Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.495
Filtrar
1.
Braz. j. oral sci ; 20: e211701, jan.-dez. 2021. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254532

RESUMEN

Aim: This study aimed to evaluate how meta-analyses are conducted and reported in dentistry. Methods: We conducted a search to identify dentistry-related Systematic Reviews (SRs) indexed in PubMed in 2017 (from January 01 until December 31) and published in the English language. We included only SRs reporting at least one meta-analysis. The study selection followed the 4-phase flow set forth in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), and it was independently conducted by two researchers. Data extraction was performed by one of three reviewers, and data related to conducting and reporting of the meta-analysis were collected. Descriptive data analysis was performed summarizing frequencies for categorical items or median and interquartile range for continuous data. Results: We included 214 SRs with meta-analyses. Most of the studies reported in the title that a meta-analysis was conducted. We identified three critical flaws in the included studies: Ninety (90) meta-analyses (43.1%) did not specify the primary outcome; most of the meta-analyses reported that a measure of statistical heterogeneity was used to justify the use of a fixed-effect or random-effects meta-analysis model (n=114, 58.5%); and a great part did not assess publication bias (n=106, 49.5%). Conclusion: We identified deficiencies in the reporting and conduct of meta-analysis in dentistry, suggesting that there is room for improvement. Educational approaches are necessary to improve the quality of such analyses and to avoid biased and imprecise results


Asunto(s)
Salud Bucal , Informe de Investigación , Revisiones Sistemáticas como Asunto
2.
Braz. j. oral sci ; 20: e213641, jan.-dez. 2021. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254539

RESUMEN

Aim: To review the current literature regarding the bond strength of self-adhesive flowable resin composites (SAFRCs) to tooth structure, comparing the outcomes with conventional flowable resin composites (CFRCs). Methods: PubMed/Medline, EbscoHost and Scopus databases were screened (last update on November 2020) using related Medical Subject Headings (MeSH) and free terms. We included in vitro studies published in English language comparing the bond strength of SAFRCs and CFRCs to enamel and/or dentin from primary and/or permanent teeth. Results: In total, 23 articles were included. Unlike CFRCs, SAFRCs such as Vertise® Flow and Fusio™ Liquid Dentin exhibited statistically lower bond strength to enamel and dentin from permanent teeth. There were limited studies comparing the enamel bond strength of CFRCs and SAFRCs (prior phosphoric acid etching and/or adhesive system use). Also, we found few studies that evaluated the bonding effectiveness of Constic® and other SAFRCs to primary teeth. Conclusions: Current SAFRCs showed low bond strength to permanent teeth, which impedes to recommend them as a reliable alternative to CFRCs. The bonding performance of Constic® on both hard dental tissues should be evaluated on future studies. Also, more evidence assessing the bond strength of SAFRCs to primary teeth and etched enamel is needed


Asunto(s)
Recubrimiento Dental Adhesivo , Resinas Compuestas , Revisiones Sistemáticas como Asunto
3.
Braz. j. oral sci ; 20: e211223, jan.-dez. 2021. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254623

RESUMEN

Aim: Verify the accuracy of objective assessments compared to subjective tests in detecting changes in somatosensory perception in individuals affected by maxillofacial trauma. Methods: The review (PROSPERO n ° CRD42019125546) used the databases: MEDLINE, Cochrane, EMBASE, LILACS and other bibliographic resources. Prospective and retrospective studies that used objective and subjective methods of assessing facial sensitivity in maxillofacial fractures were included. There was no restriction on language or publication date. Risk of bias was assessed using the QUADAS-2. Data extraction and analysis were performed using a form developed for the study. Results: 21 studies were included. The clinical objective examination mainly includes assessments of: tactile sensitivity (95.24%) and nociceptive sensitivity (57.14%). The subjective assessment was based on the patient's report, spontaneously (61.90%), guided by structured questionnaires (33.33%) and/or using scales (9.52%) to measure the degree of impairment. In risk of bias assessment, were observed no adequate interpretation and classification of changes in subjective sensitivity, subject to inappropriate analysis of the data. In addition, the studies bring several instruments without standardization for assessing sensory modalities. Conclusion: The objective assessment is a complement to the subjective assessment, using the touch assessment as the main parameter in the profile of the facial peripheral integrity, associated or not with nociceptive assessment. Lack of consensus on the indication of specific instruments for testing is a limiting factor. Thus, based on the studies, is proposed a minimum battery of sensitivity assessment to obtain an overview of the patient's peripheral nervous situation


