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The Clinical Respiratory Journal Feb 2021Exogenous lipoid pneumonia (ELP) is a lung inflammatory disease with low prevalence and has the feature of external lipid substances presented in the alveoli.... (Review)
Review
INTRODUCTION AND OBJECTIVES
Exogenous lipoid pneumonia (ELP) is a lung inflammatory disease with low prevalence and has the feature of external lipid substances presented in the alveoli. Therapeutic lung lavage (segmental bronchoalveolar lavage and whole lung lavage) has been gradually recognized as an important therapy for the disease. There was no comprehensive summary on its efficacy and safety.
METHODS
We searched PubMed, Embase, Cochrane Library, CNKI, Wanfang Database, clinicaltrials.gov, and the references of included studies. After study selection, data extraction and quality assessment, we performed a qualitative description of current data.
RESULTS
We included 90 ELP patients from 25 case reports and 8 case series studies. Eighty-four (93.3%) patients received segmental bronchoalveolar lavage and six (6.7%) patients received whole lung lavage. Eighty-seven (96.7%) patients got clinical improvement after lavages, while three (3.3%) patients had no improvement and eventually died. The follow-up status was reported in 29 patients, of whom 24 patients remained well without any use of drugs and 4 patients remained well with some periods of corticosteroids. One patient endured recurrence. The radiological change was reported in 72 patients, of whom 41 (56.9%) patients had full resolution until the last follow-up. Two studies reported acute pulmonary edema and transient hypoxemia during lavages.
CONCLUSIONS
Therapeutic lung lavage might be an effective and safe therapy with long-term benefits for ELP. Current studies were all case reports and case series with relatively high risk of bias. Prospective controlled studies are needed to explore the actual efficacy, safety, individualized indications, and optimized treatment procedures of therapeutic lung lavage for ELP.
Topics: Bronchoalveolar Lavage; Humans; Lung; Pneumonia, Lipid; Prospective Studies; Therapeutic Irrigation
PubMed: 32940399
DOI: 10.1111/crj.13273 -
Nutrition, Metabolism, and... Nov 2023This systematic review and dose-response meta-analysis were conducted to summarize data from available clinical trials on the effects of curcumin supplementation on...
AIMS
This systematic review and dose-response meta-analysis were conducted to summarize data from available clinical trials on the effects of curcumin supplementation on systolic BP (SBP) and diastolic BP (DBP).
DATA SYNTHESIS
Using related keywords, multiple databases, including the Web of Sciences, Scopus, Embase, PubMed, Cochrane Library, and Google Scholar, were searched until November 2022. We chose the studies that examined the effects of curcumin on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Seventeen eligible studies with a total sample size of 1377 participants were included in the meta-analysis. The findings of the meta-analysis did not indicate any significant effect of curcumin on SBP (WMD = -0.06 mmHg, 95% CI: -0.62, 0.50, p = 0.85; I = 44.2%) and DBP (WMD = -0.18 mmHg, 95% CI: -1.17, 0.82, p = 0.62; I = 77.2%). Moreover, in our dose-response analysis, we found that the dose and duration of curcumin supplementation were non-significantly associated with the reduction of SBP and DBP. However, subgroup analysis revealed a significant reduction only in DBP levels (WMD: -0.76 mmHg, 95% CI: -1.46,-0.05; P = 0.03) but not in SBP in studies with ≥12-week supplementation. Also, a significant reduction in SBP (WMD: -1.55 mmHg, 95% CI: -2.85, -0.25; P = 0.01) and DBP (WMD: -1.73 mmHg, 95% CI: 2.67, -0.79; P < 0.01) was noticed by curcumin supplementation in studies performed on women.
CONCLUSIONS
The current study suggests that consuming curcumin may improve DBP when administered for long durations ≥12 weeks. However, more trials are required to confirm these findings.
