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Clinics and Research in Hepatology and... Aug 2023Current nonalcoholic fatty liver disease (NAFLD) guidelines do not provide any recommendations regarding the waist-to-height ratio (WHtR), a simple obesity metric... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Current nonalcoholic fatty liver disease (NAFLD) guidelines do not provide any recommendations regarding the waist-to-height ratio (WHtR), a simple obesity metric calculated by dividing waist circumference by height. Therefore, we performed a systematic review and meta-analysis aiming to evaluate WHtR in NAFLD.
METHODS
We performed a systematic electronic search on PubMed, Embase, and Scopus, identifying observational studies assessing WHtR in NAFLD. QUADAS-2 tool was used to evaluate the quality of included studies. The two main statistical outcomes were the area under the curve (AUC) and the mean difference (MD).
RESULTS
We included a total of 27 studies in our quantitative and qualitative synthesis, with a total population of 93,536 individuals. WHtR was significantly higher in NAFLD patients compared to controls with an MD of 0.073 (95% CI 0.058 - 0.088). This was also confirmed after conducting a subgroup analysis according to the hepatic steatosis diagnosis method, for ultrasound (MD 0.066 [96% CI 0.051 - 0.081]) and transient elastography (MD 0.074 [96% CI 0.053 - 0.094]). Moreover, NAFLD male patients presented significantly lower WHtR compared to female patients (MD -0.022 [95% CI -0.041 - -0.004]). The AUC of WHtR for predicting NAFLD was 0.815 (95% CI 0.780 - 0.849).
CONCLUSIONS
WHtR is considerably higher in NAFLD patients compared to controls. Female NAFLD patients present higher WHtR compared to NAFLD male patients. In comparison to other presently suggested scores and markers, the WHtR's accuracy in predicting NAFLD is considered acceptable.
Topics: Humans; Male; Female; Non-alcoholic Fatty Liver Disease; Waist-Height Ratio; Waist Circumference; Ultrasonography; Elasticity Imaging Techniques; Body Mass Index
PubMed: 37321322
DOI: 10.1016/j.clinre.2023.102160 -
PloS One 2023Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older... (Meta-Analysis)
Meta-Analysis
Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis.
BACKGROUND
Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists.
OBJECTIVE
Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs.
METHODS
Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses.
RESULTS
3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence.
CONCLUSIONS
Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
Topics: Quality of Life; Accidental Falls; Independent Living; Fear; Physical Therapy Modalities; Gait
PubMed: 37683025
DOI: 10.1371/journal.pone.0291193 -
Journal of Bodywork and Movement... Oct 2023We are unsure if continuous passive motion (CPM) has any role in the nonoperative management of the Primary Stiff Shoulder (frozen shoulder). We hypothesized that there... (Meta-Analysis)
Meta-Analysis Review
Is there any advantage between using continuous passive motion and conventional physical therapy in patients with primary adhesive capsulitis?: A systematic review and meta-analysis.
BACKGROUND
We are unsure if continuous passive motion (CPM) has any role in the nonoperative management of the Primary Stiff Shoulder (frozen shoulder). We hypothesized that there is no difference in pain improvement, range of motion, and function with or without CPM in patients with a primary stiff shoulder.
METHOD
We searched the databases for clinical trials comparing CPM versus no-CPM physiotherapy. In the final step, we reviewed five randomized clinical trials. We collected the data of Constant Shoulder Score (CSS), the visual analog scale of pain, shoulder pain and disability index (SPADI), and range of motion (flexion, abduction, external and internal rotation). We used a random-effects model to analyze the data.
RESULTS
Five studies with a total of 224 patients were included. There were 113 patients in the CPM arm and 111 in the control arm. Both the CPM and control groups showed significant improvements in all measured parameters compared to the first visit after 8-24 weeks. Meta-analysis of pooled data showed significant differences in pain improvement, forward flexion, and CSS favoring the CPM. Still, there was no significant difference in abduction, external and internal rotation, and SPADI.
