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Materials (Basel, Switzerland) Aug 2021To evaluate marginal bone loss (MBL) in immediate implant procedures (IIP) placed in conjunction with platelet concentrates (PCs) compared to IIP without PCs. (Review)
Review
BACKGROUND
To evaluate marginal bone loss (MBL) in immediate implant procedures (IIP) placed in conjunction with platelet concentrates (PCs) compared to IIP without PCs.
METHODS
A search was performed in four databases. Clinical trials evaluating MBL of IIP placed with and without PCs were included. The random effects model was conducted for meta-analysis.
RESULTS
Eight clinical trials that evaluated MBL in millimeters were included. A total of 148 patients and 232 immediate implants were evaluated. The meta-analysis showed a statistically significant reduction on MBL of IIP placed with PCs when compared to the non-PCs group at 6 months ( < 0.00001) and 12 months ( < 0.00001) follow-ups. No statistically significant differences were observed on MBL of IIP when compared PCs + bone graft group vs. only bone grafting at 6 months ( = 0.51), and a significant higher MBL of IIP placed with PCs + bone graft when compared to only bone grafting at 12 months was found ( = 0.03).
CONCLUSIONS
MBL of IIP at 6 and 12 months follow-ups is lower when PCs are applied in comparison to not placing PCs, which may lead to more predictable implant treatments in the medium term. However, MBL seems not to diminish when PCs + bone graft are applied when compared to only bone grafting.
PubMed: 34443105
DOI: 10.3390/ma14164582 -
World Neurosurgery Oct 2021To assess the global sagittal balance of spine (GSBS) in asymptomatic controls. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the global sagittal balance of spine (GSBS) in asymptomatic controls.
METHODS
PubMed, Scopus, Cochrane library, and Web of Science searched up to July 2020. Studies were screened for the GSB parameters including T1 pelvic angle (TPA), spinosacral angle (SSA), sagittal vertical axis (SVA), C7/sacrofemoral distance ratio (Barrey index), odontoid hip axis (OD-HA), and Full Balance Index (FBI) as measured in asymptomatic participants. A meta-analysis was performed to synthesize pooled estimates. Heterogeneity and publication bias were assessed.
RESULTS
Overall, 76 studies were identified including 12,169 participants (54.7% female) with mean age ranges from 12.0 to 72.9 years old. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of studies included in this review. Begg's test did not indicate obvious publication bias. The pooled analysis reveals that the mean (standard deviation) normative values were: 1) age ˃18 years, SSA (°), 127.6 (0.89); SVA absolute value (millimeters), 13.1 (1.13); TPA (°), 9.8 (1.13); T1SPI (°), -4.3 (0.57); and Barrey index absolute value, 0.51 (0.3). The mean value of the OD-HA (°) was reported 2.9 (1.6), and the FBI average value was less than 5°. 2) Age ≤18 years, SSA (°), 132.1 (8.3); SVA absolute value (millimeters), 11.9 (2.0); and Barrey index, -0.7 (8.3). A significant difference was observed between the 2 age groups based on SVA and SSA.
CONCLUSIONS
This paper presents normative data on TPA, SSA, SVA, Barrey index, OD-HA, and FBI as a reference for evaluating/measuring a GSB of spine in asymptomatic controls.
Topics: Adolescent; Adult; Aged; Child; Female; Healthy Volunteers; Humans; Male; Middle Aged; Postural Balance; Reference Values; Spine; Young Adult
PubMed: 34314909
DOI: 10.1016/j.wneu.2021.07.036 -
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 -
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 -
Orthopaedics & Traumatology, Surgery &... Oct 2021Surgical treatment of osteochondral lesions of the talus (OLT) is warranted if medical treatments fail, achieving good results in around 85% of cases. Numerous...
