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Journal of Gastroenterology and... Aug 2023We aim to conduct a systematic review and determine the association between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIM
We aim to conduct a systematic review and determine the association between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD).
METHODS
Literature search for eligible studies was performed across major databases. The main endpoint was to assess the association between GERD and OSA. Subgroup analyses were performed to determine this strength of the association stratified by the diagnostic tools used for OSA (nocturnal polysomnogram or Berlin questionnaire) and GERD (validated reflux questionnaire or esophagogastroduodenoscopy). We also compared sleep efficiency, apnea hypopnea index, oxygen desaturation index, and Epworth Sleepiness Scale in OSA patients with or without GERD. Results were pooled together using Reviewer Manager 5.4.
RESULTS
Six studies involving 2950 patients with either GERD or OSA were included in the pooled analysis. Our findings suggest that there was a statistically significant unidirectional association between GERD and OSA (odds ratio [OR] = 1.53, P = 0.0001). Subgroup analyses redemonstrated an OSA-GERD association irrespective of the tools used for diagnosing either GERD or OSA (P = 0.24 and P = 0.82, respectively). Sensitivity analyses demonstrated the same association after controlling for gender (OR = 1.63), BMI (OR = 1.81), smoking (OR = 1.45), and alcohol consumption (OR = 1.79). In patients with OSA, there were no statistically significant differences between patients with or without GERD in terms of apnea hypopnea index (P = 0.30), sleep efficiency (P = 0.67), oxygen desaturation index (P = 0.39), and Epworth Sleepiness Scale (P = 0.07).
CONCLUSION
There exists an association between OSA and GERD that is independent of the modalities used for screening or diagnosing both disorders. However, the presence of GERD did not affect the severity of OSA.
Topics: Humans; Sleepiness; Sleep Apnea, Obstructive; Gastroesophageal Reflux; Polysomnography; Alcohol Drinking
PubMed: 37300443
DOI: 10.1111/jgh.16245 -
Journal of Bodywork and Movement... Jul 2023Cerebral palsy (CP) can be described as a group of permanent non-progressive disorders that occur in the developing fetal or infant brain. Studies have shown that... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Cerebral palsy (CP) can be described as a group of permanent non-progressive disorders that occur in the developing fetal or infant brain. Studies have shown that children and adolescents with CP have low cardiorespiratory fitness and higher energy expenditure during daily activities when compared to typical children. Therefore, interventions focused on the physical conditioning of this population could be critical.
OBJECTIVE
To evaluate the effect of physical conditioning training on distance walked and maximum oxygen consumption (VO₂ max) in individuals with CP, through a systematic review.
METHOD
Two independent researchers performed systematic searches in the PUBMED, SciELO, PEDro, ERIC, and Cochrane databases using the search terms "physical fitness", "aerobic training" or "endurance" combined with "cerebral palsy".
INCLUSION CRITERIA
(1) population (children and adolescents with CP between 5 and 18 years old); (2) type of study (experimental studies); (3) type of intervention (physical conditioning protocols); (4) outcome (distance walked in the 6 min walking test - 6MWT, and VO₂ max).
RESULTS
386 studies were identified and 5 articles were considered eligible. After physical conditioning training, there was an increase of 46.34 m (p = 0.07) and 5.93. ml. kg-1. min -1 (p < 0.001) in the 6MWT and VO₂ max, respectively.
CONCLUSION
Physical conditioning training appears to be clinically beneficial to the cardiorespiratory fitness of children and adolescents with CP.
