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BJU International Jun 2015To systematically review and create nomograms of flaccid and erect penile size measurements. (Review)
Review
OBJECTIVE
To systematically review and create nomograms of flaccid and erect penile size measurements.
METHODS
Study key eligibility criteria: measurement of penis size by a health professional using a standard procedure; a minimum of 50 participants per sample.
EXCLUSION CRITERIA
samples with a congenital or acquired penile abnormality, previous surgery, complaint of small penis size or erectile dysfunction. Synthesis methods: calculation of a weighted mean and pooled standard deviation (SD) and simulation of 20,000 observations from the normal distribution to generate nomograms of penis size.
RESULTS
Nomograms for flaccid pendulous [n = 10,704, mean (SD) 9.16 (1.57) cm] and stretched length [n = 14,160, mean (SD) 13.24 (1.89) cm], erect length [n = 692, mean (SD) 13.12 (1.66) cm], flaccid circumference [n = 9407, mean (SD) 9.31 (0.90) cm], and erect circumference [n = 381, mean (SD) 11.66 (1.10) cm] were constructed. Consistent and strongest significant correlation was between flaccid stretched or erect length and height, which ranged from r = 0.2 to 0.6.
LIMITATIONS
relatively few erect measurements were conducted in a clinical setting and the greatest variability between studies was seen with flaccid stretched length.
CONCLUSIONS
Penis size nomograms may be useful in clinical and therapeutic settings to counsel men and for academic research.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anthropometry; Humans; Male; Middle Aged; Nomograms; Organ Size; Penile Erection; Penis; Reference Values; Young Adult
PubMed: 25487360
DOI: 10.1111/bju.13010 -
The Journal of Orthopaedic and Sports... Dec 2017Study Design Systematic review. Background Electromyography (EMG) has previously been used to guide postoperative rehabilitation progression following rotator cuff... (Review)
Review
Study Design Systematic review. Background Electromyography (EMG) has previously been used to guide postoperative rehabilitation progression following rotator cuff repair to prevent deleterious loading of early surgical repair. Objective To review the current literature investigating EMG during rehabilitation exercises in normal shoulders, and to identify exercises that meet a cut point of 15% maximal voluntary isometric contraction (MVIC) or less and are unlikely to result in excessive loading in the early postoperative stages. Methods An electronic search of MEDLINE via Ovid, Embase, CINAHL, SPORTDiscus, PubMed, and the Cochrane Library for all years up to June 2016 was performed. Studies were selected in relation to predefined selection criteria. Pooled mean MVICs were reported and classified as low (0%-15% MVIC), low to moderate (16%-20% MVIC), moderate (21%-40% MVIC), high (41%-60% MVIC), and very high (greater than 60% MVIC). Results A search identified 2159 studies. After applying the selection criteria, 20 studies were included for quality assessment, data extraction, and data synthesis. In total, 43 exercises spanning passive range of motion, active-assisted range of motion, and strengthening exercises were evaluated. Out of 13 active-assisted exercises, 9 were identified as suitable (15% MVIC or less) to load the supraspinatus and 10 as suitable to load the infraspinatus early after surgery. All exercises were placed in a theoretical-continuum model, by which general recommendations could be made for prescription in patients post rotator cuff repair. Conclusion This review identified passive and active-assisted exercises that may be appropriate in the early stages after rotator cuff repair. J Orthop Sports Phys Ther 2017;47(12):931-944. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7271.