BACKGROUND
Surgical treatment of osteochondral lesions of the talus (OLT) is warranted if medical treatments fail, achieving good results in around 85% of cases. Numerous classification systems, based on all possible imaging modalities (radiography, MRI, CT scan, scintigraphy, and CT arthrography), have been proposed to guide surgical treatments, but none has proven to be superior. A recent study demonstrated the prognostic value of CT arthrography by accurately describing the subchondral bone plate. A systematic review of the literature has brought new criteria to predict good outcome following bone marrow stimulation surgical techniques: lesions should measure less than 1 centimeter in size and 5 millimeters in depth. Based on these data, we are proposing a new simple, 3-stage CT arthrographic classification system of OLT.
MATERIALS AND METHODS
After a brief overview of the classification, 60 CT-arthrographies of ankles with OLT were organized according to this new CT arthrographic classification system by four surgeons (two juniors and two seniors). Two imaging assessments were performed one month apart. Statistical analysis was performed using the Fleiss' kappa coefficient to determine the inter- and intraobserver agreement.
RESULTS
An excellent inter- and intraobserver agreement was found with overall Fleiss' kappa coefficients of 0.897 and 0.847, respectively.
CONCLUSION
The results of our study showed an excellent inter- and intraobserver agreement for this new CT arthrographic classification system of OLT. The principal advantage of this new classification system, based on the latest data in the literature, is its ability to easily distinguish lesions that are more amenable to bone marrow stimulation techniques.
LEVEL OF EVIDENCE
II.
Topics: Ankle Joint; Arthrography; Magnetic Resonance Imaging; Talus; Tomography, X-Ray Computed
PubMed: 33713874
DOI: 10.1016/j.otsr.2021.102890 -
Giornale Italiano Di Medicina Del... Dec 2020An up-to-date knowledge on the occupational risk related to electromagnetic fields (EMF) exposure and its prevention, and on the criteria and methods for an appropriate...
[The development of the new guidelines of the Italian association of medical radioprotection (AIRM) for the protection of the workers exposed to EMF related risks: new approaches and criteria].
An up-to-date knowledge on the occupational risk related to electromagnetic fields (EMF) exposure and its prevention, and on the criteria and methods for an appropriate health surveillance (HS) of exposed workers are highly important, as: EMF are almost ubiquitous; in recent years, relevant changes and advancements in the technologies applied have been observed, e.g. the introduction of new equipment for Magnetic Resonance, involving potentially higher exposures for operators, and the development of the 5G technology, using also EMF bands with millimetric wavelengths, not often applied previously; in Italy the new Legislative Decree 159/2016 has been promulgated, implementing the Directive 2013/35/EU and, accordingly, introducing several substantial changes to the Legislative Decree 81/2008 on safety and health at work, in particular to its fourth chapter of the eight section ("Physical Agents"), entitled "The protection of workers from the risks related to electromagnetic fields exposure". For these reasons, the Italian Association of Medical Radioprotection (AIRM) has fully revised the "Guidelines for the health surveillance of workers exposed to non-ionizing radiation", published in 2012 together with the Italian Society of Occupational Medicine (SIML). Therefore, AIRM involved a multidisciplinary panel of experts, working in accordance to a rigorous scientific methodology, based on the recognized international indications for the development of guidelines (GL) in the medical field, as those proposed by the Guidelines International Network (GIN), the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the National Institute for Health and Care Excellence (NICE) and the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration. Furthermore, the multidisciplinary panel conducted a systematic review of the scientific literature according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA) criteria, aimed at answering to specific research questions, including the "PECO" (Populations of interest, Exposures, Comparators, and Outcomes) questions. The final stages of the GL include the revision of the GL-draft from an external group of independent experts, giving also an overall evaluation and opinions on the Recommendations elaborated, so that the panel group can elaborate a final document to be shared again, after agreement among all the experts, with a consensus reached by Delphi method in case of disagreement. The main GL objective is to guide occupational physicians in charge for the HS of EMF exposed workers, providing up-to-date indications on the contents and methods for an adequate HS of the workers, but also on the regulations and standards applicable, on the relevant occupational EMF exposure sources, on the possible adverse effects to be considered, including indications on the biological mechanisms involved, on the conditions of particular susceptibility to the EMF risk, on the criteria to be considered for the evaluation of "fitness to work" in case of occupational EMF exposure and finally also on the contents of adequate information and training for the workers exposed. As a final objective, the AIRM GL on HS of workers exposed to EMF will be proposed for public consultation to the Italian National Guidelines System, as required according to the Law n. 24/2017, also known as the «Gelli law».
