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1.
Artículo en Inglés | MEDLINE | ID: mdl-38648000

RESUMEN

PURPOSE OF REVIEW: Laser acupuncture (LA) demonstrates promising results in the treatment of musculoskeletal disorders. However, its effects on temporomandibular disorder (TMD) are not yet fully understood. Thus, the aim of this systematic review and network meta-analysis was to assess the effectiveness of LA on pain intensity and maximum mouth opening range (MMO) related to TMD. A search was carried out in 11 electronic databases and references of included studies to locate randomized clinical trials (RCTs) that evaluated LA as a primary treatment for TMD. The risk of bias was assessed using the RoB 2 tool. Network meta-analysis was conducted on the MetaInsight platform, considering the pain intensity and counseling (C) as the outcome of reference. The GRADE system was used to assess the certainty of the evidence. RECENT FINDINGS: Five studies evaluated pain intensity, four with a high risk of bias and one with a low risk. Two studies evaluated pain intensity on palpation (one with high and one with low risk of bias), and one study with high risk of bias evaluated MMO. Laser parameters were: 690-810 nm, 40-150 mW, and 7.5-112.5 J/cm2. Occlusal splint (OS) [- 2.47; CI 95% - 3.64, - 1.30] and Physiotherapy (PT) [-2.64; CI 95% - 3.94, - 1.34] reduced pain intensity compared to C. The ranking of treatments in order of effectiveness was PT > OS > LA > C > CR (craniopuncture). The certainty of the evidence was very low or low. The data do not support the indication of LA for the treatment of TMDs and new placebo-controlled RCTs must be conducted to demonstrate its effectiveness more precisely.

2.
Int J Dev Neurosci ; 84(4): 265-280, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38526313

RESUMEN

Social isolation (SI) is related to adverse neurobehavioral effects and neurochemical changes when it occurs early in development. On the other hand, environmental enrichment (EE) is associated with a reduction in anxiety-like and depression-like behavior, as well as an increase in serotonin (5-HT) levels in the prefrontal cortex and hippocampus in rodents. This study systematically reviewed the effects of SI and EE on emotional behavior and serotonergic system components in rats after weaning. Primary experimental studies that used subgroups of rats subjected to SI, EE, and normal social conditions after weaning were considered eligible. Studies that used transgenic rodents, ex vivo studies, in vitro studies, human research, or in silico studies were ineligible. Two authors completed searches in Medline/PubMed, LILACS, Scopus, Web of Science, EMBASE, and Open Gray. The Kappa index was calculated to assess agreement between reviewers and assess study quality. The results showed that the animals exposed to EE showed better adaptation to a new environment. Furthermore, EE increased 5-HT levels in the hippocampus and prefrontal cortex of rodents. Thus, it appears that an EE during the critical period of development may reduce anxiety/depression-like behaviors, as well as increase long-term neurotransmitter response.


Asunto(s)
Emociones , Ambiente , Serotonina , Aislamiento Social , Animales , Ratas , Ansiedad , Conducta Animal/fisiología , Emociones/fisiología , Hipocampo/metabolismo , Corteza Prefrontal/metabolismo , Serotonina/metabolismo , Aislamiento Social/psicología , Destete
3.
Oral Maxillofac Surg ; 27(1): 1-8, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35301604

RESUMEN

The purpose of this systematic review was to define the effectiveness of palatally positioned dental implants placed in atrophic maxillae. Searches were performed in five databases including the gray literature, up to August 2021, by 2 independent reviewers, in order to answer the following research question: Is the palatal approach technique effective in the rehabilitation of atrophic maxillae? In the initial search, 1948 articles were found and after applying the inclusion and exclusion criteria, five studies were selected, none of which was a randomized clinical trial. A total of 681 implants were placed, 549 of them with a palatal approach and 132 at the alveolar crest, with an effectiveness of 98.38% and 99.5%, respectively, with no statistically significant difference between the groups. In assessing the risk of bias, only one of the studies had a low risk of bias. Implants installed with the palatal approach technique showed high effectiveness for rehabilitation of atrophic maxilla; however, few studies in the literature report this technique, requiring more controlled studies, and with less risk of bias, to confirm the results obtained in this systematic review.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Boca Edéntula , Humanos , Implantación Dental Endoósea/métodos , Maxilar/cirugía , Arcada Edéntula/patología , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Prótesis Dental de Soporte Implantado , Boca Edéntula/patología , Atrofia/patología , Resultado del Tratamiento , Estudios de Seguimiento , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
Cleft Palate Craniofac J ; 60(10): 1211-1219, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-35535395

