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Sports Health 2023Hamstring strain is a common injury to the lower limbs. Early intervention in the acute phase aids with restoring hamstring function and prevents secondary related... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Hamstring strain is a common injury to the lower limbs. Early intervention in the acute phase aids with restoring hamstring function and prevents secondary related injury.
OBJECTIVE
To systematically review and summarize the effectiveness of exercise-based interventions combined with physical modalities currently used in athletes with acute hamstring injuries.
DATA SOURCES
Five databases (EMBASE, Medline, Cochrane Library, SPORTDiscus, and Web of Science) were searched from inception to July 2021.
STUDY SELECTION
A total of 4569 studies were screened. Nine randomized controlled trials (RCTs) on the effect of therapeutic exercise programs with and without physical agents in athletes with acute hamstring injuries were identified for meta-analysis.
STUDY DESIGN
Systematic review and meta-analysis.
LEVEL OF EVIDENCE
Level 1.
DATA EXTRACTION
The studies were screened, and the evidence was rated using the PEDro scale. Nine RCTs with PEDro scores ranging between 3 and 9 were included and extracted pain intensity, time to return to play (TTRTP), and reinjury rate in the study.
RESULTS
Loading exercises during extensive lengthening were shown to facilitate TTRTP at < 0.0001 but did not prevent recurrence ( = 0.17), whereas strengthening with trunk stabilization and agility exercise did not reduce the duration of injury recurrence ( = 0.16), but significantly reduced the reinjury rate ( < 0.007) at a 12-month follow-up. The results of the stretching programs and solely physical modalities could not be pooled in the statistical analysis.
CONCLUSION
The meta-analysis indicated that a loading program helps athletes to return to sports on a timely basis. Although strengthening with trunk stabilization and agility exercise cannot significantly reduce recovery time, the program can prevent reinjury. The clinical effects of stretching programs and pure physical modality interventions could not be concluded in this study due to limited evidence.
PROSPERO REGISTRATION
CRD42020183035.
Topics: Humans; Muscle, Skeletal; Athletic Injuries; Reinjuries; Exercise Therapy; Leg Injuries; Soft Tissue Injuries; Athletes
PubMed: 35996322
DOI: 10.1177/19417381221118085 -
European Respiratory Review : An... Jun 2023Weaning is a critical stage of an intensive care unit (ICU) stay, in which the respiratory muscles play a major role. Weakness of the respiratory muscles, which is...
Weaning is a critical stage of an intensive care unit (ICU) stay, in which the respiratory muscles play a major role. Weakness of the respiratory muscles, which is associated with significant morbidity in the ICU, is not limited to atrophy and subsequent dysfunction of the diaphragm; the extradiaphragmatic inspiratory and expiratory muscles also play important parts. In addition to the well-established deleterious effect of mechanical ventilation on the respiratory muscles, other risk factors such as sepsis may be involved. Weakness of the respiratory muscles can be suspected visually in a patient with paradoxical movement of the abdominal compartment. Measurement of maximal inspiratory pressure is the simplest way to assess respiratory muscle function, but it does not specifically take the diaphragm into account. A cut-off value of -30 cmHO could identify patients at risk for prolonged ventilatory weaning; however, ultrasound may be better for assessing respiratory muscle function in the ICU. Although diaphragm dysfunction has been associated with weaning failure, this diagnosis should not discourage clinicians from performing spontaneous breathing trials and considering extubation. Recent therapeutic developments aimed at preserving or restoring respiratory muscle function are promising.
Topics: Humans; Noninvasive Ventilation; Respiration, Artificial; Ventilator Weaning; Respiration; Respiratory Muscles; Muscle Weakness; Respiratory Insufficiency
PubMed: 37019456
DOI: 10.1183/16000617.0205-2022 -
Frontiers in Immunology 2023The pathophysiology of immune thrombocytopenia (ITP) is complex and encompasses innate and adaptive immune responses, as well as megakaryocyte dysfunction. Rituximab is... (Review)
Review
The pathophysiology of immune thrombocytopenia (ITP) is complex and encompasses innate and adaptive immune responses, as well as megakaryocyte dysfunction. Rituximab is administered in relapsed cases and has the added benefit of inducing treatment-free remission in over 50% of patients. Nevertheless, the responses to this therapy are not long-lasting, and resistance development is frequent. B cells, T cells, and plasma cells play a role in developing resistance. To overcome this resistance, targeting these pathways through splenectomy and novel therapies that target FcγR pathway, FcRn, complement, B cells, plasma cells, and T cells can be useful. This review will summarize the pathogenetic mechanisms implicated in rituximab resistance and examine the potential therapeutic interventions to overcome it. This review will explore the efficacy of established therapies, as well as novel therapeutic approaches and agents currently in development.
Topics: Humans; Rituximab; Purpura, Thrombocytopenic, Idiopathic; Thrombocytopenia; B-Lymphocytes; Remission Induction
PubMed: 37575230
DOI: 10.3389/fimmu.2023.1215216 -
Ugeskrift For Laeger Jan 2024Non-pharmacological treatment for pain in children is seeing more interest as various interventions are investigated and found to be efficacious and free from adverse... (Review)
Review
Non-pharmacological treatment for pain in children is seeing more interest as various interventions are investigated and found to be efficacious and free from adverse side effects. Some of the most used non-pharmacological treatments include distractive play, music therapy, virtual reality, hospital clowns, and hypnosis. This review summarises studies examining these modalities and finds that the available literature, although at times limited, mostly concludes that they are effective at reducing pain and/or anxiety in children. The population and setting for each modality are discussed.
