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Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Aug 2023To evaluate the effects of a Twin-block appliance on the condyles of patients with ClassⅡmalocclusion by conducting a systematic review and a Meta-analysis. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the effects of a Twin-block appliance on the condyles of patients with ClassⅡmalocclusion by conducting a systematic review and a Meta-analysis.
METHODS
Pubmed, Embase, Cochrane Library, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and VIP Database were electronically searched. Randomized controlled trials, controlled clinical trials, and single-arm trials on condylar changes produced by a Twin-block appliance in patients with ClassⅡmalocclusion were included. Two reviewers independently extracted and assessed the risk of bias. Meta-analyses were conducted with Review Manager 5.3.
RESULTS
Eight studies were included; among which, seven were of high quality. After treatment with a twin block appliance, condyles moved anteriorly. The anterior joint spaces decreased (<0.000 01), whereas the posterior spaces increased (<0.000 01). The superior spaces were not changed (=0.11). Moreover, a significant difference was observed in the increase of the condylar space index (<0.000 01). After treatment, the anteroposterior diameters of the condyles and condylar height increased (=0.000 2 and <0.000 01, respectively). By contrast, no significant changes were discovered in the medial external diameters of the condyles (=0.42).
CONCLUSIONS
A Twin-block appliance can promote the growth of a condyle in the posterior and upper direction and move it forward in favor of the correction of Class Ⅱ malocclusion.
Topics: Humans; Malocclusion, Angle Class II; Temporomandibular Joint; Bone and Bones; China; Orthodontic Appliances, Functional; Cephalometry
PubMed: 37474479
DOI: 10.7518/hxkq.2023.2023052 -
Journal of Clinical Nursing Sep 2023Older adults frequently suffer from postprandial hypotension, associated with an increased risk of falls, syncope, acute cardiovascular and cerebrovascular diseases, and... (Review)
Review
BACKGROUND
Older adults frequently suffer from postprandial hypotension, associated with an increased risk of falls, syncope, acute cardiovascular and cerebrovascular diseases, and even death. Researchers use non-pharmacological interventions, but related literature is dispersed and lacks a latest summary.
OBJECTIVE
The aim of this study was to map and examine non-pharmacological interventions currently employed to assist older adults with postprandial hypotension and lay a solid foundation for future studies.
METHODS
This study adhered to the JBI methodology for scoping reviews and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. PubMed, Web of Science, Embase, Cochrane Library, CINAHL, SCOPUS, Chinese Biomedical Journal, China National Knowledge Infrastructure, VIP and WAN FANG Data were retrieved from their inception to 1 August 2022.
RESULTS
Two randomized controlled trials and seven quasi-experimental studies were included. Small meals, exercise interventions, fibre with meals, green tea and water therapy have been reported to prevent postprandial hypotension effectively; however, position changes have been reported to have no impact on postprandial blood pressure decrease. Additionally, the blood pressure determination methods and test meals may affect observed trial effects.
CONCLUSION
Large samples and long-term follow-up studies are needed to prove the efficacy and safety of existing non-pharmacological interventions. Future studies should develop a BP determination method based on the postprandial BP decline trajectory induced by a given test meal to improve the reliability of study results.
RELEVANCE TO CLINICAL PRACTICE
This review broadly summarizes existing studies on developing and validating non-pharmacological interventions for older adults with postprandial hypotension. It also analyses special factors that may influence the trial effects. This may provide a useful reference for future research.
Topics: Humans; Aged; Reproducibility of Results; Hypotension; Blood Pressure; Postprandial Period; Meals
PubMed: 37219354
DOI: 10.1111/jocn.16719 -
British Medical Bulletin Sep 2023It is unclear whether hydrodilatation is beneficial in the management of frozen shoulder compared with other common conservative management modalities. This systematic... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
It is unclear whether hydrodilatation is beneficial in the management of frozen shoulder compared with other common conservative management modalities. This systematic review evaluates the efficacy of hydrodilatation for the management of frozen shoulder.
SOURCES OF DATA
A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An extensive search of PubMed, Embase, Scopus, Cochrane Central, Web of Science and CINAHL databases using multiple keyword combinations of 'shoulder', 'rotator', 'adhesive capsulitis', 'hydrodilatat*', 'distension' since inception of the databases to June 2023 was implemented.
AREAS OF AGREEMENT
Hydrodilatation leads to at least transient more marked improvements in shoulder disability and passive external rotation compared with intra-articular corticosteroid injections.
