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The Cochrane Database of Systematic... Jun 2013Foot ulcers in people with diabetes are a prevalent and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Foot ulcers in people with diabetes are a prevalent and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from. A clear and current overview of current evidence is required to facilitate decision-making regarding dressing use.
OBJECTIVES
The review aimed to evaluate the effects of foam wound dressings on the healing of foot ulcers in people with diabetes.
SEARCH METHODS
For this first update we searched the following databases the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL in April 2013. There were no restrictions based on language or date of publication.
SELECTION CRITERIA
Published or unpublished randomised controlled trials (RCTs) that evaluated the effects on ulcer healing of one or more foam wound dressings in the treatment of foot ulcers in people with diabetes.
DATA COLLECTION AND ANALYSIS
Two review authors independently performed study selection, risk of bias assessment and data extraction.
MAIN RESULTS
We included six studies (157 participants) in this review. Meta analysis of two studies indicated that foam dressings do not promote the healing of diabetic foot ulcers compared with basic wound contact dressings (RR 2.03, 95%CI 0.91 to 4.55). Pooled data from two studies comparing foam and alginate dressing found no statistically significant difference in ulcer healing (RR 1.50, 95% CI 0.92 to 2.44). There was no statistically significant difference in the number of diabetic foot ulcers healed when foam dressings were compared with hydrocolloid (matrix) dressings. All included studies were small and/or had limited follow-up times.
AUTHORS' CONCLUSIONS
Currently there is no research evidence to suggest that foam wound dressings are more effective in healing foot ulcers in people with diabetes than other types of dressing however all trials in this field are very small. Decision makers may wish to consider aspects such as dressing cost and the wound management properties offered by each dressing type e.g. exudate management.
Topics: Aerosols; Bandages; Diabetic Foot; Humans; Polyurethanes; Randomized Controlled Trials as Topic; Wound Healing
PubMed: 23740766
DOI: 10.1002/14651858.CD009111.pub3 -
Evidence-based Dentistry Mar 2024The clinical effectiveness of clear aligners depends on the material properties both physical and mechanical. The purpose of this systematic review is to evaluate the...
INTRODUCTION
The clinical effectiveness of clear aligners depends on the material properties both physical and mechanical. The purpose of this systematic review is to evaluate the physical and mechanical properties of different clear aligner materials and changes in the same during and after intra-oral use.
METHODS
Search was done in five electronic databases: Pubmed, Embase, Scopus, Web of Science and Ovid individually by two reviewers. In vivo, Ex vivo and In vitro studies that evaluated the physical and mechanical properties of clear aligner materials were selected. The risk of bias assessment was performed using a modified Cochrane risk of bias tool.
RESULTS
From the 24 articles selected, 19 evaluated a single physical property and 23 articles evaluated a single mechanical property of clear aligner materials. All domains in the risk of bias assessment showed low risk of bias except for 'blinding of outcome' which was unclear in almost all the selected studies. Properties such as hardness, optical properties, stiffness, and yield strength were found to be different for different clear aligner materials and were found to change with thermoforming, with intra-oral aging, and in simulated intraoral conditions. Due to heterogenicity in the parameters used to assess physical or mechanical properties a meta-analysis could not be done.
CONCLUSIONS
Properties like hardness, color, stiffness, stress relaxation and creep behavior were different for various clear aligner materials and were found to deteriorate with thermoforming and intra-oral aging. Polyurethane-based materials have a higher level of hardness and stiffness but exhibit increased creep and stress relaxation properties.
PROSPERO REGISTRATION NUMBER
CRD42021269597.
Topics: Humans; Tooth Movement Techniques; Polyurethanes; Treatment Outcome; Physical Examination; Orthodontic Appliances, Removable
PubMed: 38017152
DOI: 10.1038/s41432-023-00937-w -
The Journal of Trauma and Acute Care... Apr 2021Burns cause a huge economic burden to society, and the wounds can be very difficult to manage. Clinical experience suggests that amniotic membrane (AM) is an economical... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Burns cause a huge economic burden to society, and the wounds can be very difficult to manage. Clinical experience suggests that amniotic membrane (AM) is an economical and effective biological dressing for burns. However, few systematic reviews or meta-analyses have been published on such use. We aimed to evaluate the role of AM dressings in burn wounds.
METHODS
A systematic search of the PubMed, Cochrane, Embase, and Web of Science databases was conducted in March 2020. The search was conducted to identify randomized control trials that compared selected features of AM with those of other dressings, such as silver sulfadiazine, polyurethane membrane, and honey. For skin-grafted wounds, we compared AM-covered skin grafts and traditional staple-fixed skin grafts. Outcomes of interest for the efficacy analysis included wound infection, pain, itching, scarring, and healing time. The number of adverse events in each treatment group, the rate of withdrawal because of adverse effects, the cost of treatment, and patient acceptability were assessed for the feasibility analysis.
