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Alimentary Pharmacology & Therapeutics Jun 2015Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable... (Review)
Review
BACKGROUND
Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) restricted diet has been recommended for IBS.
AIM
To systematically examine recent evidence for dietary interventions with fibre in CC and IBS and FODMAP-restricted diet in IBS, and provide recommendations.
METHODS
We searched PUBMED, MEDLINE, OVID and COCHRANE databases from 2004 to 2014. Published studies in adults with CC and IBS and constipation-predominant IBS (IBS-C) that compared fibre with placebo/alternative and FODMAP-restricted diet with alternative were included.
RESULTS
Of 550 potentially eligible clinical trials on fibre, 11 studies were found and of 23 potentially eligible studies on FODMAPs, six were found. A meta-analysis was not performed due to heterogeneity and methodological quality. Fibre was beneficial in 5/7 studies in CC and 3/3 studies in IBS-C. FODMAP-restricted diet improved overall IBS symptoms in 4/4 and IBS-C symptoms in 1/3 studies and three studies did not meet inclusion criteria. There were significant disparities in subject selection, interventions and outcome assessments in both fibre and FODMAPs studies.
CONCLUSIONS
Fibre supplementation is beneficial in mild to moderate CC and IBS-C, although larger, more rigorous and long-term RCTs are needed (Fair evidence-Level II, Grade B). Although the FODMAP-restricted diet may be effective in short-term management of selected patients with IBS (Fair evidence-Level II, Grade C) and IBS-C (Poor evidence-Level III, Grade C), more rigorous trials are needed to establish long-term efficacy and safety, particularly on colonic health and microbiome.
Topics: Adult; Constipation; Diet Therapy; Dietary Fiber; Disaccharides; Disease Management; Fermentation; Humans; Irritable Bowel Syndrome; Monosaccharides; Oligosaccharides; Polymers
PubMed: 25903636
DOI: 10.1111/apt.13167 -
International Urogynecology Journal Jul 2022This study was aimed at identifying the difference in collagen type-1 expression in women with and without pelvic organ prolapse (POP). (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION AND HYPOTHESIS
This study was aimed at identifying the difference in collagen type-1 expression in women with and without pelvic organ prolapse (POP).
METHODS
A systematic review and meta-analysis was carried out women with and without pelvic organ prolapse. This meta-analysis was conducted on research articles describing the evaluation of collagen type-1 expression between patients with and without POP. The articles were obtained from PubMed, EBSCO, and ProQuest, and were published between January 2000 and June 2021. Pooled mean difference (MD) and pooled odds ratio (OR) were calculated using fixed effect models. Review Manager (RevMan 5.4) was used to analyze the data. The main outcome measures were pooled MD and pooled OR of collagen type-1 expression in patients with and without POP.
RESULTS
A total of seven case-control studies were included in the meta-analysis using the effect size of the MD and two case-control studies were included in the meta-analysis using the effect size of the OR. A total of 247 POP cases and 132 non-POP cases were identified from the studies. Our study indicated that patients with POP had a lower level of collagen type-1 expression than non-POP patients (MD = -6.77; 95% CI: -8.37, -5.17, p < 0.00001). Patients with low expression of collagen type-1 in pelvic support tissue are at a more than 3 times higher risk of suffering from pelvic organ prolapse (OR = 3.23, 95% CI: 1.52 to 6.87, p = 0.002).
CONCLUSION
The results of this study showed that patients with pelvic organ prolapse have lower expression of collagen type-1 than nonpelvic organ prolapse patients.
Topics: Collagen Type I; Female; Humans; Pelvic Organ Prolapse
PubMed: 35596801
DOI: 10.1007/s00192-022-05229-y -
Clinical Oral Investigations Feb 2021This systematic review and meta-analysis compared the effects of immediate and delayed post space preparation on apical sealing. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This systematic review and meta-analysis compared the effects of immediate and delayed post space preparation on apical sealing.
