New complementary alternatives in third molar autotransplantation: A systematic review

Background: Dental autotransplantation (DAT) is defined as the replacement or direct transfer of an impacted, semi-impacted or erupted tooth to a donor site, either to a post-extraction socket or to a surgically created socket within the same individual. The use of new technological advances, such as 3-D dental models based on computer-aided design, among others, have been reported to improve the success rate of DAT. Therefore, we aimed to perform a systematic review to explore the possible benefits that the use of these innovative techniques can provide when applied to DAT. Material and Methods: The literature search was conducted in PubMed, Scopus, and Web of Science databases following the PRISMA guidelines. The research question was: "Are computerized technological advancements a useful tool for improving the success of third molar autotransplantation technique? Results: The initial literature search identified 195 articles, of which only 11 were included for qualitative analysis. All studies used 3D dental models based on computer-aided design data. Surgical guides and stereolithographic models were used by 4 and 1 study respectively. A total of 91 transplanted teeth were evaluated, out of which only 88 were considered within the parameters of clinical success (96.7%). Only 7 out of the 11 articles reported the specific autotransplanted tooth, being mandibular third molars the most prevalent autotransplanted teeth. Conclusions: Although the application of new technologies for DAT increases the success rate of this technique, further primary studies are still needed to address long-term teeth survival rates and complications. The cost and availability to implement the integration of these techniques to DAT may be a variable to consider, as this can be a limitation for some patients or for low-income countries. (AU)

Prophylactic therapy for prevention of surgical site infection after extraction of third molar: An overview of reviews

Background: To compare the effect of different prophylactic therapies on prevention of surgical site infection after extraction of third molars with different degree of impaction. Material and Methods: Systematic reviews and meta-analyses evaluating the effect of different prophylactic therapies on prevention of surgical site infection after extraction of third molars were included. An electronic search was performed in PubMed, EMBASE, and the Cochrane Database of Systematic reviews. AMSTAR 2 tool was used to evaluate the confidence in results from the included reviews. Descriptive analyses were performed. Results: Six reviews were included. A significant benefit of different antibiotics to the prevention of site infection after extraction of third molars was reported. Amoxicillin/amoxicillin clavulanic acid could significantly reduce the rate of surgical site infection versus placebo. Chlorhexidine gel could significantly reduce the frequency of alveolar osteitis versus placebo. Conclusions: Based on the limited evidence, there is a significant benefit of prophylactic therapy while the comparative effect of different types of prophylactic regimes are controversial. (AU)

Revisión sistemática y coste efectividad del tratamiento con abobotulinumtoxinA Para la espasticidad post-ictus en comparación con fisioterapia / Systematic review and cost-effectiveness analysis of the treatment of post-stroke spasticity with abobotulinumtoxinA compared to physiotherapy

Objective Post-stroke spasticity (PSS) is a common complication in stroke survivors, causing severe burden to patients living with it. The aim of this review was to conduct a cost-effectiveness analysis (CEA) of the treatment of post-stroke spasticity, in adults, with abobotulinumtoxinA compared to the best supportive care, based on results from a systematic literature review. Given that abobotulinumtoxinA (aboBoNT-A) is always accompanied by the best supportive care treatment, the CEA compared aboBoNT-A plus the best supportive care with the best supportive care alone. Methods A systematic literature review in EMBASE (including Medline and PubMed), Scopus, and other sources (Google Scholar) was conducted. Articles of all types, providing information on the costs and/or effectiveness measures for the current treatments of PSS in adults were included. The synthesis of information from the review provided the parameters for the design of a cost-effectiveness analysis of the mentioned treatment of interest. The societal perspective was compared to a perspective where only direct costs were observed. Results In total, 532 abstracts were screened. Full information was revised from 40 papers and 13 of these were selected as core papers for full data extraction. Data from the core publications formed the basis for the development of a cost-effectiveness model. In all the included papers physiotherapy was the best supportive care treatment (SoC)... (AU)

