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Ageing Research Reviews Apr 2023Mild cognitive impairment (MCI) and dementia are associated with lifestyle risk factors, making lifestyle medicine a potentially viable intervention for people with MCI... (Meta-Analysis)
Meta-Analysis Review
Mild cognitive impairment (MCI) and dementia are associated with lifestyle risk factors, making lifestyle medicine a potentially viable intervention for people with MCI and dementia. The present study aims to examine the effectiveness of lifestyle medicine on cognitive functions among people with MCI and dementia, by performing a systematic review and meta-analysis on randomized controlled trials (RCT). A systematic literature search was conducted to extract RCTs adopting lifestyle interventions of diet, exercise, and stress management or emotional well-being. Results showed that 65 studies were eligible. Exercise was the most promising lifestyle intervention that improved various cognitive functions among people with MCI and dementia, and was more effective in MCI than in dementia. Interventions on stress management or emotional well-being did not show a significant effect on people with MCI, and the evidence for people with dementia was insufficient to conclude. Similarly, due to the lack of RCTs on a healthy dietary pattern, the effectiveness of diet interventions was not examined. In conclusion, the exercise component of lifestyle medicine can be an effective and clinically significant intervention for protecting people with MCI and dementia against cognitive declines, especially when served as an early intervention at the stage of MCI.
Topics: Humans; Randomized Controlled Trials as Topic; Cognitive Dysfunction; Cognition; Life Style; Dementia
PubMed: 36806378
DOI: 10.1016/j.arr.2023.101886 -
The Journal of Maternal-fetal &... Dec 2022Moderate to severe intrauterine adhesions (IUAs) may greatly impact fertility, predisposing to pregnancy and obstetric complications. The impact of mild IUAs on... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Moderate to severe intrauterine adhesions (IUAs) may greatly impact fertility, predisposing to pregnancy and obstetric complications. The impact of mild IUAs on reproductive performance remains unclear. A systematic review and meta-analysis was performed to examine the long-term reproductive outcomes in women with hysteroscopic identified and treated mild IUAs mild intrauterine adhesions (IUAs).
METHODS
An electronic literature search was conducted using MEDLINE and EMBASE from inception to June 2019. All prospective cohort, cross-sectional studies or randomized controlled trials Clinical trials in which reproductive outcomes of women with mild IUAs, were reported were included.
RESULTS
Five studies, reporting on reproductive outcomes of 229 women with hysteroscopic identified and treated mild IUAs, were included. The pregnancy rate was 62.3% (142 of 228; 95% CI: 0.55-0.72, 25%, = .21) and in 86.6% (123 of 142) a live birth was encountered (95% CI: 0.71-0.97) with 83.1% (108 out of 130) term deliveries (95% CI: 0.53-0.95). A miscarriage was reported in 10% (13 of 130; 95% CI: 0.02-0.26). Due to the lack of a control group, reproductive outcomes were compared to a general population. Pregnancy and live birth rates were significantly lower in women with identified and treated mild IUAs, 90% versus 62.3% and respectively 99.5% versus 86.6%. The miscarriage rate was similar. Data on obstetric and neonatal outcomes are lacking.
CONCLUSIONS
Women with hysteroscopic identified and treated mild IUAs seem to have lower pregnancy and live birth rate compared to the general population. Future studies consisting of a large cohort of women with hysteroscopic identified and treated IUAs with structural follow-up and a control group are needed to confirm our findings.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Hysteroscopy; Abortion, Spontaneous; Cross-Sectional Studies; Prospective Studies; Uterine Diseases; Tissue Adhesions
PubMed: 34044740
DOI: 10.1080/14767058.2021.1931103 -
Journal of Clinical Medicine Apr 2023Mild cognitive impairment (MCI) is a syndrome defined as a decline in cognitive performance greater than expected for an individual according to age and education level,... (Review)
Review
INTRODUCTION
Mild cognitive impairment (MCI) is a syndrome defined as a decline in cognitive performance greater than expected for an individual according to age and education level, not interfering notably with daily life activities. Many studies have focused on the memory domain in the analysis of MCI and more severe cases of dementia. One specific memory system is represented by autobiographical memory (AM), which has been largely studied in Alzheimer's disease and its effect on AM; however, the impairment of AM in moderate forms of decline, such as MCI, is still controversial.
OBJECTIVE
The main aim of this systematic review is to analyze the functioning of autobiographical memory in patients with MCI, considering both the semantic and the episodic components.
MATERIALS
The review process was conducted according to the PRISMA statement. The search was conducted until 20 February 2023 in the following bibliographical databases: PubMed, Web of Science, Scopus, and PsycInfo, and twenty-one articles were included.
