Antimicrobial resistance of microorganisms present in periodontal diseases: A systematic review and meta-analysis.

Objective: The aim of this study was to estimate the antimicrobial resistance in microorganisms present in periodontal diseases. Methods: A systematic review was conducted according to the PRISMA statement. The MEDLINE (PubMed/Ovid), EMBASE, BVS, CINAHL, and Web of Science databases were searched from January 2011 to December 2021 for observational studies which evaluated the antimicrobial resistance in periodontal diseases in permanent dentition. Studies that allowed the antimicrobial consumption until the time of sample collection, studies that used laboratory acquired strains, studies that only characterized the microbial strain present, assessment of cellular morphological changes, sequencing system validation, and time series were excluded. Six reviewers, working in pairs and independently, selected titles, abstracts, and full texts extracting data from all studies that met the eligibility criteria: characteristics of patients, diagnosis of infection, microbial species assessed, antimicrobial assessed, identification of resistance genes, and virulence factors. "The Joanna Briggs Institute" critical appraisal for case series was adapted to assess the risk of bias in the included studies. Results: Twenty-four studies (N = 2.039 patients) were included. Prevotella and Porphyromonas species were the most cited microorganisms in the included studies, and the virulence factors were related to Staphylococcus aureus. The antimicrobial reported with the highest frequency of resistance in the included studies was ampicillin (39.5%) and ciprofloxacin showed the lowest frequency of resistance (3.4%). The most cited genes were related to macrolides. The quality of the included studies was considered critically low. Conclusion: No evidence was found regarding the profile of antimicrobial resistance in periodontal diseases, requiring further research that should focus on regional population studies to address this issue in the era of increasing antimicrobial resistance. Clinical relevance: The knowledge about the present microorganism in periodontal diseases and their respective antimicrobial resistance profiles should guide dentists in prescribing complementary therapy for these infections. Systematic review registration: [http://dx.doi.org/10.1097/MD.0000000000013158], identifier [CRD42018077810].

Prevalence of childhood obesity in Brazil: systematic review and meta-analysis

Abstract Objective: To estimate the prevalence of childhood obesity in Brazil by means of a systematic review of representative studies. Sources: We searched for population-based studies that assessed obesity in Brazilian children aged < 10 years in MEDLINE, EMBASE, Scopus and other sources up to September, 2019. Paired researchers selected studies, extracted data and assessed the quality of these studies. Meta-analysis of prevalence and confidence interval (95% CI) was calculated, weighted by the population sizes using Freeman-Tukey double-arccosine transformation. Heterogeneity (I2) and publication bias were investigated by meta-regression and Egger's test, respectively. Summary of the findings: 53 studies were included (n = 122,395), which were held from 1986 to 2015 and limited mainly due to inadequate response rates. Prevalence of obesity in the threedecade period was of 8.2% ([95% CI]: 8.1-8.4%, I2 = 98.5%). Higher prevalence was observed in boys (9.7% [9.4-9.9%], I2 = 97.4%) than girls (7.3% [7.1 7.5%], I2 = 96.1%). Prevalence increased according to the decade (1990: 6.5% [6.0-7.0 %], I2 = 96.8%; 2000: 7.9% [7.7-8.0 %], I2 = 98.8%; 2010: 12.0% [11.5-12.6 %], I2 = 95.8%), and Brazilian region (Northeast: 6.4% [6.2−6.7%], I2 = 98.1%; North: 6.7% [6.3−7.2%], I2 = 98.8%; Southeast:10.6% [10.2−11.0%], I2 = 98.2%; South: 10.1 [9.7−10.4%], I2 = 97.7%). Heterogeneity was affected by age and region (p < 0.05) and publication bias was discarded (p = 0.746). Conclusion: For every 100 Brazilian children, over eight had obesity in the three-decade period and 12 in each 100 had childhood obesity in more recent estimates. Higher prevalence occurred in boys, recent decades and more developed Brazilian regions.

Time-trend in excess weight in Brazilian adults: A systematic review and meta-analysis.

BACKGROUND: This review aimed to estimate the time-trend prevalence of excess weight, overweight and obesity in the Brazilian adult population, from the 1970s-2020, through systematic review and meta-analysis (Protocol: CRD42018091002). METHODS: A search for articles was conducted in the databases MEDLINE, EMBASE, Scopus, and LILACS up to June 2021. Studies that assessed excess weight, overweight and obesity in the adult population were eligible. Two authors selected studies, collected data and assessed the methodological quality of the studies. The primary outcomes were the prevalence of excess weight, overweight, and obesity by sex and period of years. Pooled prevalence and 95% confidence intervals (CIs) were calculated in the meta-analysis of the random effects model. Heterogeneity (I2) was investigated by meta-regression and publication bias was investigated by Egger's test. RESULTS: A total of 7,938 references were identified in the search strategies, of which eighty-nine studies and nine national surveys, conducted from 1974-2020, were included in the meta-analysis. The pooled prevalence of excess weight in Brazilian adults increased from 33.5% (95% CI: 25.0; 42.6%) in 1974-1990 to 52.5% (95% CI: 47.6; 57.3%) in 2011-2020. The pooled prevalence of overweight in Brazilian adults was 24.6% (95% CI: 18.8; 31.0%) from 1974-1990 and 40.5% (95% CI: 37.0; 43.9%) from 2011-2020. The pooled prevalence of obesity in Brazilian adults increased by 15.0% from 1974-1990 to 2011-2020. The increases were observed for both men and women in almost all periods. The prevalence of excess weight and obesity remained higher among women in all periods. CONCLUSIONS: A continuous increase in the prevalence of excess weight, overweight and obesity were observed over the years. The prevalence of excess weight affected half of Brazilian adults in the period from 2011-2020 and both sexes.

