Oral Interventions for Obstructive Sleep Apnea.

Abstract:

BACKGROUND:The effectiveness of intraoral appliances (IOA), maxillary expansion (ME), and maxillomandibular advancement (MMA) in the treatment of children and adults with obstructive sleep apnea (OSA) has not yet been adequately assessed. METHODS:An umbrella review was performed based on established guidelines for evidence-based medicine. Data synthesis was performed only from randomized controlled trials with Paule-Mandel random-effects meta-analyses / meta-regressions using mean differences (MDs) and 95% confidence intervals (CIs) and was followed by the qualitative evaluation of the meta-evidence. RESULTS:29 systematic reviews were included, 7 of which provided quantitative data. IOA were effective in improving apnea hypopnea index (AHI) compared to both, placebo appliances (12 trials; 525 patients; MD = -11.70; 95% CI: [-15.38; -8.01]; p<0.001) and no treatment (1 trial; 24 patients; MD = -14.30; [-21.59; -7.01]; p<0.001). Only the former comparison was supported by robust meta-evidence. Effectiveness of IOA as measured by the Epworth Sleepiness Scale, on the other hand, was not supported by robust meta-evidence. No randomized or prospective controlled trials were found on the effectiveness of ME (conventional or surgically assisted) and MMA. CONCLUSION:Intraoral appliances are effective in reducing AHI and their use is substantiated by robust evidence. There is no evidence from high-quality research to support treatment with ME (conventional or surgically assisted) or MMA in patients with OSA.

journal_name

Dtsch Arztebl Int

authors

Koretsi V,Eliades T,Papageorgiou SN

doi

10.3238/arztebl.2018.0200

subject

Has Abstract

pub_date

2018-03-23 00:00:00

pages

200-207

issue

12

issn

1866-0452

pii

arztebl.2018.0200

journal_volume

115

pub_type

杂志文章,评审
  • Fecal transplant in refractory Clostridium difficile colitis.

    abstract:BACKGROUND:Clostridium difficile infections are becoming more common, more severe, and more likely to recur. Conventional treatment with antibiotics often fails to eradicate the infection; even when it succeeds, recurrent infection is common. Complementary treatment with probiotic agents to reconstitute the physiologic...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2013.0108

    authors: Kleger A,Schnell J,Essig A,Wagner M,Bommer M,Seufferlein T,Härter G

    更新日期:2013-02-01 00:00:00

  • Non-specific, functional, and somatoform bodily complaints.

    abstract:BACKGROUND:4-10% of the general population and 20% of primary care patients have what are called "non-specific, functional, and somatoform bodily complaints." These often take a chronic course, markedly impair the sufferers' quality of life, and give rise to high costs. They can be made worse by inappropriate behavior ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2012.0803

    authors: Schaefert R,Hausteiner-Wiehle C,Häuser W,Ronel J,Herrmann M,Henningsen P

    更新日期:2012-11-01 00:00:00

  • Breast cancer in young women after treatment for Hodgkin's disease during childhood or adolescence--an observational study with up to 33-year follow-up.

    abstract:BACKGROUND:The treatment of Hodgkin's disease (HD; also called Hodgkin's lymphoma) in children and adolescents with radiotherapy and chemotherapy leads to high survival rates but has a number of late effects. The most serious one is the development of a secondary malignant tumor, usually in the field that was irradiate...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0003

    authors: Schellong G,Riepenhausen M,Ehlert K,Brämswig J,Dörffel W,German Working Group on the Long-Term Sequelae of Hodgkin's Disease.,Schmutzler RK,Rhiem K,Bick U,German Consortium for Hereditary Breast and Ovarian Cancer.

    更新日期:2014-01-06 00:00:00

  • Smoking cessation in lung cancer-achievable and effective.

    abstract:BACKGROUND:Lung cancer is the leading cause of death from cancer in Germany. 90% of cases are due to the inhalation of tobacco smoke. About 40% of patients with newly diagnosed lung cancer are still smokers. A structured smoking cessation program is medically reasonable in this situation but is only rarely offered. ME...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2013.0719

    authors: Andreas S,Rittmeyer A,Hinterthaner M,Huber RM

    更新日期:2013-10-01 00:00:00

  • Idiopathic scoliosis.