RESUMEN

OBJECTIVE: Verify the effectiveness of surgical repositioning of the premaxilla and its stabilization methods in patients with bilateral cleft lip and palate during mixed dentition. DESIGN: Systematic review. MATERIAL AND METHODS: The search was conducted in 7 databases (eg, Medline via PubMed; Scopus; Central Cochrane; LILACS; Embase, Web of Science; and Sigle via OpenGrey until August 2021), using the descriptors "premaxilla", "cleft Palate", and "bone transplantation". INCLUSION CRITERIA: Clinical trials and observational studies that have patients with bilateral cleft who had a need for superior/posterior repositioning of the premaxilla on mixed dentition; Studies in any language was evaluted whitout time restriction of publication. RESULTS: From 5572 records, 6 studies were included in the review with a total sample of 212 patients. Regarding the type of stabilization used in the premaxilla, the hybrid method (rigid and complementary semi-rigid stabilization) predominated, being observed in 184 patients (86.8%). A total of 17 failures were identified related to the surgical repositioning of the premaxilla, corresponding to 8% of the total number of surgeries. A meta-analysis of prevalence was performed, only with the retrospective studies. It was observed that the effectiveness rate of premaxilla repositioning was 92%, with a CI between 0.04 and 0.13, with all included studies showing a similar failure rate (0.08-0.09). The included studies also showed great homogeneity in this analysis (I2 = 0%; P = .75). CONCLUSION: Although there are several alternatives and techniques for repositioning and stabilizing the premaxilla, the statistical result did not differ between the different techniques.


Asunto(s)
Labio Leporino , Fisura del Paladar , Humanos , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Dentición Mixta , Estudios Retrospectivos
5.
J Stomatol Oral Maxillofac Surg ; 124(1S): 101324, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36330865

RESUMEN

INTRODUCTION: The purpose of this systematic review is to determine if the zirconia implants present better clinical results when compared to titanium implants. METHODS: Searches were conducted in 5 databases including, until March 2022, by 2 independent reviewers, according to the inclusion and exclusion criteria established in the study and according whit this question: Do zirconia dental implants present better clinical results than titanium dental implants? RESULTS: 3235 studies were initially found in the researched databases. 03 randomized clinical trials were included in this systematic review and meta-analysis. A total of 71 patients with 192 implants (87 titanium and 105 zirconia) were evaluated, showing an effectiveness of 87,4% and 78,1% respectively and there was no statistically significant difference in terms of survival rate in the meta-analysis (P = 0.70; I2 = 0%). Still in the meta-analysis, there was no statistically significant difference between titanium and zirconia implants in relation to the pink esthetich score or bleeding on probing, however, a favorable difference was observed for titanium in relation to marginal bone loss (P = 0.001; I2 = 0%). None of the studies evaluated had a low risk of bias. CONCLUSION: Oral rehabilitation with zirconia implants showed no advantages over titanium in this systematic review. However, the small number of studies included and the uncertain risk of bias may raise doubts in this interpretation and the results should be analyzed with caution. New studies with greater methodological rigor, follow-up time and number of interventions should be performed in order to safely determine the indication for the use of zirconia implants.


