RESUMO

BACKGROUND: To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry. METHODS: The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted. RESULTS: Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%). CONCLUSION: The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision. REGISTRATION: PROSPERO database #CRD42022365443.

Assuntos

RESUMO

This is a protocol for an overview to summarize the findings of Systematic Reviews (SR) dealing with Photodynamic Inactivation (PDI) for control of oral diseases. Specific variables of oral infectious will be considered as outcomes, according to dental specialty. Cochrane Database of Systematic Reviews (CDSR), MEDLINE, LILACS, Embase, and Epistemonikos will be searched, as well as reference lists. A search strategy was developed for each database using only terms related to the intervention (PDI) aiming to maximize sensitivity. After checking for duplicate entries, selection of reviews will be performed in a two-stage technique: two authors will independently screening titles and abstracts, and then full texts will be assessed for inclusion/exclusion criteria. Any disagreement will be resolved through discussion and/or consultation with a third reviewer. Data will be extracted following the recommendations in Chapter V of Cochrane Handbook and using an electronic pre-specified form. The evaluation of the methodological quality and risk of bias (RoB) of the SR included will be carried out using the AMSTAR 2 and ROBIS. Narrative summaries of relevant results from the individual SR will be carried out and displayed in tables and figures. A specific summary will focus on PDI parameters and study designs, such as the type and concentration of photosensitizer, pre-irradiation time, irradiation dosimetry, and infection or microbiological models, to identify the PDI protocols with clinical potential. We will summarize the quantitative results of the SRs narratively.

Assuntos

RESUMO

Background: Osteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored. Objective: To perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA. Methodology: Systematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the "Assessment of Multiple Systematic Reviews" (AMSTAR-2) tool. Systematic Review Registration: PROSPERO, CRD42022367209.

RESUMO

OBJECTIVE: This study aimed to evaluate, qualify, and summarize evidence presented in systematic reviews (SR) on treatments for bruxism. METHODS: The overview was conducted using the PICO strategy: children, adolescents, and adults with bruxism (P) were submitted to different treatments (I) compared to other treatments, placebo, or no treatment (C) in order to evaluate incidence, prevalence, and number of episodes of bruxism (O). The search was carried out in six databases and gray literature up to July 2023. Data were extracted, and the ROBS tool was used, followed by a descriptive synthesis of the results. RESULTS: A total of 31 SR were included. Sixteen showed a positive effect on episodes of bruxism (BE), while two had negative, one had neutral, and nine had inconclusive effects. Using the risk of bias in systematic reviews tool (ROBIS), risk of bias varied from low (n = 23) to high (n = 5) among the SR. Pharmacological treatment, oral rehabilitation, and other therapeutic approaches presented inconclusive or negative effects on BE, while oral appliances showed controversial effects. Biofeedback, physical therapy, laser therapy, and botulinum toxin showed positive effects on the reduction of BE. CONCLUSION: Biofeedback, physical therapy, laser therapy, and botulinum toxin showed positive effects on the reduction of BE; there is still a lack of studies to support the safe and long-term use of these therapies. REGISTRATION NUMBER: PROSPERO CRD42021273905.

Assuntos

RESUMO

BACKGROUND: Energy-based devices (laser and radiofrequency) have been used to treat genitourinary syndrome of menopause (GSM). OBJECTIVES: To evaluate the efficacy and safety of physical energy use in managing GSM symptoms. SEARCH STRATEGY: Five databases were searched from inception to December 2022. Language restrictions were not imposed. SELECTION CRITERIA: We included all Cochrane and non-Cochrane systematic reviews with or without meta-analyses that described postmenopausal women with symptoms of GSM treated with physical energy. DATA COLLECTION AND ANALYSIS: We performed a network meta-analysis using frequentist methods to calculate standardized mean differences (SMDs) and their corresponding 95% confidence intervals (CIs). Methodological and reporting quality were assessed using the Assessment of Multiple Systematic Reviews (AMSTAR 2). MAIN RESULTS: Nine reviews were included in the overview, six of which were meta-analyses. Four randomized controlled trials, representing 218 participants and nine different study arms, met the criteria for inclusion in our component network meta-analysis. Confidence in review findings was low in six reviews and critically low in three. Our network meta-analysis results showed that premarin (SMD 2.60, 95% CI 7.76-3.43), conjugated estrogens (SMD 2.13, 95% CI 1.34-2.91), carbon dioxide laser (SMD 1.71, 95% CI 1.10-2.31), promestriene (SMD 1.41, 95% CI 0.59-2.24), and vaginal lubricant (SMD 1.37, 95% CI 0.54-2.20) were more effective than sham for reducing sexual dysfunction, with a consequent increase in Female Sexual Function Index (FSFI). Two studies showed a high risk of bias, owing to a lack of blinding. CONCLUSION: Several gaps in the use of physical energy for managing GSM still need to be addressed. The small number of blind clinical trials made the results fragile.