Asunto(s)
Fracturas Cigomáticas , Trastornos de la Sensación , Trastornos Somatosensoriales , Traumatismos Faciales , Revisiones Sistemáticas como Asunto , Fracturas Maxilomandibulares
4.
Trials ; 22(1): 612, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34503563

RESUMEN

BACKGROUND: Globally, over 1.2 million people die from chronic kidney disease (CKD) every year. Patients with CKD are up to 10 times more likely to die prematurely than progress to kidney failure requiring kidney replacement therapy. The burden of symptoms and impaired quality of life in CKD may be compounded by comorbidities and treatment side effects. However, patient-important outcomes remain inconsistently and infrequently reported in trials in patients with CKD, which can limit evidence-informed decision-making. The Standardised Outcomes in Nephrology - Chronic Kidney Disease (SONG-CKD) aims to establish a consensus-based core outcome set for trials in patients with CKD not yet requiring kidney replacement therapy to ensure outcomes of relevance to patients, caregivers and health professionals are consistently reported in trials. METHODS: SONG-CKD involves four phases: a systematic review to identify outcomes (domains and measures) that have been reported in randomised controlled trials involving adults with CKD who do not require kidney replacement therapy; stakeholder key informant interviews with health professionals involved in the care of adults with CKD to ascertain their views on establishing core outcomes in CKD; an international two-round online Delphi survey with patients, caregivers, clinicians, researchers, policy makers and industry representatives to obtain consensus on critically important outcome domains; and stakeholder consensus workshops to review and finalise the set of core outcome domains for trials in CKD. DISCUSSION: Establishing a core outcome set to be reported in trials in patients with CKD will enhance the relevance, transparency and impact of research to improve the lives of people with CKD. TRIAL REGISTRATION: Not applicable. This study is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database: http://www.comet-initiative.org/Studies/Details/1653 .


Asunto(s)
Nefrología , Insuficiencia Renal Crónica , Adulto , Técnica Delfos , Humanos , Evaluación de Resultado en la Atención de Salud , Calidad de Vida , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/terapia , Terapia de Reemplazo Renal , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
5.
Zhongguo Zhong Yao Za Zhi ; 46(12): 2963-2971, 2021 Jun.
Artículo en Chino | MEDLINE | ID: mdl-34467686

RESUMEN

To overview the systematic reviews of Panax notoginseng saponins in the treatment of acute cerebral infarction. CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library and EMbase databases were retrieved to collect the systematic reviews of the efficacy of P. notoginseng saponins in the treatment of acute cerebral infarction. The retrieval time was from the time of database establishment to January 2021. After two researchers independently screened out the literature and extracted the data, AMSTAR-2 scale was used to evaluate the methodological quality of the included systematic reviews, GRADE system was used to grade the quality of evidences of the outcome indicators, and the efficacy evaluation was summarized. A total of 5 systematic reviews were included. AMSTAR-2 evaluation results showed that 3 items were relatively complete, while 4 items had a poor overall quality. P. notoginseng saponins combined with conventional Western medicine therapy was superior to single conventional therapy in the recovery of neurological function, enhancement of the total effective rate in clinic, and improvement of activities of daily living. GRADE evaluation results showed that the quality of evidence was from low quality to very low quality. In conclusion, in the treatment of acute cerebral infarction, P. notoginseng saponins can improve the clinical efficacy, with a good safety but a not high methodological quality and a low evidence quality. It is suggested that high-quality clinical studies shall be further carried out to provide evidence-based basis for the application of P. notoginseng saponins in the treatment of acute cerebral infarction.