Prevalence of childhood obesity in Brazil: systematic review and meta-analysis.

OBJECTIVE: To estimate the prevalence of childhood obesity in Brazil by means of a systematic review of representative studies. SOURCES: We searched for population-based studies that assessed obesity in Brazilian children aged < 10 years in MEDLINE, EMBASE, Scopus and other sources up to September, 2019. Paired researchers selected studies, extracted data and assessed the quality of these studies. Meta-analysis of prevalence and confidence interval (95% CI) was calculated, weighted by the population sizes using Freeman-Tukey double-arccosine transformation. Heterogeneity (I2) and publication bias were investigated by meta-regression and Egger's test, respectively. SUMMARY OF THE FINDINGS: 53 studies were included (n = 122,395), which were held from 1986 to 2015 and limited mainly due to inadequate response rates. Prevalence of obesity in the three-decade period was of 8.2% ([95% CI]: 8.1-8.4%, I2 = 98.5%). Higher prevalence was observed in boys (9.7% [9.4-9.9%], I2 = 97.4%) than girls (7.3% [7.1-7.5%], I2 = 96.1%). Prevalence increased according to the decade (1990: 6.5% [6.0-7.0 %], I2 = 96.8%; 2000: 7.9% [7.7-8.0 %], I2 = 98.8%; 2010: 12.0% [11.5-12.6 %], I2 = 95.8%), and Brazilian region (Northeast: 6.4% [6.2-6.7%], I2 = 98.1%; North: 6.7% [6.3-7.2%], I2 = 98.8%; Southeast:10.6% [10.2-11.0%], I2 = 98.2%; South: 10.1 [9.7-10.4%], I2 = 97.7%). Heterogeneity was affected by age and region (p < 0.05) and publication bias was discarded (p = 0.746). CONCLUSION: For every 100 Brazilian children, over eight had obesity in the three-decade period and 12 in each 100 had childhood obesity in more recent estimates. Higher prevalence occurred in boys, recent decades and more developed Brazilian regions.

Effect of mushrooms on obesity in animal models: study protocol for a systematic review and meta-analysis.

BACKGROUND: Obesity and its consequences are worldwide epidemic problem; therefore, studies with strategies and mechanisms that favor weight loss to improve outcomes in health are necessary. Effects of mushrooms on body weight are uncertain. The aim of this systematic review is to determine the efficacy of mushrooms in weight loss in animal preclinical models. METHOD: This is a systematic review of preclinical studies of animal models of obesity (any type of non-aquatic mammal), which were exposed to edible and medicinal mushrooms orally in comparison with the control. The following databases will be used: MEDLINE (PubMed), Web of Science, BIOSIS, SCOPUS, and gray literature. There will be no restriction of language, date, or publication status. The primary outcome will be body weight loss. And the secondary outcomes include the total amount of food consumed by the animals, analysis of metabolic parameters, inflammatory mediators, mortality for any causes, and any adverse effect reported. A team of reviewers will select, in pairs and independently, the titles and abstracts, extract data from qualifying studies, and assess bias risk (using SYstematic Review Centre for Laboratory animal Experimentation SYRCLE's risk of bias tool and the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) checklist). The standardized mean difference (SMD) will be calculated to measure treatment effect, with 95% confidence intervals (95% CI). The heterogeneity between-study will be calculated by I2 inconsistency values and Cochran's Q statistical test, where I2 > 50% and/or p < 0.10 suggest high heterogeneity meta-analyses of random effects will be conducted as possible. DISCUSSION: Although many experimental studies about the effects of mushrooms on obesity have already been published, there is still no consensus in the literature. This study will provide evidences of preclinical research on mushrooms and their relation to body weight loss in animal models of obesity, being non-aquatic mammals. Also, this systematic review will show the limitations and strengths of the studies available in the literature, as well as it will to encourage the financing of new studies by public health managers and governmental entities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42019125299).

Sleeping pill use in Brazil: a population-based, cross-sectional study.

OBJECTIVES: This study aimed to assess the prevalence of sleeping pill use in Brazil. DESIGN: A population-based cross-sectional study with a three-stage cluster sampling design (census tracts, households and adult residents) was used. SETTING: The Brazilian 2013 National Health Survey was used. PARTICIPANTS: The study population consisted of household residents aged ≥18 years. A total of 60 202 individuals were interviewed, including 52.9% women, and 21% reported depressive symptoms. OUTCOMES: The primary outcome was sleeping pill use, which was self-reported with the question, 'Over the past two weeks, have you used any sleeping pills?' The prevalence was calculated and stratified according to sociodemographic characteristics. The associated factors were identified from prevalence ratios (PRs) obtained through a Poisson regression with robust variance and adjusted for sex and age. RESULTS: The prevalence of sleeping pill use was 7.6% (95% CI 7.3% to 8.0%), and the average treatment duration was 9.75 (95% CI 9.49 to 10.00) days. Self-medication was found in 11.2% (95% CI 9.6% to 12.9%) of users. The following factors were associated with sleeping pill use: female sex (PR=2.21; 95% CI 1.97 to 2.47), an age of ≥60 years (PR=5.43; 95% CI 4.14 to 7.11) and smoking (PR=1.47; 95% CI 1.28 to 1.68). Sleeping pill use was also positively associated with the severity of depressive symptoms (p<0.001), whereas alcohol intake was inversely associated (PR=0.66; 95% CI 0.56 to 0.77). CONCLUSIONS: One in every 13 Brazilians adults uses sleeping pills. There is a lack of information about the reasons for this use. Actions are required to raise awareness about the risks. The results could assist programmes in targeting rational sleeping pill use and the identification of factors demanding intervention.