Topics: Humans; Adolescent; Child; Child, Preschool; Exercise; Physical Fitness; Walking; Exercise Test; Cerebral Palsy; Paralysis
PubMed: 37330763
DOI: 10.1016/j.jbmt.2023.04.036 -
Heart Failure Reviews Mar 2024Hypertrophic cardiomyopathy (HCM) is the most common heritable myocardial disorder worldwide. Current pharmacological treatment options are limited. Mavacamten, a... (Meta-Analysis)
Meta-Analysis Review
Hypertrophic cardiomyopathy (HCM) is the most common heritable myocardial disorder worldwide. Current pharmacological treatment options are limited. Mavacamten, a first-in-class cardiac myosin inhibitor, targets the main underlying pathology of HCM. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of Mavacamten in patients with HCM. PRISMA flow chart was utilized using PubMed, SCOPUS, and Cochrane databases for all up-to-date studies using pre-defined keywords. Pre-specified efficacy outcomes comprised several parameters, including an improvement in peak oxygen consumption (pVO2) and ≥ 1 NYHA class, the need for septal reduction therapy (SRT), change from baseline in Kansas City Cardiomyopathy Questionnaire (KCCQ), changes in biochemical markers and LVEF, along with peak left ventricular outflow tract gradient at rest and after Valsalva maneuver. Safety outcomes included morbidity and serious adverse events. This systematic review included five studies, four RCTs and one non-randomized control trial comprised a total of 524 (Mavacamten [273, 54.3%] vs placebo [230, 45.7%] adult (≥ 18 years) patients with a mean age of 56 years. The study. comprised patients with Caucasian and Chinese ethnicity and patients with obstructive (oHCM) and non-obstructive (nHCM) HCM. Most baseline characteristics were similar between the treatment and placebo groups. Mavacamten showed a statistically significant increase in the frequency of the primary composite endpoint (RR = 1.92, 95% CI [1.28, 2.88]), ≥ 1 NYHA class improvement (RR = 2.10, 95% CI [1.66, 2.67]), a significant decrease in LVEF, peak left ventricular outflow tract gradient at rest and after Valsalva maneuver. Mavacamten also showed a significant reduction in SRT rates (RR = 0.29, 95% CI [0.21, 0.40], p < 0.00001), KCCQ clinical summary scores (MD = 8.08, 95% CI [4.80, 11.37], P < 0.00001) troponin levels and N-terminal pro-B-type natriuretic peptide levels. However, there was no statistically significant difference between Mavacamten and placebo regarding the change from baseline peak oxygen consumption. Mavacamten use resulted in a small increase in adverse events but no statistically significant increment in serious adverse events. Our study showed that Mavacamten is a safe and effective treatment option for Caucasian and Chinese patients with HCM on the short-term. Further research is needed to explore the long-term safety and efficacy of Mavacamten with HCM. In addition, adequately powered studies including patients with nHCM is needed to ascertain befits of Mavacamten in those patients.
Topics: Adult; Humans; Middle Aged; Cardiomyopathy, Hypertrophic; Heart; Benzylamines; Myocardium; Uracil
PubMed: 38112937
DOI: 10.1007/s10741-023-10375-6 -
International Journal of Environmental... Dec 2020Obesity or overweight is associated with many health risk factors and preventable mortality. Even people with normal weight and without history of obesity or overweight... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Obesity or overweight is associated with many health risk factors and preventable mortality. Even people with normal weight and without history of obesity or overweight should avoid weight gain to reduce health risks factors. In this regard Latin aerobic dances involved in Zumba practice make this modality motivating for people. Apart from weight loss and VO2 benefits, Zumba practice is also interesting by the increase in adherence which can also avoid weight regain. The aim was to systematically review the scientific literature about the effects of any randomized intervention of Zumba practice on total fat mass (%) and maximum oxygen consumption (VO), besides establishing directions for the clinical practice.
EVIDENCE ACQUISITION
Two systematic searches were conducted in two electronic databases following the PRISMA guidelines. The eligibility criteria were (a) outcomes: body mass or VO data including mean and standard deviation (SD) before and after Zumba intervention, (b) study design: randomized controlled trial (RCT) and (c) language: English. GRADE guidelines were used to assess the quality of evidence. A meta-analysis was performed to determine mean differences. Nine and four studies were selected for fat mass percentage and VO in the systematic review, respectively. However, only eight studies for fat mass percentage and three for VO could be included in the meta-analysis.
EVIDENCE SYNTHESIS
The overall standardized mean difference for fat mass was -0.25 with a 95% CI from -0.67 to 0.16 with a p-value of 0.69, with large heterogeneity. On the other hand, the overall effect size for VO was 0.53 (95% CI from 0.04 to 1.02 with a p-value of 0.03) with large heterogeneity.
CONCLUSIONS
Based on the evidence, we cannot conclude that Zumba is effective at reducing body mass but it may improve VO. However, the limited number of studies that met the inclusion criteria makes it too early to reach a definite conclusion, so more research is needed.