MATERIALS AND METHOD
Two independent authors conducted a systematic search (PubMed/Medline, Cochrane Library, and other databases, until February 2020) and a risk of bias evaluation. Only in vitro studies that compared the effects of immediate and delayed post space preparations on apical filling and adhesion of the post were eligible.
RESULT
Of the 742 articles retrieved, 32 were included. Most of the studies used single-rooted human teeth and rotary files for root canal preparation, a single-cone technique for the filling protocol, and rotary instruments for post space preparation. Various delayed preparation times were evaluated: 8-72 h, 5-30 days (mainly 7 days), and 4 months. In nine studies, the delayed groups showed more apical leakage, while four studies reported more leakage in the immediate groups; ten studies found no significant difference. One study found more bacterial penetration in the delayed group, whereas three studies showed no significant difference. One study reported more voids in the delayed group, while another found no such difference. Three studies showed better post-bond strength in the delayed group, one in the immediate group, whereas three found no significant difference in post-bond strength. Three studies employing varied sealers for root canal fillings were considered for meta-analysis. Two subgroup analyses were also performed (one concerning the use of resin-based sealers (AH Plus), another for zinc oxide-eugenol-based sealers). The results of the meta-analysis showed that a delayed post space preparation led to a significantly higher apical leakage than an immediate preparation (mean difference = 0.41 mm, confidence interval = 0.24-0.59, p < 0.001).
CONCLUSION
Delayed post space preparation seems to negatively influence apical sealing; however, further studies are needed to determine the influence of the timing of post space preparation on the other parameters.
CLINICAL RELEVANCE
Immediate post space preparation may be the safest clinical choice to prevent apical leakage.
Topics: Dental Leakage; Epoxy Resins; Gutta-Percha; Humans; Post and Core Technique; Root Canal Filling Materials; Root Canal Obturation; Root Canal Preparation
PubMed: 33417064
DOI: 10.1007/s00784-020-03690-x -
European Spine Journal : Official... May 2021Interbody cages are commonly used to augment interbody fusion. Commonly used materials include titanium (Ti) and polyetheretherketone (PEEK), with their inherent... (Meta-Analysis)
Meta-Analysis Review
Titanium (Ti) cages may be superior to polyetheretherketone (PEEK) cages in lumbar interbody fusion: a systematic review and meta-analysis of clinical and radiological outcomes of spinal interbody fusions using Ti versus PEEK cages.
AIM
Interbody cages are commonly used to augment interbody fusion. Commonly used materials include titanium (Ti) and polyetheretherketone (PEEK), with their inherent differences. The aim of this study is to perform a systematic review and meta-analysis to compare between the various clinical and radiological outcomes of Ti and PEEK interbody spinal cages.
METHODS
A systematic review and meta-analysis comparing clinical and radiological outcomes between Ti and PEEK interbody cages in patients undergoing spinal fusion was performed. PubMed, Scopus, Web of Science, Embase, and Cochrane Central Register of Controlled Trials database were searched. All studies that compared the clinical and radiological outcomes of patients who underwent Ti and PEEK cages were included. Subgroup analyses was performed to differentiate between patients who had cervical and lumbar interbody fusion.
RESULTS
A total of 11 articles were identified, with a total of 743 patients. Spinal fusion rates at final follow-up did not differ between Ti and PEEK cages (OR 1.50, 95% CI 0.57-3.94, P = 0.41), although in patients undergoing lumbar fusion, Ti cages demonstrated superior fusion (OR 2.12, 95% CI 1.05-4.28, P = 0.04). In patients with non-infective etiologies, Ti cages had a higher rate of cage subsidence (RR 2.17, 95% CI 1.13-4.16, P = 0.02). Both types of cages had similar operating time, postoperative hematoma formation, neuropathic pain, segmental angle correction and postoperative clinical outcome improvement.
CONCLUSION
In non-infective lumbar spine conditions, Ti cage may be the superior option due to the higher fusion rate.
LEVEL OF EVIDENCE
III.
