Crystalloids and different component colloids, used for volume resuscitation, are sometimes associated with various adverse effects. Clinical trial findings for such fluid types in different ...patients' conditions are conflicting. Whether the mortality benefit of balanced crystalloid than saline can be inferred from sepsis to other patient group is uncertain, and adverse effect profile is not comprehensive. This study aims to compare the survival benefits and adverse effects of seven fluid types with network meta-analysis in sepsis, surgical, trauma, and traumatic brain injury patients.
Searched databases (PubMed, EMBASE, and Cochrane CENTRAL) and reference lists of relevant articles occurred from inception until January 2020. Studies on critically ill adults requiring fluid resuscitation were included. Intervention studies reported on balanced crystalloid, saline, iso-oncotic albumin, hyperoncotic albumin, low molecular weight hydroxyethyl starch (L-HES), high molecular weight HES, and gelatin. Network meta-analyses were conducted using random-effects model to calculate odds ratio (OR) and mean difference. Risk of Bias tool 2.0 was used to assess bias. Confidence in Network Meta-Analysis (CINeMA) web application was used to rate confidence in synthetic evidence.
Fifty-eight trials (n = 26,351 patients) were identified. Seven fluid types were evaluated. Among patients with sepsis and surgery, balanced crystalloids and albumin achieved better survival, fewer acute kidney injury, and smaller blood transfusion volumes than saline and L-HES. In those with sepsis, balanced crystalloids significantly reduced mortality more than saline (OR 0.84; 95% CI 0.74-0.95) and L-HES (OR 0.81; 95% CI 0.69-0.95) and reduced acute kidney injury more than L-HES (OR 0.80; 95% CI 0.65-0.99). However, they required the greatest resuscitation volume among all fluid types, especially in trauma patients. In patients with traumatic brain injury, saline and L-HES achieved lower mortality than albumin and balanced crystalloids; especially saline was significantly superior to iso-oncotic albumin (OR 0.55; 95% CI 0.35-0.87).
Our network meta-analysis found that balanced crystalloids and albumin decreased mortality more than L-HES and saline in sepsis patients; however, saline or L-HES was better than iso-oncotic albumin or balanced crystalloids in traumatic brain injury patients.
PROSPERO website, registration number: CRD42018115641).
Aims
We aimed to update a previous network meta‐analysis comparing the efficacy of periodontal regenerative therapies on the treatment of infrabony lesions.
Materials and Methods
Seven clinical ...trials were added after literature research for studies published between January 2011 and September 2019. We conducted network meta‐analysis (NMA) to compare the effects of guided tissue regeneration (GTR), enamel matrix derivatives (EMD) and their combination therapies on probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain. Sequential network meta‐analysis (SNMA) was also used to control the type‐I error rate due to multiple testing.
Results
A total of 60 studies were included. For both PPD reduction and CAL gain, the flap operation (FO) was the least effective treatment. Although the differences between periodontal regenerative therapies were small, GTR attained the greatest reduction in PPD, and EMD with bone graft the greatest CAL gain compared to other therapies. SNMA used stricter efficacy criteria, yielding slightly different results from NMA.
Conclusions
EMD, GTR, and their combined therapies were more effective than flap operation, although the differences between regenerative therapies remain small in this updated study. SNMA reduces the risk of false‐positive findings, thereby providing more robust evidence on the superiority of treatments.
Aim
This systematic review aimed to investigates the types and incidences of complications following sinus floor elevations (SFE) along with their prevention and management strategies.
Materials and ...methods
Electronic database and hand search were conducted to screen the literature published from January 1960 to June 2021. The selected studies had to report well‐described SFE techniques, complications during, and post‐SFE. Data extraction included types of SFE techniques, complications, and their treatment strategies.
Results
A total of 74 studies with 4411 SFE procedures met the inclusion criteria. Different SFE techniques demonstrated varying patterns for both complications and complication rates. Postoperative pain, swelling, and edema were widely reported. The most common complications that required intervention following Lateral SFE (LSFE) were sinus membrane perforation (SMP), wound dehiscence, graft exposure and failure, and sinusitis. LSFE had more SMPs and sinusitis cases compared with a transcrestal SFE (TSFE). The presence of benign paroxysmal positional vertigo following TSFE was significant in certain selected studies.
Conclusion
Given the inherent limitations, this systematic review showed distinct features of complications in SFE using varying techniques. Treatment planning for these procedures should incorporate strategies to avoid complication occurrence.
Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and ...cardiovascular disease risk is unclear. Embase and PubMed were searched from their inception to 17 August 2020 and studies that examined the association between sodium intake and cardiovascular disease in adolescents were not included in this review. We conducted a meta-analysis to estimate the effect of high sodium intake using a random effects model. The Newcastle-Ottawa Scale assessment was performed. A random-effects dose-response model was used to estimate the linear and nonlinear dose-response relationships. Subgroup analyses and meta-regression were conducted to explain the observed heterogeneity. We identified 36 reports, which included a total of 616,905 participants, and 20 of these reports were also used for a dose-response meta-analysis. Compared with individuals with low sodium intake, individuals with high sodium intake had a higher adjusted risk of cardiovascular disease (Rate ratio: 1.19, 95% confidence intervals = 1.08-1.30). Our findings suggest that there is a significant linear relationship between dietary sodium intake and cardiovascular disease risk. The risk of cardiovascular disease increased up to 6% for every 1 g increase in dietary sodium intake. A low-sodium diet should be encouraged and education regarding reduced sodium intake should be provided.
AbstractObjectiveTo assess the efficacy and safety of different endoscopic surgical treatments for benign prostatic hyperplasia.DesignSystematic review and network meta-analysis of randomised ...controlled trials.Data sourcesA comprehensive search of PubMed, Embase, and Cochrane databases from inception to 31 March 2019.Study selectionRandomised controlled trials comparing vapourisation, resection, and enucleation of the prostate using monopolar, bipolar, or various laser systems (holmium, thulium, potassium titanyl phosphate, or diode) as surgical treatments for benign prostatic hyperplasia. The primary outcomes were the maximal flow rate (Qmax) and international prostate symptoms score (IPSS) at 12 months after surgical treatment. Secondary outcomes were Qmax and IPSS values at 6, 24, and 36 months after surgical treatment; perioperative parameters; and surgical complications.Data extraction and synthesisTwo independent reviewers extracted the study data and performed quality assessments using the Cochrane Risk of Bias Tool. The effect sizes were summarised using weighted mean differences for continuous outcomes and odds ratios for binary outcomes. Frequentist approach to the network meta-analysis was used to estimate comparative effects and safety. Ranking probabilities of each treatment were also calculated.Results109 trials with a total of 13 676 participants were identified. Nine surgical treatments were evaluated. Enucleation achieved better Qmax and IPSS values than resection and vapourisation methods at six and 12 months after surgical treatment, and the difference maintained up to 24 and 36 months after surgical treatment. For Qmax at 12 months after surgical treatment, the best three methods compared with monopolar transurethral resection of the prostate (TURP) were bipolar enucleation (mean difference 2.42 mL/s (95% confidence interval 1.11 to 3.73)), diode laser enucleation (1.86 (−0.17 to 3.88)), and holmium laser enucleation (1.07 (0.07 to 2.08)). The worst performing method was diode laser vapourisation (−1.90 (−5.07 to 1.27)). The results of IPSS at 12 months after treatment were similar to Qmax at 12 months after treatment. The best three methods, versus monopolar TURP, were diode laser enucleation (mean difference −1.00 (−2.41 to 0.40)), bipolar enucleation (0.87 (−1.80 to 0.07)), and holmium laser enucleation (−0.84 (−1.51 to 0.58)). The worst performing method was diode laser vapourisation (1.30 (−1.16 to 3.76)). Eight new methods were better at controlling bleeding than monopolar TURP, resulting in a shorter catheterisation duration, reduced postoperative haemoglobin declination, fewer clot retention events, and lower blood transfusion rate. However, short term transient urinary incontinence might still be a concern for enucleation methods, compared with resection methods (odds ratio 1.92, 1.39 to 2.65). No substantial inconsistency between direct and indirect evidence was detected in primary or secondary outcomes.ConclusionEight new endoscopic surgical methods for benign prostatic hyperplasia appeared to be superior in safety compared with monopolar TURP. Among these new treatments, enucleation methods showed better Qmax and IPSS values than vapourisation and resection methods.Study registrationCRD42018099583.
•Solubility of gliclazide and captopril in ScCO2 was measured.•Experiments were conducted at 308.2–328.2 K in a pressure range of 10–18.6 MPa.•Experimental data self-consistency was confirmed by ...semi-empirical models.•Two approaches based on Peng-Robinson EOS provide good correlation results.•PR+MHV1+COSMOSAC predictions are within a factor of three of experiment.