Asunto(s)
Implantes Dentales , Humanos , Titanio , Diseño de Prótesis Dental , Fracaso de la Restauración Dental
6.
Life Sci ; 307: 120880, 2022 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-35963301

RESUMEN

Maternal exposure to a high-fat diet (HFD) during pregnancy and lactation has been related to changes in the hypothalamic circuits involved in the regulation of food intake. Furthermore, maternal HFD during the critical period of development can alter the offspring's metabolic programming with long-term repercussions. This study systematically reviewed the effects of HFD consumption during pre-pregnancy, pregnancy and/or lactation. The main outcomes evaluated were food intake, body weight and cellular or molecular aspects of peptides and hypothalamic receptors involved in the regulation of energy balance in mice. Two independent authors performed a search in the electronic databases Medline/PubMed, LILACS, Web of Science, EMBASE, SCOPUS and Sigle via Open Gray. The experimental studies of mice exposed to HFD during pregnancy and/or lactation that evaluated body composition, food intake, energy expenditure and hypothalamic components related to energy balance were included. Internal validity was assessed using the SYRCLE risk of bias. The Kappa index was measured to analyze the agreement between reviewers. The PRISMA statement was used to report this systematic review. Most studies demonstrated that there was a higher body weight, body fat deposits and food intake, as well as alterations in the expression of hypothalamic neuropeptides in offspring that consumed HFD. Therefore, the maternal diet can affect the phenotype and metabolism of the offspring, in addition to harming the hypothalamic circuits and favoring the orexigenic pathways.


Asunto(s)
Neuropéptidos , Efectos Tardíos de la Exposición Prenatal , Animales , Peso Corporal/fisiología , Dieta Alta en Grasa , Ingestión de Alimentos , Metabolismo Energético/genética , Femenino , Humanos , Fenómenos Fisiologicos Nutricionales Maternos , Ratones , Neuropéptidos/metabolismo , Embarazo , Efectos Tardíos de la Exposición Prenatal/metabolismo
7.
Br J Oral Maxillofac Surg ; 60(6): 723-730, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35184916

RESUMEN

The objective of this umbrella review was to determine the effectiveness of rhBMP-2 in the reconstructive surgery of cleft patients through an evaluation of bone filling and volume of newly formed bone in the cleft area. A systematic search was carried out in PubMed/ Medline, Scopus, Cochrane Database of Abstracts of Reviews of Effects (DARE), Latin American and Caribbean Health Sciences Literature (LILACS), and the System for Information on Grey Literature in Europe (SIGLE) via Open Grey, until June 2020. Risk of bias was assessed using the ROBIS tool. A total of 2739 articles were identified and, based on the inclusion and exclusion criteria, six were included for final evaluation. The bone filling rate was 74.23% in the rhBMP-2 group and 72.38% in the autogenous group. Regarding the risk of bias, none of the articles had a low risk, four had an uncertain risk, and two a high risk. The results of this umbrella review show that the studies had high and uncertain risks of bias, and high heterogeneity. There was a lack of evidence regarding the possible complications offered by this therapy. The recommendation to use BMP-2 for alveolar cleft reconstruction, especially in a paediatric population, should be viewed with caution. New primary studies are needed to assess this variable and safely determine the use of rhBMP-2 in reconstructive surgery for cleft patients.


Asunto(s)
Proteína Morfogenética Ósea 2 , Fisura del Paladar , Procedimientos de Cirugía Plástica , Proteína Morfogenética Ósea 2/uso terapéutico , Trasplante Óseo/métodos , Niño , Fisura del Paladar/cirugía , Humanos , Ilion/trasplante , Proteínas Recombinantes/uso terapéutico , Procedimientos de Cirugía Plástica/métodos
8.
Rev Assoc Med Bras (1992) ; 66(10): 1444-1448, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33174941

RESUMEN

OBJECTIVE: To conduct a review of articles which have evaluated the relationship between vitamin D and cardioprotection in adult. METHODS: A literature search was performed in the Pubmed and Scielo databases. The results were extracted from primary and secondary sources and will be presented in the form of a bibliographic review. RESULTS: Twenty-three articles were identified from the electronic search that reported on physiological mechanisms relating the vitamin D axis and the cardiovascular system through receptors. Of the ten studies that evaluated the therapeutic effect of vitamin D in cardiovascular diseases, none reported significant results. CONCLUSION: The articles assessed in this review did not demonstrate a cardioprotective effect of vitamin D, despite the epidemiological correlation of vitamin D deficiency with a higher prevalence of cardiovascular diseases.