Topics: Benzophenones; Humans; Ketones; Lumbar Vertebrae; Polyethylene Glycols; Polymers; Spinal Fusion; Titanium; Treatment Outcome
PubMed: 33555365
DOI: 10.1007/s00586-021-06748-w -
Journal of Integrative Medicine Mar 2022Propolis and honey have been studied as alternative treatments for patients with coronavirus disease 2019 (COVID-19). However, no study has yet summarized the full body... (Review)
Review
BACKGROUND
Propolis and honey have been studied as alternative treatments for patients with coronavirus disease 2019 (COVID-19). However, no study has yet summarized the full body of evidence for the use of propolis and honey in COVID-19 prevention and treatment.
OBJECTIVE
This study systematically reviews the mechanisms of propolis and honey against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and current evidence for the use of propolis and honey in COVID-19 prevention and treatment.
SEARCH STRATEGY
A systematic search was conducted of electronic databases including PubMed, Scopus, ScienceDirect, and Cochrane Library from their inceptions to April 2021.
INCLUSION CRITERIA
Studies that evaluated the effect of propolis or bee products against SARS-CoV-2 using in silico methods, clinical studies, case reports and case series were included.
DATA EXTRACTION AND ANALYSIS
A standardized data extraction form was used, and data were extracted by two independent reviewers. Narrative synthesis was used to summarize study results concerning the use of propolis or honey in COVID-19 prevention and treatment and their potential mechanisms of action against SARS-CoV-2.
RESULTS
A total of 15 studies were included. Nine studies were in silico studies, two studies were case reports, one study was a case series, and three studies were randomized controlled trials (RCTs). In silico studies, using molecular docking methods, showed that compounds in propolis could interact with several target proteins of SARS-CoV-2, including angiotensin-converting enzyme 2, the main protease enzyme, RNA-dependent RNA polymerase, and spike protein. Propolis may have a positive effect for clinical improvement in mild and moderate-to-severe COVID-19 patients, according to case reports and case series. The included RCTs indicated that propolis or honey could probably improve clinical symptoms and decrease viral clearance time when they were used as adjuvant therapy to standard of care.
CONCLUSION
In silico studies showed that compounds from propolis could interact with target proteins of SARS-CoV-2, interfering with viral entry and viral RNA replication, while clinical studies revealed that propolis and honey could probably improve clinical COVID-19 symptoms and decrease viral clearance time. However, clinical evidence is limited by the small number of studies and small sample sizes. Future clinical studies are warranted.
Topics: Honey; Humans; Propolis; Randomized Controlled Trials as Topic; SARS-CoV-2; COVID-19 Drug Treatment
PubMed: 35144898
DOI: 10.1016/j.joim.2022.01.008 -
Environmental Pollution (Barking, Essex... Nov 2022The soil environment serves as an assembling area for microplastics, and is an important secondary source of microplastics in other environmental media. Recently, soil... (Meta-Analysis)
Meta-Analysis Review
The soil environment serves as an assembling area for microplastics, and is an important secondary source of microplastics in other environmental media. Recently, soil microplastics have been extensively studied; however, high variability is observed among the research results owing to different soil properties, and the complexity of soil microplastic composition. The present study amassed the findings of 2886 experimental groups, across 38 studies from 2016 to 2022, and used meta-analysis to quantitatively analyze the differences in the effects of microplastic exposure on soil physicochemical properties and biota. The results showed that among the existing soil microplastic research, agricultural soils maintained a higher environmental exposure distribution than other environments. Microplastic fibers and fragments were the predominant shapes, indicating that the extensive use of agricultural films are the primary influencing factor of soil microplastic pollution at present. The results of the meta-analysis found that microplastic exposure had a significant negative effect on soil bulk density (lnRR = -0.04) and aggregate stability (lnRR = -0.085), indicating that microplastics may damage the integrity of soil structure or damage the soil surface. The significant changes in plant root biomass and soil phosphatase further signified the potential impact of microplastics on soil nutrient and geochemical element cycling. We further constructed species sensitivity distribution curves, revealing that invertebrates had a higher species sensitivity to microplastics, as they can pass through the gut wall of soil nematodes, causing oxidative stress and affecting gene expression. In general, soil is an interconnected complex, and microplastic exposure can directly or indirectly interact with environmental chemical processes in the soil environment, potentially harming the soil ecosystem; however, current research remains insufficient with respect to breadth and depth in terms of the comprehensive "source-sink" mechanism of soil microplastics, the hazard of exposure, and the overall toxic effects.