Topics: Body Weight; Dancing; Exercise; Female; Humans; Male; Muscle Strength; Obesity; Overweight; Oxygen Consumption; Physical Fitness; Randomized Controlled Trials as Topic
PubMed: 33375758
DOI: 10.3390/ijerph18010105 -
Journal of Cachexia, Sarcopenia and... Dec 2022Iron is an essential nutrient for oxygen supply and aerobic metabolism. Iron deficiency impacts cellular respiration and mitochondrial energy metabolism, which can lead... (Meta-Analysis)
Meta-Analysis Review
Iron is an essential nutrient for oxygen supply and aerobic metabolism. Iron deficiency impacts cellular respiration and mitochondrial energy metabolism, which can lead to reduced skeletal muscle function and muscle mass, causing sarcopenia. Intravenous iron offers the ability to rapidly correct iron deficiency, but the functional impact on patient mental and physical health is unclear. We assessed the effects of intravenous iron therapy on physical function and quality of life in the treatment of adults with non-anaemic iron deficiency. An update and reanalysis of a previously published Cochrane systematic review was performed to assess randomized controlled trials that compared any intravenous iron preparation with placebo in adults. The primary functional outcome measure was physical performance as defined by the trial authors. Secondary outcome measures included fatigue and quality-of-life scores, and adverse effects at the end of follow-up. Biochemical efficacy was assessed by change in serum ferritin and haemoglobin concentration levels. Twenty-one randomized controlled trials, comprising 3514 participants, were included. Intravenous iron compared with placebo resulted in significantly increased physical function measured by mean peak oxygen consumption (mean difference [MD] 1.77 mL/kg/min, 95% confidence interval [CI] 0.57 to 2.97). An overall improvement in fatigue was seen (standardized MD 0.30, 95% CI -0.52 to -0.09) but no overall difference in quality of life (MD 0.15, 95% CI -0.01 to 0.31). Biochemically, intravenous iron resulted in improved serum ferritin (MD 245.52 μg/L, 95% CI 152.1 to 338.9) and haemoglobin levels (MD 4.65 g/L, 95% CI 2.53 to 6.78). There was a higher risk of developing mild adverse events in the intravenous iron group compared with the placebo group (risk ratio 1.77, 95% CI 1.10 to 2.83); however, no differences were seen in serious adverse events (risk difference 0, 95% CI -0.01 to 0.01). The quality of evidence was rated 'low' and 'very low' for all outcome variables, except for fatigue, mainly due to most studies being judged as having a high risk of bias. In non-anaemic iron-deficient adults, the use of intravenous iron compared with placebo improved physical function and reduced fatigue scores. However, we remain uncertain about the efficacy in this population due to low-quality evidence, and there is a need for further studies to address potential impact on overall quality of life.
Topics: Adult; Humans; Fatigue; Hemoglobins; Iron; Iron Deficiencies; Quality of Life
PubMed: 36321348
DOI: 10.1002/jcsm.13114 -
Antioxidants (Basel, Switzerland) Jul 2023Ethanol consumption triggers oxidative stress by generating reactive oxygen species (ROS) through its metabolites. This process leads to steatosis and liver... (Review)
Review
Ethanol consumption triggers oxidative stress by generating reactive oxygen species (ROS) through its metabolites. This process leads to steatosis and liver inflammation, which are critical for the development of alcoholic liver disease (ALD). Autophagy is a regulated dynamic process that sequesters damaged and excess cytoplasmic organelles for lysosomal degradation and may counteract the harmful effects of ROS-induced oxidative stress. These effects include hepatotoxicity, mitochondrial damage, steatosis, endoplasmic reticulum stress, inflammation, and iron overload. In liver diseases, particularly ALD, macroautophagy has been implicated as a protective mechanism in hepatocytes, although it does not appear to play the same role in stellate cells. Beyond the liver, autophagy may also mitigate the harmful effects of alcohol on other organs, thereby providing an additional layer of protection against ALD. This protective potential is further supported by studies showing that drugs that interact with autophagy, such as rapamycin, can prevent ALD development in animal models. This systematic review presents a comprehensive analysis of the literature, focusing on the role of autophagy in oxidative stress regulation, its involvement in organ-organ crosstalk relevant to ALD, and the potential of autophagy-targeting therapeutic strategies.