RESULTS
Eleven randomized controlled trials with 816 participants total were identified in our review. Amniotic membrane treatment was more effective than conventional methods, silver sulfadiazine, and polyurethane membrane in treating burn wounds, but AM appears to be less effective than honey. No reports of AM-related disease transmission or adverse reactions were described in the included articles.
CONCLUSION
Amniotic membrane has beneficial effects in treating burn wounds; however, the evidence needs to be strengthened by further robust randomized controlled trials.
LEVEL OF EVIDENCE
Systematic Review/Meta-analysis, level III.
Topics: Amnion; Biological Dressings; Burns; Humans
PubMed: 33284236
DOI: 10.1097/TA.0000000000003050 -
Supportive Care in Cancer : Official... Feb 2020To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients...
PURPOSE
To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients undergoing hematopoietic stem cell transplantation.
METHODS
Systematic Review. The search was performed in the following electronic databases: CINAHL, Cochrane Library CENTRAL, EMBASE, LILACS, PubMed, Scopus, and Web of Science. Google Scholar was used for the gray literature search.
RESULTS
Seven studies were included which tested different arrangements of dressings: sterilized gauze and adhesive tape with a transparent polyurethane film (n = 2), transparent polyurethane film with a different replacement interval frequency (n = 2), transparent polyurethane film with and without chlorhexidine released continuously by the dressing at the site of intravascular catheter insertion (n = 2), and dressings vs. no dressings (n = 1). The meta-analysis for catheter-related infection prevention showed no difference between type of dressing (RR 1.76, [95% CI 0.82; 3.75], I 0%) and for the replacement frequency at different intervals (RR 1.04, [95% CI 0.67; 1.61], I 0%). The meta-analysis for skin irritation evaluated the transparent polyurethane film replacement frequency and indicated that a longer dressing replacement interval (10 to 15 days) reduces the risk of developing this outcome (RR 0.71, 0.52; 0.96, 95% CI, I 24%).
CONCLUSIONS
Regarding the type of the dressing, there is no evidence indicating the best dressing. Although there is no evidence available for the ideal replacement frequency, the risk to develop skin irritation is reduced in longer dressing replacements intervals.
Topics: Bandages; Catheter-Related Infections; Central Venous Catheters; Hematopoietic Stem Cell Transplantation; Humans; Polyurethanes
PubMed: 31493134
DOI: 10.1007/s00520-019-05065-9 -
Bioactive Materials Nov 2021Acute or degenerative meniscus tears are the most common knee lesions. Meniscectomy provides symptomatic relief and functional recovery only in the short- to mid-term... (Review)
Review
Acute or degenerative meniscus tears are the most common knee lesions. Meniscectomy provides symptomatic relief and functional recovery only in the short- to mid-term follow-up but significantly increases the risk of osteoarthritis. For this reason, preserving the meniscus is key, although it remains a challenge. Allograft transplants present many disadvantages, so during the last 20 years preclinical and clinical research focused on developing and investigating meniscal scaffolds. The aim of this systematic review was to collect and evaluate all the available evidence on biosynthetic scaffolds for meniscus regeneration both and in clinical studies. Three databases were searched: 46 preclinical studies and 30 clinical ones were found. Sixteen natural, 15 synthetic, and 15 hybrid scaffolds were studied . Among them, only 2 were translated into clinic: the Collagen Meniscus Implant, used in 11 studies, and the polyurethane-based scaffold Actifit®, applied in 19 studies. Although positive outcomes were described in the short- to mid-term, the number of concurrent procedures and the lack of randomized trials are the major limitations of the available clinical literature. Few studies also combined the use of cells or growth factors, but these augmentation strategies have not been applied in the clinical practice yet. Current solutions offer a significant but incomplete clinical improvement, and the regeneration potential is still unsatisfactory. Building upon the overall positive results of these "old" technologies to address partial meniscal loss, further innovation is urgently needed in this field to provide patients better joint sparing treatment options.
PubMed: 33898878
DOI: 10.1016/j.bioactmat.2021.03.033 -
European Journal of Vascular and... Feb 2021There is discordance between reviews comparing eversion endarterectomy (EvE) with conventional carotid endarterectomy (CEA) mostly because under this term various... (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
There is discordance between reviews comparing eversion endarterectomy (EvE) with conventional carotid endarterectomy (CEA) mostly because under this term various "closure" techniques are included, from direct closure to a wide spectrum of patches with different materials.
