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Biomedicines Aug 2023This systematic review and meta-analysis examines how pulmonary rehabilitation impacts in patients suffering from subacute and long COVID-19 infections, gauging... (Review)
Review
BACKGROUND
This systematic review and meta-analysis examines how pulmonary rehabilitation impacts in patients suffering from subacute and long COVID-19 infections, gauging enhancements in of dyspnea, physical function, quality of life, psychological state (anxiety and depression), and fatigue.
METHODS
Three electronic databases (PubMed, Web of Science, Cochrane Library) were systematically searched for full-text articles published from inception to January 2023. Randomized, quasi-experimental, and observational studies were included, with adults diagnosed with subacute or long COVID-19 who received pulmonary rehabilitation as intervention. Outcomes related to dyspnea, physical function, quality of life, fatigue, and psychological status were included. Risk of bias was assessed with Cochrane Risk of Bias Tool for Randomized Controlled Trials and Risk of bias in non-randomized studies of intervention. The review was registered before starting in PROSPERO (CRD: 42022373075).
RESULTS
Thirty-four studies were included, involving 1970 patients with subacute and long COVID-19. The meta-analysis demonstrated moderate to large effects on dyspnea, physical function, quality of life, and depressive symptoms compared to usual care intervention. No significant differences were found in fatigue compared to usual care, nor in anxiety levels after pulmonary rehabilitation intervention.
CONCLUSIONS
Pulmonary rehabilitation has the potential to improve health outcomes in patients with subacute and long COVID-19. However, due to the high risk of bias of included studies, conclusions should be taken with caution.
PubMed: 37626710
DOI: 10.3390/biomedicines11082213 -
Neuropsychology Review Dec 2023Numerous psychologists have shown interest in applying neuropsychological tests to study intimate partner violence (IPV) perpetrators and gain a further understanding of... (Review)
Review
Numerous psychologists have shown interest in applying neuropsychological tests to study intimate partner violence (IPV) perpetrators and gain a further understanding of the underlying nature of this type of violence. However, up until now, no meta-analysis has drawn on all the available scientific literature to calculate whether consistent differences exist between the neuropsychological performance of IPV perpetrators and other samples of men (non-violent men, IPV perpetrators with drug misuse, and other men with criminal history). The aim of this study was to carry out this calculation and also measure whether neuropsychological performance explained IPV perpetration. We conducted a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. After initially identifying 7243 sources, we eventually included a total of 25 publications. The number of studies included for effect size calculation in each cognitive domain ranged from two to nine. Taking solely into account studies comparing IPV perpetrators with non-violent men, our findings indicate that both IPV perpetrators who misuse drugs and those who do not exhibit worse neuropsychological functioning compared to non-violent men. These differences range from moderate to large for working memory, switching attention, cognitive flexibility, planning abilities, and phonemic fluency. However, while low functioning in response IQ was only observed in IPV perpetrators without drug misuse, continuous attention performance only differed in IPV perpetrators with drug misuse. It should be noted that most conclusions were consistent. In addition, the comparison between IPV perpetrator subsamples and other types of criminal convictions only revealed differences in switching attention, with IPV perpetrators presenting worse abilities than the rest of the subsamples. Finally, we also found some support for significant associations between neuropsychological performance and both physical and psychological IPV perpetration. This meta-analysis is a significant contribution that will help inform future clinical strategies for the early detection of cognitive needs. It will also guide the implementation of new or complementary intervention programs.
PubMed: 38085434
DOI: 10.1007/s11065-023-09628-w -
Child Abuse & Neglect Dec 2023Child sexual abuse (CSA) is a type of maltreatment considered a global health problem. CSA is a traumatic experience with important consequences for the victim's health.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Child sexual abuse (CSA) is a type of maltreatment considered a global health problem. CSA is a traumatic experience with important consequences for the victim's health. It is essential to report the effectiveness of CSA prevention programs to offer society useful tools to combat this abuse.
OBJECTIVE
We aimed to study the effectiveness of CSA prevention programs on the knowledge acquisition based on comparing pre- and post-treatment changes, and also if their effectiveness is related to program-related and methodological variables.
PARTICIPANTS AND SETTINGS
Standardised mean change (with studies that report pre-post program measures) of the effectiveness of CSA prevention programs published between 2014 and 2021 was carried out.