AREAS OF CONTROVERSY
Hydrodilatation improves passive external rotation in the longer term. Moreover, hydrodilatation may be a preferable option over manipulation under anaesthesia, given its lower cost and better patient convenience.
GROWING POINTS
Intensive mobilization after hydrodilatation is a promising adjuvant treatment option for patients suffering from a frozen shoulder.
AREAS TIMELY FOR DEVELOPING RESEARCH
Although current evidence suggests that hydrodilatation provides a transient improvement in disability in patients with frozen shoulder, its clinical relevance remains unclear. Further research is necessary to establish its role in the management of the condition.
Topics: Humans; Shoulder Joint; Bursitis; Adrenal Cortex Hormones; Injections, Intra-Articular; Anesthesia; Range of Motion, Articular
PubMed: 37496207
DOI: 10.1093/bmb/ldad018 -
British Journal of Sports Medicine Mar 2024To investigate the association between walking speed and the risk of type 2 diabetes. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the association between walking speed and the risk of type 2 diabetes.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, Scopus, CENTRAL and Web of Science to 30 May 2023.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included cohort studies that explored the association between walking speed and the risk of type 2 diabetes in adults. We used random-effects meta-analyses to calculate relative risk (RR) and risk difference (RD). We rated the credibility of subgroup differences and the certainty of evidence using the Instrument to assess the Credibility of Effect Modification ANalyses (ICEMAN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools, respectively.
RESULTS
Ten cohort studies were included. Compared with easy/casual walking (<3.2 km/hour), the RR of type 2 diabetes was 0.85 (95% CI 0.70 to 1.00); RD=0.86 (95% CI 1.72 to 0) fewer cases per 100 patients; n=4, GRADE=low) for average/normal walking (3.2-4.8 km/hour), 0.76 (95% CI 0.65 to 0.87); RD=1.38 (95% CI 2.01 to 0.75) fewer cases per 100 patients; n=10, GRADE=low) for fairly brisk walking (4.8-6.4 km/hour) and 0.61 (95% CI 0.49 to 0.73; RD=2.24 (95% CI 2.93 to 1.55) fewer cases per 100 patients; n=6, GRADE=moderate) for brisk/striding walking (>6.4 km/hour). There was no significant or credible difference across subgroups based on adjustment for the total volume of physical activity and time spent walking per day. Dose-response analysis suggested that the risk of type 2 diabetes decreased significantly at a walking speed of 4 km/h and above.
CONCLUSIONS
Low to moderate certainty evidence, mainly from studies with a high risk of bias, suggests that walking at faster speeds is associated with a graded decrease in the risk of type 2 diabetes.
PROSPERO REGISTRATION NUMBER
CRD42023432795.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Walking Speed
PubMed: 38050034
DOI: 10.1136/bjsports-2023-107336 -
European Journal of Clinical Nutrition Nov 2023The effect of time-restricted eating (TRE) has been summarized in previous studies, but its benefits in combination with calorie restriction (CR) still need to be... (Meta-Analysis)
Meta-Analysis Review
The effect of time-restricted eating (TRE) has been summarized in previous studies, but its benefits in combination with calorie restriction (CR) still need to be determined. The present meta-analysis aimed to evaluate the efficacy of TRE with CR on weight loss and cardiometabolic risk. PubMed, Embase, Cochrane Library, and gray literature databases were searched from inception to October 18, 2022, for potential randomized controlled trial (RCT) studies based on predefined inclusion and exclusion criteria. Body weight and other cardiometabolic risk factors were described as weighted mean difference (WMD) with a 95% confidence interval (CI). Eight RCTs involving 579 participants were enrolled in the present analysis. The pooled results showed that TRE with CR reduced the body weight, fat mass, and waist circumference significantly (WMD: -1.40, 95% CI: -1.81 to -1.00, and I: 0%; WMD: -0.73, 95% CI: -1.39 to -0.07, and I: 0%; WMD: -1.87, 95% CI: -3.47 to -0.26, and I: 67.25%, respectively). However, compared with CR alone, TRE plus CR exhibited no significant benefit on the blood pressure, glucose profile, and lipid profile. Subgroup analysis suggested that early TRE is more effective in weight loss (WMD: -1.42, 95% CI: -1.84 to -1.01, and I: 0%) and improving fat mass (WMD: -1.06, 95% CI: -1.91 to -0.22, and I: 0%) than delayed or broader TRE when combined with CR. Although the combination of TRE and CR can effectively decrease body weight, fat mass, and waist circumference, the long-term effects, particularly those on cardiometabolic risk in participants with chronic cardiovascular disease and diabetes, remain to be explored.
