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Frontiers in Oncology 2018We systematically reviewed the literature for trials addressing the efficacy of prophylactic cranial irradiation (PCI) in patients with non-small-cell lung cancer...
BACKGROUND
We systematically reviewed the literature for trials addressing the efficacy of prophylactic cranial irradiation (PCI) in patients with non-small-cell lung cancer (NSCLC) treated with a curative intent.
METHODS
Randomized controlled trials (RCT) comparing PCI to no PCI in patients with NSCLC treated with a curative intent were eligible for inclusion. We searched EMBASE, MEDLINE, PubMed, and CENTRAL between 1946 and July 2016. We also received continual search alerts from PubMed through September 2017. Search terms included "non-small-cell lung carcinoma," "cranial irradiation," and "randomized controlled trials." We conducted meta-analyses using random-effects models for relative measures of treatment effect for the incidence of brain metastasis, overall survival (OS), and disease-free survival (DFS). We used Parmar's methodology to derive hazard ratios (HR) when not explicitly stated in RCTs. We narratively synthesized data for the impact of PCI on quality of life (QoL) and neurocognitive function (NCF). We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation methodology.
RESULTS
Out of 3,548 citations captured by the search strategy, we retained 8 papers and 1 abstract, reporting on 6 eligible trials. Patients who received PCI had a significant reduction in the risk of developing brain metastases as compared with patients who did not [relative risk (RR) = 0.37; 95% confidence interval (CI): 0.26-0.52; moderate quality evidence]. However, there was no OS benefit (HR = 1.08, 95% CI: 0.90-1.31; moderate quality evidence). Sensitivity analysis excluding older studies did not show substantively different findings. DFS was reported in the two most recent trials that included only stage III patients. There was significant improvement in DFS with PCI (HR = 0.67; 95% CI: 0.46-0.98; high quality evidence). Two studies that reported on QoL reported no statistically significant differences. There was no significant difference in NCF decline in the only study that reported on this outcome, except in immediate and delayed recall, as assessed by the Hopkins Verbal Learning Test.
CONCLUSION
There is moderate quality evidence that the use of PCI in patients with NSCLC decreases the risk of brain metastases, but does not provide an OS benefit. However, data limited to stage III patients suggests that PCI improves DFS, with no effect on QoL.
PubMed: 29732317
DOI: 10.3389/fonc.2018.00115 -
The Clinical Neuropsychologist 2019People living with HIV (PLWH) are at risk for HIV-Associated Neurocognitive Disorders (HAND)/Neurocognitive Impairment (NCI). HIV prevalence in Sub-Saharan Africa (SSA)...
People living with HIV (PLWH) are at risk for HIV-Associated Neurocognitive Disorders (HAND)/Neurocognitive Impairment (NCI). HIV prevalence in Sub-Saharan Africa (SSA) is high, but neuropsychological screening and testing for NCI among HIV-infected individuals is not done frequently. This systematic review aims to establish how NCI among HIV-infected individuals is being assessed in SSA, if and how the tests are adapted, if norms exist and identify personnel who administer them. We searched PubMed, Medline, EBSCO, PsycINFO, and Web of Science. Two reviewers screened the articles for inclusion and risk of bias. We included studies from SSA with a comprehensive neuropsychological assessment battery. We retrieved 212 articles and 23 articles met inclusion criteria. The most commonly used tests were the Color Trails Test 1, Color Trails Test 2, and the WAIS III Digit Symbol Test. Some tests were translated into French (Cameroon), Luganda (Uganda), Chichewa (Malawi), isiXhosa (South Africa), and Afrikaans (South Africa). Some verbal learning tests were adapted to reflect culturally appropriate language. Test administrators were either non-specialized personnel supervised by clinical neuropsychologists or clinical psychologists. Overall, the tests used are similar to the tests being used globally to assess NCI among HIV-infected individuals and there is a general consistency across countries. However, there is generally a lack of norms for the tests and the process of adaptation is not always well described. Future research should establish whether these tests measure neuropsychological constructs as successfully as they do in western populations where the tests were developed.
Topics: Female; HIV Infections; Humans; Male; Neurocognitive Disorders; Neuropsychological Tests; South Africa
PubMed: 31043112
DOI: 10.1080/13854046.2019.1606284 -
The Analysis of Verbal Behavior Dec 2019Skinner (1957) differentiated the roles of the speaker and the listener in a verbal encounter. Although not extensively emphasized, Skinner suggested an individual often...
The Effect of Joint Control Training on the Performance of Multiply Controlled Behavior: A Systematic Literature Review Relevant to Children With Autism Spectrum Disorder and Other Developmental Disabilities.
Skinner (1957) differentiated the roles of the speaker and the listener in a verbal encounter. Although not extensively emphasized, Skinner suggested an individual often behaves verbally even when responding as a listener. Children diagnosed with autism spectrum disorders (ASD) often display the absence of important, and basic verbal repertoires that limit their ability to engage in a variety of social skills or problem-solving skills. Joint control suggests that multiply controlled verbal responding involves functional control of two 2 or more stimuli or verbal operants. This systematic literature review provides a summary of publications specifying the relation and implications of the analysis of joint control and joint control training in the acquisition of multiply controlled, non-speaker behaviors (e.g., selection-based behavior; , sequencing behavior). The synthesis suggests that joint control training presents as a promising analytic tool in guiding interventions to teach complex, multiply controlled verbal and non-verbal repertoires to children diagnosed with autism ASD and/or other developmental disabilities. Recommendations for future research in joint control, as well as the implementation of joint control training, are provided.
PubMed: 31976228
DOI: 10.1007/s40616-019-00116-y -
Clinical Interventions in Aging 2019This systematic review examines intervention studies using Tai Chi in the early stages of dementia to determine the effectiveness of Tai Chi for the short-term...
This systematic review examines intervention studies using Tai Chi in the early stages of dementia to determine the effectiveness of Tai Chi for the short-term improvement of cognitive functions for elderly persons with the disease. A keyword search was done in PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), and Cochrane Library databases using keywords such as Tai Chi, Dementia*, and cognition. A secondary search strategy consisting of a manual search in the reference lists of selected articles was also used. A total of nine studies were reviewed including six randomized controlled trials, two non-randomized controlled trials, and one non-randomized prospective study. The studies suggest Tai Chi has impacts on global cognitive functions, visuospatial skills, semantic memory, verbal learning/memory, and self-perception of memory. The effects of Tai Chi on overall cognition for people with mild cognitive impairment are comparable to those in control groups which engaged in exercise. The studies reviewed affirm the potential of Tai Chi to improve short-term cognitive function in the elderly at the onset of dementia.
Topics: Aged; Clinical Trials as Topic; Cognition; Cognitive Dysfunction; Dementia; Humans; Memory; Prospective Studies; Tai Ji
PubMed: 31190769
DOI: 10.2147/CIA.S202055