Efficacy, safety, and potential industry bias in using deoxycholic acid for submental fat reduction ‒ A systematic review and meta-analysis of randomized clinical trials

Lipolytic substance injections to reduce localized fat have been extensively used because it is a low-invasive method. This review aimed to evaluate the efficacy and safety of deoxycholic acid in submental fat reduction compared to a placebo and investigate the potential industry sponsorship bias in the results of randomized clinical trials on this topic. Ten electronic databases were extensively searched for randomized clinical trials without restriction on language and year of publication. Two reviewers extracted the data and assessed the individual risk of bias in the studies with the RoB 2.0 tool. The industry sponsorship bias was evaluated according to citations in the articles regarding industry funding/sponsorship throughout the texts. Fixed and random effects meta-analyses were performed, and the results were reported in Risk Ratio (RR) at a 95% Confidence Interval (95% CI). The initial search provided 5756 results, of which only five were included. Only two studies had a low risk of bias. All studies showed a potential industry bias. The meta-analysis showed that patients treated with deoxycholic acid had significant positive results for all efficacy outcomes and a higher risk of fibrosis, pain, erythema, numbness, swelling, edema, pruritus, nodules, headache, and paresthesia. The low to moderate certainty of evidence found allows concluding that deoxycholic acid is effective in submental fat reduction, causing well-tolerated adverse effects. However, all eligible studies showed a potential industry bias.

Domestic Violence against Women Detected and Managed in Dental Practice: a Systematic Review

This study aimed to investigate the knowledge of dental care professionals to identify and manage clinical situations that indicate violence against women. PRISMA guidelines were followed and a systematic review protocol was registered in PROSPERO. The systematic search was designed based on the PICo strategy. Six databases were used as primary research sources (PubMed, Scopus, LILACS, SciELO, Web of Science, and Embase). Three databases (OpenGrey, OpenThesis, and OATD) were used to detect the "grey literature". Observational studies (cross-sectional, cohort, or case-control) were included, and there were no restrictions of year or language of publication. Two authors selected and extracted the data from the eligible studies. The risk of bias was assessed with the JBI Critical Appraisal Checklist. The search resulted in 10,115 studies. Eleven met the eligibility criteria and were included in the qualitative synthesis. The studies were published from 1994 to 2018. All studies presented low risk of bias. Among the dental care professionals, only 1-7.1% of the dentists included injury search and examination of their patients for signs of violence. Less than 47% of the professionals had knowledge to identify violence injuries. When it comes to knowledge to identify signs of domestic violence, positive answers were below 24%. Considering all the variables assessed in this study, dental care professionals presented deficiencies regarding the knowledge and management of situations of domestic violence against women. Educational strategies are necessary to prepare dental care professional to identify and report suspicious cases.