Asunto(s)
Panax notoginseng , Saponinas , Actividades Cotidianas , Infarto Cerebral/tratamiento farmacológico , Humanos , Revisiones Sistemáticas como Asunto
6.
Zhongguo Zhong Yao Za Zhi ; 46(12): 2972-2983, 2021 Jun.
Artículo en Chino | MEDLINE | ID: mdl-34467687

RESUMEN

There have been many clinical trials, systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke, but with fewer comprehensive descriptions. In this study, an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice. CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science were retrieved through computers. A total of 6 literatures were included in this study. By AMSTAR-2 checklist and GRADE, the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated. The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews. According to the results of GRADE evaluation, among 55 outcomes, there were 2 outcomes with a medium quality, 4 outcomes with a low quality and 49 outcomes with an extremely low quality. The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke. This therapy could improve the total efficacy, neurological deficit scores, hemodynamic and hemodynamic parameters. However, the methodolo-gical quality of all literatures was extremely low. The evidence levels of outcomes were between extremely low to medium. The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies. In the future, relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Isquemia Encefálica/tratamiento farmacológico , Medicamentos Herbarios Chinos , Humanos , Accidente Cerebrovascular/tratamiento farmacológico , Revisiones Sistemáticas como Asunto
7.
Zhongguo Zhong Yao Za Zhi ; 46(15): 3998-4007, 2021 Aug.
Artículo en Chino | MEDLINE | ID: mdl-34472277

RESUMEN

To summarize and evaluate the efficacy and safety of Shenmai Injection in the treatment of viral myocarditis, shock, pulmonary heart disease, coronary heart disease, neutropenia and tumor chemotherapy, so as to provide supportive evidences for clinical rational use of Shenmai Injection. By searching literatures about studies on the systematic reviews on Shenmai Injection in treatment of viral myocarditis, shock, pulmonary heart disease, coronary heart disease, neutropenia and tumor chemotherapy from the main Chinese and English databases. Primary efficacy and safety outcome measures were selected for comparative analysis and summary, and the appraisal tool of AMSTAR 2 was used to evaluate the included studies.A total of 36 systematic reviews(published from 2005 to 2020) were included, involving viral myocarditis, shock, pulmonary heart disease, malignant tumor and coronary heart disease. The number of cases included in each type of the above diseases was 3 840, 2 484, 12 702, 28 036 and 27 082, respectively. The comparison results showed that, Shenmai Injection combined with conventional/western medicine treatment groups had better efficacy than conventional/western medicine groups alone in the prevention and treatment of the above five diseases. The main adverse reactions of Shenmai Injection reported in the included studies were facial flushing, rash, palpitation, etc., but the incidence was low and the general symptoms were mild, so no special treatment was needed. Therefore, the application of Shenmai Injection on the basis of conventional treatment or western medicine treatment had better prevention and treatment efficacy of the diseases. It was suggested that more multi-center and larger sample-size randomized controlled trials should be carried out in the future, and the relevant reporting standards should be strictly followed in systematic reviews, so as to improve the scientificity and transparency of the study.


Asunto(s)
Medicamentos Herbarios Chinos , Enfermedad Cardiopulmonar , Combinación de Medicamentos , Humanos , Revisiones Sistemáticas como Asunto
8.
Medicine (Baltimore) ; 100(35): e27111, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477152

