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The combined effect of extraoral vibratory stimulus and external cooling on pain perception during intra-oral local anesthesia administration in children: a systematic review and meta-analysis

  • Tirupathi, Sunny Priyatham;Nanda, Neethu;Pallepagu, Sneha;Malothu, Sardhar;Rathi, Nilesh;Chauhan, Rashmi Singh;Priyanka, VakaJeevan;Basireddy, Rameshreddy
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.2
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    • pp.87-96
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    • 2022
  • This study aimed to assess the combined use of extraoral vibratory stimulation and extraoral cooling in reducing the pain (subjective and objective) of dental local anesthesia administration in children. PubMed, Cochrane Central Register of Controlled Trials, and Ovid SP databases were searched up to July 2021. Article titles were screened and full-text evaluations of the selected articles were performed. Finally, seven studies (391 children, aged 4 - 12 years) were included in this qualitative and quantitative analysis. The pooled data determined the combined effect of extraoral vibration and extraoral cooling as a single measure. Extraoral vibration or cooling alone were not compared. The measured primary and secondary outcomes were pain perception and subjective and objective pain, respectively. When compared with the control, extraoral vibration and cooling resulted in significant differences in the mean combined data for the variables, pain perception, and pain reaction. Children's subjective pain as measured by pain scores were reduced when extraoral vibration and cooling was used during local anesthesia administration (mean difference -3.52; 95% confidence interval [-5.06 - 1.98]) and objective pain (mean difference -1.46; 95% confidence interval [-2.95 - 0.02] ; mean difference -1.93; 95% confidence interval [-3.72 - 0.14]). Within the confines of this systematic review, there is low-quality evidence to support the use of combined extraoral vibration and cooling for reducing pain (subjective and objective) during intraoral local anesthesia administration in children.

Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis

  • Hadilou, Mahdi;Gholami, Leila;Ghojazadeh, Morteza;Emadi, Naghmeh
    • Imaging Science in Dentistry
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    • v.52 no.2
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    • pp.141-153
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    • 2022
  • Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.

Effects of Herbal Medicines on Osteoporosis in Rheumatoid Arthritis: Study Protocol for a Systematic Review and Meta-Analysis (한약이 류마티스 관절염 환자의 골다공증에 미치는 영향: 체계적 문헌 고찰 및 메타분석을 위한 프로토콜)

  • Kwon, Do Young;Gu, Ji Hyang;Lee, Eun Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.77-84
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    • 2022
  • Objectives This study is designed to identify the effectiveness of herbal medicine for osteoporosis in rheumatoid arthritis. Methods We will investigate 10 databases, 4 Korean databases (KoreaMed, KMBASE, Koreanstudies Information Service System [KISS], ScienceOn) and 6 of abroad (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], WanFang, Citation Information by NII [CiNii]) without publication date, language limitation for clinical study of herbal medicine for osteoporosis in rheumatoid arthritis. Type, dose, duration, frequency of herb medicine will be analyzed. Results Randomized controlled trials about herbal medicine or herb extract for osteoporosis in rheumatoid arthritis should be included in the study. Cochrane's risk of bias tools will be used to assess quality of the study. Mean differences or standardized mean differences of 95% confidence intervals will calculated and data synthesis will be conducted using Review Manager (RevMan, ver.5.3; The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Conclusions It is expected to provide basic data for the active use of herb medicine by systematically synthesizing and analyzing the actual situation, effectiveness, and safety of herb medicine for osteoporosis in rheumatoid arthritis.

Jang Woo-Jae's Theater Aesthetics and Thought Experiment (장우재의 연극미학과 사유실험)

  • Shim, Jae-Min
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.3
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    • pp.101-125
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    • 2021
  • This paper aims from various angles to examine the context of the problem situations that Jang Woo-Jae describes from contemporary korean society, to examine which chance of thinking is in this case given to the audience, and to examine whether through the plays in the theater this chance of thinking can be referred to public opinion. This study considers not only the contribution of Jang's thought experiment that is connected to the dramaturgical function including the aspects of dramatic form and content to dramatic effects for the audience, but also the possibility of an arrangement for a new way of thinking by the audience. Thus, Jang's thought experiment should be understood in connection with the whole message of his plays. And this study researches, how an new attention to the public nature of common world, which should be demanded for the sake of a mature civil society comes into existence within the point of contention in every play based on Jang's thought experiment. Finally this paper inspects through Jang's plays the possibility of contribution of performing art to contemporary korean society, and takes account of self-examination in meta-dimension of the theater regarding the role and meaning for the sake of human being and gemeinschaft.