RESULTS
The results highlight controversial findings concerning the semantic component of AM since only seven studies have found a worse semantic AM performance in patients with MCI compared to the HC group. The results of impaired episodic AM in individuals with MCI are more consistent than those concerning semantic AM.
CONCLUSIONS
Starting from the evidence of this systematic review, further studies should detect and investigate the cognitive and emotional mechanisms that undermine AM performance, allowing the development of specific interventions targeting these mechanisms.
PubMed: 37109193
DOI: 10.3390/jcm12082856 -
Ageing Research Reviews Nov 2022In 2021, the US Food and Drug Administration granted an accelerated approval to aducanumab for patients with mild cognitive impairment (MCI) and mild dementia caused by... (Meta-Analysis)
Meta-Analysis Review
Comparative efficacy of lithium and aducanumab for cognitive decline in patients with mild cognitive impairment or Alzheimer's disease: A systematic review and network meta-analysis.
BACKGROUND
In 2021, the US Food and Drug Administration granted an accelerated approval to aducanumab for patients with mild cognitive impairment (MCI) and mild dementia caused by Alzheimer's disease (AD); however, the cost of aducanumab is high, at approximately $28,000 for one year per person. On the other hand, lithium is much cheaper at $40 a year, and has been reported to be effective for the cognitive decline observed in both patients with MCI and AD. In contrast to acetylcholinesterase inhibitors and N-methyl D-aspartate receptor antagonists, aducanumab and lithium may be disease-modifying drugs. Therefore, we focused on aducanumab and lithium and compared the effects of these drugs on the cognitive decline in MCI and AD patients using a network meta-analysis.
METHODS
PubMed, the Cochrane Library, CINHAL, and ClinicalTrials.gov were searched for randomized controlled trials testing lithium or aducanumab for the treatment of cognitive decline in patients with MCI or AD, up to January 31, 2022. A frequentist fixed-effect network meta-analysis was performed to estimate direct and indirect effects. The primary outcome was change scores in cognitive decline measured by Mini-Mental State Examination. This study has been registered with PROSPERO (number CRD42022304807).
RESULTS
Network meta-analysis demonstrated that lithium was significantly more effective than aducanumab in the primary outcome.
CONCLUSION
Although there were various limitations in this study, lithium may be a more cost-effective treatment than aducanumab for MCI and AD.
Topics: Acetylcholinesterase; Alzheimer Disease; Antibodies, Monoclonal, Humanized; Cholinesterase Inhibitors; Cognitive Dysfunction; Humans; Lithium; Network Meta-Analysis; United States
PubMed: 35961514
DOI: 10.1016/j.arr.2022.101709 -
Irish Journal of Medical Science Aug 2023Molnupiravir is an oral antiviral drug that received Emergency Use Authorization in three countries for the treatment of mild COVID-19. The aim of this systematic review... (Review)
Review
BACKGROUND
Molnupiravir is an oral antiviral drug that received Emergency Use Authorization in three countries for the treatment of mild COVID-19. The aim of this systematic review was to find out the safety and efficacy of Molnupiravir in SARS-COV-2 infections.
METHODS
The electronic databases such as PubMed, MedRxiv, BioRxiv, FDA, ClinicalTrials.Gov, ctri.nic.in and Google Scholar were searched for articles from January 2021 to March 2022 using the keywords such as "Molnupiravir", "COVID-19", "Oral antiviral pill", "MK-4482", "EIDD-280", "Efficacy" and "Safety". Details of published, unpublished with interim reports and ongoing studies of Molnupiravir in COVID-19 were retrieved, and a systematic review was performed.
RESULTS
A total of 6 articles and 18 ongoing trials data were collected. Out of these, data from 4 published and 2 unpublished with interim reports were extracted. After review of these studies, it was observed that the daily dose of 1600 mg Molnupiravir for 5 days was safe and tolerable with nausea, diarrhea and headache as the common adverse effects. The results also showed significant decrease in time to viral clearance with 800 mg twice daily in mild patients and reduction in the risk of hospitalization or death by 50% in non-hospitalized COVID-19 patients.
CONCLUSION
Evidence from clinical studies showed that Molnupiravir caused significant reduction in the risk of hospitalization or death in high-risk mild COVID-19 patients. Molnupiravir was also found to be well tolerated and safe without any major adverse events on short-term use. For confirmative use of this drug in mild-to-moderate COVID-19 disease, further studies are required in vaccinated COVID-19 patients and against emerging variants.
Topics: Humans; COVID-19; SARS-CoV-2; Databases, Factual; Drug-Related Side Effects and Adverse Reactions
PubMed: 36087236
DOI: 10.1007/s11845-022-03139-y -
Frontiers in Pharmacology 2023The therapeutic value of neostigmine as a prokinetic drug in acute pancreatitis (AP), especially in non-mild AP, including moderately severe and severe AP remains...