RESUMEN

BACKGROUND: We aimed to conduct a meta-analysis to assess the impact of coronavirus disease 2019 (COVID-19) on college students' physical activity. METHODS: All cohort studies comparing college students undertaking physical exercise at school before the COVID-19 pandemic and physical exercise at home during the COVID-19 pandemic will be included in this review. We will use index words related to college students, physical exercise, and COVID-19 to perform literature searches in the PubMed, Medline, Embase, and CNKI databases, to include articles indexed as of June 20, 2021, in English and Chinese. Two reviewers will independently select trials for inclusion, assess trial quality, and extract information for each trial. The primary outcomes are exercise frequency, duration, intensity, and associated factors. Based on the Cochrane assessment tool, we will evaluate the risk of bias of the included studies. Revman 5.3 (the Cochrane collaboration, Oxford, UK) will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysis, and funnel plot generation. RESULT: We will discuss the impact of COVID-19 on college students' physical activity. CONCLUSION: Stronger evidence about the impact of COVID-19 on college students' physical activity will be provided to better guide teaching practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021262390.


Asunto(s)
Ejercicio Físico , Estudiantes/estadística & datos numéricos , COVID-19/epidemiología , Femenino , Humanos , Masculino , Metaanálisis como Asunto , Pandemias , SARS-CoV-2 , Revisiones Sistemáticas como Asunto , Universidades
9.
Prog Orthod ; 22(1): 26, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34486079

RESUMEN

BACKGROUND: Detection of skeletal maturity is vital in orthodontic treatment timing and planning. Traditional methods include hand-wrist radiography and cervical vertebral maturation index (CVMI). Though the radiographic methods are well established and routinely used to assess skeletal maturation, they carry the drawback of subjective perception and low reproducibility. With evolving concepts, skeletal maturation has been assessed quantitatively through biomarkers obtained from saliva, gingival crevicular fluid (GCF), and urine. The scoping review aims to explore the various biomarkers assessed through non-invasive methods and their correlation with radiographic skeletal maturity. METHODOLOGY: The literature search was carried out on MEDLINE via Pubmed, Cochrane Library (Cochrane database of systematic reviews), Cochrane central register of controlled trials (CENTRAL), Google Scholar, Semantic Scholar, ScienceDirect, and Opengrey.eu for articles up to and including November 2020. Pertinent articles were selected based on inclusion and exclusion criteria. The results were tabulated based on the type of sample collected, the biomarker assessed, method of sample collection, and the radiographic method used. RESULTS: The literature search resulted in 12 relevant articles. Among all the studies, 10 studies showed that the concentration of biomarkers increases during the pubertal growth peak. On the contrary, 2 articles showed no significant difference between the levels of biomarkers and pubertal growth peak. CONCLUSION: It can be concluded that the level of biomarkers increases during the pubertal growth spurt and can provide a quantitative way of assessing skeletal maturity.


Asunto(s)
Vértebras Cervicales , Líquido del Surco Gingival , Biomarcadores/análisis , Humanos , Reproducibilidad de los Resultados , Revisiones Sistemáticas como Asunto
10.
Medicine (Baltimore) ; 100(35): e26920, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477123

RESUMEN

BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and changes in bowel habits. Many pieces of evidence show that acupuncture and moxibustion therapy has advantages in the treatment of IBS, but there are many acupuncture and moxibustion therapy options, each of which has different therapeutic effects. This study will evaluate the clinical efficacy of different acupuncture and moxibustion therapies in the treatment of IBS by means of a network meta-analysis. METHODS: According to the retrieval strategy, we retrieved the randomized controlled trials of acupuncture and moxibustion treatment of IBS from China National Knowledge Infrastructure, Wanfang, VIP, Chinese biomedical databases, PubMed, Embase, Web of Science, and the Cochrane Library databases from the database establishment to July 2021. We assessed the quality of the studies using the Cochrane Risk Bias Assessment Tool and assessed the strength of the evidence using the Grading of Recommendation Assessment, Development, and Evaluation methodology. All data analyses were performed by RevMan5.3, Gemtc 0.14.3, and Stata 14.0. RESULTS: This study evaluated the efficacy of different acupuncture and moxibustion therapies in the treatment of IBS by evaluating the clinical efficacy rate, symptom scores, quality of life scores, adverse reactions, etc, and further explore the mechanism of action of each therapy. CONCLUSION: This study will provide a reliable evidence-based basis for selecting the best acupuncture and moxibustion therapy for IBS. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/3278Y.