Topics: Biota; Ecosystem; Environmental Monitoring; Microplastics; Phosphoric Monoester Hydrolases; Plastics; Soil; Soil Pollutants
PubMed: 36126769
DOI: 10.1016/j.envpol.2022.120183 -
Clinical Oral Investigations Jun 2023This meta-analysis aimed to elucidate the effects of various acid etching patterns on the sensitivity of teeth and their clinical effectiveness following composite resin... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This meta-analysis aimed to elucidate the effects of various acid etching patterns on the sensitivity of teeth and their clinical effectiveness following composite resin repair.
MATERIALS AND METHODS
PubMed, Cochrane Library, Web of Science, and Embase databases were searched for relevant studies on the postoperative sensitivity (POS) of composite resin restorations after using different bonding systems. The retrieval was from the inception of the databases to August 13, 2022, with no filter of written language. Literature screening was conducted by two independent researchers. The Cochrane risk-of-bias assessment tool was adopted for quality evaluation, and Stata 15.0 for analysis.
RESULTS
Twenty-five randomized controlled trials were included in the present study. Following resin composite restoration, 1309 restorations were bonded by self-etching (SE) adhesives, whereas 1271 restorations were bonded by total-etching (TE) adhesives. The meta-analyses showed that there is no evidence to prove the SE and TE will affect POS at present when measured using the modified United States Public Health Service (USPHS) criteria [RR = 1.00 (95% CI: 0.96, 1.04)], the World Dental Federation (FDI) [RR = 1.06 (95% CI: 0.98, 1.15)], or the visual analog scale (VAS) [SMD = 0.02 (95% CI: -0.15, 0.20)] scales. At a certain follow-up time, TE adhesives provide better outcomes in terms of color match, marginal staining, and marginal adaptation. In other words, TE adhesives have better esthetic results.
CONCLUSIONS
The type of bonding technique (ER and SE) does not affect the risk and degree of POS in class I/II and class V restorations. Further research is required to verify whether these findings apply to different forms of composite resin restorations.
CLINICAL RELEVANCE
Besides the fact that TE barely increase postoperative sensitivity, it also yields superior cosmetic results.
Topics: Composite Resins; Dental Cements; Dentin-Bonding Agents; Resin Cements; Dental Restoration, Permanent; Acid Etching, Dental; Esthetics, Dental; Dental Marginal Adaptation
PubMed: 37017757
DOI: 10.1007/s00784-023-05007-0 -
BJU International Sep 2023To assess the safety of vascular closure devices in living-donor nephrectomy (LDN), as staplers and non-transfixion techniques (polymer locking and metal clips) are the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the safety of vascular closure devices in living-donor nephrectomy (LDN), as staplers and non-transfixion techniques (polymer locking and metal clips) are the methods employed to secure the renal vessels during laparoscopic and robotic LDN, but the use of clips has come into question since the United States Food and Drug Administration and manufacturers issued a contraindication.
METHODS
A systematic review and meta-analysis were conducted to assess the safety of vascular closure devices (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD42022364349). The PubMed, Scopus, the Excerpta Medica dataBASE (EMBASE), and the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) databases were searched in September 2022. For comparative and non-comparative studies, incidence estimates and odds ratios (ORs), respectively, for the main variables regarding safety of vascular closure devices were pooled by using random effects meta-analyses. Quality assessment of the included comparative studies was conducted using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool.