METHODS
The general effectiveness of these programs and whether the results were influenced by program-related variables (the duration, the target population, participants' age, or the type of intervention) or by methodology-related factors (the agent who taught them, the geographical area where they were carried out or the way the programs were evaluated) were analysed. A total of 43 samples analysing knowledge about CSA as a dependent variable were included.
RESULTS
The results reported a combined effect size considered large (d = -0.96, 95 % CI [-1.10, -0.82], p < .001). High inter-study heterogeneity was observed in the meta-analysis, although only the geographic area where the studies were conducted appears as a significant moderator.
CONCLUSIONS
In conclusion, the prevention programs included in this analysis significantly improved the participants' knowledge acquisition.
Topics: Child; Humans; Child Abuse, Sexual; Child Abuse; Surveys and Questionnaires
PubMed: 37804801
DOI: 10.1016/j.chiabu.2023.106489 -
Nutrition (Burbank, Los Angeles County,... Dec 2023This study aimed to describe the eating habits of para-athletes who attended a specialized training center in Brazil.
OBJECTIVE
This study aimed to describe the eating habits of para-athletes who attended a specialized training center in Brazil.
METHODS
Participants were recruited from the Sports Training Center at the Universidade Federal de Minas Gerais, Brazil. Energy, macronutrient (expressed in absolute terms and relative to body weight), fiber, cholesterol, and micronutrient intakes were assessed via a food frequency questionnaire, based on intakes over the preceding 12 mo. Sociodemographic factors were assessed using a purpose-designed survey, which included self-reported weight and height. Differences in nutrient intake based on sex, age, body mass index, and sporting factors were evaluated.
RESULTS
A total of 30 para-athletes (in para athletics, para-powerlifting, para-swimming, and para-taekwondo) were included in the study. The median total energy intake was 4089 (2855-5829) kcal. The median consumption of carbohydrates, proteins, and fats was 512.3 (358.7-853.5), 184.5 (118.5-246.4), and 137.1 (96.8-189.5) g/d, respectively. Adolescent athletes had higher protein intakes than adult athletes (P = 0.02). Para-athletes with a longer sports career had lower consumption of fiber (P = 0.01) and thiamine (P = 0.02). Participants with a higher body mass index had higher intake of alcohol (P = 0.04) and monounsaturated fats (P = 0.01). Higher consumption of alcohol was also reported by older para-athletes (P = 0.02).
CONCLUSIONS
We identified a higher saturated fat intake in male than in female para-athletes as well as higher protein intake (g/kg) in younger compared with older athletes. In addition, sociodemographic characteristics influenced the dietary intake of some para-athletes, such as length of sports career, age, and income.
Topics: Adult; Adolescent; Humans; Male; Female; Diet; Para-Athletes; Dietary Carbohydrates; Eating; Energy Intake; Athletes; Dietary Fats; Dietary Proteins; Nutritional Requirements
PubMed: 37562185
DOI: 10.1016/j.nut.2023.112168 -
Sleep & Breathing = Schlaf & Atmung Aug 2023To investigate the short-term effects of rapid maxillary expansion (RME) on the quality of life of children who had persistent snoring post-adenotonsillectomy (AT). (Review)
Review
PURPOSE
To investigate the short-term effects of rapid maxillary expansion (RME) on the quality of life of children who had persistent snoring post-adenotonsillectomy (AT).
METHODS
The study included children with maxillary constriction aged 5 to 12 years, two or more years after AT whose parents/guardians reported that they still snored ≥ 5 nights per week. We enrolled children with sleep-disordered breathing, including children with primary snoring and children with obstructive sleep apnea (OSA). All patients underwent laryngeal nasofibroscopy and complete polysomnography. Quality of Life (QOL) Questionnaire (OSA-18), the Pediatric Sleep Questionnaire (PSQ), Conners Abbreviated Scale (CAS), and the Epworth Sleepiness Scale (ESS) were administered before and after RME.
RESULTS
Of 24 children enrolled, 13 had primary snoring and 11 had OSA. Overall OSA-18 scores were reduced in both groups (intragroup difference, p < 0.001). The PSQ total score, CAS, and ESS were significantly reduced in both groups (p < 0.001) In the evaluation of snoring, there was a reduction due to the treatment effect in both groups (p < 0.001). Daytime sleepiness and attention deficit hyperactivity disorders were also positively affected in both groups.