Asunto(s)
Deficiencia de Vitamina D , Adulto , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Humanos , Prevalencia , Vitamina D , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/prevención & control , Vitaminas/uso terapéutico
9.
Rev. Assoc. Med. Bras. (1992) ; 66(10): 1444-1448, Oct. 2020. tab, graf
Artículo en Inglés | Sec. Est. Saúde SP, LILACS | ID: biblio-1136162

RESUMEN

SUMMARY OBJECTIVE: To conduct a review of articles which have evaluated the relationship between vitamin D and cardioprotection in adult. METHODS: A literature search was performed in the Pubmed and Scielo databases. The results were extracted from primary and secondary sources and will be presented in the form of a bibliographic review. RESULTS: Twenty-three articles were identified from the electronic search that reported on physiological mechanisms relating the vitamin D axis and the cardiovascular system through receptors. Of the ten studies that evaluated the therapeutic effect of vitamin D in cardiovascular diseases, none reported significant results. CONCLUSION: The articles assessed in this review did not demonstrate a cardioprotective effect of vitamin D, despite the epidemiological correlation of vitamin D deficiency with a higher prevalence of cardiovascular diseases.


Asunto(s)
Humanos , Adulto , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/prevención & control , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D , Vitaminas/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/epidemiología , Prevalencia
10.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e541-e548, jul. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-196508

RESUMEN

BACKGROUND: Oral rehabilitation of atrophic maxillae features high complexity, for which there are several therapeutic modalities reported on scientific literature. Zygomatic implant placement is a viable option that features low morbidity and allows immediate prosthetic loading. The purpose of the present study was to determine the methodological quality of systematic reviews that assessed the effectiveness of zygomatic implants placed in atrophic maxillae. MATERIAL AND METHODS: Searches were conducted on Medline via Pubmed, LILACS, Dare Cochrane, Scopus, and Sigle via Open Grey up to June 2019. RESULTS: Seven systematic reviews were eligible for Overview and comprised a total of 2313 patients, 4812 zygomatic implants, and a 96,72% success rate. Common surgical complications, in decreasing order, were: maxillary sinusitis, peri-implant mucositis, prosthetic fracture, and infections. Methodological quality was assessed using the AMSTAR 2 tool, which revealed that six systematic reviews showed critically low methodological quality and one review was assessed as of low methodological quality. CONCLUSIONS: Zygomatic implants seem to be an adequate option for atrophic maxilla rehabilitation, however, new studies with a higher methodological rigor are needed to provide more reliable results to professionals and patients undergoing this modality of oral rehabilitation


No disponible


Asunto(s)
Humanos , Revisiones Sistemáticas como Asunto , Implantación Dental Endoósea/métodos , Cigoma/cirugía , Enfermedades Maxilares/cirugía , Resultado del Tratamiento
11.
Oral Oncol ; 102: 104524, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32062592

RESUMEN

Oral Mucositis is a frequent and debilitating inflammatory complication in patients with head and neck malignancies and may lead to unplanned treatment interruptions due to intense pain and dysphagia. This systematic review with meta-analysis was performed to determine the effectiveness of low-level laser therapy in preventing oral mucositis in this context. The following databases were searched through September 2018, with last search performed on May 2019, for clinical trials: MEDLINE via PubMed, Cochrane Central, Scopus, Lilacs, ISI Web of Science and SIGLE via Open Grey. From 14,525 records, 4 studies were included in the review and 3 studies were included in meta-analysis. Data from 500 patients (mean age of 53.595 and 54.14 for intervention and control groups, respectively) were analysed. Meta-analysis showed that laser therapy prevents oral mucositis incidence in 28% and 23% of cases during the third and fourth follow-up week, respectively, in comparison to a placebo-treated control group. There was no statistically significant difference the prevention of pain; dysphagia and quality of life were not analysed due to missing. Laser therapy was effective in preventing oral mucositis from the 15th to the 45th days of chemoradiotherapy. However, new primary studies with low risk of bias are needed so a higher scientific evidence can be obtained.