    abstract:BACKGROUND:Scoliosis is a three-dimensional deviation of the spinal axis. The main diagnostic criterion is spinal curvature exceeding 10° on a plain anteroposterior X-ray image. Scoliosis is called idiopathic when no other underlying disease can be identified. METHODS:Selective literature review and recommendations of...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2010.0875

    authors: Trobisch P,Suess O,Schwab F

    更新日期:2010-12-01 00:00:00

  • The Pathology of Severe COVID-19-Related Lung Damage.

    abstract:BACKGROUND:The histomorphological changes of lung damage in severe coronavirus disease 2019 (COVID-19) have not yet been adequately characterized. In this article, we describe the sequence of pathological changes in COVID-19 and discuss the implications for approaches to treatment. METHODS:Standardized autopsies were ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0500

    authors: Kommoss FKF,Schwab C,Tavernar L,Schreck J,Wagner WL,Merle U,Jonigk D,Schirmacher P,Longerich T

    更新日期:2020-07-20 00:00:00

  • Aggression and violence against primary care physicians—a nationwide questionnaire survey.

    abstract:BACKGROUND:International studies show that aggressive behavior against primary care physicians is not an uncommon occurrence. There has been no systematic study to date of the nature and frequency of such occurrences in Germany. METHODS:A four-page questionnaire was sent to a nationwide random sample of 1500 primary c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0159

    authors: Vorderwülbecke F,Feistle M,Mehring M,Schneider A,Linde K

    更新日期:2015-03-06 00:00:00

  • Not all acne is acne vulgaris.

    abstract:BACKGROUND:Acne is the most common skin disease in adolescence, with a prevalence of nearly 100%. About 60% of affected adolescents have mild acne for which they use non-prescription preparations without consulting a physician. The remaining 40% constitute the population of acne patients seen in medical practice. The c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2014.0301

    authors: Gollnick HP,Zouboulis CC

    更新日期:2014-04-25 00:00:00

  • Red Eye: A Guide for Non-specialists.

    abstract:BACKGROUND:Red eye can arise as a manifestation of many different systemic and ophthalmological diseases. The physician whom the patient first consults for this problem is often not an ophthalmologist. A correct assessment of the urgency of the situation is vitally important for the planning of further diagnostic evalu...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0302

    authors: Frings A,Geerling G,Schargus M

    更新日期:2017-04-28 00:00:00

  • Suspected infertility after treatment for leukemia and solid tumors in childhood and adolescence.

    abstract:BACKGROUND:With improved cure rates of cancer in children and adolescents, the long-term effects of oncological treatment, including impaired fertility, have become an important clinical issue. METHODS:In 2008, we conducted a nationwide survey in Germany in which we asked 4689 female and male patients who had been tre...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2012.0126

    authors: Balcerek M,Reinmuth S,Hohmann C,Keil T,Borgmann-Staudt A

    更新日期:2012-02-01 00:00:00

  • Durability of bioprosthetic cardiac valves.

    abstract:INTRODUCTION:The choice of type of heart valve prosthesis is determined by the patient's age since bioprostheses have a limited lifespan. This article reviews current recommendations and the literature on cardiac valve replacement. METHODS:Selective literature search in Medline/PubMed back to 1996 and review of curren...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0143

    authors: Hoffmann G,Lutter G,Cremer J

    更新日期:2008-02-01 00:00:00

  • Long-term Rehabilitation in Patients With Acquired Brain Injury.

    abstract:BACKGROUND:Patients with acquired brain injury who have been discharged from inpatient neurological rehabilitation often continue to suffer from limited independence, participation, and quality of life. Participation-focused outpatient treatment (in German: teilhabeorientierte ambulan. METHODS:In a randomized, control...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,随机对照试验

    doi:10.3238/arztebl.2016.0634

    authors: Bender A,Adrion C,Fischer L,Huber M,Jawny K,Straube A,Mansmann U

    更新日期:2016-09-23 00:00:00

  • The pharmacotherapy of neuropsychiatric symptoms of dementia: a cross-sectional study in 18 homes for the elderly in Berlin.

    abstract:BACKGROUND:The neuropsychiatric symptoms of dementia, including aggressiveness, agitation, depression, and apathy are often treated with psychotropic drugs and are a frequent reason for hospitalization, placing an economic burden on the health care system. International guidelines recommend syndrome-specific pharmacoth...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,多中心研究

    doi:10.3238/arztebl.2010.0320

    authors: Majic T,Pluta JP,Mell T,Aichberger MC,Treusch Y,Gutzmann H,Heinz A,Rapp MA

    更新日期:2010-05-01 00:00:00

  • The Range and Scientific Value of Randomized Trials.

