Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.
Hidayat, Cecep;Sumiati, Sumiati;Jayanegara, Anuraga;Wina, Elizabeth
Asian-Australasian Journal of Animal Sciences
/
v.33
no.3
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pp.465-479
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2020
Objective: This study performed a meta-analysis of published trials to determine the effects of zinc on the immune response and production performance of broilers. Methods: A database was built from published literature regarding the addition of zinc forms or doses and their relation to the immune response and production performance of broilers. Different doses or forms of zinc were identified in the database. The recorded parameters were related to the immune response and production performance. The database contained a total of 323 data points from 41 studies that met the criteria. Then, the data were processed for a meta-analysis using a mixed model methodology. The doses or different forms of zinc were considered fixed effects, different studies were treated as random effects, and p-values were used as the model statistics. Results: An increase in zinc dose increased (p<0.05) pancreas metallothionein (MT) and zinc concentrations in the plasma, tibia and meat, all in quadratic patterns, but linearly decreased (p<0.05) the heterophil/lymphocyte (H/L) ratio. Regarding the different zinc forms, both inorganic and organic zinc increased (p<0.05) the zinc concentrations in the plasma and tibia, the calcium and phosphorus contents in the tibia, and the antioxidant activity of superoxide dismutase in meat as compared to control. An increase in zinc dose increased average daily gain (ADG) and decreased feed conversion ratio (FCR) following a quadratic pattern (p<0.05). Inorganic and organic zinc decreased (p<0.05) FCR and H/L ratio than that of control, but these two forms were similar for these parameters. Conclusion: Zinc addition has a positive impact on immunity and broiler production. Zinc can suppress stress and inhibit the occurrence of lipid peroxidation in broilers, and it can also improve ADG, FCR, and the quality of broiler carcasses.
Objectives: In order to evaluate the association between occupational exposure to chloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL), we conducted a meta-analysis of retrospective cohort studies and casecontrol studies and attempted to summarize the evidence of the association from molecular-epidemiological studies and experiments with human cells. Methods: In the meta-analysis, we restricted the analysis to those studies with data for chlorinated solvents, degreasers, or TCE. Studies involving dry cleaners or launderers were excluded from the analysis because use of TCE as a dry cleaning fluid has been rare since the 1960s. The data were combined using a random-effects model to estimate the summary risks (OR and RR) and 95% confidence intervals (CIs). Molecular evidence of the effect of TCE on human immune system were also reviewed and summarized. Results: Occupational exposure to TCE was strongly associated with NHL among cohort studies (number of studies=13, summary RR=1.33, 95% CI=1.04-1.70) whereas the association was not statistically significant among case-control studies (number of studies=15, summary OR=1.10, 0.98-1.23). When exposure level was considered, it became statistically significant for the highest exposure level (number of studies=5, summary OR=1.70, 1.25-2.32). Molecular evidences showed that TCE exposure in human or cultured human cells may cause a significant decrease immune cell subsets and changes in hormone levels related to immune response. Conclusions: Our results from meta-analysis and additional molecular evidence suggest that occupational exposure to TCE may cause NHL. However, unmeasured potential confounding and unclear dose-response relationships warrant further study on the role of TCE exposure in NHL carcinogenesis.
Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography. Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: post-expansion (2-6 weeks) and post-retention (4-8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data. Results: All the investigated outcomes showed significant differences post-expansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion. Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.
Purpose: To systematically review efficacyand safety of robotic gastrectomy (RG) compared with conventional laparoscopic gastrectomy (LG) for gastric carcinoma. Materials and Methods: A systematic literature search was carried out using PubMed, Cochrane Library, CBM, CNKI, WanFang, VIP and other sources like relevant references to obtain comparative studies assessing the effectiveness and safety between RG and LG published between 2013 and 2016. Then the literature was screened and the data were extracted by 2 independent reviewers. The quality of the literature was assessed, and the data analyzed using Stata/SE 14 software. Fixed effects or random effects models wereapplied according to heterogeneity. Results: A total of 12 non-randomized observational clinical studies involving 3,580 patients were included, of which 1,096 had undergone RG and 2,484 had received LG. The results of the meta-analysis showed in terms of effectiveness, RG was associated with less blood loss, less time to first flatus and greater number of harvested lymph nodes, but there were no significant differences in proximal and distal resection margins, compared with LG. In terms of efficiency, RG was associated with shorter hospital stay, but longer operative time. In terms of safety, there were no statistically significant differences in complications, mortality and conversions between RG and LG. Conclusions: RG can achieve comparable or better short-term and radical effects than LG, with respect to effectiveness, efficiency and safety in treatment of gastric carcinoma. Future studies involving RG should focus on decreasing operative time and reducing cost. Moreover, there is a need for randomized controlled trials comparing the two techniques with long-term follow-up.
