Now showing 1 - 10 of 19
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Chemo-mechanical removal versus conventional removal for deep caries lesion
    (Medwave Estudios Limitada, 2022-02-23)
    Paula Zambrano-Achig
    ;
    ;
    Francisca Verdugo-Paiva
    <jats:p>INTRODUCCION La caries dental tradicionalmente es manejada con la remoción no selectiva del tejido carioso (remoción total). Sin embargo, los efectos adversos y el temor que produce esta técnica en los pacientes ha promovido la utilización de técnicas de remoción de caries más conservadoras como la remoción químico-mecánica, pero aún existe controversia respecto a su efectividad y seguridad. MÉTODOS Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane Library, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metaanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos siete revisiones sistemáticas que en conjunto incluyeron 34 estudios primarios, de los cuales 30 corresponden a ensayos aleatorizados. Concluimos que la remoción químico-mecánica de caries probablemente disminuye la necesidad de anestesia. Además, podría disminuir el dolor que experimenta el paciente, disminuir el riesgo del fracaso de la restauración y aumentar el tiempo del procedimiento, pero la certeza de la evidencia es baja. No es posible establecer con claridad si la remoción químico- mecánica disminuye el riesgo de exposición pulpar debido a que la certeza de la evidencia existente ha sido evaluada como muy baja.</jats:p>
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    Item type:Publication,
    GRADE-Based Recommendations for Surgical Repair of Nonruptured Abdominal Aortic Aneurysm
    (SAGE Publications, 2019-04-08)
    Margarita Posso
    ;
    M. Jesús Quintana
    ;
    Sergi Bellmunt
    ;
    Laura Martínez García
    ;
    José R. Escudero
    <jats:p> The objective of this study was to provide evidence-based recommendations for endovascular aneurysm repair (EVAR) versus open surgical repair (OSR) for patients with a nonruptured abdominal aortic aneurysm (AAA). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and adhered to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Both low- and high surgical risk patients treated with EVAR showed decreased 30-day mortality, but the low-risk group had no differences in 4-year mortality. Compared with friendly anatomy, patients with hostile anatomy had an increased risk of type I endoleak. Young patients may prefer OSR. Endovascular aneurysm repair was not cost-effective in Europe. Four conditional recommendations were formulated: (1) OSR for low-risk patients up to 80 years old, (2) EVAR for low-risk patients older than 80 years, (3) EVAR for high-risk patients as long as is anatomically feasible, and (4) OSR in patients in whom it is not anatomically feasible to perform EVAR. Based on GRADE criteria, either OSR or EVAR can be suggested to patients with nonruptured AAA taking into account their surgical risk, hostile anatomy, and age. Given the weakness of the recommendations, personal preferences are determinant. </jats:p>
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    Item type:Publication,
    The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews
    (Springer Science and Business Media LLC, 2021-04-19)
    Ena Niño de Guzmán Quispe
    ;
    Laura Martínez García
    ;
    Carola Orrego Villagrán
    ;
    Monique Heijmans
    ;
    Rosa Sunol
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    Item type:Publication,
    Perceived stress and subjective well-being of COVID-19 confinement in Latin American pediatric dentists and dental students: A cross sectional study
    (Medknow, 2021)
    Ortega-López Miriam Fernanda
    ;
    Armas-Vega, Ana
    ;
    PARISE VASCO, JUAN MARCOS
    ;
    Agudelo-Suárez Andrés
    ;
    Arroyo-Bonilla David
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    Item type:Publication,
    Vasodilators for women undergoing fertility treatment
    (Wiley, 2018-10-12)
    Rosa B Gutarra-Vilchez
    ;
    Xavier Bonfill Cosp
    ;
    Demián Glujovsky
    ;
    ;
    Fernando M. Runzer-Colmenares
    Background: The rate of successful pregnancies brought to term has barely increased since the first assisted reproductive technology (ART) technique became available. Research suggests that vasodilators may increase endometrial receptivity, thicken the endometrium, and favour uterine relaxation, all of which could improve the chances of successful assisted pregnancy. Objectives: To evaluate the effectiveness and safety of vasodilators in women undergoing fertility treatment. Search methods: We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, three other databases, and two clinical trial registries in April 2024, with no language or date restrictions. We also searched grey literature sources and checked the reference lists of relevant articles. Selection criteria: We included randomised controlled trials (RCTs) comparing vasodilators (alone or combined with other treatments) versus placebo or no treatment or versus other agents in women undergoing fertility treatment. Data collection and analysis: Two review authors independently selected studies, assessed risk of bias, extracted data, and calculated risk ratios (RRs). We combined study data using a fixed-effect model and assessed evidence certainty using the GRADE approach. Our primary outcomes were live birth or ongoing pregnancy and vasodilator side effects. Our secondary outcomes were clinical pregnancy, endometrial thickness, multiple gestation, miscarriage, and ectopic pregnancy. Main results: We included 45 studies with a total of 4404 women. The included studies compared a vasodilator versus a placebo or no treatment (40 RCTs), vasodilators plus another agent versus placebo or no treatment (3 RCTs) or versus oestrogens (3 RCTs). The mean length of follow-up was 15.45 weeks. Overall, the certainty of evidence was very low to moderate. The