    abstract:BACKGROUND:The randomized, controlled trial (RCT) is the gold standard of scientific evidence for the attribution of clinical effects (benefits and harms) to medical interventions. Many different designs for RCTs have been developed in order to counter legitimate critical objections and to better adapt the trials to th...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2017.0635

    authors: Lange S,Sauerland S,Lauterberg J,Windeler J

    更新日期:2017-09-22 00:00:00

  • Inherited cardiac arrhythmias: diagnosis, treatment, and prevention.

    abstract:BACKGROUND:The incidence of sudden cardiac death in persons under age 40 is roughly 3 per 100 000 persons per year in Germany and North America. Many of these deaths are found to be due to hereditary heart diseases, often a primary structural heart disease associated with arrhythmia or else a primary arrhythmia syndrom...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0623

    authors: Beckmann BM,Pfeufer A,Kääb S

    更新日期:2011-09-01 00:00:00

  • Inflammatory Bowel Disease.

    abstract:BACKGROUND:Inflammatory bowel diseases are common in Europe, with prevalences as high as 1 in 198 persons (ulcerative colitis) and 1 in 310 persons (Crohn's disease). METHODS:This review is based on pertinent articles retrieved by a search in PubMed and in German and European guidelines and Cochrane reviews of control...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2016.0072

    authors: Wehkamp J,Götz M,Herrlinger K,Steurer W,Stange EF

    更新日期:2016-02-05 00:00:00

  • The role of the complement system in age-related macular degeneration.

    abstract:BACKGROUND:Age-related macular degeneration (AMD) is a common retinal disease in older people. In Europe, about 1.6% of persons over age 65 and more than 13% of persons over age 85 have late-stage AMD, which can severely impair vision. The development of AMD is influenced both by environmental factors and by a strong h...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2014.0133

    authors: Weber BH,Charbel Issa P,Pauly D,Herrmann P,Grassmann F,Holz FG

    更新日期:2014-02-21 00:00:00

  • Reduction in mortality of severely injured patients in Germany.

    abstract:INTRODUCTION:The trauma registry of the German Society of Trauma Surgery is a multicentric prospective record of the treatment of severely injured patients. METHODS:The present study examines the effect of a quality management system on key processes and outcomes, in hospitals included in the trauma registry. The stud...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0225

    authors: Ruchholtz S,Lefering R,Paffrath T,Oestern HJ,Neugebauer E,Nast-Kolb D,Pape HC,Bouillon B

    更新日期:2008-03-01 00:00:00

  • The treatment of colorectal carcinoma with monoclonal antibodies: the importance of KRAS mutation analysis and EGFR status.

    abstract:BACKGROUND:The epidermal growth factor receptor (EGFR) is an important target in the treatment of metastatic colorectal carcinoma (mCRC). The combination of anti-EGFR antibodies with chemotherapy has led to a higher response rate of certain kinds of tumor as well as a significant prolongation of the progression-free in...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2009.0202

    authors: Stintzing S,Heinemann V,Moosmann N,Hiddemann W,Jung A,Kirchner T

    更新日期:2009-03-01 00:00:00

  • The Diagnosis and Treatment of Nail Disorders.

    abstract:BACKGROUND:Nail disorders can arise at any age. About half of all nail disorders are of infectious origin, 15% are due to inflammatory or metabolic conditions, and 5% are due to malignancies and pigment disturbances. The differential diagnosis of nail disorders is often an area of uncertainty. METHODS:This review is b...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2016.0509

    authors: Wollina U,Nenoff P,Haroske G,Haenssle HA

    更新日期:2016-07-25 00:00:00

  • Antipsychotic prescription in children and adolescents: an analysis of data from a German statutory health insurance company from 2005 to 2012.

    abstract:BACKGROUND:Despite sparse documentation of their long-term therapeutic effects and side effects, antipsychotic drugs have come to be prescribed more frequently for children and adolescents in recent years, both in the USA and in Europe. No current data are available about antipsychotic prescriptions for this age group ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0025

    authors: Bachmann CJ,Lempp T,Glaeske G,Hoffmann F

    更新日期:2014-01-17 00:00:00

  • Problematic Medication With Benzodiazepines, "Z-drugs", and Opioid Analgesics.

