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Immunity, Inflammation and Disease Feb 2024There has been a global increase in the use of electronic cigarettes (EC). However, to our knowledge, no review has summarized or categorized changes in inflammatory... (Meta-Analysis)
Meta-Analysis
CONTEXT
There has been a global increase in the use of electronic cigarettes (EC). However, to our knowledge, no review has summarized or categorized changes in inflammatory biomarkers after EC use in the extant literature.
OBJECTIVE
To evaluate changes in general, cardiopulmonary, and oxidative stress-related inflammatory biomarkers in healthy adults who use ECs.
METHODS
A scoping review was conducted according to the Arksey and O'Malley framework. PubMed and MEDLINE (Ovid) databases were used for our search. After initial pilot searches and discussions, we performed a final search with medical subject headings and plain language terms related to inflammation, biomarkers, ECs, and adult humans. All full-text articles, gray literature, and primary studies dating from the inception of the searched databases to the present were included. Studies of human participants with known confounding medical histories were excluded.
RESULTS
Thirty-seven studies met the inclusion criteria. After short-term (<1 month) use, ECs containing nicotine moderately increased cardiovascular (CV) and oxidative stress markers of inflammation. Of all reported results, 50% of CV biomarkers were increased, and 64% of oxidative stress markers were increased. After long-term (>1 month) use, ECs containing nicotine produced mixed results. Two commonly measured biomarkers in this group, matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6), were elevated in 75% and 60% of measured instances, respectively.
CONCLUSION
The results of studies evaluated in our scoping review suggested that short-term use of nicotine-containing ECs may result in increased CV and oxidative stress inflammation, contributing to potential CV or neurologic disease development. The results of studies evaluated in our scoping review also suggested that long-term use of nicotine-containing ECs resulted in no significant changes in general inflammatory biomarker levels. A rigorous systematic review and meta-analysis is necessary to corroborate our findings and to determine the effect of long-term EC use on MMP-9 and IL-6 levels.
Topics: Adult; Humans; Biomarkers; Electronic Nicotine Delivery Systems; Inflammation; Interleukin-6; Matrix Metalloproteinase 9; Nicotine; Vaping
PubMed: 38353387
DOI: 10.1002/iid3.1170 -
European Journal of Obstetrics,... Dec 2023Botulinum toxin (BoNT) administration has been proposed in the gynecologic field for pelvic, vulvar and vaginal disorders. On this regard, we aimed assessing the... (Review)
Review
INTRODUCTION
Botulinum toxin (BoNT) administration has been proposed in the gynecologic field for pelvic, vulvar and vaginal disorders. On this regard, we aimed assessing the therapeutic effectiveness and safety of BoNT usage in the treatment of vaginal, vulvar and pelvic pain disorders.
METHODS
We searched for all the original articles without date restriction until 31.12.2021. We included all the original articles which administered botulinum toxin in the vulva or vagina of women suffering from vaginismus, dyspareunia, and chronic pelvic pain. Only English language studies and those performed in humans were eligible. We excluded all case reports and pilot study from the qualitative analysis, although we accurately evaluated them. 22 original studies were finally included in the systematic review.
RESULTS
Botulinum toxin injection was found to be effective in improving vulvar and vaginal dyspareunia, vaginismus, and chronic pelvic pain. No irreversible side effects were detected. Major side effects reported were transient urinary or fecal incontinence, constipation and rectal pain. The risk of bias assessment proved original articles to be of medium quality. No metanalysis could have been performed since lack of congruency in the definition of pathology and methods of botulinum toxin administration.
CONCLUSION
Data extraction pointed out different endpoints and different methods of analysis. Studies focus on different types of participants and use various techniques and timing. According to the best evidence available, different techniques provide evidence about positive outcomes, with the need for a standardized protocol.
Topics: Female; Humans; Dyspareunia; Vaginismus; Pilot Projects; Botulinum Toxins; Vulva; Pelvic Pain; Chronic Pain; Pelvic Floor; Vagina; Botulinum Toxins, Type A
PubMed: 38353087
DOI: 10.1016/j.ejogrb.2023.10.028 -
Ophthalmic Plastic and Reconstructive...This meta-analysis aimed to evaluate the safety and efficacy of abobotulinumtoxinA (ABO) and ABO solution for injection (ASI) for treating moderate-to-severe glabellar... (Meta-Analysis)
Meta-Analysis
PURPOSE
This meta-analysis aimed to evaluate the safety and efficacy of abobotulinumtoxinA (ABO) and ABO solution for injection (ASI) for treating moderate-to-severe glabellar lines.
METHODS
The EMBASE, PubMed, and web of science databases were systematically searched. Methodological quality was checked using the Cochrane Risk of Bias tool. We also performed statistical analyses using Stata software to examine the efficacy and safety of ABO.