Assuntos

RESUMO

Gastric cancer (GC) is a highly prevalent and deadly malignant neoplasm worldwide. Currently, long non-coding RNAs (lncRNAs) have recently been identified as crucial regulators implicated in GC development and progression. Dysregulated expression of lncRNAs is commonly associated with enhanced tumor migration, invasiveness, and therapy resistance, highlighting their potential as promising targets for clinical applications. This review offers a comprehensive historical overview of lncRNAs in GC, describes the molecular mechanisms, and discusses the prospects and challenges of establishing lncRNAs as precision biomarkers.

RESUMO

There is currently an extensive record of scientific studies on the general characteristics of filamentous fungus Trichoderma spp., which demonstrates its wide range of interrelation in ecosystems and its fungal activity that benefits the agricultural sector and agroindustry, as well as its importance in the preservation and restoration of the soil microbiota. The success of the biological and ecological benefits of Trichoderma is due to its reproductive capacity, as well as its efficiency in the use of soil nutrients; the efficacy of the genus has been reported against a variety of phytopathogenic fungi, as well as the potential to synthesize and release enzymes (cellulases, xylanases, and chitinases) that have been implemented in agroindustrial bioprocesses. It has also been reported that various species of Trichoderma spp. can produce auxins and gibberellin-type growth regulators, reported as growth promoters of some agricultural crops; however, their most relevant fact is their ability to prevail at certain doses of 'agrotoxic' active ingredients and contribute studies regarding processes for obtaining biofuel and bioremediation of the agricultural soil. In this overview, a general description of the current and relevant studies of the different subspecies of Trichoderma and their contribution in agriculture is made, presenting results obtained in vitro, in greenhouses and in the field. This analysis will serve as a starting point for future research in Mexico, specifically on the genus Trichoderma and its benefits for the Mexican countryside.

Assuntos

RESUMO

Contextualização: A vitamina D tem sido utilizada na prática clínica e amplamente divulgada na mídia como opção preventiva ou terapêutica em muitas doenças esqueléticas e não esqueléticas, mas sua efetividade, em muitos casos, é ainda incerta. Objetivos: Sumarizar as evidências de revisões sistemáticas da Cochrane, referentes à efetividade da vitamina D para tratamento e prevenção de doenças. Métodos: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca na Cochrane Library (2023), sendo utilizado o descritor MeSH "VITAMIN D". Todas as revisões sistemáticas de ensaios clínicos foram incluídas. O desfecho primário de análise foi a melhora clínica, a redução dos sintomas ou a prevenção da doença. Resultados: 22 estudos foram incluídos, totalizando 284.404 participantes. Há evidência de baixa qualidade relativa a benefícios da suplementação da vitamina D na gestação para mãe e recém-nascido, não sendo encontrados, até o momento, benefícios para outras condições avaliadas. Discussão: Nenhuma intervenção mostrou efetividade com evidência de boa qualidade. Embora haja descrição de benefícios na redução do risco de pré-eclâmpsia, diabetes gestacional, baixo peso do bebê ao nascimento, redução no risco de hemorragia grave pós-parto e redução de fraturas em idosos (quando associada à suplementação de cálcio), esses achados têm evidência limitada e carecem de melhor análise no futuro próximo, a partir de novos ensaios clínicos. Conclusão: Atualmente, não há suporte com bom nível de evidência para a maioria das intervenções com suplementação de vitamina D, sendo recomendada a realização de novos ensaios clínicos para melhor robustez dos achados desses estudos.