CONCLUSIONS
Our study demonstrated the potential benefit of RME in treating children with persistent snoring and transverse maxillary deficiency (TMD). RME can improve snoring and the QOL of children with refractory SDB after AT.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: RBR-463byn.
Topics: Child; Humans; Snoring; Tonsillectomy; Quality of Life; Palatal Expansion Technique; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Adenoidectomy; Surveys and Questionnaires
PubMed: 36251209
DOI: 10.1007/s11325-022-02724-w -
European Neuropsychopharmacology : the... Oct 2023Little is known about genetic predisposition to relapse. Previous studies have linked cognitive and psychopathological (mainly schizophrenia and bipolar disorder)...
Little is known about genetic predisposition to relapse. Previous studies have linked cognitive and psychopathological (mainly schizophrenia and bipolar disorder) polygenic risk scores (PRS) with clinical manifestations of the disease. This study aims to explore the potential role of PRS from major mental disorders and cognition on schizophrenia relapse. 114 patients recruited in the 2EPs Project were included (56 patients who had not experienced relapse after 3 years of enrollment and 58 patients who relapsed during the 3-year follow-up). PRS for schizophrenia (PRS-SZ), bipolar disorder (PRS-BD), education attainment (PRS-EA) and cognitive performance (PRS-CP) were used to assess the genetic risk of schizophrenia relapse.Patients with higher PRS-EA, showed both a lower risk (OR=0.29, 95% CI [0.11-0.73]) and a later onset of relapse (30.96± 1.74 vs. 23.12± 1.14 months, p=0.007. Our study provides evidence that the genetic burden of neurocognitive function is a potentially predictors of relapse that could be incorporated into future risk prediction models. Moreover, appropriate treatments for cognitive symptoms appear to be important for improving the long-term clinical outcome of relapse.
PubMed: 37603902
DOI: 10.1016/j.euroneuro.2023.06.003 -
Frontiers in Pharmacology 2024Perinatal hypoxia-ischemia represents a significant risk to CNS development, leading to high mortality rates, diverse damages, and persistent neurological deficits.... (Review)
Review
Perinatal hypoxia-ischemia represents a significant risk to CNS development, leading to high mortality rates, diverse damages, and persistent neurological deficits. Despite advances in neonatal medicine in recent decades, the incidence of HIE remains substantial. Motor deficits can manifest early, while cognitive impairments may be diagnosed later, emphasizing the need for extended follow-up. This review aims to explore potential candidates for therapeutic interventions for hypoxic-ischemic encephalopathy (HIE), with a focus on cognitive deficits. We searched randomized clinical trials (RCT) that tested drug treatments for HIE and evaluated cognitive outcomes. The results included studies on erythropoietin, melatonin, magnesium sulfate, topiramate, and a combination of vitamin C and ibuprofen. Although there are several indications of the efficacy of these drugs among animal models, considering neuroprotective properties, the RCTs failed to provide complete effectiveness in the context of cognitive impairments derived from HIE. More robust RCTs are still needed to advance our knowledge and to establish standardized treatments for HIE.
PubMed: 38469401
DOI: 10.3389/fphar.2024.1347529 -
Basic & Clinical Pharmacology &... May 2024Studies have demonstrated the neuroprotective effect of cannabidiol (CBD) and other Cannabis sativa L. derivatives on diseases of the central nervous system caused by... (Review)
Review
Therapeutic applicability of cannabidiol and other phytocannabinoids in epilepsy, multiple sclerosis and Parkinson's disease and in comorbidity with psychiatric disorders.