    abstract:BACKGROUND:An estimated 1.4 to 2.6 million people in German suffer from drug dependence. Most of them are long-term users of benzodiazepines (BZD), Z drugs (ZD), or opioid analgesics (OA). METHODS:This analysis is based on prescription data from patients of the national statutory health insurance system in the German ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2019.0607

    authors: Buth S,Holzbach R,Martens MS,Neumann-Runde E,Meiners O,Verthein U

    更新日期:2019-09-13 00:00:00

  • Diagnostics of cerebral gliomas with radiolabeled amino acids.

    abstract:INTRODUCTION:Magnetic resonance tomography (MRT) is the investigation of choice for diagnosing cerebral glioma, but its capacity to differentiate tumor tissue from non-specific tissue changes is limited. Positron emission tomography (PET) and single photon emission computerized tomography (SPECT) using radiolabeled ami...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0055

    authors: Langen KJ,Tatsch K,Grosu AL,Jacobs AH,Weckesser M,Sabri O

    更新日期:2008-01-01 00:00:00

  • The Treatment of Incisional Hernia.

    abstract:BACKGROUND:A meta-analysis of studies from multiple countries has shown that the incidence of incisional hernia varies from 4% to 10% depending on the type of operation. No epidemiological surveys have been conducted so far. The worst possible complication of an incisional hernia if it is not treated surgically is inca...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析

    doi:10.3238/arztebl.2018.0031

    authors: Dietz UA,Menzel S,Lock J,Wiegering A

    更新日期:2018-01-19 00:00:00

  • Preventing postoperative delirium.

    abstract:BACKGROUND:Delirium is a common complication in elderly hospitalized patients. It prolongs the length of hospital stay, raises costs, increases the workload of the nursing staff, and may necessitate transfer of the patient to a nursing home. The risk of postoperative delirium is particularly high in elderly patients wi...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0289

    authors: Kratz T,Heinrich M,Schlauß E,Diefenbacher A

    更新日期:2015-04-24 00:00:00

  • QTc prolongation by psychotropic drugs and the risk of Torsade de Pointes.

    abstract:INTRODUCTION:Many psychotropic drugs can delay cardiac repolarization and thereby prolong the rate-corrected QT interval (QTc). A prolonged QTc often arouses concern in clinical practice, as it can be followed, in rare cases, by the life-threatening polymorphic ventricular tachyarrhythmia called torsade de pointes (TdP...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0687

    authors: Wenzel-Seifert K,Wittmann M,Haen E

    更新日期:2011-10-01 00:00:00

  • The Association of Climatic Factors with Rates of Surgical Site Infections: 17 Years' Data From Hospital Infection Surveillance.

    abstract:BACKGROUND:Surgical site infections (SSI) are among the most common healthcare- associated infections. The aim of our explorative study was to determine how selected climatic factors are associated with SSI rates. METHODS:SSI rates were calculated for operative procedures included in the surgi- cal site infection surv...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2019.0529

    authors: Aghdassi SJS,Schwab F,Hoffmann P,Gastmeier P

    更新日期:2019-08-05 00:00:00

  • Hematological Malignancies in Adults With a Family Predisposition.

    abstract:BACKGROUND:Some hematological malignancies arise in persons with a hereditary predisposition. The hereditary nature of these diseases often goes unrecognized, particularly when symptoms begin in adulthood. METHODS:This review is based on pertinent publications retrieved by a selective search in PubMed. RESULTS:Many r...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2018.0848

    authors: Bochtler T,Haag GM,Schott S,Kloor M,Krämer A,Müller-Tidow C

    更新日期:2018-12-14 00:00:00

  • The Screening, Diagnosis, Treatment, and Follow-Up of Breast Cancer.

    abstract:BACKGROUND:Breast cancer is the most common cancer in women. The German S3 guideline of 2012 has now been updated to take account of advances in the early detection, diagnostic evaluation, treatment, and follow-up care of this disease. METHODS:The updating process was based on the adaptation of identified source guide...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2018.0316

    authors: Wöckel A,Albert US,Janni W,Scharl A,Kreienberg R,Stüber T

    更新日期:2018-05-04 00:00:00

  • Hormonal therapy in the elderly prostate cancer patient.

    abstract:BACKGROUND:Prostatic cancer (PCa) is the most common cancer in men in Germany. The goal of this review is to define the indication for hormonal treatment in patients over age 70. METHODS:A selective search of the literature up to 2008 for the terms "prostate cancer", "androgen suppression and deprivation", "hormone th...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2009.0242

    authors: Pfitzenmaier J,Altwein JE

    更新日期:2009-04-01 00:00:00