Assuntos

RESUMO

AIMS: Evaluate the existing evidence of osteoradionecrosis (ORN) treatment in adults with head and neck cancer, the methodological quality and the evidence grade within systematic reviews (SRs). METHODS: An extensive systematic literature search of SRs that addressed ORN in head and neck cancer patients was conducted with screening of eligible studies, data extraction, methodological (AMSTAR 2) and evidence quality assessment (GRADE) of the SRs by independent and calibrated authors. RESULTS: A total of six SRs were enrolled. Based primarily on studies from the 1990s, there is critically low- or moderate-quality evidence that hyperbaric oxygen therapy (HBO) improves ORN healing. From 2005 onward, evidence has been discovered in relation to treatment with pentoxifylline and tocopherol (PENTO). The SRs indicate that the management of ORN with PENTO appears to be promising. The greatest rates of healing are seen in mild and moderate stages of ORN. However, the quality of evidence regarding PENTO, surgery and other treatments remains critically low. CONCLUSION: There is no standardized protocol to treat ORN. PENTO appears to be the most promising conservative treatment; however, the current level of evidence regarding PENTO is still critically low. More robust clinical studies are needed to establish the best treatment for ORN.

RESUMO

La expansión y consolidación de la práctica clínica basada en la evidencia ha llevado entre otras, a la necesidad de realizar una variedad cada vez mayor de tipos de revisión de la literatura científica; lo que permite avanzar en el conocimiento y comprender la amplitud de la investigación sobre un tema de interés, teniendo en cuenta que una de las propiedades del conocimiento es su carácter acumulativo. Sin embargo, la diversidad de la terminología utilizada genera confusión de términos y conceptos. El objetivo de este manuscrito fue proporcionar un listado de los tipos de revisiones de la literatura más frecuentemente utilizados con sus características y algunos ejemplos de ellas. Revisión cualitativa. Se examinaron de forma dirigida las bases de datos PubMed, WoS y Scopus, en búsqueda de términos asociados a tipos de revisiones y síntesis de la literatura científica. Se encontraron 21 tipos de revisión; y 29 variantes y sinonimias asociadas; las que ilustran los procesos de cada una de ellas. Se da una descripción general de las características de cada cual, junto con las fortalezas y debilidades percibidas. No obstante, se verificó que sólo algunos tipos de revisión poseen metodologías propias y explícitas. Este enfoque, proporciona un punto de referencia para quienes realizan o interpretan revisiones en el ámbito sanitario, y sugiere dos tipos de propuestas de clasificación.

SUMMARY: The expansion and consolidation of evidence-based clinical practice has led, among other things, to the need to carry out an increasing variety of types of literature reviews, which allows advancing in knowledge and understanding the breadth of research on a topic of interest. However, the diversity of the terminology used generates confusion of terms and concepts. The aim of this manuscript was to provide a list of the most frequently used review types with their characteristics and some examples. Qualitative review. PubMed, WoS and Scopus databases were examined in a directed way, searching for terms associated with types of reviews and syntheses of the scientific literature. Twenty-one types of review, and 29 variants and associated synonymies were found; those that illustrate the processes of each of them. An overview of the characteristics of each is given, along with perceived strengths and weaknesses. However, it was verified that only some types of review have their own explicit methodologies. This approach, provides a point of reference for those who perform or interpret reviews in the health field and suggests two classification proposals.

Assuntos

RESUMO

The increasing production of primary research and literature reviews in the last decades has made it necessary to develop a new methodological design to synthesize the evidence: the overviews. An overview is a type of evidence synthesis that uses systematic reviews as the unit of analysis, with the aim of extracting and analyzing the results for a new or broader research question, helping the shared decision-making processes. The aim of this article is to introduce the reader to this type of evidence summaries, highlighting the differences between overviews and other types of synthesis, the unique methodological aspects of overviews, and future challenges. This is the twelfth article from a collaborative methodological series of narrative reviews about biostatistics and clinical epidemiology.