PubMed: 37567790
DOI: 10.1016/j.numecd.2023.07.003 -
Nutrition, Metabolism, and... Sep 2023This systematic review and dose-response meta-analysis was conducted to summarize data from available clinical trials on the effects of whey protein (WP) supplementation... (Meta-Analysis)
Meta-Analysis
AIMS
This systematic review and dose-response meta-analysis was conducted to summarize data from available clinical trials on the effects of whey protein (WP) supplementation on blood pressure (BP) in adults.
DATA SYNTHESIS
A comprehensive literature search was conducted in the electronic databases PubMed, Web of Science, ProQuest, Embase, and SCOPUS from inception to October 2022. Weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated to assess pooled effect sizes. Heterogeneity between studies was assessed using the Cochran's Q test and I. Subgroup analysis was performed to assess potential sources of heterogeneity. The dose-response relationship was assessed using fractional polynomial modeling. Of the 2,840 records, 18 studies with 1,177 subjects were included. Pooled analysis showed that whey protein supplementation resulted in a significant reduction in systolic blood pressure (WMD: -1.54 mmHg; 95% CI: -2.85 to -0.23, p = 0.021), with significant heterogeneity between studies (I = 64.2%, p < 0.001), but not for diastolic blood pressure (DBP) (WMD: -0.27 mmHg; 95% CI: -1.14, 0.59, p = 0.534) with high heterogeneity between studies (I = 64.8%, p < 0.001). However, WP supplementation significantly reduced DBP at a dose of ˃30 g/day, in RCTs that used WP isolate powder for their intervention, in sample sizes ≤100, in studies with an intervention duration of ≤10 weeks, and in those studies that were conducted in patients with hypertension and had participants with a BMI of 25-30 kg/m.
CONCLUSION
This meta-analysis demonstrated that WP intake significantly reduced SBP levels. Further large-scale studies are needed to specify the exact mechanism, and optimal dosage of WP supplementation to obtain a beneficial effect on BP.
Topics: Adult; Humans; Blood Pressure; Whey Proteins; Randomized Controlled Trials as Topic; Hypertension; Databases, Factual; Dietary Supplements
PubMed: 37419751
DOI: 10.1016/j.numecd.2023.05.025 -
Acta Neurologica Scandinavica Aug 2021Among the various non-motor symptoms of Parkinson's disease (PD), pain is often cited as the most common and debilitating feature. Currently, the literature contains... (Review)
Review
Among the various non-motor symptoms of Parkinson's disease (PD), pain is often cited as the most common and debilitating feature. Currently, the literature contains gaps in knowledge with respect to the various forms of treatment available, particularly non-pharmacological therapies. Thus, the purpose of this systematic review is to provide an examination of the literature on non-pharmacological therapies for pain in PD. We compared the findings of research articles indexed within various literature databases related to non-pharmacological treatments of pain in PD patients. Our review identified five major non-pharmacological methods of pain therapy in PD: acupuncture, hydrotherapy, massage therapy, neuromodulation, and exercise. Treatments such as exercise therapy found a reduction in pain perception due to various factors, including the analgesic effects of neurotransmitter release during exercise and increased activity leading to a decrease in musculoskeletal rigidity and stiffness. By the same token, hydrotherapy has been shown to reduce pain perception within PD patients, with authors often citing a combined treatment of exercise and hydrotherapy as an effective treatment for pain management. Multiple methods of neurostimulation were also observed, including deep brain stimulation and spinal cord stimulation. Deep brain stimulation showed efficacy in alleviating certain pain types (dystonic and central), while not others (musculoskeletal). Hence, patients may consider deep brain stimulation as an additive procedure for their current treatment protocol. On the other hand, spinal cord stimulation showed significant improvement in reducing VAS scores for pain. Finally, although the literature on massage therapy and acupuncture effectiveness on pain management is limited, both have demonstrated a reduction in pain perception, with common reasons such as tactile stimulation and release of anti-nociceptive molecules in the body. Although literature pertaining to non-pharmacological treatments of pain in PD is sparse, there is copious support for these treatments as beneficial to pain management. Further exploration in the form of clinical trials is warranted to assess the efficacy of such therapies.
