RESUMO
The purpose of this systematic review was to evaluate implant survival in irradiated nasal, auricular, orbital sites and to compare them with non-irradiated respective sites. Four electronic databases and seven related journals were searched until December and March 2018, respectively. A total of 7892 articles were identified, 18 of which were included in this review; one non-randomized clinical trial, two prospective cohort, eight retrospective cohort and seven cross-sectional studies. Using the ROBIN-I Cochrane tool for risk assessment, 13 studies were judged at serious, one at moderate and four at critical risk of bias. Thirteen were included in 18 meta-analyses, the results of which showed a significant difference between irradiated and non-irradiated sites, favouring non-irradiated with risk ratio (RR) = 0.93, 95% confidence interval (CI) 0.89-0.97, P=0.001. Comparisons among nasal, auricular and orbital sites revealed no significant differences, whether in irradiated or non-irradiated patients at P<0.05. Hence, it was concluded that, within the limitations of this review, survival of craniofacial implants is negatively affected by radiotherapy, especially in orbital sites. Level of evidence is moderate. Therefore, further prospective cohort studies with calculated sample sizes, restricted or properly managed confounders and no deviations from intended interventions might produce different results.
Assuntos
Implantes Dentários , Estudos Transversais , Humanos , Prognóstico , Estudos Prospectivos , Estudos RetrospectivosRESUMO
In a double-blind study, glycosaminoglycan polysulfate (GAGPS, Arteparon) was compared to saline solution: both preparations were applied intramuscularly in two groups of 70 patients, each over a period of 8 weeks. The patients were suffering from pain and impaired function of the knee and hip joints. To assess the therapeutic efficacy, the following parameters were employed: pain, joint mobility, and walking distance. The post trial observation period lasted for 6 months. In the GAGPS group, a statistically significant improvement compared to the results in the saline group was noted during the 2nd and 6th months of observation respectively. The global assessment by investigator and patient at the end of the observation period was superior in the GAGPS group to that in the saline group. While the difference regarding the onset of pain remission between the GAGPS and the saline groups was insignificant, the rate of complete relief from pain was better in the GAGPS group, and pain worsened in fewer incidences in this group, too. Laboratory findings did not reveal any detrimental effect of either treatment with respect to hematology, blood chemistry, or urinalysis. 3 patients of the GAGPS group developed harmless hematomas of short duration at the site of injection.
Assuntos
Glicosaminoglicanos/administração & dosagem , Articulação do Quadril , Articulação do Joelho , Osteoartrite/tratamento farmacológico , Cloreto de Sódio/administração & dosagem , Adulto , Idoso , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Osteoartrite/fisiopatologia , Dor/tratamento farmacológicoRESUMO
The purpose of ths study was to confirm the authors' impression of parallel margins between the lower vertebral plate of the last lumbar vertebra and the upper plate of the first sacral vertebra in patients suffering from herniation of the last disc. The study involved 3 groups of patients: the first comprised patients with sciatica due to compression of the S1 nerve root, the second group consisted of normal subjects and the third included patients suffering from low back pain without disc pathology. The results show that a parallel appearance between the L5 ad S1 vertebral bodies was apparent for angles of lambda less than or equal to 10 degrees. The authors have found these parallel margins only in patients suffering from disc herniation between L5 and S1.