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The solubility of drugs in supercritical carbon dioxide (ScCO2) is crucial information for crystal engineering designs and pharmaceutical applications. A semi-flow apparatus was used to measure the solubility of gliclazide and captopril in ScCO2 at 308.2 K, 318.2 K, and 328.2 K within the pressure range of 10.0–18.6 MPa. The newly measured solubility data were correlated and confirmed to be self-consistency with four semi-empirical correlation models: Chrastil, Méndez-Santiago & Teja (MST), Bartle, and Kumar & Johnston (K-J). The newly measured data were then used to evaluate the accuracy of three approaches based on the Peng-Robinson equation of state (PR EOS). PR EOS combining with the Wilson model through the Wong-Sandler mixing rule with two adjustable parameters shown excellent fit with experimental data, while PR EOS combining with the COSMO-SAC model through the MHV1 mixing rule provided reasonable solubility prediction without adjustable parameters.
•Consumer’s TFF safety and nutrition perceptions affected their TFF health benefits perceptions.•Consumer’s safety and health benefits perceptions affected their affective commitment to ...TFF.•Consumer’s health benefits perceptions and affective commitment affected their repurchase intentions.
Because numerous food safety problems have gained public attention, consumers are now focused on food safety and nutrition as well as health benefits. While traceability is considered the most effective intervention to ensure food safety, understanding how to encourage consumers to purchase traceable fresh food (TFF) is crucial in developing the safe food market. A questionnaire survey was conducted in Taiwan to explore the effects of the perception of TFF safety and nutrition on perceived health benefits, affective commitment, and repurchase intention. TFF consumers, defined as those who had purchased TFF in the past three months, were asked to participate in the study; in total, 393 valid questionnaires were collected. Results of structural equation modeling analysis indicated that consumers’ TFF safety and nutrition perception affected their health benefit perceptions, which consequently influenced their affective commitment to TFF and repurchase intentions. These findings explain how TFF repurchase intentions are influenced by TFF safety and nutrition perception and health benefit perceptions. This paper provides some practical suggestions for TFF marketers to increase TFF consumption.
Purpose
The aim of the present systematic review was to evaluate the effect of different lateral bone augmentation (LBA) procedures on the complete correction of a peri‐implant bone dehiscence (BD) ...or fenestration (BF) from implant placement to implant surgical uncovering.
Methods
Electronic (Medline, Scopus, and Cochrane databases) and hand literature searches were performed for studies including at least one treatment arm where any LBA had been applied to correct a BD/BF at implant placement (T0). Studies where BD/BF was left untreated were also retrieved as negative control. Data from 24 selected articles were used to perform a network meta‐analysis. Based on the proportion of nonresolved BD/BF at implant surgical uncovering (T1), a hierarchy of LBA procedures, and was determined. Spontaneous healing (i.e., exposed implant surface covered by a full‐thickness flap; SELF) was also included in the hierarchy. Resorbable membrane + bone graft (RM + BG) was used as reference group. An analysis on the effect of nonhuman (NHBS) vs human (HBS) derived bone substitutes was also performed. NHBS was used as the reference group.
Results
No statistically significant differences were found among treatments for the proportion of nonresolved BD/BF. SELF performed substantially worse compared to RM + BG (OR: 5.78 × 10, CI: 4.83 × 10 – 1.3 × 1086). Treatment based on a combination of a graft material and membrane/periosteum appeared to perform slightly better than treatments using graft material or membrane alone. NHBS appeared to perform better than HBS.
SELF had the worst effect among all treatments for both BD/BF height reduction (BDH) and BD/BF width reduction (BDW). Nonresorbable membrane (NRM) and patient's own periosteum (PERI) + BG showed greater increases in buccal bone thickness than RM + BG.
Conclusion
Reconstructive treatment (including use of graft alone, membrane alone, or combinations of grafts and either membrane or patient's own periosteum) of a BD/BF at implant placement favorably and significantly impacts on the probability to obtain complete correction of the BD/BF at implant uncovering when compared to full‐thickness flap repositioning on the BD/BF. When using a bone substitute, a nonhuman derived one may be suggested.
Component network meta‐analysis (CNMA) compares treatments comprising multiple components and estimates the effects of individual components. For network meta‐analysis, a standard network plot with ...nodes for treatments and edges for direct comparisons between treatments is drawn to visualize the evidence structure and the connections between treatments. However, the standard network plot does not effectively illustrate the connections between components for a CNMA. For example, the comparison between linear combinations of components within a trial is not shown directly in a standard network plot, and whether all components are identifiable cannot be deduced directly from the plot. Therefore, we need a new approach to visualizing the evidence structure of a CNMA. In this article, we proposed a new graph, a modified signal‐flow graph representing a system of equations, to evaluate the evidence structure for CNMA. In our new graph, each node represents a component, and arrows are used to show linear relationships between components. We used two examples to demonstrate how to draw and interpret the graph and how to use it to identify components that require more evidence.
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