Topics: Electromyography; Exercise Therapy; Humans; Muscle, Skeletal; Range of Motion, Articular; Reference Values; Rotator Cuff Injuries; Shoulder
PubMed: 28704624
DOI: 10.2519/jospt.2017.7271 -
International Journal of Environmental... Sep 2021Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual.... (Review)
Review
Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual. Previous studies have identified various instruments used in the measuring of diabetes-specific health-related quality of life (HRQOL). The aim of this paper is to provide a systematic review of the various instruments used for the diabetes-specific measure of HRQOL, and place emphasis on its content and measurement properties. Methods Preferred Reporting Items for Systematic Reviews and Meta analyses (PRISMA) guidelines was used. A systematic search strategy was used to identify publications reporting diabetes HRQOL measures. The search terms used were: "diabetes quality of life", "measurements", and "instruments". The database that was searched includes PubMed, Science Direct, CINAHL, and Medline. Articles written in the English language and published from January 1990 to December 2020 were included. Those articles that did not measure HRQOL for diabetic patients were excluded. Results: A total of seventeen instruments met the inclusion criteria and included in the review. The appraisal of diabetes scale (ADS), Audit of Diabetes-Dependent QOL measure (ADDQOL), Diabetes Health Profile (DHP), and Problem Areas in Diabetes (PAID) are more suitable for single-scale questionnaires when investigating one or more specific aspects of diabetes-specific quality of life (QOL). The ADDQOL, ADS, Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ-R), Malay Version of Diabetes Quality of Life (DQOL), Iranian Diabetes Quality of Life (IRDQOL), Brief Clinical Inventory, and PAID are relevant measures of HRQOL for insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) patients. The Asian Diabetes Quality of Life AsianDQOL, The Chinese Short Version of DQOL, Elderly Diabetes Burden Scale (EDBS), Malay Version of Diabetes Quality of Life (DQOL), are relevant measures of HRQOL for NIDDM patients. Only two instruments assess for responsiveness, namely PAID and DQLCTQ-R. In PAID, the effect sizes ranged from 0.32 to 0.65 for interventions. The DQLCTQ-R four domains were responsive to clinical change in metabolic control. Based on this review ADDQOL, DSQOLS, and EDBS psychometric properties are sufficient. Conclusion: Most studies did not check for responsiveness, and future studies should prioritize responsiveness to change, which was not included in the psychometric finding of the reviewed instruments.
Topics: Aged; Diabetes Mellitus, Type 2; Humans; Iran; Psychometrics; Quality of Life; Surveys and Questionnaires
PubMed: 34501838
DOI: 10.3390/ijerph18179245 -
The Journal of Clinical Endocrinology... Sep 2022Interpretation of thyroid function tests during pregnancy is limited by the generalizability of reference intervals between cohorts due to inconsistent methodology. (Meta-Analysis)
Meta-Analysis
CONTEXT
Interpretation of thyroid function tests during pregnancy is limited by the generalizability of reference intervals between cohorts due to inconsistent methodology.
OBJECTIVE
(1) To provide an overview of published reference intervals for thyrotropin (TSH) and free thyroxine (FT4) in pregnancy, (2) to assess the consequences of common methodological between-study differences by combining raw data from different cohorts.
METHODS
(1) Ovid MEDLINE, EMBASE, and Web of Science were searched until December 12, 2021. Studies were assessed in duplicate. (2) The individual participant data (IPD) meta-analysis was performed in participating cohorts in the Consortium on Thyroid and Pregnancy.
RESULTS
(1) Large between-study methodological differences were identified, 11 of 102 included studies were in accordance with current guidelines; (2) 22 cohorts involving 63 198 participants were included in the meta-analysis. Not excluding thyroid peroxidase antibody-positive participants led to a rise in the upper limits of TSH in all cohorts, especially in the first (mean +17.4%; range +1.6 to +30.3%) and second trimester (mean +9.8%; range +0.6 to +32.3%). The use of the 95th percentile led to considerable changes in upper limits, varying from -10.8% to -21.8% for TSH and -1.2% to -13.2% for FT4. All other additional exclusion criteria changed reference interval cut-offs by a maximum of 3.5%. Applying these findings to the 102 studies included in the systematic review, 48 studies could be used in a clinical setting.
CONCLUSION
We provide an overview of clinically relevant reference intervals for TSH and FT4 in pregnancy. The results of the meta-analysis indicate that future studies can adopt a simplified study setup without additional exclusion criteria.