El aumento de la producción de investigación primaria y de las revisiones de la literatura durante las últimas décadas ha hecho necesario el desarrollo de un nuevo diseño metodológico para sintetizar la evidencia: los overviews. Un overview es un diseño de síntesis de evidencia que toma como unidad de análisis a las revisiones sistemáticas, con el objetivo de extraer y analizar los resultados para una pregunta de interés nueva o más amplia, ayudando así a mejorar los procesos de toma de decisiones informadas. El objetivo de este artículo es introducir al lector a este tipo de resúmenes de evidencia, destacando las diferencias con los otros tipos de síntesis de evidencia, los aspectos metodológicos particulares de los overviews, y los desafíos pendientes. Este artículo es el duodécimo de una serie metodológica colaborativa de revisiones narrativas sobre temáticas de bioestadística y epidemiología clínica.

Assuntos

RESUMO

El aumento de la producción de investigación primaria y de las revisiones de la literatura durante las últimas décadas ha hecho necesario el desarrollo de un nuevo diseño metodológico para sintetizar la evidencia: los overviews. Un overview es un diseño de síntesis de evidencia que toma como unidad de análisis a las revisiones sistemáticas, con el objetivo de extraer y analizar los resultados para una pregunta de interés nueva o más amplia, ayudando así a mejorar los procesos de toma de decisiones informadas. El objetivo de este artículo es introducir al lector a este tipo de resúmenes de evidencia, destacando las diferencias con los otros tipos de síntesis de evidencia, los aspectos metodológicos particulares de los overviews, y los desafíos pendientes. Este artículo es el duodécimo de una serie metodológica colaborativa de revisiones narrativas sobre temáticas de bioestadística y epidemiología clínica.

The increasing production of primary research and literature reviews in the last decades has made it necessary to develop a new methodological design to synthesize the evidence: the overviews. An overview is a type of evidence synthesis that uses systematic reviews as the unit of analysis, with the aim of extracting and analyzing the results for a new or broader research question, helping the shared decision-making processes. The aim of this article is to introduce the reader to this type of evidence summaries, highlighting the differences between overviews and other types of synthesis, the unique methodological aspects of overviews, and future challenges. This is the twelfth article from a collaborative methodological series of narrative reviews about biostatistics and clinical epidemiology.

Assuntos

RESUMO

BACKGROUND: The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. OBJECTIVE: This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. METHODS: A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: "pharmacoeconomics," "pharmaceutical care," and "hospital." The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. RESULTS: It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. CONCLUSIONS: This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. TRIAL REGISTRATION: PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43.

RESUMO

OBJECTIVE: To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age. METHODS: An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes. RESULTS: A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction. CONCLUSIONS: Effective dose levels varied notably between systems and operation modes.Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization.

Assuntos

RESUMO

BACKGROUND: Childhood overweight and obesity is a global public health issue. Although there is evidence of a reduced prevalence in some countries, there is still much controversy about the efficacy of health interventions that aim to prevent and treat obesity in this specific population. The objective of the present study is to develop an overview of systematic reviews (OSRs) that assesses the effects of school-based, family, and multi-component health interventions for the prevention and treatment of obesity, change in physical activity, dietary, and/or hydration behaviors, and change in metabolic risk factors in school-aged children. METHODS: This protocol was developed using the methodology proposed by Cochrane. It outlines a comprehensive search in 12 electronic databases to identify systematic reviews of health interventions, including studies that evaluate and how to prevent and/or treat overweight and/or obesity in children aged 6 to 12 years. The risk of bias of the included Systematic Reviews will be assessed with the ROBIS tool. DISCUSSION: Since the OSRs methodology's purpose is only to harmonize evidence from open access publications, ethical consent is not necessary for the present protocol. In terms of diffusion, a paper will be submitted for publication in a scientific journal to describe the main results obtained through the OSRs. TRIAL REGISTRATION: The present overview of the systematic review protocol has been registered in PROSPERO (ID number 218296).