Topics: Humans; Caloric Restriction; Body Weight; Weight Loss; Cardiovascular Diseases; Blood Pressure
PubMed: 37488260
DOI: 10.1038/s41430-023-01311-w -
Clinical Nutrition (Edinburgh, Scotland) Dec 2023Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent.
OBJECTIVE
Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis.
METHODS
From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis.
RESULTS
There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096).
CONCLUSIONS
General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.
Topics: Humans; Overweight; Thinness; Obesity, Abdominal; Obesity; Body Mass Index
PubMed: 37925778
DOI: 10.1016/j.clnu.2023.10.013 -
Resuscitation Oct 2023To perform an updated systematic review and meta-analysis on temperature control in adult patients with cardiac arrest. (Meta-Analysis)
Meta-Analysis Review
AIM
To perform an updated systematic review and meta-analysis on temperature control in adult patients with cardiac arrest.
METHODS
The review is an update of a previous systematic review published in 2021. An updated search including PubMed, Embase, and the Cochrane Central Register of Controlled Trials was performed on May 31, 2023. Controlled trials in humans were included. The population included adult patients with cardiac arrest. The review included all aspects of temperature control including timing, temperature, duration, method of induction and maintenance, and rewarming. Two investigators reviewed trials for relevance, extracted data, and assessed risk of bias. Data were pooled using random-effects models. Certainty of evidence was evaluated using GRADE.
RESULTS
The updated systematic search identified six new trials. Risk of bias in the trials was assessed as intermediate for most of the outcomes. For temperature control with a target of 32-34 °C vs. normothermia or 36 °C, two new trials were identified, with seven trials included in an updated meta-analysis. Temperature control with a target of 32-34 °C did not result in an improvement in survival (risk ratio: 1.06 [95%CI: 0.91, 1.23]) or favorable neurological outcome (risk ratio: 1.27 [95%CI: 0.89, 1.81]) at 90-180 days after the cardiac arrest (low certainty evidence). Subgroup analysis according to location of cardiac arrest (in-hospital vs. out-of-hospital) found similar results. A sensitivity analysis of nine trials comparing temperature control at 32-34 °C to normothermia or 36 °C for favorable neurological outcome at any time point also did not show an improvement in outcomes (risk ratio: 1.14 [95%CI 0.98, 1.34]). New individual trials comparing a target of 31-34 °C, temperature control for 12-24 hours to 36 hours, a rewarming rate of 0.25-0.5 °C/hour, and the effect of temperature control with fever prevention found no differences in outcomes.
CONCLUSIONS
This updated systematic review showed no benefit of temperature control at 32-34 °C compared to normothermia or 36 °C, although the 95% confidence intervals cannot rule out a potential beneficial effect. Important knowledge gaps exist for topics such as hypothermic temperature targets, rewarming rate, and fever control.
Topics: Humans; Adult; Temperature; Body Temperature; Hypothermia, Induced; Heart Arrest; Hypothermia; Out-of-Hospital Cardiac Arrest
PubMed: 37558083
DOI: 10.1016/j.resuscitation.2023.109928 -
AANA Journal Dec 2023This systematic review was conducted to examine the value of the preoperative history and physical (H&P) examination and preoperative care prior to cataract extraction...
This systematic review was conducted to examine the value of the preoperative history and physical (H&P) examination and preoperative care prior to cataract extraction and the resulting outcomes of adverse events, patient experience, and cost. Four databases were searched using appropriate keywords from 2012 to 2022. Observational studies, randomized controlled trials, and quality improvement studies with data on the precataract H&P were included. Outcome measures were adverse events, cost, and patient experience. Of the 4,170 studies screened, 12 studies were included. Risk stratification of patients into a high-risk group with an H&P and a low-risk group without an H&P resulted in an increased incidence of minor adverse events in the low-risk group but did not increase the incidence of major adverse events or surgical adverse events. A short-term cost savings was reported, and patient experience was unchanged. In 2020, the Centers for Medicare and Medicaid Services removed the requirement for the precataract H&P within 30 days prior to ambulatory surgery, which has implications for surgery center policy. More research on the role of the preoperative H&P on patient experience, adverse events, cost, and outcomes should be conducted, given the methodological heterogeneity of this review.