Topics: Female; Humans; Iodide Peroxidase; Pregnancy; Reference Values; Thyroid Function Tests; Thyroid Gland; Thyrotropin; Thyroxine
PubMed: 35861700
DOI: 10.1210/clinem/dgac425 -
Expert Review of Respiratory Medicine Dec 2016The 6-minute walk test is a submaximal exercise test used to quantify the functional exercise capacity in clinical populations. It measures the distance walked within a... (Review)
Review
The 6-minute walk test is a submaximal exercise test used to quantify the functional exercise capacity in clinical populations. It measures the distance walked within a period of 6-minutes. Obtaining reference values in the pediatric population is especially demanding due to factors as the development stage and age. RV provide a comparative basis for answering questions concerning the normality of health status, exercise responses and functional exercise capacity in patients. Areas covered: The aim of this review is to provide an overview of reference values and reference value prediction equations for the 6-minute walk test in the children and in adolescent pediatric population and of the methodology used to obtain them. A total of 22 studies from MEDLINE, EMBASE and Cinahl were included containing healthy participants aged ≤18 years. Reported reference values ranged from 383 m ± 41 m to 799 m ± 54 m. The prediction equation 6MWD = (4.63*height(cm))-(3.53*weight(kg))+(10.42*age)+56.32 yields the highest R value (0.6). Expert commentary: It is impossible to present a single best reference value. A flow-chart is presented to aid the selection of reference values or reference value prediction equations. Consensus regarding testing procedures should lead to an update and stricter application of the current guidelines.
Topics: Adolescent; Age Factors; Child; Exercise Tolerance; Female; Health Status; Humans; Male; Reference Values; Walk Test
PubMed: 27817221
DOI: 10.1080/17476348.2016.1258305 -
British Journal of Sports Medicine Nov 2018To develop sex-specific and age-specific normative values for the nine Eurofit tests in European children and adolescents aged 9-17 years. (Review)
Review
OBJECTIVE
To develop sex-specific and age-specific normative values for the nine Eurofit tests in European children and adolescents aged 9-17 years.
METHODS
A systematic review was undertaken to identify papers that explicitly reported descriptive results for at least one of nine Eurofit tests (measuring balance, muscular strength, muscular endurance, muscular power, flexibility, speed, speed-agility and cardiorespiratory fitness (CRF)) on children and adolescents. Data were included on apparently healthy (free from known disease/injury) children and adolescents aged 9-17 years. Following harmonisation for methodological variation where appropriate, pseudodata were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu Sigma (LMS) method. Sex-specific and age-specific differences were expressed as standardised differences in means, with the percentage of children and adolescents with healthy CRF estimated at the sex-age level.
RESULTS
Norms were displayed as tabulated centiles and as smoothed centile curves for the nine Eurofit tests. The final dataset included 2 779 165 results on children and adolescents from 30 European countries, extracted from 98 studies. On average, 78% of boys (95% CI 72% to 85%) and 83% of girls (95% CI 71% to 96%) met the standards for healthy CRF, with the percentage meeting the standards decreasing with age. Boys performed substantially (standardised differences >0.2) better than girls on muscular strength, muscular power, muscular endurance, speed-agility and CRF tests, but worse on the flexibility test. Physical fitness generally improved at a faster rate in boys than in girls, especially during the teenage years.
CONCLUSION
This study provides the largest and most geographically representative sex-specific and age-specific European normative values for children and adolescents, which have utility for health and fitness screening, profiling, monitoring and surveillance.
Topics: Adolescent; Cardiorespiratory Fitness; Child; Europe; Exercise Test; Female; Humans; Male; Muscle Strength; Physical Endurance; Physical Fitness; Postural Balance; Reference Values
PubMed: 29191931
DOI: 10.1136/bjsports-2017-098253 -
Journal of the American Society of... Jan 2017Recent advances in the assessment of myocardial function have facilitated the direct measurement of atrial function using speckle-tracking echocardiography. Currently,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Recent advances in the assessment of myocardial function have facilitated the direct measurement of atrial function using speckle-tracking echocardiography. Currently, normal reference ranges for atrial function using speckle-tracking echocardiography are based on a few initial studies, with variations among modestly sized (n = 100-350) studies.