Asunto(s)
Terapia por Acupuntura/normas , Protocolos Clínicos , Síndrome del Colon Irritable/terapia , Moxibustión/normas , Terapia por Acupuntura/métodos , Humanos , Metaanálisis como Asunto , Moxibustión/métodos , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
11.
Medicine (Baltimore) ; 100(35): e27087, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477143

RESUMEN

BACKGROUND: Diabetic nephropathy (DN) is one of the most serious complications in the development of diabetes mellitus, which has become the main cause of end-stage renal disease and one of the main causes of death in diabetic patients. With the prevalence of diabetes, the number of patients at risk for developing DN is increasing, with 20-40 percent of all patients with diabetes at risk for developing DN. Acupuncture and Chinese herbal medicine treatments are often combined to treat DN; however, there has been no meta-analysis on their synergistic effects. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture combined with Chinese herbal medicine for DN treatment. METHODS: Nine electronic databases were retrieved for this study. The English databases mainly retrieved PubMed, Web of Science, Embase, AMED, and the Cochrane Library, while the CNKI, VIP, CBM, and Wanfang databases were used to retrieve the Chinese literature. There is no definite time limit for the retrieval literature, and the languages are limited to Chinese and English. We will consider articles published between database initiation and August 2021. We used Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture combined with Chinese herbal medicine for DN were included in this study. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with Chinese herbal medicine for treating DN. CONCLUSION: This systematic review will provide evidence to determine whether acupuncture combined with Chinese herbal medicine is an effective and safe intervention for patients with DN. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. REGISTRATION NUMBER: INPLASY202180018.


Asunto(s)
Terapia por Acupuntura/normas , Protocolos Clínicos , Nefropatías Diabéticas/tratamiento farmacológico , Medicamentos Herbarios Chinos/normas , Terapia por Acupuntura/métodos , Terapia por Acupuntura/estadística & datos numéricos , Nefropatías Diabéticas/fisiopatología , Medicamentos Herbarios Chinos/uso terapéutico , Humanos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
12.
Medicine (Baltimore) ; 100(35): e27090, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477144

RESUMEN

BACKGROUND: Glaucoma is the second most-common blinding ophthalmic disease in the world, and its incidence has been rising year by year in recent years. Currently, the main treatment of glaucoma still relies on surgery. Glaucoma patients often suffer from various psychological problems like anxiety and depression not only because of the lack of understanding of the surgical treatment of glaucoma, but also the long-term stress and the poor prognosis. As alternative therapies, non-pharmacological interventions can greatly alleviate psychological burdens and improve sleep quality in surgically treated glaucoma patients. Randomized controlled trials of non-pharmacologic interventions for glaucoma have been reported, although the results remain conflicting. Evidences for determining the efficacy of non-pharmacologic interventions for glaucoma are scant. This study aims to assess the effects of non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma through a network meta-analysis. METHODS: A systematic search of relevant literatures published before August 2021 about the effects of non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma will be performed in Wanfang, VP Information Chinese Journal Service Platform, China National Knowledge Infrastructure, Chinese BioMedicine Literature Database, Pubmed, Embase, Cochrane, and Web of science. Two reviewers will be independently responsible for literature screening and selection, quality assessment, and data extraction. WinBUGS 1.4 will be used for the network meta-analysis. RESULTS: This meta-analysis will provide additional and stronger evidences for non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma, which will help clinicians and decision makers to make an optimal therapeutic strategy. CONCLUSION: This study will provide a reliable evidence-based basis for the clinical application of non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma. ETHICS AND DISSEMINATION: Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/TYJPK.


