Treatment of Childhood Brucellosis: A Systematic Review.

BACKGROUND: Proper treatment for brucellosis is crucial to eradicate the infection and prevent complications, but there is a notable gap in evidence for pediatric treatment. This study aims to address this gap by reviewing current literature, analyzing the efficacy and safety of brucellosis treatment in children, and identifying areas that require further investigation. METHODS: A systematic review, following preferred reporting items for systematic reviews and meta-analyses and Cochrane Handbook guidelines, assessed antimicrobial regimens' efficacy and safety for treating human brucellosis in children. Original human studies with clinical outcomes after drug therapy intervention for children up to 10 years were included. Searches were conducted in Medline, Embase, Cochrane Library and LILACS databases for studies indexed until March 6, 2023. Study selection, data extraction, and bias risk assessment were performed by pairs of reviewers. The quality assessment used Joanna Briggs Institute tools and grading of recommendations assessment, development and evaluation system. Data were analyzed using R software. RESULTS: A total of 1773 records were reviewed, yielding 11 eligible studies encompassing 1156 children. All included studies presented an observational design. The most reported treatment approaches included sulfamethoxazole-trimethoprim with rifampicin or aminoglycosides, with summarized failure rates of 2% (95% confidence interval: 0.0-0.49) and 13% (95% confidence interval: 0.06-0.29), respectively (very low certainty of evidence). Adverse events and time to defervescence were not reported. CONCLUSIONS: Sulfamethoxazole-trimethoprim + rifampicin were the most prescribed antibiotics for brucellosis for pediatrics. The study highlights the need for more research with robust designs, and emphasizes uncertainty regarding the efficacy of antimicrobial regimens, emphasizing the importance of further investigations to guide specific treatment protocols for this population.

Tenosynovial giant cell tumor: Case report and molecular investigation.

Tenosynovial giant cell tumor is a benign neoplasm arising from the synovium of joints, including the temporomandibular joint (TMJ). Despite its benign nature, these tumors may exhibit aggressive behavior. A 57-year-old woman with a swollen, hardened area in the left TMJ was referred to the university´s clinic. The diagnosis of tenosynovial giant cell tumor was made based on the presence of hyperplastic synovial lining containing mononuclear and giant cells, hemorrhagic areas, hemosiderin deposits, and calcification foci in the biopsy. A low condylectomy was performed, and histopathologic analysis of the surgical piece upheld the diagnosis. Due to histopathologic resemblance with other giant cell-rich lesions (giant cell granuloma of the jaws, brown tumor of hyperparathyroidism, and non-ossifying fibroma) for which signature mutations are known, mutational analysis of KRAS, FGFR1, and TRPV4 genes was conducted. The results revealed wild-type sequences for all the mutations tested, thereby supporting the diagnosis of tenosynovial giant cell tumor.

Efficacy and safety of therapeutic strategies for human brucellosis: A systematic review and network meta-analysis.

BACKGROUND: Human brucellosis is a neglected, re-emerging, and endemic zoonosis in many countries. The debilitating and disabling potential of the disease is a warning about its morbidity, generating socioeconomic impact. This review aims to update the current evidence on the efficacy and safety of therapeutic options for human brucellosis using the network meta-analysis (NMA). METHODOLOGY: A systematic search was conducted in four different databases by independent reviewers to assess overall therapy failure, adverse events, and time to defervescence associated with different therapies. Randomized clinical trials (RCTs) evaluating any therapeutic drug intervention were selected, excluding non-original studies or studies related to localized forms of the disease or with less than 10 participants. Data were analyzed by frequentist statistics through NMA by random effects model. The risk of bias and certainty of evidence was assessed, this review was registered at PROSPERO. RESULTS: Thirty-one (31) RCTs involving 4167 patients were included. Three networks of evidence were identified to evaluate the outcomes of interest. Triple therapy with doxycycline + streptomycin + hydroxychloroquine for 42 days (RR: 0.08; CI 95% 0.01-0.76) had a lower failure risk than the doxycycline + streptomycin regimen. Doxycycline + rifampicin had a higher risk of failure than doxycycline + streptomycin (RR: 1.96; CI 95% 1.27-3.01). No significant difference was observed between the regimens when analyzing the incidence of adverse events and time to defervescence. In general, most studies had a high risk of bias, and the results had a very low certainty of evidence. CONCLUSIONS: This review confirmed the superiority of drugs already indicated for treating human brucellosis, such as the combination of doxycycline and aminoglycosides. The association of hydroxychloroquine to the dual regimen was identified as a potential strategy to prevent overall therapy failure, which is subject to confirmation in future studies.

Does cyanoacrylate have the best postoperative outcomes after third molar extractions when compared to conventional sutures? A systematic review and meta-analysis.

Purpose: Tissue synthesis is extremely important for the attenuation of postoperative discomforts, as it keeps the tissues coapted, accelerates the healing process, and reduces the bleeding period of the surgical wound. Thus, this study aimed to systematically review the results of clinical trials that compared the use of cyanoacrylate with conventional sutures after third molars extraction. Materials and methods: Searches were conducted on MEDLINE (via PubMed), Cochrane Central Registry of Controlled Trials (CENTRAL), Virtual Health Library (VHL), and Web of Science. Articles published up to February 20, 2022, were included. No restrictions were imposed on data or language of publication. Results: A total of 8 studies (5 randomized controlled trials and 3 non-randomized comparative clinical studies) were included in this review and five studies were included in the meta-analysis, comprising 440 patients. The use of cyanoacrylate promoted better results in pain reduction in the first postoperative day when compared to the use of conventional suture (SMD: -1.01; 95%CI -1.90 to -0.12). Cyanoacrylate group promoted significant but borderline edema reduction compared to conventional sutures in the 7th postoperative day (SMD: -0.24, 95%CI -0.46 to -0.01, I2 = 0 %). For the trismus outcome, in all periods evaluated no differences were found between the groups. Conclusion: Although promising results, there is no high-quality evidence to suggest the use of cyanoacrylate was better than conventional sutures.