RESULTS
Nine randomized controlled trials were included in the meta-analysis. The results showed that at maximum frown, the proportion of responders as measured by the investigator's live assessment and subject's self-assessment of moderate-to-severe glabellar lines were significantly higher in the ABO and ASI treatment groups than in the placebo group. In addition, from baseline to maximum frown, the ≥1-grade improvement rate in moderate-to-severe glabellar lines severity was also significantly higher in the ABO and ASI treatment groups than in the placebo group. No significant differences in adverse events were found between ABO, ASI and placebo groups, indicating that ABO and ASI have good safety.
CONCLUSIONS
ABO and ASI are effective and safe options for the treatment of moderate-to-severe glabellar lines. More high-quality studies are needed to verify these conclusions.
Topics: Humans; Botulinum Toxins, Type A; Databases, Factual; Software
PubMed: 38319153
DOI: 10.1097/IOP.0000000000002491 -
BMC Neurology Feb 2024Cervical dystonia is a movement disorder typically characterized by a patterned and twisting movement of sustained or intermittent muscle contractions. Recently, new... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cervical dystonia is a movement disorder typically characterized by a patterned and twisting movement of sustained or intermittent muscle contractions. Recently, new clinical trials are emerging, highlighting the potential benefit of physiotherapy (PT) on disease outcomes. Thus, the objective of this review is to update the effectiveness of PT on cervical dystonia disease outcomes and subsequently perform a meta-analysis.
METHODS
Interventional studies published in English with adult patients with isolated cervical dystonia following a physiotherapy program were included. Relevant articles were searched in PubMed (MEDLINE), Web of Science, and Scopus. Cochrane and Joanna Briggs Institute risk of bias checklists were used for quality reporting. Meta-analysis was done using Review Manager 5.3 statistical software and a pooled mean difference for pain was presented.
RESULTS
Fourteen articles were included in the review and two articles were included in the meta-analysis. The meta-analysis revealed that PT intervention had a significant effect on pain reduction scale (-5.00, 95% CI -6.26, -3.74) when used as an additional therapy with botulinum toxin (BoNT) injection. Additionally, findings indicate a possible positive effect of PT disease severity, disability, and quality of life.
CONCLUSIONS
Physiotherapy in addition to BoNT is recommended to decrease pain. The findings suggest a reduction of disease severity, disability, and improvement in quality of life. The variety in the type and duration of PT interventions did not allow a clear recommendation of a specific type of PT.
Topics: Adult; Humans; Torticollis; Quality of Life; Botulinum Toxins; Dystonic Disorders; Pain; Physical Therapy Modalities
PubMed: 38302911
DOI: 10.1186/s12883-023-03473-3 -
The Laryngoscope Jul 2024Sialorrhea, also known as drooling, hypersalivation, or ptyalism, has a significant impact on the medical and psychosocial well-being of children. Onabotulinum toxin A... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Sialorrhea, also known as drooling, hypersalivation, or ptyalism, has a significant impact on the medical and psychosocial well-being of children. Onabotulinum toxin A (BoNT-A) is the most commonly used botulinum toxin worldwide for the treatment of sialorrhea in children.
OBJECTIVES
To conduct a comprehensive systematic review and meta-analysis to assess the clinical efficacy and potential adverse effects of BoNT-A as a treatment for drooling in children.
METHODS
Cochrane, Embase, and Medline databases were systematically searched (up to May 2023). Out of 535 identified publications, 20 were found eligible for inclusion. A systematic review and meta-analysis were performed to determine the efficacy of BoNT-A treatment in children in reducing the frequency and severity of drooling.
RESULTS
Out of the 20 studies included, a meta-analysis was conducted on the complete dataset of eight studies involving 131 patients. BoNT-A was found to significantly decrease the severity of drooling in patients with sialorrhea (standardized mean difference [SMD], -2.07; 95% confidence interval [CI], -2.91 to -1.23; p < 0.0001) when compared with the conditions before injections using random-effects models. Six studies out of 20 reported dysphagia as an adverse effect after injection. Other side effects included thickness of saliva and pain at the site of injection.
CONCLUSION
BoNT-A is a clinically effective therapy that improves drooling severity in children with sialorrhea. Although there were some adverse side effects reported, they were transient and not severe. Future studies are needed to further evaluate the best techniques and to identify the ideal dosages required to achieve the optimal outcomes. Laryngoscope, 134:3012-3017, 2024.