Topics: Aged; United States; Humans; Medicare; Cataract Extraction; Cost Savings; Physical Examination; Cataract
PubMed: 37987726
DOI: No ID Found -
PloS One 2024Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous... (Clinical Trial)
Clinical Trial Meta-Analysis
BACKGROUND
Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous nervous system and influences mortality. By surveying this meta-analysis, we investigated the impact of physical activity on HRV.
METHODS
Databases, online journal libraries and clinical trial registries were searched for publications of randomized controlled and non-randomized controlled trials concerning adults with coronary artery disease (CAD)/ischemic heart disease (IHD), congestive heart failure (CHF), peripheral arterial disease (PAD) or after acute coronary syndrome (ACS) joining an intervention group with physical activity or a control group with usual care or no intervention. Extracted time-domain and frequency-domain parameter of HRV were analyzed in a meta-analysis using a random effect model. Subgroup analyses concerning intervention type, study design and type of heart disease and sensitivity analysis were performed.
RESULTS
Significant results were obtained for RR-Interval (p = 0.05) and standard deviation of Normal-to-Normal intervals (SDNN) (p = 0.01) for short-term assessment and for the ratio of low-frequency power (LF) to high-frequency power (HF) (p = 0.05) for 24-hour assessment. Subgroup analyses also resulted significant: root-mean-square difference of successive normal R-R intervals (RMSSD) (p = 0.01), SDNN (p = 0.02) and HF (p < 0.01) concerning CHF.
CONCLUSION
We were able to demonstrate the positive impact of physical activity on HRV, especially in patients with CHF. Cardiac rehabilitation exercise programs need to be individualized to identify the most beneficial method of training for improving the prognosis of patients with CVD.
Topics: Adult; Humans; Heart Rate; Coronary Artery Disease; Myocardial Ischemia; Heart Failure; Randomized Controlled Trials as Topic
PubMed: 38578755
DOI: 10.1371/journal.pone.0299793 -
Archives of Physical Medicine and... Nov 2023To evaluate the effects of whole-body vibration training (WBVT) on lower limb muscle strength and physical performance in older adults. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the effects of whole-body vibration training (WBVT) on lower limb muscle strength and physical performance in older adults.
DATA SOURCES
Web of Science, PubMed, Cochrane Library, and MEDLINE databases were searched for papers published in English, from January 1, 2000, to May 30, 2022.
STUDY SELECTION
Randomized controlled trials of WBVT in older adults (mean age, 65 years or older) published in English. The Physiotherapy Evidence Database Scale was used to assess the quality of the selected studies.
DATA EXTRACTION
Two investigators independently assessed articles according to the evaluation criteria. Differences between investigator assessments were resolved by consulting a third investigator before reassessment.
DATA SYNTHESIS
Systematic review of 18 randomized controlled studies found that WBVT produced significant improvements in lower limb muscle strength and physical performance among older adults. We used the Cochrane Collaboration method to assess risk of bias and RevMan version 5.4 to extract means and calculate SDs. WBVT significantly improved knee strength (standard mean difference [SMD]=0.72, 95% confidence interval [CI] [0.38, 1.07], P<.0001, I=58%) and explosive power (SMD=0.47, 95% CI [0.10, 0.83], P=.01, I=0%) among older adults. Significant improvements in each physical performance were observed in the sit-to-stand test (SMD=0.57, 95% CI [0.30, 0.84], P<.0001, I=35%), the subgroup of studies that evaluated balance with timed Up and Go test, SMD was 0.53 (95% CI [0.19, 0.88], P=.002, I=56%) and the Tinetti total score, SMD was 0.72 (95% CI [0.04, 1.41], P=.04, I=81%), walking speed (SMD=0.46, 95% CI [0.14, 0.77], P=.005, I=49%), and walking endurance (SMD=0.43, 95% CI [0.02, 0.85], P=.04, I=24%).
CONCLUSIONS
WBVT may be an effective intervention to improve lower limb muscle strength and physical performance in older adults. Tinetti total score remains controversial and warrants assessment in future high-quality randomized controlled trials.
Topics: Humans; Aged; Postural Balance; Vibration; Muscle Strength; Time and Motion Studies; Lower Extremity; Physical Functional Performance
PubMed: 37169245
DOI: 10.1016/j.apmr.2023.04.002