Assuntos

RESUMO

BACKGROUND AND OBJECTIVE: The coronavirus disease 2019 Living OVerview of Evidence (COVID-19 L·OVE) is a public repository and classification platform for COVID-19 articles. The repository contains more than 430,000 articles as of September 20, 2021 and intends to provide a one-stop shop for COVID-19 evidence. Considering that systematic reviews conduct high-quality searches, this study assesses the comprehensiveness and currency of the repository against the total number of studies in a representative sample of COVID-19 systematic reviews. METHODS: Our sample was generated from all the studies included in the systematic reviews of COVID-19 published during April 2021. We estimated the comprehensiveness of COVID-19 L·OVE repository by determining how many of the individual studies in the sample were included in the COVID-19 L·OVE repository. We estimated the currency as the percentage of studies that was available in the COVID-19 L·OVE repository at the time the systematic reviews conducted their own search. RESULTS: We identified 83 eligible systematic reviews that included 2,132 studies. COVID-19 L·OVE had an overall comprehensiveness of 99.67% (2,125/2,132). The overall currency of the repository, that is, the proportion of articles that would have been obtained if the search of the reviews was conducted in COVID-19 L·OVE instead of searching the original sources, was 96.48% (2,057/2,132). Both the comprehensiveness and the currency were 100% for randomized trials (82/82). CONCLUSION: The COVID-19 L·OVE repository is highly comprehensive and current. Using this repository instead of traditional manual searches in multiple databases can save a great amount of work to people conducting systematic reviews and would improve the comprehensiveness and timeliness of evidence syntheses. This tool is particularly important for supporting living evidence synthesis processes.

Assuntos

RESUMO

Recent engineering and neuroscience applications have led to the development of brain-computer interface (BCI) systems that improve the quality of life of people with motor disabilities. In the same area, a significant number of studies have been conducted in identifying or classifying upper-limb movement intentions. On the contrary, few works have been concerned with movement intention identification for lower limbs. Notwithstanding, lower-limb neurorehabilitation is a major topic in medical settings, as some people suffer from mobility problems in their lower limbs, such as those diagnosed with neurodegenerative disorders, such as multiple sclerosis, and people with hemiplegia or quadriplegia. Particularly, the conventional pattern recognition (PR) systems are one of the most suitable computational tools for electroencephalography (EEG) signal analysis as the explicit knowledge of the features involved in the PR process itself is crucial for both improving signal classification performance and providing more interpretability. In this regard, there is a real need for outline and comparative studies gathering benchmark and state-of-art PR techniques that allow for a deeper understanding thereof and a proper selection of a specific technique. This study conducted a topical overview of specialized papers covering lower-limb motor task identification through PR-based BCI/EEG signal analysis systems. To do so, we first established search terms and inclusion and exclusion criteria to find the most relevant papers on the subject. As a result, we identified the 22 most relevant papers. Next, we reviewed their experimental methodologies for recording EEG signals during the execution of lower limb tasks. In addition, we review the algorithms used in the preprocessing, feature extraction, and classification stages. Finally, we compared all the algorithms and determined which of them are the most suitable in terms of accuracy.

Assuntos

RESUMO

Overviews synthesising the results of multiple systematic reviews help inform evidence-based clinical practice. In this first of two companion papers, we evaluate the bibliometrics of overviews, including their prevalence and factors affecting citation rates and journal impact factor (JIF). We searched MEDLINE, Epistemonikos and Cochrane Database of Systematic Reviews (CDSR). We included overviews that: (a) synthesised reviews, (b) conducted a systematic search, (c) had a methods section and (d) examined a healthcare intervention. Multivariable regression was conducted to determine the association between citation density, JIF and six predictor variables. We found 1218 overviews published from 2000 to 2020; the majority (73%) were published in the most recent 5-year period. We extracted a selection of these overviews (n = 541; 44%) dated from 2000 to 2018. The 541 overviews were published in 307 journals; CDSR (8%), PLOS ONE (3%) and Sao Paulo Medical Journal (2%) were the most prevalent. The majority (70%) were published in journals with impact factors between 0.05 and 3.97. We found a mean citation count of 10 overviews per year, published in journals with a mean JIF of 4.4. In multivariable analysis, overviews with a high number of citations and JIFs had more authors, larger sample sizes, were open access and reported the funding source. An eightfold increase in the number of overviews was found between 2009 and 2020. We identified 332 overviews published in 2020, which is equivalent to one overview published per day. Overviews perform above average for the journals in which they publish.