DISCUSSION
The CPM seems to be slightly effective in improving pain and motion in the short term, but its long-term efficacy is still under question. The extra cost and time must be considered when offering the CPM.
Topics: Humans; Physical Therapy Modalities; Range of Motion, Articular; Shoulder Pain; Pain Measurement; Bursitis; Shoulder Joint; Treatment Outcome
PubMed: 37949549
DOI: 10.1016/j.jbmt.2023.06.005 -
Frontiers in Endocrinology 2023Despite the fact that obesity and overweight are serious major health problems worldwide, fighting against them is also considered a challenging issue. Several...
BACKGROUND
Despite the fact that obesity and overweight are serious major health problems worldwide, fighting against them is also considered a challenging issue. Several interventional studies have evaluated the potential weight-reduction effect of Tirzepatide. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of subcutaneous Tirzepatide on obesity and overweight.
METHODS
Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase databases were searched using standard keywords to identify all controlled trials investigating the weight loss effects of Tirzepatide. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis for the best estimation of outcomes. The statistical heterogeneity and publication bias were determined using the Cochran's test and I statistics and using the funnel plot and Egger's test, respectively.
RESULTS
Twenty three treatments arm with 7062 participants' were included in this systematic review and meta-regression analysis. The pooled findings showed that Tirzepatide vs placebo significantly reduced body weight (weighted mean difference (WMD): -11.34 kg, 95% confidence interval (CI): -12.79 to -9.88, P< 0.001), body mass index (BMI) (WMD: -3.11 kg/m2, 95% CI: -4.36 to -1.86, P< 0.001), and waist circumference (WC) (WMD: -7.24 cm, 95% CI -10.12 to -4.36, P< 0.001). These reductions were even greater, especially with higher doses and duration of Tirzepatide.
CONCLUSIONS
Tirzepatide medication had significant effects on weight management with the reduction of body weight, BMI, and WC. Administration of Tirzepatide can be considered a therapeutic strategy for overweight or obese people.
Topics: Humans; Overweight; Randomized Controlled Trials as Topic; Obesity; Body Weight; Regression Analysis
PubMed: 37621649
DOI: 10.3389/fendo.2023.1230206 -
Diabetes & Metabolic Syndrome Dec 2023To systematically review the effects of the ketogenic diet on glycaemic control, body weight, cardiovascular risk factors, and liver and kidney function in patients with... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review the effects of the ketogenic diet on glycaemic control, body weight, cardiovascular risk factors, and liver and kidney function in patients with type 2 diabetes.
METHODS
PubMed, MEDLINE, Embase, Cochrane Library and CINAHL were searched for randomised controlled trials published between 2001 and 2021 that compared the ketogenic diet to a control diet for effects on glycaemic control, body weight, cardiovascular risk factors, liver and renal function markers in adults with type 2 diabetes for >14 days. Meta-analyses using fixed or random effects models were conducted.
RESULTS
Nineteen reports from 11 randomised controlled trials were included. Compared to the control, the ketogenic diet showed no significant difference in changes in glycaemic control or body weight, but greater increases in HDL (standardised mean difference 0.19; 95%CI 0.02-0.37; I = 0 %; moderate-quality evidence) and greater reductions in triglycerides (standardised mean difference -0.41; 95%CI -0.64 to -0.18; I = 0 %; low-quality evidence).
CONCLUSIONS
The ketogenic diet may improve lipid profiles but showed no additional benefits for glycaemic control or weight loss compared to control diets in type 2 diabetes patients over two years.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Diet, Ketogenic; Body Weight; Diet; Weight Loss
PubMed: 38006799
DOI: 10.1016/j.dsx.2023.102905 -
Systematic Reviews Jul 2023A limited number of studies have directly examined the effect of whole eggs on body weight and composition in adults, and they have led to inconsistent results. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A limited number of studies have directly examined the effect of whole eggs on body weight and composition in adults, and they have led to inconsistent results. This study aimed to summarize the evidence on the effect of whole egg consumption on body weight and body composition in adults from clinical trials.