Asunto(s)
Quimioradioterapia/efectos adversos , Neoplasias de Cabeza y Cuello/terapia , Terapia por Luz de Baja Intensidad , Estomatitis/prevención & control , Sesgo , Análisis de Datos , Trastornos de Deglución/etiología , Trastornos de Deglución/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/prevención & control , Estomatitis/etiología , Resultado del Tratamiento
12.
Rev. bras. anestesiol ; 70(1): 42-47, Jan.-Feb. 2020. tab, graf
Artículo en Inglés, Portugués | LILACS | ID: biblio-1137142

RESUMEN

Abstract Introduction and objectives: Magnesium sulphate has been used in anesthesia because it has relevant clinical features such as: analgesia, autonomic response control and muscle relaxation. Using the agent to establish adequate conditions for tracheal intubation remains controversial. The aim of the study was to compare the effectiveness of magnesium sulfate and rocuronium for rapid sequence tracheal intubation in adults. Methods: Double blind, randomized, unicentric, prospective study assessed 68 patients, ASA 1 or 2, over 18 years, scheduled for appendectomy under general anesthesia. Patients were divided into two groups. GM patients received 50 mg.kg-1magnesium sulfate and GR patients, 1 mg.kg-1 rocuronium immediately before anesthesia induction. Arterial Blood Pressure (BP) and Heart Rate (HR) were measured in both groups at five times related to the administration of the drugs studied. The primary variable was the clinical status of tracheal intubation. Trial Registry: RBR-4xr92k. Results: GM was associated with no significant hemodynamic parameter change after injection. GM showed 85% (29/34) poor intubation clinical status, 15% (5/34) good, and 0% excellent (< 0.0001). Conclusion: Magnesium sulfate did not provide adequate clinical status when compared to rocuronium at a dose of 50 mg.kg-1 for rapid sequence intubation in adult patients.


Resumo Justificativa e objetivos: O sulfato de magnésio vem sendo utilizado em anestesia por apresentar características relevantes à prática clínica como: analgesia, controle dos reflexos autonômicos e relaxamento muscular. A utilização deste agente para garantir condições adequadas para a intubação traqueal permanece controverso. O objetivo deste trabalho é determinar a efetividade do sulfato de magnésio comparado ao rocurônio para intubação orotraqueal em sequência rápida em pacientes adultos. Métodos: Este estudo duplamente encoberto, aleatorizado, unicêntrico e prospectivo avaliou 68 pacientes, ASA 1 ou 2, maiores de 18 anos, escalados para cirurgias de apendicectomia sob anestesia geral. Foram alocados em dois grupos, o GM recebeu 50 mg.kg-1 de sulfato de magnésio e o GR, 1 mg.kg-1 de rocurônio imediatamente antes da indução anestésica. Os valores de Pressão Arterial (PA) e Frequência Cardíaca (FC) foram aferidos nos dois grupos em cinco momentos relacionados com a administração dos fármacos do estudo. A variável primária foi condição clínica da intubação. Registro: RBR-4xr92k. Resultados: O GM não apresentou alteração significativa dos parâmetros hemodinâmicos após infusão. O GM apresentou 85% (29/34) de condição pobre, 15% (5/34) condição clínica boa e 0% condição clínica excelente (< 0,0001). Conclusão: O sulfato de magnésio não propiciou condições clínicas aceitáveis quando comparado ao rocurônio para intubação orotraqueal em sequência rápida em pacientes adultos quando utilizada a dose de 50 mg.kg-1.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Anciano , Adulto Joven , Fármacos Neuromusculares no Despolarizantes , Rocuronio , Intubación e Inducción de Secuencia Rápida , Analgésicos , Sulfato de Magnesio , Método Doble Ciego , Estudios Prospectivos , Resultado del Tratamiento
13.
Rev. bras. anestesiol ; 69(5): 493-501, Sept.-Oct. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1057452