Antecedentes La espasticidad post-ictus es una enfermedad común que afecta a los adultos y causa una carga grave a los pacientes que la padecen. El objetivo de la revisión fue realizar un análisis coste-efectividad (ACE) del tratamiento de la espasticidad post-ictus, en adultos, con abobotulinumtoxinA (aboBoNT-A) en comparación con el tratamiento convencional, basado en los resultados de una revisión sistemática de la literatura. Dado que este tratamiento se proporciona siempre al mismo tiempo que el tratamiento convencional, el ACE se realizó del tratamiento aboBoNT-A con el tratamiento convencional, en comparación con recibir únicamente el tratamiento convencional. Métodos Se realizó una revisión sistemática de la literatura en EMBASE (incluyendo Medline y Pubmed), Scopus y otras fuentes (Google Scholar). Se incluyeron artículos de todo tipo que proporcionaran información sobre los costes y/o las medidas de efectividad de los tratamientos actuales del PSS en adultos. La síntesis de la información de la revisión proporcionó los parámetros para el diseño de un análisis coste-efectividad del mencionado tratamiento de interés. Se comparó la perspectiva social con una perspectiva donde solo se observaron los costes directos del tratamiento. Resultados Se revisaron un total de 532 resúmenes. Se revisó la información completa de 40 artículos y se seleccionaron 13 artículos para la extracción completa de datos. La información de estos documentos se sintetizó y utilizó para desarrollar un modelo de coste-efectividad. En todos los artículos incluidos se identificó el tratamiento con fisioterapia como el tratamiento convencional principal... (AU)

Bloqueo anestésico del nervio occipital mayor en el tratamiento de las cefaleas. Revisión de la evidencia / Greater occipital nerve block in the treatment of headaches. Review of evidence

Introducción Los bloqueos anestésicos de nervios pericraneales han constituido un tratamiento habitual de múltiples cefaleas. El más utilizado en la práctica clínica habitual y que cuenta con mayor evidencia que avale su efectividad es el bloqueo del nervio occipital mayor. Métodos búsqueda en Pubmed de Meta-Analysis/Systematic Review de los últimos 10 años, seleccionando para su revisión aquellos metaanálisis, y en su defecto revisiones sistemáticas, acerca del bloqueo del nervio occipital mayor en el tratamiento de las cefaleas. Resultados Se obtuvieron 95 trabajos, 13 incluyeron los criterios de inclusión. Conclusión El bloqueo del occipital mayor es una técnica eficaz y segura, fácil de realizar, y que ha mostrado su utilidad en migraña, cefalea en racimos, cefalea cervicogénica y pospunción lumbar. No obstante, hacen falta más estudios que aclaren su eficacia a largo plazo, su lugar en el tratamiento habitual, la posible diferencia entre diversos anestésicos, la posología más conveniente y el papel del uso concomitante de corticoides (AU)

Introduction Peripheral nerve blocks have been a common treatment for multiple headaches. By far, the greater occipital nerve block is the most used and with the stronger body of evidence in routine clinical practice. Methods We searched Pubmed Meta-Analysis/Systematic Review, in the last 10 years. Of these results, meta-analyses, and in the absence of these systematic reviews, assessing Greater Occipital Nerve Block in headache has been selected for review. Results We identified 95 studies in Pubmed, 13 that met the inclusion criteria. Conclusion Greater occipital block is an effective and safe technique, easy to perform and which has shown its usefulness in migraine, cluster headache, cervicogenic headache and Post-dural puncture headache. However, more studies are needed to clarify its long-term efficacy, its place in clinical treatment, the possible difference between different anaesthetics, the most convenient dosage and the role of concomitant use of corticosteroids (AU)

Atención farmacéutica y asma: protocolo de una revisión de revisiones sistemáticas / Pharmaceutical care and asthma: Protocol of an umbrella review of systematic reviews

Introducción las revisiones sistemáticas y metaanálisis recientes sugieren que las intervenciones por parte de farmacéuticos en pacientes asmáticos tienen un impacto positivo en resultados en salud. Sin embargo, la asociación no está bien establecida y el papel de los farmacéuticos clínicos está pobremente representado, así como el de los pacientes con asma grave. El objetivo de esta revisión de revisiones es identificar revisiones sistemáticas publicadas que evalúen el impacto de las intervenciones farmacéuticas en resultados en salud medidos en pacientes asmáticos, así como describir los componentes clave de las intervenciones, los resultados medidos y cualquier asociación entre las intervenciones farmacéuticas y los resultados en salud medidos. Métodos se hará una busqueda en PubMed, Embase, Scopus y la Cochrane Library desde el primer registro hasta diciembre de 2022. Se considerará la inclusión de revisiones sistemáticas de todo tipo de estudios primarios, severidad del asma o nivel asistencial que midan resultados en salud. La calidad metodológica se medirá usando A Measurement Tool to Assess Systematic Reviews 2. Dos investigadores independientes realizarán la selección de los estudios, la evaluación de la calidad y la extracción de datos. Cualquier discrepancia será solventada por un tercer investigador. Ambos resultados, narrativos y metaanálisis, de los estudios primarios incluidos en las revisiones sistemáticas serán sintetizados. Si los datos son apropiados para un análisis cuantitativo, las medidas de asociación se expresarán como cociente de riesgos y diferencia de medias. Discusión los primeros resultados del establecimiento de una red multidisciplinar para el manejo de los pacientes asmáticos mostraron beneficios en integrar los diferentes niveles asistenciales en el control de la enfermedad y la reducción de la morbilidad...(AU)