PubMed: 37507963
DOI: 10.3390/antiox12071425 -
Frontiers in Psychology 2023The practice of racket sports has had an exponential growth in the last decade, along with it, the scientific interest in researching the different disciplines:... (Review)
Review
The practice of racket sports has had an exponential growth in the last decade, along with it, the scientific interest in researching the different disciplines: badminton, padel, table tennis, tennis, and squash. However, most research has focused on the technical and tactical field. Therefore, the aim of this review is to analyze and compare the indicators of the internal load of each sport: heart rate (HR), maximum oxygen consumption (VO), oxygen consumption (VO), and lactate (LA) in order to reset physiological references to adjust the training of the players and also use these references to propose the practice of these sports for healthy purposes to the general population. PRISMA Guidelines for Systematic Review were used to search for articles that met the inclusion criteria in three databases: Web of Science, Pubmed, and Sportdiscus. The search was performed between January 2010, and September 2022. Finally, a total 27 records were included for analysis in this study. The main findings were related to the differences in the intensity rates between sports. The highest lactate concentrations and heart values were found in badminton in the intensity of effort values (whose highest values were found in badminton) 10.11 (±4.99) mmol/L and 182.6 (±2.7) bpm respectively, whereas table tennis showed the lowest ones 1.2 (± 0.4) mmol/L, and 103.99 (±15.09) bpm, respectively. The highest mean VO was found in table tennis with a value of 36.8 (±13.2) ml/kg/min and the lowest in tennis with a value of 26.6 (±2.7) ml/kg/min. The highest VO was found in tennis players 58.0 (±4.6) ml/kg/min, and the lowest value was in table tennis with a value of 42.9 (±4.2) ml/kg/min. Since most of the studies were carried out on elite men players, future research should focus on amateur and women level players.
PubMed: 37063547
DOI: 10.3389/fpsyg.2023.1149295 -
JAMA Network Open Jun 2023Preoperative high-intensity interval training (HIIT) is associated with improved cardiorespiratory fitness (CRF) and may improve surgical outcomes. (Meta-Analysis)
Meta-Analysis
Association of Preoperative High-Intensity Interval Training With Cardiorespiratory Fitness and Postoperative Outcomes Among Adults Undergoing Major Surgery: A Systematic Review and Meta-Analysis.
IMPORTANCE
Preoperative high-intensity interval training (HIIT) is associated with improved cardiorespiratory fitness (CRF) and may improve surgical outcomes.
OBJECTIVE
To summarize data from studies comparing the association of preoperative HIIT vs standard hospital care with preoperative CRF and postoperative outcomes.
DATA SOURCES
Data sources included Medline, Embase, Cochrane Central Register of Controlled Trials Library, and Scopus databases with no language constraints, including abstracts and articles published before May 2023.
STUDY SELECTION
The databases were searched for randomized clinical trials and prospective cohort studies with HIIT protocols in adult patients undergoing major surgery. Thirty-four of 589 screened studies met initial selection criteria.
DATA EXTRACTION AND SYNTHESIS
A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data were extracted by multiple independent observers and pooled in a random-effects model.
MAIN OUTCOMES AND MEASURES
The primary outcome was change in CRF, as measured by either peak oxygen consumption (V̇o2 peak) or 6-Minute Walk Test (6MWT) distance. Secondary outcomes included postoperative complications; hospital length of stay (LOS); and changes in quality of life, anaerobic threshold, and peak power output.
RESULTS
Twelve eligible studies including 832 patients were identified. Pooled results indicated several positive associations for HIIT when compared with standard care either on CRF (V̇o2 peak, 6MWT, anaerobic threshold, or peak power output) or postoperative outcomes (complications, LOS, quality of life), although there was significant heterogeneity in study results. In 8 studies including 627 patients, there was moderate-quality evidence of significant improvement in V̇o2 peak (cumulative mean difference, 2.59 mL/kg/min; 95% CI, 1.52-3.65 mL/kg/min; P < .001). In 8 studies including 770 patients, there was moderate-quality evidence of a significant reduction in complications (odds ratio, 0.44; 95% CI, 0.32-0.60; P < .001). There was no evidence that HIIT differed from standard care in hospital LOS (cumulative mean difference, -3.06 days; 95% CI, -6.41 to 0.29 days; P = .07). The analysis showed a high degree of heterogeneity in study outcomes and an overall low risk of bias.
CONCLUSIONS AND RELEVANCE
The results of this meta-analysis suggest that preoperative HIIT may be beneficial for surgical populations through the improvement of exercise capacity and reduced postoperative complications. These findings support including HIIT in prehabilitation programs before major surgery. The high degree of heterogeneity in both exercise protocols and study results supports the need for further prospective, well-designed studies.