RESUMEN

Abstract Background and objectives: Low back pain is a prevalent disease in the adult population, whose quality of life is considerably affected. In order to solve this problem, several therapies have been developed, of which ozone therapy is an example. Our objective in this study was to determine the effectiveness of ozone therapy for lumbar pain relief in adult patients compared to other therapies (steroid and placebo). Method: We used randomized clinical trials to compare the effectiveness of ozone and other therapies for lumbar pain relief in adults (Prospero: CRD42018090807). Two independent reviewers searched the Medline (1966-April/2018), Scopus (2011-May/2018), Lilacs (1982-May/2018), and EMBASE (1974-March/2018) databases. We use the terms ozone and pain as descriptors. The primary variable was pain relief and the secondary ones were complication, degree of satisfaction, quality of life and recurrence of pain. Results: Of the 779 identified articles, six selected clinical trials show that ozone therapy is more effective for lumbar pain relief; however, they were mostly classified as having a high or uncertain risk of bias (Cochrane Handbook). The meta-analysis regarding the effectiveness of pain relief did not show a significant difference between groups in the three-month period (RR = 1.98, 95% CI: 0.46-8.42, p= 0.36; 366 participants). It also showed greater effectiveness of the ozone therapy at six months compared to other therapies (steroid and placebo) (RR = 2.2, 95% CI: 1.87-2.60, p< 0.00001; 717 participants). Conclusions: The systematic review has shown that ozone therapy used for six months for lumbar pain relief is more effective than other therapies; however, this result is not definitive as data from studies with moderate to high risk of bias were used.


Resumo Justificativa e objetivos: A lombalgia é uma enfermidade prevalente na população adulta, que tem sua qualidade de vida afetada consideravelmente. Com intuito de resolver este problema, desenvolveram-se várias terapias. Um exemplo é a ozonioterapia. Objetivamos neste estudo determinar a efetividade da ozonioterapia para alívio da dor lombar em pacientes adultos, quando comparada a outras terapias (esteroide e placebo). Método: Usamos de ensaios clínicos randomizados para comparar a efetividade do ozônio e de outras terapias para o alívio da dor lombar em adultos (Prospero: CRD42018090807). Dois revisores independentes analisaram as bases Medline (1966-Abril/2018), Scopus (2011-Maio/2018), Lilacs (1982-Maio/2018) e Embase (1974-Março/2018). Como descritores, usamos termos ozone e pain. Temos como variável primária o alívio da dor e como variáveis secundárias: complicação, grau de satisfação, qualidade de vida e recorrência da dor. Resultados: Os seis ensaios clínicos selecionados, de 779 artigos identificados, mostram que o grupo do ozônio é mais efetivo para o alívio da dor lombar, porém, foram classificados em sua maioria com alto ou incerto risco de viés (Handbook Cochrane). A metanálise referente à efetividade no alívio da dor não apresentou diferença significante entre os grupos no período de três meses (RR = 1,98; 95% IC: 0,46-8,42; p= 0,36; 366 participantes). Também denotou maior efetividade em seis meses do grupo ozônio em relação a outras terapias (esteroide e placebo) (RR = 2,2; 95% IC: 1,87-2,60; p< 0,00001; 717 participantes). Conclusões: A revisão sistemática demonstrou que ozonioterapia usada por seis meses para alívio da dor lombar é mais efetiva do que outras terapias. Entretanto, esse resultado não é definitivo, visto que foram usados dados de estudos com moderado a alto risco de viés.


