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Medicine Dec 2017The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility during stimulation of sensory branches of the trigeminal nerve. Since the first description of the TCR 1999, there is an ongoing discussion about a more flexible than the existing clinical definition. Aim of this work was to create a clinical surrogate definition through a systematic review of the literature.
METHODS
In this meta-analysis study, literature about TCR occurrences was, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, systematically identified through various search engines including PubMed (Medline), Embase (Ovid SP), and ISI Web of Sciences databases from January 2005 to August 2015. TCR was defined as a drop of heart rate (HR) below 60 bpm or 20% to the baseline. We extracted detailed data about hemodynamic changes and searched for connections between arterial blood pressure (BP) and HR changes during such episodes.
RESULTS
Overall 45 studies harboring 57 patients were included in the study but only 32 patients showed sufficient data for final analyze. HR showed a nonlinear behavior with a "tipping point" phenomena that differs in variance from the central/peripheral (20-30% drop) to ganglion (40-49% drop). BP showed a linear behavior with a "central limit" phenomena not differing in variance in the whole subgroup (30-39% drop). An analyzation of the correlation between BP and HR showed a trend to a linear correlation.
CONCLUSIONS
We can show for the first time that HR is the dominant variable in the TCR and present a new surrogate definition model. This model and the role of BP must be better investigated in further studies.
Topics: Adolescent; Adult; Aged; Analysis of Variance; Arterial Pressure; Child; Child, Preschool; Female; Heart Rate; Humans; Male; Middle Aged; Models, Theoretical; Reflex, Trigeminocardiac; Young Adult
PubMed: 29245296
DOI: 10.1097/MD.0000000000009033 -
Journal of Human Hypertension Feb 2019Due to systolic blood pressure (SBP) amplification, brachial SBP may not accurately reflect central SBP, the pressure the organs are exposed to. Patients with type 2... (Meta-Analysis)
Meta-Analysis
Due to systolic blood pressure (SBP) amplification, brachial SBP may not accurately reflect central SBP, the pressure the organs are exposed to. Patients with type 2 diabetes (T2D) have vascular irregularities that may affect blood pressure (BP) amplification and central BP indices (i.e. augmentation index [AIx] and augmentation pressure [AP]). By systematic review and meta-analysis, this study aimed firstly to determine the magnitude of central-to-brachial SBP and pulse pressure (PP) amplification in T2D compared to healthy controls and secondly, the difference in AIx and AP between the groups. Online databases were searched for published studies reporting invasive or non-invasive central and brachial SBP in T2D and healthy controls up to the 20th of February 2018. Random effects meta-analyses and meta-regression were used to analyze the studies. Eighteen studies (all non-invasive: 17 radial tonometry, 1 carotid tonometry, 2 brachial oscillometry) with a total of 2758 patients with T2D and 10,561 healthy controls were identified. There was no significant difference in SBP amplification between groups (T2D = 9.9 ± 4.7, healthy controls = 9.6 ± 4.5 mmHg, p = 0.84; pooled difference = 0.64 mmHg, 95%CI -0.27 1.54, p = 0.17) or PP amplification ratio (p = 0.16). However, among these studies, central BP indices (AIx corrected for heart rate and AP) were significantly higher in T2D (p < 0.05 for both). Despite a similar magnitude of central-to-brachial SBP amplification, patients with T2D have increased central systolic loading (AIx and AP) that cannot be discerned from brachial BP alone.
Topics: Blood Pressure; Brachial Artery; Diabetes Mellitus, Type 2; Humans
PubMed: 30425327
DOI: 10.1038/s41371-018-0124-4 -
Journal of Obstetrics and Gynaecology... Jun 2024Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga... (Review)
Review
OBJECTIVE
Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga activity lowers harmful inflammatory secretions that provide comfort for premenstrual syndrome (PMS) sufferers.
DATA SOURCES
The following worldwide databases were searched for this systematic review: Scopus, PubMed, Cochrane Library, PEDro, and Google Scholar from inception to August 2022.