Asunto(s)
Ansiedad/terapia , Protocolos Clínicos , Depresión/terapia , Glaucoma/complicaciones , Trastornos del Sueño-Vigilia/terapia , Ansiedad/psicología , Depresión/psicología , Glaucoma/terapia , Humanos , Metaanálisis como Asunto , Trastornos del Sueño-Vigilia/psicología , Revisiones Sistemáticas como Asunto
13.
Medicine (Baltimore) ; 100(35): e27110, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477151

RESUMEN

BACKGROUND: Constipation is one of the common complications of thoracolumbar compression fractures, which seriously affects the quality of life and increases pain of patients. External treatment of traditional Chinese medicine (TCM) has been widely used clinically for constipation after thoracolumbar compression fractures, but there are no systematic review and meta-analysis of its efficacy. Therefore, we will conduct this study to systematically evaluate the clinical effects of external treatment of TCM for patients with constipation after thoracolumbar compression fractures. METHODS: We will search the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infastructure, Chinese Biomedical Literatures Database, Chinese Scientific Journal Database, and Wanfang Database. Randomized controlled trials on the treatment of constipation after thoracolumbar compression fractures with external treatment of TCM published from inception to May 2021 will be included in the search scope. The observation group was treated with Simple external treatment of TCM (such as external application of Chinese medicine, Chinese drugs at the acupoint, acupuncture, moxibustion, etc) or external treatment of TCM combined with conventional treatment/nursing of Western medicine, while the control group only was treated by conventional treatment/nursing of Western medicine. After screening literatures, extracting data, and assessing the risk of bias in the included studies, meta-analysis will be performed by Revman 5.3 software. RESULTS: This study is expected to provide an evidence of the efficacy of external treatment of TCM for constipation after thoracolumbar compression fractures. CONCLUSION: The results of this meta-analysis may help provide evidence to determine whether external treatment of TCM can be effective interventions for thoracolumbar compression fractures patients with constipation. TRIAL REGISTRATION NUMBER: INPLASY202150005.


Asunto(s)
Protocolos Clínicos , Estreñimiento/tratamiento farmacológico , Fracturas por Compresión/complicaciones , Medicina China Tradicional/normas , Estreñimiento/etiología , Humanos , Medicina China Tradicional/métodos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto
14.
BMC Pediatr ; 21(Suppl 1): 351, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496756

RESUMEN

We looked at existing recommendations and supporting evidence on the effectiveness and potential harms of the different fluoride interventions in preventing dental caries in children under 5 years of age.We conducted a literature search up to the 12th of September 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.Water fluoridation has been widely implemented worldwide for several decades and evidence shows it reduces the prevalence of dental caries. Salt or milk fluoridation are other collective fluoride interventions that are also effective to prevent dental caries in children. The evidence of effects of oral fluoride supplements for caries prevention is limited and inconsistent. The use of fluoride toothpastes has consistently been proven to be effective in the prevention of dental caries. The evidence for the effects of the different levels of fluoride concentration in toothpastes is more limited. Topical fluorides (gels and varnishes) are effective in preventing dental caries and are mainly recommended to children with high risk of dental caries. Early childhood intake of fluoride supplements and fluoride level of 0.7 ppm (ppm) in drinking water are associated with the risk of dental fluorosis, ranging from minor forms to severe forms that are of aesthetic concerns.


Asunto(s)
Caries Dental , Fluoruros , Cariostáticos/efectos adversos , Niño , Preescolar , Caries Dental/epidemiología , Caries Dental/prevención & control , Susceptibilidad a Caries Dentarias , Fluoruros/efectos adversos , Humanos , Revisiones Sistemáticas como Asunto
15.
BMC Pediatr ; 21(Suppl 1): 305, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496777

RESUMEN

We looked at existing recommendations and supporting evidence addressing the effectiveness of pulse oximetry effective for detecting critical congenital heart defects (CCHDs) in newborns. We also looked at the impact of timing of oximetry and the site of testing in the accuracy of screening, and at the potential harms and limitations of pulse oximetry screening,We conducted a literature search up to the 13th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.Current evidence supports consistent accuracy for detection of CCHDs in newborns by pulse oximetry screening in addition to antenatal ultrasonography and clinical examination. Overall, early diagnosis of CCHD with pulse oximetry is judged to be beneficial and cost-effective, and potential harms associated with false-positive tests are not serious, while missing CCHDs and other serious diseases detected by hypoxaemia in absence of pulse oximetry screening can lead to serious consequences. The site of testing (post-ductal versus pre- and post-ductal) had no significant effect on sensitivity nor specificity for detection of CCHDs.