MicroRNA 200c is a microRNA 200 family member that plays an important role in regulation of the epithelial-to-mesenchymal transition (EMT). The prognostic value of microRNA 200c in solid tumors remains controversial because of inconsistent data. Here, we report a meta-analysis of the association of microRNA 200c expression and survival in patients with solid tumors. Pubmed was searched up to November 2013 for studies investigating microRNA 200c expression and overall survival (OS) in solid tumors. Hazard ratios (HRs) with 95% confidence intervals (CIs) for OS were extracted from each study. Pooled HR and CIs were calculated using the Mantel-Haenszel fixed-effects models. A total of five studies evaluating colorectal cancer, gastric cancer, ovarian cancer, pancreatic cancer and endometrial cancer were included in the analysis. Data were divided into tissue microRNA 200c expression group and serum microRNA 200c expression group. The combined HRs [95%CIs] estimated for OS were 0.62 [0.42-0.91] and 2.16 [1.32-3.52] respectively. Low expression of microRNA 200c in tumor tissue and high expression of microRNA 200c in serum are associated with worse survival in solid tumors. Further study is needed to elucidate this contradiction.
Objectives : Due to recent developments and the wide application of percutaneous transforaminal discectomy (PTED) in China, we herein compare its clinical effects with microendoscopic discectomy (MED) for the treatment of lumbar disc herniation in terms of recurrence and revision rates. Methods : Six databases, namely, PubMed, EMBASE, Cochrane Library, Ovid, China National Knowledge Infrastructure and Wanfang, were searched by computer. The literature was screened according to inclusion and exclusion criteria, and the quality of the included literature was evaluated. After extracting the data from the papers, Review Manager 5.2 software (Cochrane Collaboration, Oxford, UK) was applied to analyze these data. Finally, sensitivity and publication bias analyses of the results were conducted. Results : A total of 12 studies consisting of 2400 patients were included in this meta-analysis. A comparison of PTED with MED revealed higher postoperative recurrence and postoperative revision rates for PTED (odds ratio [OR] recurrence, 1.60; 95% confidence interval [CI], 1.01 to 2.53; p=0.05 and OR revision, 1.77; 95% CI, 1.18 to 2.64, p=0.006). Conclusion : PTED has a number of advantages because it is a minimally invasive surgery, but its recurrence and revision rates are higher than MED. Therefore, MED should not be completely replaced by PTED.
The purpose of this study was to objectively quantify the effects of nutrition and dietary life education on preschoolers through meta-analysis. In addition, it provides basic data for the implementation of nutrition education and development of systematic nutrition and dietary life education programs. In this study, a meta-analysis of 27 papers was conducted that conformed to the selection criteria in the study conducted from January 2012 to August 2019 to derive objective data on the effects of education. As a result of the analysis, the overall effective size of nutrition and dietary life education for preschoolers was 0.829, which indicates a strong effect. According to the education method, the effect size of general education was 0.562, which indicates a medium effect size, the vegetable playing-based experience education was 0.685, which indicates a medium effect size, and cooking activity-based experience education was 1.101, which indicates a large effect size. Judging from this result, experience activity education was more effective than general nutrition education. In addition, the combined size of convergence education conducted through a combination of general and experience education was found to be the most effective at 1.301. In terms of educational effect, it was confirmed that the effect size was 0.898 for improving nutrition knowledge, 0.858 for improving dietary habits, 0.836 for improving unbalanced diet, and 0.756 for improving food preference and intake, and the sizes of effects were all found to be large. As frequency of education increased, the number of education participants decreased and the effect of education increased.
The Journal of Korean Academic Society of Nursing Education
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v.23
no.1
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pp.15-26
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2017
Purpose: This study evaluated the efficacy of a communication ability enhancement program for nursing students in Korea through a systematic review of literature and meta-analysis. Methods: The researchers searched data-bases, including the Data Base Periodical Information Academic, Research Information Sharing Service, National Digital Science Library and National Assembly Library. The key words used included 'communication' and 'nursing student'. The researchers evaluated articles published up to July 2016. Out of 381 selected articles, 20 clinical trial studies were meta-analyzed. Each article was evaluated in accordance with the Checklist of Scottish Intercollegiate Guideline Network. The effect size of communication ability, self-efficacy and interpersonal relations were synthesized by a random effects model from analysis software (R 3.2.3). The heterogeneity of effect size was analyzed by exploratory and confirmatory moderator analysis. Results: The overall effect size of the program was of a moderate level (SMD=0.78, 95% CI: 0.49~1.07) along with each outcome of self-efficacy (SMD=0.80, 95% CI: 0.23~1.37), and interpersonal relations (SMD=0.47, 95% CI: 0.14~0.80). For heterogeneity, moderator analysis was performed, by grade, and a statistically significant moderator was found. Conclusion: It is evident that a communication ability enhancement program for nursing students is moderately effective in improving communication ability, self-efficacy and interpersonal relations.
Journal of the Korean Data and Information Science Society
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v.23
no.4
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pp.649-656
/
2012
The present study was carried out to summarize the effect of caffeine in the lipid metabolic by meta-analysis. The association measure to test effect of caffeine was the Hedges's standardized mean difference (HG). In this particular fixed-effect model of Hedges's standardized mean difference, weight gain, heart weight, serum total lipid, serum triglycerides and liver triglycerides were significantly decreased (p < 0.05). Also, serum HDL cholesterol and serum LDL cholesterol were significantly increased. In this case of heterogeneous variable, random effect model was applied. In this model, weight gain, heart weight, serum total lipid, serum triglycerides, serum LDL cholesterol and liver triglycerides were significantly decreased in caffeine treated group. Also HDL-cholesterol was significantly increased in caffeine treated group.
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