METHODS
The authors searched the PubMed, Embase, and Scopus databases for the key terms "left atrial/atrial/atrium" and "strain/function/deformation/stiffness" and "speckle tracking/Velocity Vector Imaging/edge tracking." Studies of global left atrial function using speckle-tracking were selected if they involved >30 normal or healthy participants without any cardiac risk factors. Normal ranges for reservoir strain, conduit strain, and contractile strain were computed using a random-effects model. Meta-regression and subgroup analysis was performed to explore between-study heterogeneity.
RESULTS
Forty studies (2,542 healthy subjects) satisfied the inclusion criteria. Meta-analysis revealed a normal reference range for reservoir strain of 39% (95% CI, 38%-41%, from 40 articles), for conduit strain of 23% (95% CI, 21%-25%, from 14 articles), and for contractile strain of 17% (95% CI, 16%-19%, from 18 articles). Meta-regression identified heart rate (P = .02) and body surface area (P = .003) as contributors to this heterogeneity. Subgroup analyses revealed heterogeneity due to sample size (n > 100 vs N < 100, P = .02).
CONCLUSIONS
The normal reference ranges for the three components of left atrial function are demonstrated. The between-study heterogeneity is explained partly by heart rate, body surface area, and sample size.
Topics: Adult; Atrial Function; Echocardiography; Elastic Modulus; Elasticity Imaging Techniques; Evidence-Based Medicine; Heart Atria; Humans; Middle Aged; Reference Values; Reproducibility of Results; Sensitivity and Specificity; Shear Strength; Stress, Mechanical; Tensile Strength
PubMed: 28341032
DOI: 10.1016/j.echo.2016.09.007 -
Neonatology 2021The diagnosis of neonatal meningitis often rests on microscopic and biochemical findings in the cerebrospinal fluid (CSF). There is ongoing uncertainty about age-related...
BACKGROUND
The diagnosis of neonatal meningitis often rests on microscopic and biochemical findings in the cerebrospinal fluid (CSF). There is ongoing uncertainty about age-related normal values for CSF findings in neonates, and many previous studies have included infants in whom antibiotics were administered before lumbar puncture or in whom viral meningitis was not excluded.
METHODS
A systematic search was done using MEDLINE and EMBASE to identify original studies which investigated CSF normal values in either healthy neonates or febrile neonates in whom bacterial and viral meningitis were reliably excluded.
RESULTS
We identified seven studies investigating 270 term and 96 preterm neonates. There were minimal differences between preterm and term neonates in the CSF white blood cell (WBC) count and glucose concentration. In contrast, the CSF neutrophil count and protein concentration were influenced by gestational and chronological age. In the four studies that reported individual patient data, in 95% of cases the CSF WBC count was <12 cells/μL in preterm and <10 cells/μL in term neonates, the neutrophil count was <16 and 8 cells/μL, and the protein concentration was <210 and 110 mg/dL, respectively.
CONCLUSION
The normal range for CSF parameters in neonates is different to that in older infants, and some parameters are influenced by gestational and chronological age. CSF parameters alone are not sufficiently reliable to exclude meningitis.
Topics: Aged; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Leukocyte Count; Meningitis; Reference Values; Retrospective Studies; Spinal Puncture
PubMed: 34818234
DOI: 10.1159/000517630 -
The Lancet. Respiratory Medicine Jun 2019Existing normal polysomnography values are not truly normative as they are based on small sample sizes due to the fact that polysomnography is expensive and burdensome... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Existing normal polysomnography values are not truly normative as they are based on small sample sizes due to the fact that polysomnography is expensive and burdensome to obtain. There is a clear need for a large sample of truly normative data for clinical management and research. This study is a comprehensive meta-analysis of adult polysomnography parameters scored using recent criteria and establishes normative values adjusted for age and sex.
METHODS
For this meta-analysis of adult polysomnography parameters, we searched Scopus for studies of any design published between Jan 1, 2007, and July 31, 2016, that reported polysomnographic parameters scored using recent American Academy of Sleep Medicine criteria (2007 or 2012) collected during an overnight level 1 in-laboratory sleep study in healthy controls. We excluded studies of patients with conditions or subjected to treatments that might affect sleep and studies not available in English. Study endpoints were the pooled estimates of 14 reported polysomnographic parameters. Estimates for each parameter were pooled using a random-effects meta-analysis. The influence of age and sex was ascertained using multivariate mixed-effects meta-regressions. This study is registered with PROSPERO, number CRD42017074319.