Asunto(s)
Cardiopatías Congénitas , Oximetría , Femenino , Cardiopatías Congénitas/diagnóstico , Humanos , Recién Nacido , Tamizaje Neonatal , Embarazo , Sensibilidad y Especificidad , Revisiones Sistemáticas como Asunto
16.
BMC Pediatr ; 21(Suppl 1): 320, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496779

RESUMEN

We looked at existing recommendations and supporting evidence for successful strategies to prevent the sudden infant death syndrome (SIDS).We conducted a literature search up to the 14th of December 2020 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.Current evidence supports statistical associations between risk factors and SIDS, but there is globally limited evidence by controlled studies assessing the effect of the social promotion strategies to prevent SIDS through knowledge, attitude and practices, due to obvious ethical reasons. A dramatic decline in SIDS incidence has been observed in many countries after the introduction of "Back to Sleep" campaigns for prevention of SIDS. All infants should be placed to sleep in a safe environment including supine position, a firm surface, no soft objects and loose bedding, no head covering, no overheating, and room-sharing without bed-sharing. Breastfeeding on demand and the use of pacifier during sleep time protect against SIDS and should be recommended. Parents should be advised against the use of tobacco, alcohol and illicit drugs during gestation and after birth.


Asunto(s)
Muerte Súbita del Lactante , Lechos , Humanos , Lactante , Chupetes , Posición Prona , Factores de Riesgo , Sueño , Muerte Súbita del Lactante/epidemiología , Muerte Súbita del Lactante/etiología , Muerte Súbita del Lactante/prevención & control , Posición Supina , Revisiones Sistemáticas como Asunto
17.
BMC Pediatr ; 21(Suppl 1): 306, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496780

RESUMEN

We looked at existing recommendations and supporting evidence on the effectiveness of screening for visual disorders in newborns and small infants, and in children between six months and five years of age.We conducted a literature search up to the 5th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendations when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported on the accuracy of screening tests for detecting visual alterations; the efficacy of treatment for improving visual acuity, school performance, and quality of life; and potential harms derived from vision screening and treating visual alterations.Although there is little evidence supporting its validity and effectiveness, examining all newborns for congenital cataract and retinoblastoma through the red reflex examination is widely accepted due to the severity of both diseases and the good outcomes reached by early detection and treatment.Overall, there is a moderate certainty of evidence that visual screening in children between three and five years provides a moderate net benefit, as assessed by the US Preventive Services Task Force: vision screening tests are accurate for detecting amblyopia and its risk factors, and their treatment is associated with visual improvement. There is uncertain evidence on whether vision screening in children under three years of age provides net benefits. Among populations with a low prevalence of vision abnormalities, screening the youngest is associated with an increased rate of false positives, leading to unnecessary additional assessment.


Asunto(s)
Ambliopía , Selección Visual , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Calidad de Vida , Revisiones Sistemáticas como Asunto , Agudeza Visual
18.
BMC Pediatr ; 21(Suppl 1): 356, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496782

