OBJECTIVE: Efforts have been made to reduce epidemiological indicators of osteoradionecrosis in patients with head and neck cancer over recent years. This umbrella review aims to synthesize the information of the systematic reviews/meta-analyses investigating the effect of radiotherapy in patients with head and neck cancer on the frequency of osteoradionecrosis and to identify and analyze the gaps in current scientific literature.
METHODS: A systematic review of systematic reviews with and without meta-analysis of intervention studies was conducted. Qualitative analysis of the reviews and their quality evaluation were performed.
RESULTS: A total of 152 articles were obtained, and ten of them were selected for the final analysis, where six were systematic reviews and four were meta-analysis. According to the guide Assessing the Methodological Quality of Systematic Reviews (Amstar), eight articles included were of high quality and two of medium quality. These descriptive systematic reviews/meta-analyses included a total of 25 randomized clinical trials, showing that radiotherapy has positive effects on the frequency of osteoradionecrosis. Even though a reduction in the incidence of osteoradionecrosis was observed back in the history, in systematic reviews with meta-analysis, overall effect estimators were not significant.
CONCLUSIONS: Differential findings are not enough to demonstrate that there is a significant reduction in the frequency of osteoradionecrosis in patients with head and neck cancer treated by radiation. Possible explanations are related to factors such as the type of studies analyzed, indicator of irradiated complication considered, and specific variables included in the analysis. Many systematic reviews did not address publication bias and did identify gaps in knowledge that require further clarification.

UNASSIGNED: Sarcopenia is a prevalent syndrome that has seen increased awareness in the last twenty years.
UNASSIGNED: To systematically assess and evaluate the utility of bioelectrical impedance analysis (BIA) in the diagnosis of sarcopenia in adults over the age of 60.
UNASSIGNED: An electronic search strategy of databases was conducted, including Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and SportDiscus. Included articles were evaluated using The Quality Appraisal for Reliability Studies (QAREL) checklist.
UNASSIGNED: Seven articles (1336 participants) met the inclusion criteria of evaluating the diagnostic ability of BIA. Results indicate that that there is a high degree of heterogeneity in how BIA is used to diagnose sarcopenia. While BIA is an affordable and easy to use measurement tool, it does not consistently demonstrate high levels of diagnostic sensitivity.
UNASSIGNED: The current evidence does not consistently support the utility of BIA as an accurate diagnostic tool for sarcopenia in adults over 60. If utilizing BIA, clinicians should select a validated BIA equation for their patient\'s demographics. Clinicians should also consider the use of functional tests and validated screening questionnaires. This systematic review was registered at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=211586.
UNASSIGNED: La sarcopénie est un syndrome répandu qui a suscité une attention accrue ces vingt dernières années.
UNASSIGNED: Examiner et évaluer systématiquement l’utilité d’une analyse d’impédance bioélectrique dans le diagnostic de la sarcopénie chez des adultes âgés de plus de 60 ans.
UNASSIGNED: Une stratégie de recherche électronique sur des bases de données a été appliquée, notamment le Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL et SportDiscus. Les articles en question ont été évalués grâce à la liste de vérification de l’instrument Quality Appraisal for Reliability Studies (QAREL).
UNASSIGNED: Sept articles (1 336 participants) remplissaient les critères d’inclusion de l’évaluation de la capacité diagnostique de l’analyse d’impédance bioélectrique. Les résultats montrent un degré élevé d’hétérogénéité dans l’utilisation de l’analyse d’impédance bioélectrique pour diagnostiquer la sarcopénie. Si l’analyse d’impédance bioélectrique est un outil de mesure fiable et facile à utiliser, il ne démontre pas systématiquement de hauts niveaux de sensibilité diagnostique.
UNASSIGNED: Les données probantes actuelles ne justifient pas systématiquement l’utilité d’une analyse d’impédance bioélectrique comme outil diagnostic précis de la sarcopénie chez des adultes âgés de plus de 60 ans. S’ils utilisent l’analyse d’impédance bioélectrique, les cliniciens doivent choisir une équation de l’analyse validée pour les données démographiques de leurs patients. Les cliniciens doivent également envisager de recourir à des examens fonctionnels et à des questionnaires de dépistage validés.L’examen systématique a été consigné sur le site https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=211586.

This systematic review of the literature aimed to identify studies examining the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT) in various international populations on. The search was conducted in MEDLINE, SCOPUS, CINAHL and Web Of Science, with no restrictions on publication period, the country in which the study was conducted, or the age of the patients. Eligible studies were selected on the basis of inclusion criteria and data were extracted. Study quality and the risk of bias were assessed using the COnsensus-based Standards to select the health Measurement Instruments (COSMIN) checklist. 805 articles were identified; after removing duplicates, there were 361 single studies. 338 articles did not concern the psychometric properties of JTHFT. The remaining 23 studies were selected for full text review, and all were included. They comprised 8 languages and 9 pathologies. These findings suggest the JTHFT is a useful test of manual dexterity in activities of daily living. This study provides specific information on the instrument\'s psychometric properties in different populations and supports clinicians in making informed decisions when choosing instruments for upper-limb evaluations.

Our objective was to evaluate the efficacy of recombinant human growth hormone (GH) on bone mineral density (BMD) in persons age 50 and older, with normal pituitary function, with or at risk for developing osteoporosis. We systematically reviewed randomized clinical trials (RCTs), searching six databases, and conducted meta-analyses to examine GH effects on BMD of the lumbar spine and femoral neck. Data for fracture incidence, bone metabolism biomarkers, and adverse events were also extracted and analysed. Thirteen RCTs met the eligibility criteria. Pooled effect sizes suggested no significant GH effect on BMD. Pooled effect sizes were largest, but nonsignificant, when compared to placebo. GH had a significant effect on several bone metabolism biomarkers. A significantly higher rate of adverse events was observed in the GH groups. Meta-analysis of RCTs suggests that GH treatment for persons with or at risk for developing osteoporosis results in very small, nonsignificant increases in BMD.

Basic and clinical research support a link between diabetes mellitus and Alzheimer disease (AD). However, the relationship with AD progression is unclear. This review focuses on the association between diabetes and cognitive decline in patients with AD. The literature published through May 2015 was searched in 3 databases: PubMed, Embase and Cochrane. Studies evaluating the effects of diabetes on patients with AD or cognitive decline were included, and extracted data were analyzed. A total of 10 articles met the inclusion criteria for review. The results of these studies were inconsistent in terms of the association between diabetes and cognitive decline. Only 2 studies demonstrated that the presence of diabetes was independently related to the progression of cognitive decline in the patients with AD, and 3 studies suggested that histories of diabetes were not correlated with the changes in cognitive function in patients with AD. Half of the included studies even indicated that histories of diabetes were associated with lesser declines in cognitive function in patients with AD. Current evidence indicates that the link between diabetes and cognitive decline in patients with AD is uncertain. Further clinical studies are needed, with larger samples, long-term follow up and an extended battery of cognitive assessments.