Topics: Child; Humans; Pain; Anxiety; Anxiety Disorders; Pain Management; Music Therapy
PubMed: 38235722
DOI: 10.61409/V06230364 -
Supportive Care in Cancer : Official... Oct 2023Inflammation is thought to play a key role in malignant disease and may play a significant part in the expression of cancer-related symptoms. Cannabidiol (CBD) is a... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Inflammation is thought to play a key role in malignant disease and may play a significant part in the expression of cancer-related symptoms. Cannabidiol (CBD) is a bioactive compound in cannabis and is reported to have significant anti-inflammatory properties.
METHOD
Serial C-reactive protein (CRP) levels were measured in all participants recruited to a randomised controlled trial of CBD versus placebo in patients with symptoms related to advanced cancer. A panel of inflammatory cytokines was measured over time in a subset of these patients.
RESULTS
There was no difference between the two arms in the trajectory of CRP or cytokine levels from baseline to day 28.
CONCLUSION
We were unable to demonstrate an anti-inflammatory effect of CBD in cancer patients.
TRIAL REGISTRATION
ANZCTR 26180001220257, registered 20/07/2018.
Topics: Humans; Medical Marijuana; Cannabidiol; Cannabis; Anti-Inflammatory Agents; Neoplasms
PubMed: 37837446
DOI: 10.1007/s00520-023-08069-8 -
Biomedicine & Pharmacotherapy =... Dec 2023Regulatory T cells are a subgroup of T cells with immunomodulatory functions. Different from most cytotoxic T cells and helper T cells, they play a supporting role in... (Review)
Review
Regulatory T cells are a subgroup of T cells with immunomodulatory functions. Different from most cytotoxic T cells and helper T cells, they play a supporting role in the immune system. What's more, regulatory T cells often play an immunosuppressive role, which mainly plays a role in maintaining the stability of the immune system and regulating the immune response in the body. However, recent studies have shown that not only playing a role in autoimmune diseases, organ transplantation, and other aspects, regulatory T cells can also play a role in the immune escape of tumors in the body, through various mechanisms to help tumor cells escape from the demic immune system, weakening the anti-cancer effect in the body. For a better understanding of the role that regulatory T cells can play in cancer, and to be able to use regulatory T cells for tumor immunotherapy more quickly. This review focuses on the research progress of various mechanisms of regulatory T cells in the tumor environment, the related research of tumor cells acting on regulatory T cells, and the existing various therapeutic methods acting on regulatory T cells.
Topics: Humans; T-Lymphocytes, Regulatory; Immunotherapy; Neoplasms; T-Lymphocytes, Cytotoxic; Immunomodulation; Tumor Microenvironment
PubMed: 37806087
DOI: 10.1016/j.biopha.2023.115142 -
Best Practice & Research. Clinical... Jan 2024Androgens play a key biological role in libido and sexual arousal in women, and knowledge about their complex role in other systems remains ambiguous and incomplete.... (Review)
Review
Androgens play a key biological role in libido and sexual arousal in women, and knowledge about their complex role in other systems remains ambiguous and incomplete. This narrative review examines the role of endogenous androgens in women's health throughout the life span before focusing on evidence surrounding the use of androgen-based therapies to treat postmenopausal women. The role of testosterone as a therapeutic agent in women continues to attract controversy as approved preparations are rare, and use of off-label and compounded formulations is widespread. Despite this androgen therapy has been used for decades in oral, injectable, and transdermal formulations. Responses to androgen therapy have been demonstrated to improve aspects of female sexual dysfunction, notably hypoactive sexual desire disorder, in a dose related manner. Substantial research has also been conducted into the role of androgens in treating aspects of the genitourinary syndrome of menopause (GSM). Evidence for benefits beyond these is mixed and more research is required regarding long-term safety. However, It remains biologically plausible that androgens will be effective in treating hypoestrogenic symptoms related to menopause, either through direct physiological effects or following aromatization to estradiol throughout the body.
Topics: Female; Humans; Androgens; Testosterone; Hormone Replacement Therapy; Libido; Estradiol
PubMed: 37246051
DOI: 10.1016/j.beem.2023.101783 -
Cancer Radiotherapie : Journal de La... Sep 2023Several preclinical data have suggested the ability of radiation therapy to modulate the intrinsic immunogenicity of cancer cells and the tumor microenvironment, with... (Review)
Review
Several preclinical data have suggested the ability of radiation therapy to modulate the intrinsic immunogenicity of cancer cells and the tumor microenvironment, with the aim of increasing responses to checkpoint inhibitors. Early results showing a restoration of checkpoint inhibitors response in patients following irradiation have generated a lot of enthusiasm around radiation therapy beyond its usual role in local disease control. Prospective clinical trials evaluating immunoradiotherapy combinations have provided proof-of-concept that radiation therapy may induce tumor-specific T immune responses in patients treated with checkpoint inhibitors. However, these results are not always reproducible, reflecting the existence of factors related to either radiation therapy, immunotherapy and/or the host, which influence the efficacy of these combinations. Anticancer chemotherapy can play a role in amplifying the immune-radiation response by promoting tumor immunogenicity and modulating the tumor microenvironment.
Topics: Humans; Radioimmunotherapy; Prospective Studies; Combined Modality Therapy; Neoplasms; Antigens, Neoplasm; Immunotherapy; Tumor Microenvironment
PubMed: 37495428
DOI: 10.1016/j.canrad.2023.06.015