FINDINGS
Of 3712 articles, 169 studies, comprising 5273 participants, were eligible for inclusion. We report normative data stratified by age and sex. For each decade of age, total sleep time decreased by 10·1 min (95% CI 7·5 to 12·8), sleep efficiency decreased by 2·1% (1·5 to 2·6), wake after sleep onset increased by 9·7 min (6·9 to 12·4), sleep onset latency increased by 1·1 min (0·3 to 1·9), arousal index increased by 2·1 events per h (1·5 to 2·6), percentage of N1 sleep increased by 0·5% (0·1 to 0·8), apnea-hypopnea index increased by 1·2 events per h (0·9 to 1·4), mean oxygen saturation decreased by 0·6% (0·5 to 0·7), minimum oxygen saturation decreased by 1·8% (1·3 to 2·3), and periodic limb movement index increased by 1·2 events per h (0·8 to 1·6). Changes with age in the percentage of N2 sleep (0·0%, 95% CI -0·1 to 0·1), N3 sleep (-0·1%, -0·1 to 0·0), and rapid eye movement (REM) sleep (0·0%, -0·1 to 0·0) were not significant. Every 10% increase in the percentage of male participants was associated with reduced REM latency (0·9 min decrease, 95% CI 0·1 to 1·6) and mean oxygen saturation (0·1% decrease, 0·0 to 0·1), and greater arousal index (0·3 events per h, 0·0 to 0·5) and apnea-hypopnea index (0·2 events per h, 0·1 to 0·3).
INTERPRETATION
These normative values serve as a useful control reference for clinicians and for future research where it might be difficult to obtain polysomnographic controls. The resulting normative trends by age and sex might also be hypothesis-generating for a broad range of investigations.
FUNDING
None.
Topics: Adult; Aged; Aged, 80 and over; Female; Healthy Volunteers; Humans; Male; Middle Aged; Polysomnography; Reference Values; Sleep; Young Adult
PubMed: 31006560
DOI: 10.1016/S2213-2600(19)30057-8 -
Foot (Edinburgh, Scotland) Mar 2018The calf muscles are one of the muscle groups that have the most need for adequate flexibility since they are deeply related to normal lower limb function. When the goal... (Meta-Analysis)
Meta-Analysis Review
The calf muscles are one of the muscle groups that have the most need for adequate flexibility since they are deeply related to normal lower limb function. When the goal is to increase flexibility, the most commonly used technique is stretching. However, it remains unknown which stretching technique and parameters are the most effective to increase flexibility. Hence, the aim of the current review was to investigate the influence of chronic stretching on ankle dorsiflexion range of motion (DFROM) of healthy individuals. The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, LILACS, and manual search from inception to February 2017. Randomized and controlled clinical trials that have analyzed the influence of chronic stretching on DFROM were included. On the other hand, studies with special populations (children, and people with any dysfunction/disease), and articles with no control group were excluded. Twenty studies were included out of 493 identified. The meta-analysis was performed according to the stretching technique used in the study. The results show that static stretching (5.17°; 95% CI: 4.39-5.95; I: 0%) and proprioceptive neuromuscular facilitation (4.32°; 95% CI: 1.59-7.04; I: 46%) are effective in increasing DFROM. Ballistic stretching did not show positive results to increase DFROM (3.77°; 95% CI: -0.03 to 7.56; I: 46%). In conclusion, chronic stretching is an effective way of improving ankle mobility in healthy individuals, especially when it contains a static component.
Topics: Ankle Joint; Exercise Therapy; Female; Healthy Volunteers; Humans; Male; Muscle Stretching Exercises; Range of Motion, Articular; Reference Values; Time Factors
PubMed: 29223884
DOI: 10.1016/j.foot.2017.09.006