Introduction Recent systematic reviews and meta-analyses suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established and the role of clinical pharmacists is poorly represented, as well as severe asthma patients. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients, as well as to describe key components of the interventions, the outcomes assessed and any associations between pharmacists' interventions and health-related outcomes. Methods PubMed, Embase, Scopus and the Cochrane Library will be searched from inception to December 2022. Systematic reviews of all study designs, severity of asthma and level of care that measured health-related outcomes will be considered. Methodological quality will be assessed using A Measurement Tool to Assess Systematic Reviews 2. Two independent investigators will perform the study selection, quality assessment and data collection, any discrepancy will be solved by a third investigator. Both narrative findings and meta-analysis of primary study data included in the systematic reviews will be synthesized. If data are appropriate for quantitative synthesis, the measures of association will be expressed as the risk ratio and difference in means. Discussion The first results on the establishment of a multidisciplinary network for the management of asthmatic patients have shown the benefits of integrating different levels of care in disease control and morbidity reduction. Further studies showed benefits in hospital admissions, patients' basal oral corticosteroid dose, exacerbations and quality of life of asthma patients...(AU)

Revisiones sistemáticas en cinco pasos: V. Cómo interpretar la evidencia / Systematic reviews in five steps: V. Interpreting the findings

El último paso en una revisión sistemática es interpretar la evidencia de forma que pueda ser útil para sustentar la toma de resultados. Es importante presentar los resultados de forma claramente diferenciada, asignar el nivel de fuerza de la evidencia que respalda cada uno de ellos teniendo en cuenta factores como el diseño de los estudios, su calidad metodológica y el sesgo de publicación. También es necesario considerar las variaciones en la fuerza de la asociación. El objetivo es detectar en qué tipo de pacientes la intervención analizada será más o menos efectiva, tendrá mayor o menor impacto una exposición determinada, o será de mayor utilidad una prueba diagnóstica. En esta fase, para facilitar la interpretación de los resultados, se puede añadir una estimación de la magnitud de la asociación, bien global o bien estratificada en función de las características de los participantes. Toda esta información ayudará a la hora de formular recomendaciones prácticas con utilidad clínica. (AU)

The last step in a systematic review is the interpretation of the findings. The important findings need to be explicitly identified. A level of strength of evidence should be assigned to support each key finding, based on factors such as study design, methodological quality and risk of publication bias. Variations in the magnitude of associations observed also need to be explored. The aim of this analysis is to determine in which clinical groups the intervention is more or less effective, the impact of exposure is greater or lesser, or a diagnostic test is more useful. At this stage, for better interpretation of the findings, the magnitude of the association can be estimated either globally or stratified according to the characteristics of the participants. All this is helpful in formulating recommendations for clinical practice and policy. (AU)

Intervenciones para el carcinoma basocelular cutáneo (revisión Cochrane): Resumen de las principales comparaciones e interpretación práctica de los resultados / Interventions for Basal Cell Carcinoma: Summary of Main Comparisons From a Cochrane Review and a Practical Interpretation of Findings

Existen numerosas modalidades de tratamiento para el manejo de los carcinomas basocelulares (CBC), pero se desconoce la real eficacia y seguridad entre las alternativas quirúrgicas y no quirúrgicas disponibles. Este artículo resume la evidencia encontrada en la reciente revisión Cochrane de Thomson et al. y facilita la interpretación de sus resultados entre la comunidad científica iberolatinoamericana. La gran mayoría de la evidencia evaluada proviene de estudios individuales que impidieron la realización de una revisión sistemática cuantitativa. La escisión quirúrgica convencional continúa siendo la terapia más eficaz para el tratamiento de los CBC de bajo riesgo. La mayoría de estudios incluyeron tamaños de muestra pequeños y algunos tuvieron problemas con el cegamiento, lo que influiría en resultados subjetivos tales como el dolor o la cosmesis. Existe una falta de estandarización en relación con los desenlaces de recurrencia y de resultados cosméticos, lo que en conjunto afecta no solo la validez interna sino también la validez externa y la reproducibilidad de los estudios (AU)

Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility (AU)

[Translated article] Interventions for Basal Cell Carcinoma: Summary of Main Comparisons From a Cochrane Review and a Practical Interpretation of Findings / Intervenciones para el carcinoma basocelular cutáneo (revisión Cochrane): Resumen de las principales comparaciones e interpretación práctica de los resultados

Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility (AU)

Existen numerosas modalidades de tratamiento para el manejo de los carcinomas basocelulares (CBC), pero se desconoce la real eficacia y seguridad entre las alternativas quirúrgicas y no quirúrgicas disponibles. Este artículo resume la evidencia encontrada en la reciente revisión Cochrane de Thomson et al. y facilita la interpretación de sus resultados entre la comunidad científica iberolatinoamericana. La gran mayoría de la evidencia evaluada proviene de estudios individuales que impidieron la realización de una revisión sistemática cuantitativa. La escisión quirúrgica convencional continúa siendo la terapia más eficaz para el tratamiento de los CBC de bajo riesgo. La mayoría de estudios incluyeron tamaños de muestra pequeños y algunos tuvieron problemas con el cegamiento, lo que influiría en resultados subjetivos tales como el dolor o la cosmesis. Existe una falta de estandarización en relación con los desenlaces de recurrencia y de resultados cosméticos, lo que en conjunto afecta no solo la validez interna sino también la validez externa y la reproducibilidad de los estudios (AU)

Association and Interacting Factors between Bronchial Asthma and Attention-deficit Hyperactivity Disorder in Children: Meta-analysis and Systematic Review

Background: This study aims to systematically assess the possible link between bronchial asthma usage and attention-deficit hyperactivity disorder (ADHD) in children. Methods: PubMed, Web of Science, ScienceDirect, CNKI, Wanfang, and the China Biological Medicine Database (CBM) were searched for relevant articles published from database inception until September 28, 2023. The statistical analyses were conducted using Stata 15.1 software, followed by a quantitative meta-analysis to synthesize the results of the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: A total of 10 articles involving 729,375 participants were included in the meta-analysis. The overall analysis revealed a statistically significant association between ADHD and an increased likelihood of having bronchial asthma, as indicated by a pooled odds ratio (OR) of 1.46 and a 95% confidence interval (CI) ranging from 1.41 to 1.51, p < 0.001, I2 = 58%. Potential associated factors linking bronchial asthma and ADHD in children include demographic characteristics, healthcare access, socioeconomic factors, comorbidities, genetic susceptibility, immune dysregulation, chronic conditions, growth and development factors, and parental/environmental influences. Conclusion: This systematic review and meta-analysis presents convincing evidence for a notable link between bronchial asthma and ADHD in children. The results indicate an increased likelihood of bronchial asthma among children with ADHD compared to those without the condition. Additionally, various potential factors can underlie the association between bronchial asthma and ADHD in children, necessitating further research to fully comprehend their complex relationship. These findings have implications for clinical practice, highlighting the need for an integrated approach in managing asthma and ADHD.(AU)

The Depression Prevalence in Chinese Patients with Rheumatoid Arthritis: A Systematic Review and Meta-analysis

Background: The chronic course and recurring acute episodes of rheumatoid arthritis (RA) can significantly affect the psychological and mental health of patients. This study aimed to investigate the prevalence of depression in Chinese patients with rheumatoid arthritis (RA) through a systematic review and meta-analysis. Methods: We conducted a comprehensive literature search on electronic databases from the inception of the database to April 2023. The inclusion criteria included cross-sectional or case-control studies on depression prevalence with a sample size of at least 50 participants. The data was extracted from the included studies and analyzed to calculate the pooled depression prevalence, along with a 95% confidence interval (CI), using Review Manager 5.3 software (Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Results: Thirteen studies (n = 29,113) were included, with females accounting for over 50% of all participants. Based on the data pooled from all 13 studies, the observed depression prevalence in Chinese individuals with RA was 37% (95% CI: 28–46%; I2 = 95%; p < 0.0001). A subsequent subgroup analysis was conducted on scale types, age, and gender. Regarding scale types, the depression prevalence was assessed using various scales included the Hospital Anxiety and Depression Scale (HAMD), Hamilton Depression Scale (HADS), Center for Epidemiologic Studies Depression (CES-D) scale, Diagnostic and Statistical Manual of Mental Disorder (fourth edition DSM.IV) diagnostic criteria, and Self-rating Depression Scale (SDS) were 50%, 35%, 58%, 39%, and 41%, respectively...(AU)