Topics: Electromagnetic Fields; Exercise; Humans; Italy; Occupational Exposure; Radiation Protection
PubMed: 33600659
DOI: No ID Found -
Journal of Indian Prosthodontic Society 2020To evaluate different methods, techniques, and concepts documented in the literature to assess iris positioning accurately to the related dimensions needed to effectuate... (Review)
Review
AIM
To evaluate different methods, techniques, and concepts documented in the literature to assess iris positioning accurately to the related dimensions needed to effectuate maxillofacial rehabilitation of ocular prosthesis.
SETTINGS AND DESIGN
This systematic review was conducted as per the PRISMA guidelines which is the most opted reporting protocol.
MATERIALS AND METHODS
Two electronic databases PubMed and Cochrane Library) were searched for manuscripts published from 1969 till September 30, 2019. An electronic search (of peer review restricted to English language dental literature was conducted to identify the relevant scientific article on iris positioning in maxillofacial prostheses. Two observers independently read the abstracts and selected 17 full text articles fulfilling the inclusion criteria.
STATISTICAL ANALYSIS USED
No meta-analysis was conducted due to heterogeneity of data obtained.
RESULTS
All the 17 documented articles related to determination of the iris positioning to perform maxillofacial prosthetic rehabilitation depicting the use of a strip of plastic template, a Boley's gauge, a millimeter ruler, a pupillometer, window light, an ocular locator with fixed caliper, inverted anatomic tracings, a transparent graph grid were reviewed systematically.
CONCLUSION
Currently, there is no evidence in the form of a systematic review of the available literature discussing the best technique available for perfectly matching the iris positioning. However, the latest techniques making use of digital technology such as digital photography, is believed to be more precise for iris positioning in the ocular prosthesis.
PubMed: 33487961
DOI: 10.4103/jips.jips_374_19 -
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 -
The Spine Journal : Official Journal of... Feb 2021The introduction and integration of robot technology into modern spine surgery provides surgeons with millimeter accuracy for pedicle screw placement. Coupled with... (Meta-Analysis)
Meta-Analysis
BACKGROUND CONTEXT
The introduction and integration of robot technology into modern spine surgery provides surgeons with millimeter accuracy for pedicle screw placement. Coupled with computer-based navigation platforms, robot-assisted spine surgery utilizes augmented reality to potentially improve the safety profile of instrumentation.
PURPOSE
In this study, the authors seek to determine the safety and efficacy of robotic-assisted pedicle screw placement compared to conventional free-hand (FH) technique.
STUDY DESIGN/SETTING
We conducted a systematic review of the electronic databases using different MeSH terms from 1980 to 2020.
OUTCOME MEASURES
The present study measures pedicle screw accuracy, complication rates, proximal-facet joint violation, intraoperative radiation time, radiation dosage, and length of surgery.