Topics: Humans; Adult; Cardiorespiratory Fitness; High-Intensity Interval Training; Prospective Studies; Quality of Life; Postoperative Complications
PubMed: 37389875
DOI: 10.1001/jamanetworkopen.2023.20527 -
Sports Medicine (Auckland, N.Z.) Feb 2024Many sports require maximal strength and endurance performance. Concurrent strength and endurance training can lead to suboptimal training adaptations. However, how... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many sports require maximal strength and endurance performance. Concurrent strength and endurance training can lead to suboptimal training adaptations. However, how adaptations differ between males and females is currently unknown. Additionally, current training status may affect training adaptations.
OBJECTIVE
We aimed to assess sex-specific differences in adaptations in strength, power, muscle hypertrophy, and maximal oxygen consumption ( O) to concurrent strength and endurance training in healthy adults. Second, we investigated how training adaptations are influenced by strength and endurance training status.
METHODS
A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and a Cochrane risk of bias was evaluated. ISI Web of science, PubMed/MEDLINE, and SPORTDiscus databases were searched using the following inclusion criteria: healthy adults aged 18-50 years, intervention period of ≥ 4 weeks, and outcome measures were defined as upper- and lower-body strength, power, hypertrophy, and/or O. A meta-analysis was performed using a random-effects model and reported in standardized mean differences.
RESULTS
In total, 59 studies with 1346 participants were included. Concurrent training showed blunted lower-body strength adaptations in males, but not in females (male: - 0.43, 95% confidence interval [- 0.64 to - 0.22], female: 0.08 [- 0.34 to 0.49], group difference: P = 0.03). No sex differences were observed for changes in upper-body strength (P = 0.67), power (P = 0.37), or O (P = 0.13). Data on muscle hypertrophy were insufficient to draw any conclusions. For training status, untrained but not trained or highly trained endurance athletes displayed lower O gains with concurrent training (P = 0.04). For other outcomes, no differences were found between untrained and trained individuals, both for strength and endurance training status.
CONCLUSIONS
Concurrent training results in small interference for lower-body strength adaptations in males, but not in females. Untrained, but not trained or highly trained endurance athletes demonstrated impaired improvements in O following concurrent training. More studies on females and highly strength-trained and endurance-trained athletes are warranted.
CLINICAL TRIAL REGISTRATION
PROSPERO: CRD42022370894.
Topics: Adult; Humans; Male; Female; Endurance Training; Physical Endurance; Athletes; Sports; Hypertrophy; Muscle Strength; Resistance Training
PubMed: 37847373
DOI: 10.1007/s40279-023-01943-9 -
Transplantation Reviews (Orlando, Fla.) Apr 2024Frailty, malnutrition and sarcopenia lead to a significant increase in morbidity and mortality before and after liver transplantation (LT). Prehabilitation attempts to... (Review)
Review
BACKGROUND
Frailty, malnutrition and sarcopenia lead to a significant increase in morbidity and mortality before and after liver transplantation (LT). Prehabilitation attempts to optimize physical fitness of individuals before major surgeries. To date, little is known about its impact on patients awaiting LT.
AIMS
The aim of our scoping review was to describe whether prehabilitation in patients awaiting LT is feasible and safe, and whether it leads to a change in clinical parameters before or after transplantation.
METHODS
We performed a systematic review of the literature from 1946 to November 2023 to identify prospective studies and randomized controlled trials of adult LT candidates who participated in an exercise training program.
RESULTS
Out of 3262 citations initially identified, six studies were included. Studies were heterogeneous in design, patient selection, intervention, duration, and outcomes assessed. All studies were self-described as pilot or feasibility studies and had a sample size ranging from 13 to 33. Two studies were randomized controlled trials. Two study restricted to patients with cirrhosis who were eligible for liver transplantation or on the transplant list. Exercise programs lasted between 6 and 12 weeks. In terms of feasibility, proportion of eligible patients that were recruited was between 54 and 100%. Program completion ranged between 38 and 90%. Interventions appeared safe with 9 (9.2%) adverse events noted. In the intervention group, improvements were generally noted in peak oxygen consumption and workload, 6-min walking distance, and muscle strength. One study suggested a decrease in post-transplant hospital length of stay.
CONCLUSIONS
Overall, it appears that prehabilitation with exercise training is feasible, and safe in patients awaiting LT. Higher quality and larger studies are needed to confirm its impact on pre- and post-transplantation-related outcomes.
Topics: Adult; Humans; Liver Transplantation; Preoperative Exercise; Prospective Studies; Exercise; Exercise Therapy; Quality of Life; Preoperative Care; Postoperative Complications
PubMed: 38367398
DOI: 10.1016/j.trre.2024.100835