METHODS
Online databases were searched from inception to April 2023 for clinical trials that directly or indirectly assessed the effect of whole eggs consumption on anthropometric measures including body weight, body mass index (BMI), waist circumference (WC), and fat-free mass (FFM) in adults. A random effects model was used for meta-analysis.
RESULTS
In total, 32 controlled clinical trials were included in the systematic review. The analyses revealed that whole egg consumption has no significant effect on body weight (n = 22), BMI (n = 13), WC (n = 10), and FFM (n = 4, P > 0.05). The subgroup analyses showed that whole egg consumption has an increasing effect on body weight and BMI in studies that lasted more than 12 weeks and in unhealthy participants (P < 0.05). A significant increasing effect on BMI was found in studies that the control group did not receive any egg (P < 0.05). Moreover, in studies that there was no significant difference in energy intake between the intervention and control groups, weight, and WC were significantly increased (P < 0.05). Additionally, in studies that participants in the control group received another food or supplement, studies with calorie restriction, and studies on healthy subjects, whole egg intake significantly decreased BMI (P < 0.05).
CONCLUSIONS
Although whole egg consumption had no adverse effect on body composition and body weight, in overall, it might increase body weight in long term. Egg consumption beneficially affects BMI in healthy people and during weight loss diet.
SYSTEMATIC REVIEW REGISTRATION
This systematic review and meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO, Registration number: CRD42022308045).
Topics: Humans; Adult; Body Weight; Body Mass Index; Body Composition; Energy Intake; Dietary Supplements; Waist Circumference
PubMed: 37461099
DOI: 10.1186/s13643-023-02277-3 -
Revista Brasileira de Enfermagem 2023to map the scientific evidence on the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest. (Review)
Review
OBJECTIVES
to map the scientific evidence on the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest.
METHODS
this is a scoping review based on the question: "What is the evidence regarding the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest?". Publications up to August 2022 were collected from eight databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used.
RESULTS
seventeen publications were included. The identified general population consisted of adults and elderly individuals. The primary outcome revealed significant rates of return of spontaneous circulation. Secondary outcomes indicated a significant improvement in heart rate, blood pressure, oxygen saturation, and other outcomes.
CONCLUSIONS
abdominal compressions have been shown to be beneficial. However, further clinical studies are needed to identify the best execution method and its impacts.
Topics: Adult; Humans; Aged; Cardiopulmonary Resuscitation; Heart Arrest; Pressure; Blood Pressure; Heart Rate
PubMed: 38018609
DOI: 10.1590/0034-7167-2022-0400 -
Zeitschrift Fur Gerontologie Und... Dec 2023Frailty and sarcopenia are typical geriatric conditions with a complex pathophysiology. Extracellular vesicles (EVs) are key regulators of age-related diseases, but the... (Review)
Review
BACKGROUND
Frailty and sarcopenia are typical geriatric conditions with a complex pathophysiology. Extracellular vesicles (EVs) are key regulators of age-related diseases, but the mechanisms underlying physical frailty, sarcopenia, and EVs are not well understood.
METHODS
A systematic literature review was conducted to examine the evidence supporting an association between EVs and physical frailty and/or sarcopenia by searching the electronic databases, including the Cochrane Library, PubMed, and Embase, from January 2000 to January 2021.
RESULTS
A total of 216 cross-sectional studies were retrieved, and after the removal of 43 duplicate records, the title and abstract of 167 articles were screened, identifying 6 relevant articles for full-text review. Of the studies five met the inclusion criteria, and heterogeneity among studies was high. There is controversy regarding whether frailty and/or sarcopenia are related to circulating EV levels; however, the cargo of EVs has been associated with frailty and sarcopenia in various ways, such as microRNAs, mitochondrial-derived vesicles (MDVs), and protein cargoes.