RESULTS
Of the 863 articles obtained, data were retrieved from 44 studies, which included 42 902 patients. In non-comparative studies, the pooled estimate rates for device failure, severe haemorrhage rate, conversion to open surgery, and mortality were similar for both clips and staplers. Regarding the meta-analyses for comparative studies (three studies), there were no significant differences between the two groups for the severe haemorrhage rate (OR 0.57, 95% confidence interval [CI] 0.18-1.75; P = 0.33), conversion to open surgery (OR 0.35, 95% CI 0.08-1.54; P = 0.16), or death rate (OR 3.64, 95% CI 0.47-28.45; P = 0.22). Based on weak evidence, device failure was lower in the polymer clip group (OR 0.41, 95% CI 0.23-0.75; P = 0.00).
CONCLUSIONS
This study has confirmed that there is no evidence for the superiority of any vascular closure device in terms of safety in LDN. Standardised recommendations for vascular control in this context should be carefully designed and prospectively evaluated.
Topics: United States; Humans; Vascular Closure Devices; Living Donors; Nephrectomy; Polymers; Hemorrhage
PubMed: 37017627
DOI: 10.1111/bju.16025 -
Nursing Open Sep 2023To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy. (Meta-Analysis)
Meta-Analysis
AIM
To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy.
DESIGN
Systematic review and network meta-analysis.
METHODS
Articles published from several electronic databases and other resources were selected. Two reviewers independently selected studies, extracted data and assessed the quality of selected studies.
RESULTS
Twenty-five studies that contained data on moist dressings (hydrocolloidal dressing, foam dressing, silver ion dressing, biological wound dressing, hydrogel dressing, polymeric membrane dressing) and sterile gauze dressings (traditional gauze dressings) were included. All RCTs were at a medium to high risk of bias. Moist dressings were found to be more advantageous than the traditional dressings. Hydrocolloid dressings [RR = 1.38, 95% CI (1.18, 1.60)] showed a higher cure rate than sterile gauze dressing and foam dressings [RR = 1.37, 95% CI (1.16, 1.61)]. Silver ion dressings [RR = l.37, 95% CI (1.08, 1. 73)] showed a higher cure rate than sterile gauze dressings. Sterile gauze dressing dressings [RR = 0.51, 95% CI (0.44, 0.78)] showed a lower cure rate compared with polymeric membrane dressings; whereas Sterile gauze dressing dressings [RR = 0.80, 95% CI (0.47, 1.37)] had a lower cure rate compared to biological wound dressings. Foam and hydrocolloid dressings were associated with the least healing time. Few dressing changes were required for moist dressings.
Topics: Humans; Bandages, Hydrocolloid; Crush Injuries; Network Meta-Analysis; Polymers; Pressure Ulcer; Silver; Wound Healing
PubMed: 37386783
DOI: 10.1002/nop2.1867 -
International Journal of Molecular... Oct 2023We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on . The... (Meta-Analysis)
Meta-Analysis Review
We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on . The systematic search was performed in three databases (Cochrane Library, EMBASE, and PubMed) and included English-language randomized-controlled trials to compare the efficacy of chitosan in reducing the number of . To assess the certainty of evidence, the GRADE tool was used. Mean differences were calculated with a 95% confidence interval for one outcome: bacterial counts in CFU/mL. The protocol of the study was registered on PROSPERO, registration number CRD42022365006. Articles were downloaded ( = 6758) from EMBASE ( = 2255), PubMed ( = 1516), and Cochrane ( = 2987). After the selection process, a total of four articles were included in the qualitative synthesis and three in the quantitative synthesis. Our results show that chitosan reduced the number of bacteria. The difference in mean quantity was -4.68 × 10. The interval of the random-effects model was [-2.15 × 10; 1.21 × 10] and the prediction interval was [1.03 × 10; 9.40 × 10]. The I2 value was 98% ( = 0.35), which indicates a high degree of heterogeneity. Chitosan has some antibacterial effects when used as a component of chewing gum, but further studies are needed. It can be a promising antimicrobial agent for prevention.
Topics: Humans; Streptococcus mutans; Saliva; Chitosan; Anti-Infective Agents; Anti-Bacterial Agents; Chewing Gum; Dental Caries
PubMed: 37894948
DOI: 10.3390/ijms242015270