RESUMEN

BACKGROUND: Recommendations to prevent morbidity and mortality in children was a high priority for the editorial group of a WHO pocket book for primary health care in the European region. However, the benefit of preventive interventions is not always clear and recommendations differ across countries and institutions. Here, we summarize the existing recommendations and the most recent evidence on ten selected preventive interventions applied to children under five years to inform this group. In addition, we reflect on the process and challenges of developing these summaries. METHODS: For each intervention, we systematically searched for current recommendations from the WHO, the United States Preventive Services Task Force, the workgroup PrevInfad from the Spanish Association of Primary Care Pediatrics, the Centers of Disease Control and Prevention, and the National Institute for Health and Care Excellence. Then, we systematically searched the sources above and the Cochrane library for relevant systematic reviews. For each topic, we reported the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported. Categorising the ten preventive interventions in three groups allowed narrative comparisons between similar types of interventions and between groups. RESULTS AND DISCUSSION: For the single interventions of providing vitamins D and K and topical fluoride there is overall a high degree of consensus between institutions for the evidence of their effectiveness. For the multiple interventions to prevent sudden infant death syndrome and unintentional injuries consensus was more variable as evidence of effectiveness is harder to ascertain. For the screening interventions the summaries of recommendations and evidence varied too. While institutions generally agreed in recommending for vision screening and against universal screening for language and speech delay and iron deficiency, they had some differences for pulse oximetry and autism. The transparent and independent process shed light upon how institutions use existing evidence in their settings - common and different positions were accounted for and became visible. We also identified gaps and duplications of research. Our approach was a crucial starting point for developing the respective sections in the pocket book.


Asunto(s)
Trastornos del Desarrollo del Lenguaje , Atención Primaria de Salud , Niño , Preescolar , Humanos , Lactante , Tamizaje Masivo , Servicios Preventivos de Salud , Revisiones Sistemáticas como Asunto
19.
BMC Pediatr ; 21(Suppl 1): 350, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496783

RESUMEN

We looked at existing recommendations and supporting evidence on the effectiveness of vitamin K given after birth in preventing the haemorrhagic disease of the newborn (HDN).We conducted a literature search up to the 10th of December 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.All newborns should receive vitamin K prophylaxis, as it has been proven that oral and intramuscular prophylactic vitamin K given after birth are effective for preventing classical HDN. There are no randomized trials looking at the efficacy of vitamin K supplement on late HDN. There are no randomized trials comparing the oral and intramuscular route of administration of prophylactic vitamin K in newborns. From older trials and surveillance data, it seems that there is no significant difference between the intramuscular and the oral regimens for preventing classical and late HDN, provided that the oral regimen is duly completed. Evidence assessing vitamin K prophylaxis in preterm infants is scarce.


Asunto(s)
Sangrado por Deficiencia de Vitamina K , Vitamina K , Administración Oral , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Inyecciones Intramusculares , Revisiones Sistemáticas como Asunto , Vitamina K/uso terapéutico , Sangrado por Deficiencia de Vitamina K/tratamiento farmacológico , Sangrado por Deficiencia de Vitamina K/prevención & control
20.
BMC Pediatr ; 21(Suppl 1): 337, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496786

RESUMEN

We looked at existing recommendations and supporting evidence on the effectiveness of universal screening of iron deficiency anaemia (IDA) in children under five years of age for improving growth, cognitive function, and psychomotor development. We assessed the accuracy of the screening tests for detecting IDA, the efficacy of existing treatment for children with IDA, and the potential harms associated with screening and treatment.We conducted a literature search up to the 18th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.There is no suitable test for IDA screening that is non-invasive with high accuracy for detecting IDA and there is uncertainty whether IDA in children causes cognitive and psychomotor delays. There is a lack of evidence on the effects of routine screening for IDA in asymptomatic children under five years of age on growth, cognitive and psychomotor development outcomes.Universal screening of IDA in children under five years of age is not recommended by most organisations such as the Spanish Association of Primary Care Paediatrics, the United Kingdom National Screening Committee, and the United States Preventive Services Task Force, but is recommended by the American Academy of Paediatrics. However, selective screening of IDA is recommended in infants and children with risk factors including prematurity, low birth weight, and dietary risk factors.


Asunto(s)
Anemia Ferropénica , Anemia Ferropénica/diagnóstico , Niño , Preescolar , Cognición , Humanos , Lactante , Tamizaje Masivo , Revisiones Sistemáticas como Asunto , Reino Unido
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...