Top 100 Most-Cited Articles on Mandibular Fractures: A Bibliometric Analysis.

PURPOSE: This study aimed to compile a list of the 100 most cited articles on mandibular fractures and to glean key insights from these articles via a bibliometric analysis. METHODS: This bibliometric analysis was performed using the Web of Science Core Collection database. The search was performed through January 2022. The bibliometric parameters extracted included title, number of citations, citation density (number of citations per year), first author's country, year of publication, study design, and subject. The software program VOSviewer was used to create graphical bibliometric maps. RESULTS: The articles were ranked by the total number of citations, which ranged from 64 to 374, with 32 articles being cited more than 100 times. The included articles were published from 1952 to 2015, mainly in maxillofacial surgery journals. The most frequent of these were the Journal of Oral and Maxillofacial Surgery (54%) and the International Journal of Oral and Maxillofacial Surgery (14%). The studies were from 29 different countries, with the United States of America (42%) contributing substantially more than others, with the next ranked nation being Germany (9%). The most frequently used keywords were osteosynthesis (25), open reduction (18), and fixation (16). CONCLUSIONS: The country that contributed most to mandibular fracture research was the United States of America. This conclusion was based on the number of published articles by nation of origin and the origin of the Journal of Oral and Maxillofacial Surgery, in which the majority were published. Osteosynthesis was the most cited field of research among the articles in the sample set.

Oral and maxillofacial trauma in women assaulted by men: Systematic review and meta-analysis.

BACKGROUND: Violence against women represents an urgent public health problem and has been an increasingly important topic in society's discussions and concerns. Although studies report a high prevalence of injuries to the face and head of women victims of intentional violence, this physical damage has never been investigated by grouped studies. Thus, the objective of this systematic review was to research the characteristics and the overall prevalence of oral-maxillofacial trauma in women victims of physical violence caused by men. METHODS: Searches were carried out on Medline (via PubMed) and Lilacs (via Virtual Health Library) and on gray literature until June 16, 2020 (updated on February 12, 2021) without restriction on the year of publication or language. RESULTS: A total of 27 studies involving 9,318 women victims of aggression by men and 3,738 oral-maxillofacial traumas were included. The prevalence of oral-maxillofacial trauma among all injuries in women was 51% (95% CI 28% - 74%). There was no significant difference in the chance of occurrence between soft tissue injuries (bruises, lacerations, abrasions, edema, erythema, and epistaxis) and hard tissue injuries (OR: 1.44, 95% CI: 0.43 - 4.80). The relationship between the victims and the aggressors was mainly that of intimate partners and relatives. CONCLUSIONS: These results highlight the need for political and ethical reflection to prevent oral-maxillofacial trauma and ensure women's health and human rights.

Does watching an informative video reduce the anxiety in patients undergoing third molar surgery: a systematic review of randomized controlled trials.

PURPOSE: Dental anxiety (DA) is characterized by the expression of tension, stress, apprehension, irritation, anger, and frustration experienced by patients during dental appointment. The objective of this study was to systematically review the literature to assess the effectiveness of the use of informative videos in reducing DA in patients undergoing 3 M surgeries. METHODS: Searches were carried out on MEDLINE (via PubMed), the Cochrane Central Registry of Controlled Trials (CENTRAL), the Virtual Health Library (VHL), and the Web of Science. Articles published until November 20, 2021, were included. There were no restrictions on the data or language of publication. RESULTS: A total of 9 randomized clinical trials were included in this review, and five studies were included in the meta-analysis, comprising 529 patients. There was no significant difference in DA between the groups in the baseline when it was evaluated by any of the tools, indicating sample balancing at the beginning of the study. After intervention (video vs. verbal and/or written orientation) in the preoperative period, DA was assessed again; however, there was no difference in DA between the groups when assessed by the MDAS or STAI-S tools. After 3 M removals, the DA was still not significantly different between the groups when measured by the different considered tools. CONCLUSION: Informative videos addressing 3 M removal surgeries used in the preoperative period did not show an influence on the reduction of pre- and postoperative DA when compared to the verbal and/or written informative presentation.

Does kinesio taping reduce pain, swelling, and trismus after mandibular third molar surgery? A systematic review and meta-analysis.

The aim of this study is to provide an evidence-based conclusion regarding the effectiveness of kinesio taping (KT) in reducing postsurgical discomforts after mandibular third molar surgery and critically appraise the available literature. Eligible clinical trials evaluating patients older than 18 years who were treated with any type of KT compared to no taping in which pain, swelling, or trismus scores were reported were included. An electronic literature search was carried out in the following databases to identify relevant papers up to May 30, 2021: Medline, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2.0). The effect sizes were calculated using mean difference (MD) and standardized mean difference (SMD). The heterogeneity analysis was conducted using (I2) statistic at alpha = 0.10 (PROSPERO; CRD42021252670). Nine randomized clinical trials with 444 participants were included in the qualitative analysis and eight in the quantitative analysis. The results of the meta-analysis revealed a statistically significant reduction in pain and swelling scores before the 7th postoperative day. On the 7th postoperative day, no significant difference was observed between KT and control groups in terms of pain and swelling. Additionally, KT led to an increase in patients' maximum mouth opening of more than 3 mm in postoperative intervals. KT is effective in reducing postoperative pain within the first 48 h after surgery and improving mouth opening during all postoperative intervals with moderate to high certainty of evidence.