DATA SOURCES
MEDLINE (via PubMed) and SCOPUS.
REVIEW METHODS
This was a systematic review of the Medline (via PubMed) and SCOPUS databases for randomised controlled trials (RCTs) comparing different CEA closure techniques. Network meta-analysis (NMA) was performed with a frequentist approach. The primary and the secondary outcome measures were the 30 day combined stroke and death rate and the late restenosis rate, respectively.
RESULTS
Twenty-three RCTs were finally included in the NMA with a total of 4440 patients randomised, representing seven different techniques (primary carotid closure, n = 753; EvE, n = 431; vein patch closure, n = 973; polytetrafluoroethylene [PTFE] patch, n = 948; Dacron patch, n = 828; bovine pericardium patch, n = 249; and polyurethane patch, n = 258). NMA showed that EvE had a decreased 30 day combined stroke and death rate vs. all other methods of arterial closure, with the exception of PTFE and bovine pericardium patching. Additionally, EvE was associated with the lowest restenosis rate vs. all other methods of arterial closure after CEA. EvE was significantly superior to Dacron patches with regard to late restenosis, with the prediction intervals (PIs) lying completely on the beneficial side (risk ratio 0.06; PI 0.01-0.58) and increasing confidence of this comparison. Rare catastrophic complications of vein patch blow out or synthetic patch infection were reported in 0.2% of the total (n = 9/4 400) and no comparisons were made.
CONCLUSION
EvE and patching with bovine pericardium or PTFE is associated with a lower incidence in both short term and late undesired outcomes following CEA and seems to represent the best choice compared with other carotid closure techniques. These results may support the vascular surgeon's choice of technique/patch material.
Topics: Biocompatible Materials; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Carotid Arteries; Endarterectomy, Carotid; Humans; Outcome Assessment, Health Care; Postoperative Complications; Wound Closure Techniques
PubMed: 33257115
DOI: 10.1016/j.ejvs.2020.10.009 -
The Journal of Antimicrobial... Oct 2014Antimicrobial lock therapy has been widely utilized internationally for the prevention and management of intravascular catheter-related bloodstream infections. One of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Antimicrobial lock therapy has been widely utilized internationally for the prevention and management of intravascular catheter-related bloodstream infections. One of the agents commonly utilized for lock therapy is ethanol. However, a systematic review of adverse events associated with ethanol locks has not been published.
METHODS
PubMed was searched to collect articles published from May 2003 through March 2014. The bibliographies of relevant articles were also reviewed.
RESULTS
In vitro studies of the mechanical properties of catheters after ethanol immersion have revealed changes predominantly in polyurethane catheters and to a lesser extent in silicone and Carbothane catheters. An elution of polymers from polyurethane and Carbothane catheters has been observed at the ethanol concentrations used in ethanol lock therapy. Ethanol above a concentration of 28% leads to plasma protein precipitation. Ethanol locks were associated with catheter occlusion in 11 studies and independently increased the risk of thrombosis compared with heparin lock in a randomized trial. Six studies noted abnormalities in catheter integrity, including one case leading to catheter embolization. Of note, five of these studies involved silicone catheters. Ethanol lock use was associated with systemic side effects in 10 studies and possible side effects in one additional study. Four studies noted liver function test abnormalities, predominantly transaminase elevation, related to ethanol lock use. However, a prospective study did not find any difference in the risk of doubling the transaminase level above the normal range during use of ethanol locks compared with not using an ethanol lock.
CONCLUSIONS
The use of ethanol locks has been associated with structural changes in catheters, as well as the elution of molecules from the catheter polymers. Clinical studies have revealed systemic toxicity, increased catheter occlusion and breaches in catheter integrity.
Topics: Anti-Infective Agents, Local; Catheter-Related Infections; Catheters, Indwelling; Ethanol; Humans; Odds Ratio
PubMed: 24891431
DOI: 10.1093/jac/dku182 -
The Cochrane Database of Systematic... Sep 2011Foot ulcers in people with diabetes are a prevalent and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Foot ulcers in people with diabetes are a prevalent and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from. A clear and current overview of current evidence is required to facilitate decision-making regarding dressing use.
OBJECTIVES
The review aimed to evaluate the effects of foam wound dressings on the healing of foot ulcers in people with diabetes.
SEARCH STRATEGY
We searched the Cochrane Wounds Group Specialised Register (searched 10 June 2011); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2); Ovid MEDLINE (1950 to June Week 1 2011); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, 8 June, 2011); Ovid EMBASE (1980 to 2011 Week 22); EBSCO CINAHL (1982 to 3 June 2011). There were no restrictions based on language or date of publication.