main limitations were imprecision (low number of events and participants) and risk of bias (lack of blinding in studies that reported subjective outcomes). Vasodilators versus placebo or no treatment. Vasodilators may result in little to no difference in rates of live birth or ongoing pregnancy compared with placebo or no treatment (RR 1.21, 95% CI 0.93 to 1.58; I² = 0%; 6 RCTs, 740 women; low-certainty evidence), but probably increase overall rates of side effects (RR 2.14, 95% CI 1.55 to 2.98; I² = 0%; 7 RCTs, 668 women; moderate-certainty evidence). The evidence suggests that 246 per 1000 women achieve live birth or ongoing pregnancy with a placebo or no treatment, and 229 to 389 per 1000 will do so using vasodilators. Vasodilators compared with placebo or no treatment likely increase rates of clinical pregnancy (RR 1.45, 95% CI 1.28 to 1.64; I² = 22%; 25 RCTs, 2506 women; moderate-certainty evidence). Vasodilators compared with placebo or no treatment probably have little or no effect on rates of multiple gestation or birth (RR 1.37, 95% CI 0.73 to 2.55; I² = 0%; 7 RCTs, 763 women; moderate-certainty evidence), miscarriage (RR 1.01, 95% CI 0.59 to 1.74; I² = 0%; 8 RCTs; 829 women; moderate-certainty evidence), and ectopic pregnancy (RR 1.25, 95% CI 0.34 to 4.59; I² = 0%; 4 RCTs, 543 women; moderate-certainty evidence). Most studies found a beneficial effect of vasodilators for endometrial thickness, but the reported effect estimates varied (I² = 93%), from a mean difference of 0.47 mm higher (95% CI 0.90 mm lower to 1. 84 mm higher) to 1.94 mm higher (95% CI 1.37 higher to 2.51 mm higher), and the evidence was very uncertain. Hence, we are unsure how to interpret these results. Vasodilators versus oestrogens. Vasodilators compared with oestrogens may have little or no effect on rates of live birth or ongoing pregnancy (RR 0.83, 95% CI 0.30 to 1.33; 1 RCT, 44 women, low-certainty evidence). The evidence is very uncertain regarding the effect of sildenafil compared with oestrogens on clinical pregnancy rates (RR 0.99, 95% CI 0.71 to 1.38; I² = 59%; 3 RCTs, 262 women; very low-certainty evidence), endometrial thickness (RR 1.90, 95 CI 1.15 to 3.13; 1 RCT, 120 women; very low-certainty evidence) and miscarriage rates (RR 0.50, 95% CI 0.05 to 5.12; 1 RCT, 44 women; very low-certainty evidence). Authors' conclusions: Among women undergoing fertility treatment, there may be little or no difference in the rate of live birth or ongoing pregnancy in those who receive vasodilators compared with those who receive a placebo or no treatment, and compared with those who receive oestrogens. Compared with placebo or no treatment, vasodilators likely increase rates of clinical pregnancy, but probably also increase overall rates of side effects. The evidence on clinical pregnancy with vasodilators versus oestrogens is very uncertain, and we found no evidence on overall side effects for the comparison of vasodilators versus oestrogens. We are unsure about the effect of vasodilators versus placebo or no treatment and versus oestrogens on endometrial thickness. Vasodilators versus placebo or no treatment probably have little or no effect on multiple gestation or birth, miscarriage, and ectopic pregnancy. Future studies should be adequately randomised and powered to ensure a more accurate evaluation of each treatment, with live births as a primary outcome.
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    Item type:Publication,
    Selective removal compared to complete removal for deep carious lesions
    (Medwave Estudios Limitada, 2020-01-31)
    Francisca Verdugo-Paiva
    ;
    Paula Zambrano-Achig
    ;
    ;
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Self-perceived competencies on evidence-based medicine in medical students and physicians registered in a virtual course: a cross-sectional study
    (Informa UK Limited, 2021-12-17)
    Milton A. Romero-Robles
    ;
    David R. Soriano-Moreno
    ;
    Fabrizio M. García-Gutiérrez
    ;
    I. Benjamín Condori-Meza
    ;
    Caroline C. Sing-Sánchez
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    A universal dental adhesive containing copper nanoparticles stabilizes the hybrid layer in eroded dentin after 1 year
    (Elsevier BV, 2022-03)
    Taíse Alessandra Hanzen
    ;
    Mario Felipe Gutiérrez
    ;
    Thalita de Paris Matos
    ;
    Alexandra Mara de Paula
    ;
    Fabiana Suelen Figueredo de Siqueira
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Stepwise removal compared to complete removal for deep carious lesions
    (Medwave Estudios Limitada, 2022-02-23)
    María Massón
    ;
    ;
    Francisca Verdugo-Paiva
    <jats:p>INTRODUCCION Las lesiones cariosas han sido tradicionalmente tratadas mediante la remoción total (completa o no selectiva) del tejido cariado. Sin embargo, debido a sus riesgos y efectos adversos, se han desarrollado nuevas técnicas de remoción del tejido cariado, basadas en la conservación del tejido dentario, entre ellas la remoción en dos pasos o stepwise. El objetivo de este resumen es aclarar la incertidumbre sobre la efectividad y la seguridad de la técnica de remoción en dos pasos (stepwise) comparado con la remoción total. MÉTODOS Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metaanálisis, preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos tres revisiones sistemáticas que en conjunto incluyeron cinco estudios primarios, de los cuales cuatro corresponden a ensayos aleatorizados. Concluimos que la remoción en dos pasos (stepwise) podría disminuir el riesgo de exposición pulpar, el riesgo de aparición de signos y síntomas pulpares y la falla en la restauración, pero la certeza de la evidencia es baja.</jats:p>
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    Item type:Publication,
    Too few trials or too few reported trials?
    (Springer Science and Business Media LLC, 2018-10) ;
    Nicholas J. DeVito
    ;
    Ben Goldacre