Asunto(s)
Humanos , Ozono/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Dolor de la Región Lumbar/tratamiento farmacológico , Resultado del Tratamiento
14.
Braz J Anesthesiol ; 69(5): 493-501, 2019.
Artículo en Portugués | MEDLINE | ID: mdl-31521383

RESUMEN

BACKGROUND AND OBJECTIVES: Low back pain is a prevalent disease in the adult population, whose quality of life is considerably affected. In order to solve this problem, several therapies have been developed, of which ozone therapy is an example. Our objective in this study was to determine the effectiveness of ozone therapy for lumbar pain relief in adult patients compared to other therapies (steroid and placebo). METHOD: We used randomized clinical trials to compare the effectiveness of ozone and other therapies for lumbar pain relief in adults (Prospero: CRD42018090807). Two independent reviewers searched the Medline (1966-April/2018), Scopus (2011-May/2018), Lilacs (1982-May/2018), and Embase (1974-March/2018) databases. We use the terms ozone and pain as descriptors. The primary variable was pain relief and the secondary ones were complication, degree of satisfaction, quality of life, and recurrence of pain. RESULTS: Of the 779 identified articles, six selected clinical trials show that ozone therapy is more effective for lumbar pain relief; however, they were mostly classified as having a high or uncertain risk of bias (Cochrane Handbook). The meta-analysis regarding the effectiveness of pain relief did not show a significant difference between groups in the three-month period (RR = 1.98, 95% CI: 0.46-8.42, p = 0.36; 366 participants). It also showed greater effectiveness of the ozone therapy at six months compared to other therapies (steroid and placebo) (RR = 2.2, 95% CI: 1.87-2.60, p < 0.00001; 717 participants). CONCLUSIONS: The systematic review has shown that ozone therapy used for six months for lumbar pain relief is more effective than other therapies; however, this result is not definitive as data from studies with moderate to high risk of bias were used.


Asunto(s)
Dolor de la Región Lumbar/tratamiento farmacológico , Ozono/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Resultado del Tratamiento
15.
Med. oral patol. oral cir. bucal (Internet) ; 24(4): e518-e528, jul. 2019. tab, graf
Artículo en Inglés | IBECS | ID: ibc-185666

RESUMEN

Background: Alveolar infection is known as a risk factor for implant failure. Current meta-analysis on the theme could not prove statistically that immediate dental implants placed into infected sites have a higher risk of failure than immediate dental implants placed into non-infected sites. The purpose of this meta-analysis was to determine the effectiveness of immediate dental implants placed into infected versus non-infected sites. Material and Methods: Seven databases were sought by two reviewers. Randomized or non-randomized clinical trials that compared the placement of dental implants into infected versus non-infected sites were eligible for the study. Exclusion criteria were: papers in which the survival rate was not the primary outcome; papers without a control group; studies with less than one year of follow-up; studies whose patients did not receive antibiotic therapy; studies with medically compromised patients; duplicated papers. Risk of bias assessment was performed with the Cochrane Collaboration tool. Results: Of the 3.253 initial hits, 8 studies were included in both qualitative and quantitative synthesis (kappa = 0.90; very good agreement). Forest plot for implant failure showed that immediate implants placed into infected sites presented a statistically significant risk of failure that is almost 3 times higher than when placed into non-infected sites (risk ratio= 2.99; 95% confidence interval: 1.04, 8.56; p = 0.04; 935 implants; i2 = 0%). Periimplant outcomes showed no statistical difference. Conclusions: Immediate dental implants placed into infected sites presented a statistically significant higher risk of failure than immediate dental implants placed into non-infected sites. Periimplant outcomes were not statistically affected in this intervention


No disponible


Asunto(s)
Humanos , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Resultado del Tratamiento
16.
Rev. bras. anestesiol ; 69(3): 299-306, May-June 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1013417

RESUMEN

Abstract Background and objective: The systematic review of randomized clinical trials is crucial to assess the safety and effectiveness of intermediate procedures. The objective of this article is to present a tutorial for the planning and execution of systematic review and meta-analysis of randomized clinical trial studies. Method: The systematic literature review is the type of research that organizes, criticizes, and integrates available evidence published in the health field. Systematization leads to less bias, however, the quality of systematic reviews may not always be perceived due to the way it is described in the articles. The information disclosed in the articles is not always free of bias. The steps for carrying out a systematic review include design, protocol registration, implementation, mathematical analysis of results, and dissemination. PRISMA statement has improved the quality of systematic review reports by providing a list of items to be described, and this article emphasizes the key steps for performing a systematic review of interventions. Conclusion: The evidence generated through a systematic review can provide the clinician with greater confidence in decision making at the moment of clinical practice and optimize the benefits to his patients, serving as a tool to assist managers in making decisions regarding the implementation of new strategies for the health of the population.


