Efficacy and safety of ozone therapy for knee osteoarthritis: an umbrella review of systematic reviews.

The objective of this study is to evaluate the effectiveness and safety of ozone therapy (OT) in the treatment of knee osteoarthritis (KOA), which is the most common form of the disease. We analysed systematic reviews (SRs) of randomised controlled trials (RCTs) using the "A MeaSurement Tool to Assess systematic Reviews" (AMSTAR2) instrument to evaluate their quality. We developed a narrative synthesis report with eight SRs (15 RCTs/3,685 patients) to summarise the findings. The AMSTAR2 analysis indicated that all reviews had critically low confidence ratings. Statistically significant effects in pain reduction using OT compared to placebo groups were reported in three SRs. OT was shown to be comparable to other therapies in one SR and not superior in the other five. Six SRs highlighted the need for additional RCTs with improved methodological quality to confirm the efficacy of OT for KOA. SRs found fewer consistent effects for improving joint function. Regarding safety, seven SRs reported a low prevalence of minor adverse events linked with OT. Finally, this umbrella review highlights the beneficial effects and safety of OT in the treatment of KOA, particularly in pain control. The low methodological quality of RCTs and SRs limits the possibility of drawing conclusions on the effectiveness of the procedure in comparison to other therapies. Ensure adequate compliance with guidelines such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and AMSTAR2 has the ability to improve the quality of SRs in this area.

Assessment of social support and its association to depression, self-perceived health and chronic diseases in elderly individuals residing in an area of poverty and social vulnerability in rio de janeiro city, Brazil.

OBJECTIVES: Social support (SS) influences the elderly ability to cope with the losses of ageing process. This study was aimed at assessing SS among elderly users of a primary healthcare unit in a poor and violent area of Rio de Janeiro City, and at verifying its association with depression, self-perceived health (SPH), marital status and chronic illnesses. METHODS: A cross-sectional study was performed based on a convenience sample of 180 individuals aged 60 years or older. SS was measured with part of the Brazilian version of Medical Outcomes Study's SS scale, and SPH and depression were assessed, respectively, through one question and the Brazilian version of the Structured Clinical Interview for DSM-IV Axis I Disorders. SS medians were calculated for the categories of SPH, depression, marital status and chronic illnesses variables, and differences were evaluated with the Kruskal-Wallis and Mann-Whitney tests. Additionally, Pearson's chi-square test and logistic regression were employed to identify unadjusted and adjusted associations between SS and those variables. RESULTS: The participant's mean age was 73 years old, and level of education was 3 years of school education on average. They were predominantly females (73.3%), and non-married (55.0%). Among them, 74.4% perceived their SS as satisfactory, 55.0% perceived their health as good, 27.8% were diagnosed with major depression and 83.3% had hypertension. Especially for those depressed and with bad SPH, the medians of SS measure were much lower than for others, reaching an unsatisfactory level. Moreover, controlling for other factors, non-depressed individuals were more likely (OR = 2.32) to have satisfactory SS. CONCLUSION: in the violent and poor area explored in this research low SS is highly prevalent in the elderly. Depressed individuals are more likely to have low SS and this condition should be investigated in depressed elderly. The reduced scale is useful for low education individuals.