Topics: Humans; Sialorrhea; Botulinum Toxins, Type A; Child; Neuromuscular Agents; Treatment Outcome; Child, Preschool; Adolescent; Male; Female
PubMed: 38294288
DOI: 10.1002/lary.31277 -
BJOG : An International Journal of... Jul 2024Studies on the changes of extracellular matrix (ECM) in pelvic organ prolapse (POP) are still controversial. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Studies on the changes of extracellular matrix (ECM) in pelvic organ prolapse (POP) are still controversial.
OBJECTIVE
To identify the changes in the ECM in POP patients.
SEARCH STRATEGY
Comprehensive searching in Embase, PubMed, Web of Science and the Cochrane Library was carried out until 23 February 2023.
SELECTION CRITERIA
Studies comparing the protein levels of ECM-related components between women with and without POP.
DATA COLLECTION AND ANALYSIS
Quality and risk of bias were assessed using the Agency for Healthcare Research and Quality assessment. Indicators were pooled with random or fixed effect meta-analysis based on heterogeneity and sub-grouped analysed by the biopsy site.
MAIN RESULTS
Thirty cross-sectional studies were included, comprising 840 POP cases and 755 controls. Overall results showed that the expression of type III collagen (COLIII) and several matrix metalloproteinases (MMP-1, -2 and -9) were increased, whereas those of type I collagen (COLI), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were decreased in patients with POP. Subgroup analysis showed that the expression of COLIII in the anterior vaginal wall (AVW) and COLIII, MMP-2 and -9 in the uterosacral ligament (USL) were consistent with the overall results. However, the expression of COLI and MMP-1 in the AVW showed no difference and the expression of COLI and MMP-1 in the USL is still controversial based on current studies.
CONCLUSIONS
Patients with POP have lower expression of COLI and TIMP-1 and higher expression of COLIII and MMPs compared with non-POP cases, but further studies are required to investigate in specified anatomical sites.
Topics: Humans; Female; Pelvic Organ Prolapse; Extracellular Matrix; Collagen Type III; Vagina; Collagen Type I; Tissue Inhibitor of Metalloproteinase-1; Matrix Metalloproteinases; Cross-Sectional Studies
PubMed: 38291948
DOI: 10.1111/1471-0528.17768 -
Annals of Plastic Surgery Jan 2024Keloids are common benign skin lesions originating from a disorganized fibroproliferative collagen response; these lesions often lead to both physical and psychological... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Keloids are common benign skin lesions originating from a disorganized fibroproliferative collagen response; these lesions often lead to both physical and psychological problems. The optimal treatment for keloids is yet to be standardized. Intralesional injection, which is simple and nontraumatic, is one of the most commonly used treatment modalities for these lesions. In this study, we compared 5 different drugs (intralesional injections) for the treatment of keloids in terms of efficacy.
METHODS
We systemically searched relevant studies on PubMed, EMBASE, and Cochrane Library. Randomized clinical trials on the safety and efficacy of triamcinolone acetonide (TAC), 5-fluorouracil (5-FU), botulinum toxin A (BTA), verapamil, and bleomycin were included in this study.
RESULTS
This network meta-analysis included a total of 1114 patients from 20 randomized controlled trials. Botulinum toxin A alone and TAC plus 5-FU exhibited significantly better efficacy than did 5-FU, TAC, and verapamil. No significant difference in efficacy between BTA alone and TAC combined with 5-FU was observed. No significant differences were noted in the adverse event rate between BTA, TAC plus 5-FU, 5-FU, and TAC. Furthermore, we performed surface under the cumulative ranking curve analyses to predict the rank of each intervention (by efficacy and adverse event rate). The predicted ranking by efficacy was as follows: TAC plus 5-FU, BTA, bleomycin, TAC, 5-FU, and verapamil; the predicted ranking by adverse events was as follows: TAC, 5-FU, TAC plus 5-FU, and BTA. Funnel plot analysis revealed no publication bias.
CONCLUSIONS
Botulinum toxin A and TAC plus 5-FU appear to have outstanding therapeutic efficacy for keloids. The rate of adverse events was similar among BTA, TAC, 5-FU, and TAC plus 5-FU. Nonetheless, additional reviews of rigorous, large-scale randomized controlled trials are warranted for further validation of our findings.