Outcomes of Closed versus Open Rhinoplasty: A Systematic Review

  • Gupta, Rohun;John, Jithin;Ranganathan, Noopur;Stepanian, Rima;Gupta, Monik;Hart, Justin;Nossoni, Farideddin;Shaheen, Kenneth;Folbe, Adam;Chaiyasate, Kongkrit
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.569-579
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    • 2022
  • Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.

Reducing pain and opioid consumption after body contouring of the breast by application of a perioperative nerve block: a systematic review

  • Asserson, Derek B.;Sahar, David E.
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.361-365
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    • 2021
  • Background Pain in the postoperative body contouring patient has traditionally been managed with narcotic medication. In an effort to minimize side effects and prevent addiction, plastic surgeons are searching for novel ways to provide adequate analgesia, one of which is nerve blocks. This study was conducted with a meta-analysis that evaluates the efficacy of these blocks for patients who undergo breast surgery. Methods A search of the PubMed/MEDLINE database for articles including the terms "post-operative analgesia" OR "postoperative pain management" AND "in plastic surgery" OR "in cosmetic surgery" OR "in elective surgery" in February 2019 generated five studies on elective breast augmentation and reduction mammoplasty that reported pain scores and quantities of opioids consumed. Independent samples t-tests, one-way analysis of variance, and a random effects model were implemented for evaluation. Results A total of 317 patients were identified as having undergone body contouring of the breast, about half of which received a nerve block. Pain scores on a 1-10 scale and opioid dose-equivalents were calculated. Those who were blocked had an average score of 2.40 compared to 3.64 for those who did not (P<0.001), and required an average of 5.20 less narcotic doses (P<0.001). Pain relief following subpectoral augmentation was best achieved with type-II blocks as opposed to type-I and type-II with serratus plane (P<0.001). Conclusions The opioid epidemic has extended to all surgical specialties. Implementation of a nerve block seems to be an efficacious and cost-effective mechanism to not only help with post-operative pain, but also lower the need for narcotics, especially in subpectoral augmentation.

Work Conditions and Practices in Norwegian Fire Departments From 1950 Until Today: A Survey on Factors Potentially Influencing Carcinogen Exposure

  • Jakobsen, Jarle;Babigumira, Ronnie;Danielsen, Marie;Grimsrud, Tom K.;Olsen, Raymond;Rosting, Cecilie;Veierod, Marit B.;Kjaerheim, Kristina
    • Safety and Health at Work
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    • v.11 no.4
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    • pp.509-516
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    • 2020
  • Background: Meta-analyses have shown firefighters to be at an increased risk of several cancer types. Occupational carcinogen exposure may explain these increased risks. This study aims to describe Norwegian fire departments' work conditions from 1950 until today, focusing on factors relevant for potential occupational carcinogen exposure. Methods: With the help of a reference group, we developed a questionnaire on topics related to occupational exposure to carcinogens for the period 1950-2018. Selected Norwegian fire departments provided department-specific responses. Results: Sixteen departments, providing fire services for 48% of the Norwegian population as of 2019 and mainly consisting of professional firefighters, responded to our questionnaire. The introduction of synthetic firefighting foams, more regular live fire training, the introduction of chemical diving, and a higher number of diesel-driven fire service vehicles were identified as changes thought to increase exposure to occupational carcinogens. Changes thought to decrease exposure included the switch from negative to positive pressure self-contained breathing apparatuses, the use of self-contained breathing apparatuses during all phases of firefighting, the use of ventilating fans during firefighting, increased attention to flammable materials used during live fire training, increased attention to handling and cleaning of turnout gear and other equipment, and installment of exhaust removal systems in apparatus bays. Conclusion: Norwegian fire departments' work conditions have seen several changes since 1950, and this could influence firefighters' occupational carcinogen exposure. A peak of carcinogen exposure may have occurred in the 1970s and 1980s before recent changes have reduced exposure.

