI: 10.1002/14651858.CD007871.pub3