SELECTION CRITERIA
Published or unpublished randomised controlled trials (RCTs) that evaluated the effects on ulcer healing of one or more foam wound dressings in the treatment of foot ulcers in people with diabetes.
DATA COLLECTION AND ANALYSIS
Two review authors independently performed study selection, risk of bias assessment and data extraction.
MAIN RESULTS
We included six studies (157 participants) in this review. Meta analysis of two studies indicated that foam dressings do not promote the healing of diabetic foot ulcers compared with basic wound contact dressings (RR 2.03, 95%CI 0.91 to 4.55). Pooled data from two studies comparing foam and alginate dressing found no statistically significant difference in ulcer healing (RR 1.50, 95% CI 0.92 to 2.44). There was no statistically significant difference in the number of diabetic foot ulcers healed when foam dressings were compared with hydrocolloid (matrix) dressings. All included studies were small and/or had limited follow-up times.
AUTHORS' CONCLUSIONS
Currently there is no research evidence to suggest that foam wound dressings are more effective in healing foot ulcers in people with diabetes than other types of dressing however all trials in this field are very small. Decision makers may wish to consider aspects such as dressing cost and the wound management properties offered by each dressing type e.g. exudate management.
Topics: Aerosols; Bandages; Diabetic Foot; Humans; Polyurethanes; Wound Healing
PubMed: 21901731
DOI: 10.1002/14651858.CD009111.pub2 -
Journal of Pharmacy & Bioallied Sciences Feb 2024This systematic review examines the efficacy and biocompatibility of orthodontic clear aligner tooth aligners constructed from polyethylene terephthalate glycol (PeT-G),...
Effectiveness and Biocompatibility of Tooth Aligners Made from Polyethylene Terephthalate Glycol (PeT-G), Polypropylene (PP), Polycarbonate (PC), Thermoplastic Polyurethanes (TPUs), and Ethylene-Vinyl Acetate (EVA): A Systematic Review.
OBJECTIVE
This systematic review examines the efficacy and biocompatibility of orthodontic clear aligner tooth aligners constructed from polyethylene terephthalate glycol (PeT-G), polypropylene (PP), polycarbonate (PC), thermoplastic polyurethanes (TPUs), and ethylene-vinyl acetate (EVA).
MATERIALS AND METHODS
To find relevant papers published through September 2021, PubMed was searched extensively. Randomized clinical trials (RCTs) and observational studies assessing the effectiveness and biocompatibility of the aligner materials were included. Data were extracted independently, and the quality of included research was appraised using relevant procedures. The research variability necessitated a narrative synthesis.
RESULTS
Five studies were included for comparison. All materials were biocompatible; however, PeT-G and EVA aligners caused the least tissue irritation. Patients preferred TPU aligners for initial comfort and PeT-G aligners for transparency and endurance.
CONCLUSION
Biocompatible PeT-G, PP, PC, TPU, and EVA tooth aligners fix malocclusions. Aligner materials should be chosen based on patient preferences, treatment goals, and material qualities. For stronger proof, a longer-term study is needed.
PubMed: 38595485
DOI: 10.4103/jpbs.jpbs_883_23 -
Caries Research 2011The aim of this study was to systematically review the present literature on the effect of chlorhexidine varnish (CHX-V) on root caries. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this study was to systematically review the present literature on the effect of chlorhexidine varnish (CHX-V) on root caries.
MATERIALS AND METHODS
The MEDLINE-PubMed, the Cochrane-CENTRAL and EMBASE databases were searched through December 2010 to identify any appropriate studies. Root caries incidence and root caries activity were selected as outcome variables.
RESULTS
An independent screening of the unique titles and abstracts of 24 MEDLINE-PubMed, 14 Cochrane-CENTRAL and 18 EMBASE papers resulted in 6 publications that met the eligibility criteria. Data extraction provided no conclusive evidence that the application of CHX-V is effective in patients when regular professional oral prophylaxis is performed. If effective, the 40% CHX-V was found to provide a benefit over a control or fluoride varnish. CHX-V at lower concentrations (1 and 10%) may provide protection against root caries in high-risk patients (such as geriatric and xerostomia patients) in the absence of regular professional oral prophylaxis.
CONCLUSION
Within the limitations of this review, it may be concluded that in the absence of regular professional tooth cleaning and oral hygiene instructions, CHX-V may provide a beneficial effect in patients in need of special care. The strength of this recommendation is graded as 'weak'.
Topics: Cariostatic Agents; Chlorhexidine; Controlled Clinical Trials as Topic; Drug Combinations; Ethanol; Gingival Recession; Humans; Incidence; Paint; Polyurethanes; Root Caries; Thymol
PubMed: 21525751
DOI: 10.1159/000327374