RESULTS
A total of 1,525 patients (7,379 pedicle screws) from 19 studies with 777 patients (51.0% with 3,684 pedicle screws) in the robotic-assisted group were included. Perfect pedicle screw accuracy, as categorized by Gerztbein-Robbin Grade A, was significantly superior with robotic-assisted surgery compared to FH-technique (Odds ratio [OR]: 1.68, 95% confidence interval [CI]: 1.20-2.35; p=.003). Similarly, clinically acceptable pedicle screw accuracy (Grade A+B) was significantly higher with robotic-assisted surgery versus FH-technique (OR: 1.54, 95% CI: 1.01-2.37; p=.05). Furthermore, the complication rates and proximal-facet joint violation were 69% (OR: 0.31, 95% CI: 0.20-0.48; p<.00001) and 92% less likely (OR: 0.08, 95% CI: 0.03-0.20; p<.00001) with robotic-assisted surgery versus FH-group. Robotic-assisted pedicle screw implantation significantly reduced intraoperative radiation time (MD: -5.30, 95% CI: -6.83-3.76; p<.00001) and radiation dosage (MD: -3.70, 95% CI: -4.80-2.60; p<.00001) compared to the conventional FH-group. However, the length of surgery was significantly higher with robotic-assisted surgery (MD: 22.70, 95% CI: 6.57-38.83; p=.006) compared to the FH-group.
CONCLUSION
This meta-analysis corroborates the accuracy of robot-assisted pedicle screw placement.
Topics: Humans; Pedicle Screws; Robotic Surgical Procedures; Robotics; Spinal Fusion; Spine; Surgery, Computer-Assisted; Zygapophyseal Joint
PubMed: 32976997
DOI: 10.1016/j.spinee.2020.09.007 -
Arthroscopy : the Journal of... Dec 2020The purpose of this meta-analysis and systematic review was to critically evaluate the biomechanical outcomes of different fixation constructs for a variety of biceps... (Meta-Analysis)
Meta-Analysis
PURPOSE
The purpose of this meta-analysis and systematic review was to critically evaluate the biomechanical outcomes of different fixation constructs for a variety of biceps tenodesis techniques in cadaveric models based on both type of fixation and location.
METHODS
A PROSPERO-registered systematic review (CCRD42018109243) of the current literature was conducted with the terms "long head of biceps" AND "tenodesis" AND "biomechanics" and numerous variations thereof in the PubMed, Embase, and Cochrane databases, yielding 1,460 abstracts. After screening by eligibility criteria, 18 full-text articles were included. The individual biomechanical factors evaluated included ultimate load to failure (in newtons), stiffness (in newtons per millimeter), and cyclic displacement (in millimeters). After reviewing the included literature, we performed a quality analysis of the studies (Quality Appraisal for Cadaveric Studies scale score) and a meta-analysis comparing raw mean differences in data between the suprapectoral and subpectoral fixation location groups, as well as between the fixation construct groups.
RESULTS
Among the 18 included studies, 347 cadaveric specimens were evaluated for ultimate load to failure, stiffness, and cyclic displacement when comparing both location (suprapectoral vs subpectoral) and tenodesis fixation type (interference screw vs cortical button, suture anchor, or all-soft-tissue techniques). Interference screw fixation showed significantly greater mean stiffness by 8.0 N/mm (P = .013) compared with the other grouped techniques but did not show significant differences when evaluated for ultimate load to failure and cyclic displacement (P = .28 and P = .18, respectively). Additionally, no difference in construct strength was seen when comparing the fixation strength of suprapectoral versus subpectoral techniques for stiffness, ultimate load to failure, and cyclic loading (P = .47, P = .053, and P = .13, respectively).
CONCLUSIONS
In this meta-analysis, no significant biomechanical differences were found when the results were stratified by specific surgical technique (interference screw vs other tenodesis techniques) and location (suprapectoral vs subpectoral biceps tenodesis).
CLINICAL RELEVANCE
As a result of this study, when biomechanically evaluating specific tenodesis constructs, the individual clinician has the liberty of choosing the fixation technique based on his or her preference and knowledge of shortcomings of each type of fixation construct.
Topics: Arm; Biomechanical Phenomena; Bone Screws; Cadaver; Humans; Muscle, Skeletal; Suture Anchors; Tenodesis
PubMed: 32619605
DOI: 10.1016/j.arthro.2020.05.055