Topics: Acupuncture Analgesia; Exercise Therapy; Humans; Hydrotherapy; Massage; Pain; Pain Management; Parkinson Disease; Transcutaneous Electric Nerve Stimulation
PubMed: 33982803
DOI: 10.1111/ane.13435 -
Phytotherapy Research : PTR Feb 2022Some medicinal herbs and their effective components showed positive effects on the features of the cardiometabolic syndrome (CMS). The aim of the present systematic... (Meta-Analysis)
Meta-Analysis Review
Some medicinal herbs and their effective components showed positive effects on the features of the cardiometabolic syndrome (CMS). The aim of the present systematic review and meta-analysis is to examine the effects of silymarin on the components of CMS in adults. Four electronic databases including PubMed/Medline, Scopus, Web of Science, and Embase were systematically searched up to December 31, 2020 to identify all eligible clinical trials. A random-effect model using DerSimonian and Laird method was used to estimate the pooled weighted mean differences (WMDs) and the 95% confidence intervals (95%CIs). Finally, 11 clinical trials met the eligibility criteria. Our results demonstrated that silymarin significantly reduced the levels of fasting blood glucose (WMD: -17.96 mg/dL, 95% CI: -32.91, -3.02;I : 82.4%, p < 0.001), hemoglobin A1C (WMD: -1.25%, 95% CI: -2.34, 0.16; I : 92.9%, p ˂ 0.001), total cholesterol (WMD: -17.46 mg/dL, 95% CI: -30.98, -3.95; I = 62.9%, p = 0.006), triglyceride (WMD: -25.70 mg/dL, 95% CI: -47.23, -4.17; I :54.3%, p = 0.025), low-density lipoprotein-cholesterol (WMD: -10.53, 95% CI: -19.12, -1.94; I2: 37.5%, p = 0.119) and increased high-density lipoprotein- cholesterol (WMD: 3.36 mg/dL, 95% CI: 0.88, 5.84; I : 37.4%, p = 0.120) compared to placebo. However, its effects on BMI were not statistically significant. Silymarin can be an effective complementary therapy to improve most features of CMS. However, due to high heterogeneity and limited clinical trials in some parameters, further high-quality clinical trials are needed to confirm its efficacy.
Topics: Adult; Blood Glucose; Cholesterol, HDL; Glycated Hemoglobin; Humans; Metabolic Syndrome; Silymarin; Triglycerides
PubMed: 35016260
DOI: 10.1002/ptr.7364 -
Journal of Pain Research 2023Chronic Low Back Pain (CLBP) is a prevalent global health issue, leading to prolonged discomfort and functional limitations. Hot spring hydrotherapy, which utilizes...
BACKGROUND
Chronic Low Back Pain (CLBP) is a prevalent global health issue, leading to prolonged discomfort and functional limitations. Hot spring hydrotherapy, which utilizes mineral-rich, warm spring water, offers a unique physical therapy that holds promise in alleviating CLBP symptoms.
OBJECTIVE
This meta-analysis aims to assess the effectiveness of hot spring hydrotherapy in improving CLBP symptoms, encompassing pain intensity, functional disability, quality of life, and medication usage.
METHODS
A systematic review and meta-analysis were conducted by searching relevant literature in multiple databases. Included studies compared hot spring hydrotherapy with control interventions or other treatments. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated for pain intensity, functional disability, medication usage, and quality of life.
RESULTS
A total of 16 studies met the inclusion criteria, involving 1656 participants with chronic low back pain across various countries. The meta-analysis demonstrated that hot spring hydrotherapy was effective in reducing pain intensity (SMD = -0.901, 95% CI [-1.777, -0.025], < 0.05) and improving functional disability (SMD = -3.236, 95% CI [-4.898, -1.575], < 0.0001) in CLBP patients. Hot spring hydrotherapy also resulted in a significant reduction in medication usage ( < 0.05). Subgroup analysis showed that the effects of hot spring hydrotherapy were more pronounced in patients aged 60 and above, while no significant differences were observed in patients below 60 years of age, single hot Spring Hydrotherapy help improve patients' quality of life.