Studies have demonstrated the neuroprotective effect of cannabidiol (CBD) and other Cannabis sativa L. derivatives on diseases of the central nervous system caused by their direct or indirect interaction with endocannabinoid system-related receptors and other molecular targets, such as the 5-HT receptor, which is a potential pharmacological target of CBD. Interestingly, CBD binding with the 5-HT receptor may be suitable for the treatment of epilepsies, parkinsonian syndromes and amyotrophic lateral sclerosis, in which the 5-HT serotonergic receptor plays a key role. The aim of this review was to provide an overview of cannabinoid effects on neurological disorders, such as epilepsy, multiple sclerosis and Parkinson's diseases, and discuss their possible mechanism of action, highlighting interactions with molecular targets and the potential neuroprotective effects of phytocannabinoids. CBD has been shown to have significant therapeutic effects on epilepsy and Parkinson's disease, while nabiximols contribute to a reduction in spasticity and are a frequent option for the treatment of multiple sclerosis. Although there are multiple theories on the therapeutic potential of cannabinoids for neurological disorders, substantially greater progress in the search for strong scientific evidence of their pharmacological effectiveness is needed.
Topics: Humans; Cannabidiol; Parkinson Disease; Multiple Sclerosis; Receptor, Serotonin, 5-HT1A; Cannabinoids; Epilepsy; Mental Disorders; Comorbidity
PubMed: 38477419
DOI: 10.1111/bcpt.13997 -
JAMA Psychiatry Jun 2024Current interventions for posttraumatic stress disorder (PTSD) are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates.... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Current interventions for posttraumatic stress disorder (PTSD) are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates. Acupuncture is an emerging intervention with positive preliminary data for PTSD.
OBJECTIVE
To compare verum acupuncture with sham acupuncture (minimal needling) on clinical and physiological outcomes.
DESIGN, SETTING, AND PARTICIPANTS
This was a 2-arm, parallel-group, prospective blinded randomized clinical trial hypothesizing superiority of verum to sham acupuncture. The study was conducted at a single outpatient-based site, the Tibor Rubin VA Medical Center in Long Beach, California, with recruitment from April 2018 to May 2022, followed by a 15-week treatment period. Following exclusion for characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past nonadherence or treatment resistance, or indicate risk of harm, 93 treatment-seeking combat veterans with PTSD aged 18 to 55 years were allocated to group by adaptive randomization and 71 participants completed the intervention protocols.
INTERVENTIONS
Verum and sham were provided as 1-hour sessions, twice weekly, and participants were given 15 weeks to complete up to 24 sessions.
MAIN OUTCOMES AND MEASURES
The primary outcome was pretreatment to posttreatment change in PTSD symptom severity on the Clinician-Administered PTSD Scale-5 (CAPS-5). The secondary outcome was pretreatment to posttreatment change in fear-conditioned extinction, assessed by fear-potentiated startle response. Outcomes were assessed at pretreatment, midtreatment, and posttreatment. General linear models comparing within- and between-group were analyzed in both intention-to-treat (ITT) and treatment-completed models.
RESULTS
A total of 85 male and 8 female veterans (mean [SD] age, 39.2 [8.5] years) were randomized. There was a large treatment effect of verum (Cohen d, 1.17), a moderate effect of sham (d, 0.67), and a moderate between-group effect favoring verum (mean [SD] Δ, 7.1 [11.8]; t90 = 2.87, d, 0.63; P = .005) in the intention-to-treat analysis. The effect pattern was similar in the treatment-completed analysis: verum d, 1.53; sham d, 0.86; between-group mean (SD) Δ, 7.4 (11.7); t69 = 2.64; d, 0.63; P = .01). There was a significant pretreatment to posttreatment reduction of fear-potentiated startle during extinction (ie, better fear extinction) in the verum but not the sham group and a significant correlation (r = 0.31) between symptom reduction and fear extinction. Withdrawal rates were low.
CONCLUSIONS AND RELEVANCE
The acupuncture intervention used in this study was clinically efficacious and favorably affected the psychobiology of PTSD in combat veterans. These data build on extant literature and suggest that clinical implementation of acupuncture for PTSD, along with further research about comparative efficacy, durability, and mechanisms of effects, is warranted.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02869646.
Topics: Humans; Adult; Male; Stress Disorders, Post-Traumatic; Female; Middle Aged; Combat Disorders; Veterans; Young Adult; Treatment Outcome; Acupuncture Therapy; Reflex, Startle; Prospective Studies; Acupuncture, Ear
PubMed: 38381417
DOI: 10.1001/jamapsychiatry.2023.5651 -
Frontiers in Psychiatry 2023
PubMed: 37779613
DOI: 10.3389/fpsyt.2023.1284670