CONCLUSION
Recent studies, although limited, depicted that EVs could be one of the underlying mechanisms of frailty and/or sarcopenia. There is a possibility that physical frailty and sarcopenia may have specific EV concentrations and cargo profiles; however, further research is required to fully understand the mechanisms and identify potential biomarkers and early preventative strategies for physical frailty and sarcopenia.
Topics: Humans; Aged; Sarcopenia; Frailty; Cross-Sectional Studies; Physical Examination; Extracellular Vesicles
PubMed: 36580105
DOI: 10.1007/s00391-022-02150-3 -
Obesity Reviews : An Official Journal... Jan 2024Obesity may track across generations, due to genetics and shared family environmental factors, or possibly intrauterine programming. However, many studies only assess... (Meta-Analysis)
Meta-Analysis Review
Obesity may track across generations, due to genetics and shared family environmental factors, or possibly intrauterine programming. However, many studies only assess associations between maternal body mass index (BMI) and offspring BMI in childhood. To determine whether maternal and paternal associations with offspring BMI differ and whether associations persist into adulthood, a systematic review and meta-analysis was done. PubMed, Embase, Web of Science, and Google Scholar (to October 2022) were searched. Observational studies reporting associations between maternal or paternal BMI and adult offspring BMI were included. Offspring BMIs were reported as continuous or categorical measures. Forty-six studies were included in the systematic review. Meta-analyses were conducted using random-effects models. Parental BMI was positively associated with offspring BMI in adulthood. The pooled mother-offspring standardized mean difference (SMD) was 0.23 (95% confidence interval [CI]: 0.20, 0.26), and father-offspring SMD was similar: 0.22 (95% CI: 0.19, 0.25) in adjusted models. Offspring of mothers with overweight or obesity had the same risk of higher BMI as offspring of fathers with overweight or obesity. If these associations are causal, they support interventions targeting all family members, rather than focusing solely on mothers, to obtain a healthy weight development among offspring.
Topics: Female; Adult; Humans; Body Mass Index; Overweight; Adult Children; Parents; Obesity; Mothers
PubMed: 37783229
DOI: 10.1111/obr.13644 -
Nutrients Jun 2024The purpose of our systematic review was to examine the effects of any physical activity/exercise intervention combined with any diet/nutrition intervention on any... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The purpose of our systematic review was to examine the effects of any physical activity/exercise intervention combined with any diet/nutrition intervention on any biological/biochemical index, quality of life (QoL), and depression in breast, lung, colon and rectum, prostate, stomach, and liver cancer patients and/or cancer survivors.
METHODS
A systematic review and meta-analysis were undertaken, using PRISMA guidelines and the Cochrane Handbook. The systematic review protocol can be found in the PROSPERO database; registration number: CRD42023481429.
RESULTS
We found moderate-quality evidence that a combined intervention of physical activity/exercise and nutrition/diet reduced body mass index, body weight, fat mass, insulin, homeostatic model assessment for insulin resistance, C-reactive protein, triglycerides, and depression, while it increased high-density lipoprotein, the physical component of QoL, and general functional assessment of cancer therapy.
CONCLUSIONS
We conclude that a combined intervention of physical activity/exercise and diet/nutrition may decrease body weight, fat mass, insulin levels, and inflammation, and improve lipidemic profile, the physical component of QoL, and depression in cancer patients and survivors. These outcomes indicate a lower risk for carcinogenesis; however, their applicability depends on the heterogeneity of the population and interventions, as well as the potential medical treatment of cancer patients and survivors.
Topics: Humans; Neoplasms; Exercise; Quality of Life; Cancer Survivors; Diet; Depression; Male; Body Mass Index; Female
PubMed: 38892682
DOI: 10.3390/nu16111749