STUDY SELECTION
A PICOS framework (Population, Intervention, Comparison, Outcome, and Study Design) was used for searching. Population included those with premenstrual syndrome or premenstrual tension syndromes, intervention included yoga therapy, comparator was with control group, and outcome measures included blood pressure (SBP, DBP) and heart rate (HR).
DATA EXTRACTION AND SYNTHESIS
To evaluate the study, we employed the Methodological Index for Randomised Controlled Trials. Fixed effects meta-analysis and qualitative synthesis were conducted. A total of 14 studies out of 224 were included. The main outcome measures included in this review were SBP, DBP, HR, and Moos Menstrual Distress Questionnaire (MMDQ). For the meta-analysis, 7 studies were considered. 3 studies contributed data of SBP (mean difference (MD) = -0.30; 95% CI: -2.29 to 1.69; heterogenicity (I) = 96%; P = 0.00001) and DBP (MD = -0.25; 95% CI: -0.99 to 0.49; I = 79%; P = 0.009). HR results from 4 studies were included (MD = 0.08; 95% CI: -0.83 to 0.99; I = 89%; P = 0.00001). 3 studies contributed data of MMDQ (MD = 1.50; 95% CI: 0.91 to 2.10; I = 92%; P = 0.00001.
CONCLUSION
Yoga can help people with both medical and psychological conditions including menstrual pain, irregular periods, stress, tension, and anxiety. It has been shown to lessen women's emotional, behavioural, and physical PMS symptoms, which has enhanced their quality of life.
OBJECTIF
Jusqu'à 80 % des femmes en âge de procréer connaîtraient un syndrome prémenstruel (SPM), qui se caractérise par des changements physiques, psychologiques et comportementaux. Les activités de yoga réduisent les sécrétions inflammatoires nocives et soulagent les symptômes du syndrome prémenstruel. SOURCE DES DONNéES: Pour cette revue systématique, des recherches ont été effectuées dans les bases de données mondiales Scopus, PubMed, Cochrane Library, PEDro et Google Scholar pour la période allant de leur création au mois d'août 2022. SéLECTION DES éTUDES: Une méthode PICOS (population, intervention, comparaison, résultat et conception de l'étude) a été utilisée pour la recherche. La population à l'étude incluait les personnes souffrant du syndrome prémenstruel ou d'une tension prémenstruelle, l'intervention incluait la thérapie par le yoga, le comparateur était le groupe témoin, et les critères de jugement comprenaient la pression artérielle (systolique et diastolique) et la fréquence cardiaque. EXTRACTION DES DONNéES ET SYNTHèSE: Pour évaluer l'étude, nous avons utilisé l'indice méthodologique pour les essais cliniques randomisés. Une méta-analyse à effet fixe et une synthèse qualitative ont été réalisées. Au total, 14 des 224 études relevées ont été retenues. Les critères de jugement principaux de cette revue étaient les pressions artérielles systolique et diastolique, la fréquence cardiaque et le questionnaire de détresse menstruelle de Moos. Dans la méta-analyse, 7 études ont été prises en compte. Au total, 3 études avaient des données sur la pression systolique (différence moyenne [DM] = -0,30; IC à 95 % : -2,29 à 1,69; hétérogénéité [I] = 96 %; P = 0,00001) et la pression diastolique (DM = -0,25; IC à 95 % : -0,99 à 0,49; I = 79 %; P = 0,009). Les données de fréquence cardiaque de 4 études ont été incluses (DM = 0,08; IC à 95 % : -0,83 à 0,99; I = 89 %; P = 0,00001). Des données du questionnaire de Moos étaient disponibles pour 3 études (DM = 1,50; IC à 95 % : 0,91 à 2,10; I = 92 %; P = 0,00001).
CONCLUSION
Le yoga peut aider les personnes souffrant de troubles médicaux ou psychologiques, notamment les douleurs menstruelles, les menstruations irrégulières, le stress, les tensions et l'anxiété. Les données montrent que le yoga atténue les symptômes émotionnels, comportementaux et physiques du syndrome prémenstruel chez les femmes, ce qui améliore leur qualité de vie.
PubMed: 38871120
DOI: 10.1016/j.jogc.2024.102579