Revisiones sistemáticas en cinco pasos: IV. Cómo sintetizar los resultados / Systematic reviews in five steps: IV. Summarizing the evidence

En este artículo, el cuarto de una serie de cinco sobre revisiones sistemáticas, se muestra cómo recopilar y resumir los resultados de los estudios incluidos en una revisión. La síntesis de los datos extraídos consiste en tabular las características y la calidad de los estudios incluidos, y resumir los efectos y la magnitud de las asociaciones encontradas. Opcionalmente pueden utilizarse métodos estadísticos para explorar la heterogeneidad y sus fuentes. La magnitud de la heterogeneidad puede plantear la duda de si es viable realizar un metaanálisis general o es preferible hacerlo en subgrupos. Por último, se proporcionan recursos para evaluar las razones clínicas y metodológicas de la heterogeneidad (AU)

This fourth in a series of five articles on systematic reviews demonstrates how to compile and summarize the results of the studies included in a review. The synthesis of the extracted data consists of tabulating the characteristics, and the quality of the included studies, with the effects or the magnitude of the associations found in them. Statistical methods can be used to explore the differences between studies and the reasons for the inconsistencies. The magnitude of this heterogeneity influences whether it is feasible to perform an overall or subgroup meta-analysis. Finally, information is provided both to assessment of clinical and methodological reasons for heterogeneity (AU)

Calidad de las revisiones sistemáticas de COVID-19 en personas con diabetes: una revisión sistemática / Quality of systematic reviews of COVID-19 in people with diabetes: A systematic review

Objetivo: Investigar la calidad metodológica de las revisiones sistemáticas publicadas sobre factores asociados con COVID-19 en personas con diabetes. Método: Revisión sistemática con protocolo de registro en PROSPERO, bajo el número CRD42020222418. Las búsquedas se realizaron de octubre a noviembre de 2020 en las bases de datos de las bibliotecas Medline, Web of Science, Scopus, LILACS, Embase y Cochrane Library, además de la búsqueda en la lista de referencias de los estudios seleccionados. Se incluyeron estudios de revisión sistemática con o sin metaanálisis y sin restricciones de fecha e idioma. Los datos se extrajeron de forma estandarizada y la calidad de los estudios se evaluó mediante la escala Assessment of Multiple Systematic Reviews. Resultados: Se incluyeron 12 revisiones, publicadas entre 2020 y 2021, con predominio del idioma inglés; son revisiones sistemáticas de estudios observacionales con metaanálisis con una muestra que va desde 6 a 83 estudios. En cuanto a la financiación, la mayoría de los estudios informaron que no recibieron este tipo de ayuda. En cuanto a la evaluación de la calidad metodológica, 3 fueron de calidad moderada, 5 fueron clasificados como de baja calidad y 3 revisiones sistemáticas fueron evaluadas como críticamente bajas. Conclusiones: Los artículos analizados presentaron un sesgo en la elaboración de informes sobre sus estudios, evidenciando la necesidad de utilizar mecanismos para mejorar la adherencia a los lineamientos de reporte establecidos y herramientas de evaluación metodológica.(AU)

Objective: To investigate the methodological quality of published systematic reviews of factors associated with COVID-19 in people with diabetes. Method: Systematic review with registration protocol in PROSPERO, under the number CRD42020222418. Searches were carried out from October to November 2020 in the databases of the Medline, Web of Science, Scopus, LILACS, Embase and Cochrane Library, in addition to searching the reference list of the selected studies. Systematic review studies with or without meta-analysis and without date and language restrictions were included. Data were extracted in a standardized way and the quality of the studies was assessed using the Assessment of Multiple Systematic Reviews scale. Results: Twelve reviews, published between 2020 and 2021, with a predominance of the English language, systematic reviews of observational studies with meta-analysis with a sample ranging from 6 to 83 studies, were included. Regarding financing, most of the study reported did not receive this type of support. Regarding to the assessment of the methodological quality of the studies, 3 were of moderate quality, 5 were classified as low quality and 3 with critically low quality. Conclusions: The analyzed articles presented a bias in the preparation of reports on their studies, suggesting the need to use mechanisms to improve adherence to the established reporting guidelines and methodological evaluation tools.(AU)