Topics: Humans; Keloid; Botulinum Toxins, Type A; Network Meta-Analysis; Drug Therapy, Combination; Treatment Outcome; Fluorouracil; Injections, Intralesional; Bleomycin; Verapamil; Randomized Controlled Trials as Topic
PubMed: 38285997
DOI: 10.1097/SAP.0000000000003759 -
Biomolecules Jan 2024Metalloproteinases (MPs) are zinc-dependent enzymes with proteolytic activity and a variety of functions in the pathophysiology of human diseases. The main objectives of... (Review)
Review
Metalloproteinases (MPs) are zinc-dependent enzymes with proteolytic activity and a variety of functions in the pathophysiology of human diseases. The main objectives of this review are to analyze a specific family of MPs, the matrix metalloproteinases (MMPs), in the most common chronic and complex diseases that affect patients' social lives and to better understand the nature of the associations between MMPs and the psychosocial environment. In accordance with the PRISMA extension for a scoping review, an examination was carried out. A collection of 24 studies was analyzed, focusing on the molecular mechanisms of MMP and their connection to the manifestation of social aspects in human disease. The complexity of the relationship between MMP and social problems is presented via an interdisciplinary approach based on complexity paradigm as a new approach for conceptualizing knowledge in health research. Finally, two implications emerge from the study: first, the psychosocial states of individuals have a profound impact on their overall health and disease conditions, which implies the importance of adopting a holistic perspective on human well-being, encompassing both physical and psychosocial aspects. Second, the use of MPs as biomarkers may provide physicians with valuable tools for a better understanding of disease when used in conjunction with "sociomarkers" to develop mathematical predictive models.
Topics: Humans; Biomarkers; Proteolysis; Physicians; Zinc; Matrix Metalloproteinases
PubMed: 38254696
DOI: 10.3390/biom14010096 -
Toxins Dec 2023Botulinum toxin (BoNT) is an effective and safe therapy for the symptomatic treatment of several neurological disturbances. An important line of research has provided... (Review)
Review
Botulinum toxin (BoNT) is an effective and safe therapy for the symptomatic treatment of several neurological disturbances. An important line of research has provided numerous pieces of evidence about the mechanisms of action of BoNT in the central nervous system, especially in the context of dystonia and spasticity. However, only a few studies focused on the possible central effects of BoNT in Parkinson's disease (PD). We performed a systematic review to describe and discuss the evidence from studies focused on possible central effects of BoNT in PD animal models and PD patients. To this aim, a literature search in PubMed and SCOPUS was performed in May 2023. The records were screened according to title and abstract by two independent reviewers and relevant articles were selected for full-text review. Most of the papers highlighted by our review report that the intrastriatal administration of BoNT, through local anticholinergic action and the remodulation of striatal compensatory mechanisms secondary to dopaminergic denervation, induces an improvement in motor and non-motor symptoms in the absence of neuronal loss in animal models of PD. In human subjects, the data are scarce: a single neurophysiological study in tremulous PD patients found that the change in tremor severity after peripheral BoNT administration was associated with improved sensory-motor integration and intracortical inhibition measures. Further clinical, neurophysiological, and neuroimaging studies are necessary to clarify the possible central effects of BoNT in PD.
Topics: Animals; Humans; Parkinson Disease; Central Nervous System; Disease Models, Animal; Tremor; Botulinum Toxins
PubMed: 38251226
DOI: 10.3390/toxins16010009 -
Dermatologic Surgery : Official... Apr 2024Flushing is a common dermatologic complaint and can be resistant to many treatments. As the utility of botulinum toxin continues to expand, recent data suggest that it... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Flushing is a common dermatologic complaint and can be resistant to many treatments. As the utility of botulinum toxin continues to expand, recent data suggest that it may also be a therapeutic option for flushing.
OBJECTIVE
To evaluate the efficacy of botulinum toxin for the treatment of cutaneous flushing.
MATERIALS AND METHODS
A systematic search of Medline, Embase, Cochrane CENTRAL, CINAHL, Scopus, and Web of Science databases was conducted to identify studies evaluating the effect of botulinum toxin on flushing 1 month after treatment. Prespecified outcome measures included a clinical flushing score, dermatology life quality index (DLQI), and erythema index (EI). Meta-analysis was performed to calculate the mean differences in these outcomes before and after treatment at 1-month follow-up.
RESULTS
Nine studies (132 patients) were included in the analysis of this study (2 randomized controlled trials and 7 nonrandomized studies). All studies had a low risk of bias (high quality). The most frequent outcome reported was a clinical flushing score, which significantly decreased by 1.25 points overall (95% confidence interval [CI]: -2.47; -0.04) 1 month after treatment with botulinum toxin. Mean DLQI scores decreased (i.e., improved) by 9.02 points (95% CI: -19.81; 1.77) 1 month after botulinum toxin injections. The EI (measured by Mexameter) before and after botulinum toxin was evaluated in 2 studies; however, not enough statistical information was provided to analyze with meta-analytic techniques.
CONCLUSION
Based on this meta-analysis, botulinum toxin significantly improves clinical flushing scores 1 month after treatment.
Topics: Humans; Administration, Cutaneous; Botulinum Toxins, Type A; Erythema; Flushing; Neuromuscular Agents; Randomized Controlled Trials as Topic; Non-Randomized Controlled Trials as Topic
PubMed: 38232350
DOI: 10.1097/DSS.0000000000004073