Experimental study of graphene oxide on wollastonite induced cement mortar

  • Sairam, V.;Shanmugapriya, T.;Jain, Chetan;Agrahari, Himanshu Kumar;Malpani, Tanmay
    • Advances in concrete construction
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    • v.12 no.6
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    • pp.479-490
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    • 2021
  • Present research is mainly focused on, microstructural and durability analysis of Graphene Oxide (GO) in Wollastonite (WO) induced cement mortar with silica fume. The study was conducted by evaluating the mechanical properties (compressive and flexural strength), durability properties (water absorption, sorptivity and sulphate resistance) and microstructural analysis by SEM. Cement mortar mix prepared by replacing 10% ordinary portland cement with SF was considered as the control mix. Wollastonite replacement level varied from 0 to 20% by weight of cement. The optimum replacement of wollastonite was found to be 15% and this was followed by four sets of mortar specimens with varying substitution levels of cementitious material with GO at dosage rates of 0.1%, 0.2%, 0.3% and 0.4% by weight. The results indicated that the addition of up to 15%WO and 0.3% GO improves the hydration process and increase the compressive strength and flexural strength of the mortar due to the pore volume reduction, thereby strengthening the mortar mix. The resistance to water penetration and sulphate attack of mortar mixes were generally improved with the dosage of GO in presence of 15% Wollastonite and 10% silica fume content in the mortar mix. Furthermore, FE-SEM test results showed that the WO influences the lattice framework of the cement hydration products increasing the bonding between silica fume particles and cement. The optimum mix containing 0.3% GO with 15% WO replacement exhibited extensive C-S-H formation along with a uniform densified structure indicating that calcium meta-silicate has filled the pores.

Volumetric measurement of the tongue and oral cavity with cone-beam computed tomography: A systematic review

  • Kannitha Alina, Aflah;Winny, Yohana;Fahmi, Oscandar
    • Imaging Science in Dentistry
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    • v.52 no.4
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    • pp.333-342
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    • 2022
  • Purpose: The goal of this systematic review was to compare the use of cone-beam computed tomography (CBCT) with that of computed tomography (CT) for volumetric evaluations of the tongue and oral cavity. Materials and Methods: A search for articles was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The PubMed, Scopus, ScienceDirect, and SAGE Journals databases were searched for articles published between 2011 and 2021. Articles were screened and assessed for eligibility. Screening involved checking for duplication, reading the title and abstract, and reading the full text. Results: The initial search retrieved 25,780 articles. Application of the eligibility criteria yielded 16 articles for qualitative analysis. Multiple uses of CBCT were identified. In several studies, researchers assessed the volumetric correlation between tongue and oral cavity volumes, as well as other parameters. Post-treatment volumetric evaluations of the oral cavity were also reported, and the reliability of CBCT was assessed. The use of CT resembled that of CBCT. Conclusion: CBCT has been used in the evaluation of tongue and oral cavity volumes to assess correlations between those volumes and with the upper airway. It has also been used for volumetric evaluation after surgical and nonsurgical procedures and to assess the relationships between tongue volume, tooth position, occlusion, and body mass index. Participants with obstructive sleep apnea and malocclusion have been evaluated, and the reliability of CBCT has been assessed. In the included studies, CT was utilized for similar purposes as CBCT, but its reliability was not assessed.

The Medial Sural Artery Perforator Flap versus Other Free Flaps in Head and Neck Reconstruction: A Systematic Review

  • Yasser Al Omran;Ellie Evans;Chloe Jordan;Tiffanie-Marie Borg;Samar AlOmran;Sarvnaz Sepehripour;Mohammed Ali Akhavani
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.264-273
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    • 2023
  • The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.