Assuntos

RESUMO

PURPOSE: To summarize the evidence of efficacy and safety of the use of ketamine and esketamine for depression. METHODS: A literature search was performed in Medline, the Cochrane Library, LILACS, and CRD until November 2020. We included systematic reviews with meta-analyses of randomized controlled trials on the use of ketamine and esketamine in adult patients with depression. Two authors independently performed the study selection and data extraction. The AMSTAR-2 tool was used to appraise the quality of included reviews. RESULTS: A total of 118 records were identified, and 11 studies fully met the eligibility criteria. Compared to control, ketamine improved the clinical response at 40 min to 1 week and clinical remission at 80 min to 72 h, and esketamine improved both outcomes at 2 h to 4 weeks. Ketamine and esketamine also had a beneficial effect on the depression scales score and suicidality. For adverse events, oral ketamine did not show significant change compared to control, while intranasal esketamine showed difference for any events, such as dissociation, dizziness, hypoesthesia, and vertigo. Most reviews were classified as "critically low quality," and none of them declared the source of funding of the primary studies and assessed the potential impact of risk of bias in primary studies. CONCLUSION: Ketamine and esketamine showed a significant antidepressant action within a few hours or days after administration; however, the long-term efficacy and safety are lacking. In addition, the methodological quality of the reviews was usually critically low, which may indicate the need for higher quality evidence in relation to the theme.

Assuntos

RESUMO

Brazil is one of the world leaders in the agribusiness sector tending to directly influence a growing dependence on imported inputs, specifically synthetic agrochemicals. At the state level, in 2013, Tocantins stood out in first place in the ranking of agrochemical consumers, however, these products can cause several problems, such as poisoning to humans, environmental contamination, and increased resistance to phytopathogens. Biological control is an alternative to the use of agrochemicals towards eliminating pests naturally by using living organisms called Biological Control Agents (BCA). Currently, fungi of the Trichoderma genus are some of the most used organisms in biological pest control for their relevant characteristics that favor them in terms of survival in the environment, such as high capacity to adapt to ecological conditions, potential to colonize the rhizosphere of plants, mycoparasitism, production of volatile and non-volatile metabolites. In addition, it works on plant growth and productivity. In general, the use of Trichoderma favors the control of soil pathogens, such as Rhizoctonia, Pythium, Sclerotinia, and nematodes. Thus, this review aims to demonstrate the importance of using Trichoderma in biological control, as well as to present an overview and perspectives of research developed by respondents in the Brazilian Midwest region and Tocantins state.

O Brasil é um dos líderes mundiais no setor do agronegócio e essa liderança tende a impactar diretamente numa dependência crescente de insumos importados, especificamente, agroquímicos sintéticos. A nível de estado, em 2013, o Tocantins se destacava em primeiro lugar no ranking de consumidores de agroquímicos, contudo, esses produtos podem causar diversos problemas, como intoxicação ao homem, contaminação do ambiente e aumento da resistência de fitopatógenos. Um método alternativo ao uso de agroquímicos é o controle biológico, o qual busca a eliminação de pragas de forma natural, utilizando-se de organismos vivos chamados de Agentes de Controle Biológico (ACB). Atualmente, entre os organismos mais usados no controle biológico de pragas estão os fungos do gênero Trichoderma, isto, por possuir algumas características relevantes que os favorecem em termos de sobrevivência no ambiente, tais como: a alta capacidade de adaptação às condições ecológicas, potencial em colonizar a rizosfera das plantas, micoparasitismo, produção de metabólitos voláteis e não voláteis. Além disso, atua no crescimento e produtividade das plantas. Geralmente, o uso de Trichoderma favorece o controle de patógenos do solo, como: Rhizoctonia, Pythium, Sclerotinia e nematoides. Assim, a presente revisão visa demostrar a importância da utilização do Trichoderma no controle biológico, assim como apresentar um panorama e perspectivas das pesquisas desenvolvidas por pesquisados da região Centro-Oeste brasileiro e no estado do Tocantins.

Assuntos