Resumo Justificativa e objetivo: A revisão sistemática de ensaios clínicos randomizados é crucial para avaliar a segurança e a efetividade das intervenções médicas. O objetivo deste artigo é apresentar um tutorial para o planejamento e execução de revisões sistemáticas e metanálises de estudos de ensaios clínicos randomizados. Método: A revisão sistemática da literatura é o tipo de pesquisa que organiza, critica e integra as evidências disponíveis publicadas na áera da saúde. A sistematização leva a menos vieses, entretanto a qualidade das revisões sistemáticas nem sempre pode ser percebida devido à forma como têm sido descritas nos artigos. A informação divulgada nos artigos nem sempre está livre de vieses. Os passos para a revisão sistemática incluem o delineamento, o registro do protocolo, a execução, a análise matemática dos resultados e a divulgação. O PRISMA statement melhorou a qualidade dos relatos das revisões sistemáticas, pois fornece uma lista de itens a serem descritos, e este artigo enfatiza os principais passos para a execução de uma revisão sistemática de intervenção. Conclusão: A evidência gerada por meio de uma revisão sistemática pode propiciar ao médico maior confiança na tomada de decisões no momento da prática clínica, aprimorar os benefícios aos seus pacientes e servir como ferramenta para auxiliar os gestores na tomada de decisões quanto à implantação de novas estratégias em prol da saúde da população.


Asunto(s)
Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Revisiones Sistemáticas como Asunto , Anestesia/métodos , Metaanálisis como Asunto , Anestesiología
17.
Braz J Anesthesiol ; 69(3): 299-306, 2019.
Artículo en Portugués | MEDLINE | ID: mdl-30717891

RESUMEN

BACKGROUND AND OBJECTIVE: The systematic review of randomized clinical trials is crucial to assess the safety and effectiveness of intermediate procedures. The objective of this article is to present a tutorial for the planning and execution of systematic review and meta-analysis of randomized clinical trial studies. CONTENT: The systematic literature review is the type of research that organizes, criticizes, and integrates available evidence published in the health field. Systematization leads to less bias, however, the quality of systematic reviews may not always be perceived due to the way it is described in the articles. The information disclosed in the articles is not always free of bias. The steps for carrying out a systematic review include design, protocol registration, implementation, mathematical analysis of results, and dissemination. PRISMA statement has improved the quality of systematic review reports by providing a list of items to be described, and this article emphasizes the key steps for performing a systematic review of interventions. CONCLUSION: The evidence generated through a systematic review can provide the clinician with greater confidence in decision making at the moment of clinical practice and optimize the benefits to his patients, serving as a tool to assist managers in making decisions regarding the implementation of new strategies in favor of the public health.


Asunto(s)
Anestesia , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto , Humanos , Anestesia/métodos , Anestesiología , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos
18.
Lasers Med Sci ; 31(4): 779-87, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-26861987

RESUMEN

A systematic review addressing experiments with healing of skin wounds in rats using LLDLT with different active means seeking to identify a pattern in adjustments such as laser wavelength, power and fluency and analysing wound healing parameters, such as wound area, presence of fibroblasts, angiogenesis, leukocyte infiltration, epithelial coverage and antibacterial effect. It was perceived that a protocol does not exist in view of the wide variation in the use of power (9 to 500 mW) and fluency (1 to 60 J/cm2); however, between the different wavelengths, the highlight was the combined use of red and infrared wavelengths showing better results than when used alone.


Asunto(s)
Láseres de Semiconductores/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Piel/efectos de la radiación , Cicatrización de Heridas/efectos de la radiación , Animales , Fibroblastos/fisiología , Fibroblastos/efectos de la radiación , Humanos , Ratas , Piel/lesiones , Piel/fisiopatología , Revisiones Sistemáticas como Asunto
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