CONCLUSION
Hot spring hydrotherapy is an effective intervention for improving CLBP symptoms, including pain intensity, functional disability, and medication usage. It is particularly beneficial for CLBP patients aged 60 and above. These findings support the integration of hot spring hydrotherapy into the treatment approach for CLBP, although further research is needed to determine its efficacy in younger patients and to explore the underlying mechanisms of its therapeutic effects.
PROSPERO ID
CRD42023430860.
PubMed: 38026467
DOI: 10.2147/JPR.S438744 -
International Journal of Nursing... Feb 2024To explore the effect of hydrotherapy applied in the first stage of labour on the health of mother and newborn. (Meta-Analysis)
Meta-Analysis Review
AIM
To explore the effect of hydrotherapy applied in the first stage of labour on the health of mother and newborn.
METHODS
This systematic review and meta-analysis was carried out by following PRISMA. The studies were obtained by scanning EBSCO, PubMed, Science Direct, Ovid, Web of Science and Scopus electronic databases. Twenty studies published between 2013 and 2023 were included.
RESULTS
The total sample size of the studies was 8254 (hydrotherapy: 2953, control: 5301). Meta-analyses showed that the perception of pain decreased, comfort level and vaginal birth rate were higher and assisted vaginal birth rate and APGAR scores in the first minute were lower in women who underwent hydrotherapy. There was no difference between groups in terms of the duration of the first and second stage of labour, episiotomy, perineal trauma, intrapartum and postpartum bleeding amounts, use of pain medication and labour augmentations, APGAR scores in the fifth minute, positive neonatal bacterial culture and neonatal intensive care unit need.
CONCLUSION
This study revealed that the results that hydrotherapy decreased the perception of pain and assisted birth, increased the rate of vaginal birth and comfort level and did not adversely affect the health of the mother and baby during the birth process.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Labor, Obstetric; Parturition; Hydrotherapy; Mothers; Pain
PubMed: 37632390
DOI: 10.1111/ijn.13192 -
Journal of Tissue Viability Feb 2023To systematically summarize and review the existing literature to determine the difference between wound cleansing techniques, irrigation and swabbing, in relation to... (Review)
Review
Wound irrigation versus swabbing technique for cleansing noninfected chronic wounds: A systematic review of differences in bleeding, pain, infection, exudate, and necrotic tissue.
PURPOSE
To systematically summarize and review the existing literature to determine the difference between wound cleansing techniques, irrigation and swabbing, in relation to bleeding, pain, infection, necrotic tissue and exudate in non-infected chronic wounds including pressure injuries, venous and arterial leg ulcers and diabetic foot ulcers.
METHODS
A systematic search of the electronic databases Ovid Medline, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and EMBASE was performed to identify all relevant literature in English. The search also included systematic reviews as a method to obtain additional potential citations by manually searching the reference lists. Included studies were assessed for methodological quality using the Cochrane Risk of Bias Tool.
RESULTS
One study met eligibility criteria. Two hundred fifty six patients with wounds healing via secondary intention (n = 256) were included. Wound cleansing via swabbing technique was associated with increased perception of pain and increased rates of infection when compared to the irrigation group (93.4% versus 84.2% p = 0.02 and 5.2% versus 3.3% p = 0.44, respectively). Only a small proportion of this sample met the inclusion criteria, so the results are not considered externally valid.
CONCLUSION
Wound cleansing remains a controversial topic. Despite calls for further research, there continues to remain a large gap in evidence to guide practice. Irrigation continues to replace swabbing in the management of chronic wounds, although evidence of improved outcomes is virtually nonexistent. Although the one study identified was of sound methodological quality, chronic wounds accounted for only a small percentage of the sample. Therefore, results are not generalizable to those with chronic wounds. Further research is needed to determine the effectiveness of basic wound cleansing techniques before considering more costly products.
Topics: Humans; Exudates and Transudates; Pain; Surgical Wound Infection; Therapeutic Irrigation
PubMed: 36462962
DOI: 10.1016/j.jtv.2022.11.002 -
Aesthetic Surgery Journal Jan 2022Breast implant-associated infection and capsular contracture are challenging complications that can result in poor outcomes following implant-based breast surgery....
BACKGROUND
Breast implant-associated infection and capsular contracture are challenging complications that can result in poor outcomes following implant-based breast surgery. Antimicrobial irrigation of the breast pocket or implant is a widely accepted strategy to prevent these complications, but the literature lacks an evidence-based consensus on the optimal irrigation solution.
OBJECTIVES
The objective of this systematic review was to compare clinical outcomes, specifically capsular contracture, infection, and reoperation rates, associated with the use of antibiotic, antiseptic, and saline irrigation.
METHODS
A systematic review was performed in March 2020 based on the following search terms: "breast implant," "irrigation," "antibiotic," "bacitracin," "antiseptic," "povidone iodine," "betadine," "low concentration chlorhexidine," and "hypochlorous acid." Capsular contracture, infection, and reoperation rates were compared by analysis of forest plots.
RESULTS
Out of the 104 articles screened, 14 met the inclusion criteria. There was no significant difference in capsular contracture rates between antibiotic and povidone-iodine irrigation, although the data comparing these 2 groups were limited and confounded by the concurrent use of steroids. Antibiotic irrigation showed a significantly lower rate of capsular contracture compared with saline irrigation and a lower rate of capsular contracture and reoperation compared with no irrigation at all. Povidone-iodine was associated with lower rates of capsular contracture and reoperation compared with saline irrigation but there were no data on infection rates specific to povidone-iodine irrigation.
CONCLUSIONS
Our study supports the use of antibiotics or povidone-iodine for breast implant irrigation. Further research is required to better determine which of these 2 irrigation types is superior.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Breast Implantation; Breast Implants; Humans; Implant Capsular Contracture; Povidone-Iodine; Therapeutic Irrigation
PubMed: 33836057
DOI: 10.1093/asj/sjab181 -
PloS One 2023The benefits of routine gastric suctioning or lavage in neonates remain uncertain, despite the common practice worldwide. To investigate the potential advantages and... (Meta-Analysis)
Meta-Analysis
The benefits of routine gastric suctioning or lavage in neonates remain uncertain, despite the common practice worldwide. To investigate the potential advantages and harms, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effects of these procedures in healthy or meconium-stained neonates at birth. We systematically searched PubMed, Scopus, Embase, Ovid, and the Cochrane Library databases from inception to February 9, 2023. We included only RCTs assessing the outcomes of gastric suction or lavage in neonates at birth. We calculated risk ratio (RR) and weighted mean differences with 95% confidence intervals (CIs) using a random-effects model. The primary outcomes were gastrointestinal symptoms including vomiting, retching, feeding intolerance, and secondary aspiration. The secondary outcomes included time to initiation of breastfeeding and potential adverse procedure-related events. Twelve RCTs with a total of 4,122 neonates were analyzed. All the studies compared neonates who received gastric suction or lavage with those who received usual care. Gastrointestinal symptoms were significantly reduced in neonates receiving gastric suction or gastric lavage compared with the control group (RR, 0.75; 95% CI, 0.63-0.89). Gastric lavage was beneficial for infants with meconium-stained amniotic fluid (RR 0.71; 95% CI, 0.60-0.84), while gastric suction had no significant benefit in reducing gastrointestinal symptoms in infants without meconium-stained amniotic fluid (RR 0.91; 95% CI, 0.61-1.37). Our findings suggest that gastric suction or lavage may reduce gastrointestinal symptoms in neonates; however, these procedures may only benefit infants born with meconium-stained amniotic fluid. Vigorous newborns without meconium-stained amniotic fluid may not benefit from these procedures. Furthermore, gastric suction may lead to adverse outcomes such as apnea and bradycardia. Registration: This study was registered in the PROSPERO International prospective register of systematic reviews in health and social care (CRD42023247780).
Topics: Infant, Newborn; Infant; Humans; Meconium; Therapeutic Irrigation; Suction; Stomach; Gastric Lavage; Vomiting; Amniotic Fluid
PubMed: 37440527
DOI: 10.1371/journal.pone.0288398