The therapeutic value of neostigmine as a prokinetic drug in acute pancreatitis (AP), especially in non-mild AP, including moderately severe and severe AP remains controversial. This meta-analysis aimed to investigate the efficacy of neostigmine treatment in patients with non-mild AP. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases up to 24 December 2022 for RCTs comparing neostigmine plus conventional treatment versus the conventional treatment alone in patients with non-mild AP. Trial sequential analyses (TSA) were used to assess the risk of random errors and the results. Six RCTs with 318 participants were included. Compared with conventional treatment, patients who received neostigmine plus conventional treatment had a shorter time duration for their first defecation (MD: -1.74; 95% CI: -2.10 to -1.38; < 0.00001; = 205; RCTs = 4; low quality of evidence) and better relief time of abdominal symptoms (MD: -1.59, 95% CI: -2.07 to -1.11; < 0.00001; = 155; RCTs = 3; low quality of evidence) as primary outcomes, and a faster percentage decrease of IAP at 24 h ( = 0.0005; moderate quality of evidence) and a shorter length of ICU stay ( < 0.00001; moderate quality of evidence) as partial secondary outcomes. TSA suggested the sample size was limited, but the cumulative Z curves of the primary outcomes crossed the conventional boundary and the trial sequential monitoring boundary. For patients with non-mild AP, neostigmine promotes the recovery of gastrointestinal motility and may have positive effects on the improvement of a clinical prognosis. Further large-sample studies are needed for a definite conclusion. https://www.crd.york.ac.uk/prospero/; Identifier: CRD 42022381417.
PubMed: 36925642
DOI: 10.3389/fphar.2023.1131974 -
Alternative Therapies in Health and... Oct 2023This study aims to comprehensively summarize and evaluate the impact of non-pharmacological interventions on mild cognitive impairment (MCI) in elderly individuals...
OBJECTIVE
This study aims to comprehensively summarize and evaluate the impact of non-pharmacological interventions on mild cognitive impairment (MCI) in elderly individuals through a systematic review of pertinent literature. The interventions include acupuncture, massage, ear point pressing, acupoint moxibustion, dietary modifications, and exercise interventions.
METHODS
A thorough literature search spanned 2017 to 2023 across databases like Zhichou, Wanfang, PubMed, CINAHL, Web of Science, and the Cochrane Library. It covered pharmacological and non-pharmacological interventions, emphasising MCI in elderly patients. Independent screening, evaluation, and data extraction were conducted and assessed via the AMSTAR 2 scale and GRADE approach. Outcome measures (e.g., MMSE, MoCA, ADL, CDT, overall efficacy) were analyzed.
RESULTS
Three systematic evaluations were assessed using AMSTAR 2. Two were low quality, one moderate. Limited rigor in two studies led to considering only medium-quality papers for evidence grading. Key indicators in RCTs included MMSE (eight studies), MoCA (seven studies), ADL (two studies), CDT (two studies), and overall efficacy (12 studies). GRADE evaluation revealed moderate, high, and high evidence quality for intervention efficacy at one, two, and three months respectively. MMSE evidence was low, MoCA high, ADL very low, and CDT moderate. Adverse events were reported in one publication, suggesting acupuncture's potential pain and resistance.
CONCLUSIONS
Non-pharmacological interventions, like acupuncture, cognitive exercises, and exercise, show promise in mild cognitive impairment among the elderly. They enhance cognitive function and daily living while maintaining safety. Acupuncture notably improves MoCA scores, supported by robust evidence.
PubMed: 37632951
DOI: No ID Found -
The Journal of Laryngology and Otology Feb 2022The aim of this study was to identify any relationship between hearing loss and mild cognitive impairment. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The aim of this study was to identify any relationship between hearing loss and mild cognitive impairment.
METHOD
This was a systematic review and meta-analysis of randomised controlled trials conducted using Medline and the Cochrane Library up to 24 June 2020. Prospective, cohort and cross-sectional, and observational studies that reported on the relationship between mild cognitive impairment and hearing loss were included.
RESULTS
A total of 34 studies reporting data on 48 017 participants were included. Twenty-three studies observed a significant association between hearing loss and mild cognitive impairment. The pooled risk ratio across all studies of prevalence of mild cognitive impairment in people with hearing loss was 1.44 (random-effects; 95 per cent CI = 1.27-1.64; p < 0.00001; I2 = 0 per cent). Significantly more people with mild cognitive impairment had peripheral hearing loss compared with those without (risk ratio, 1.40 random-effects; 95 per cent CI = 1.10-1.77; p = 0.005; I2 = 0 per cent). When the incidence was studied, significantly more people with peripheral hearing loss had mild cognitive impairment compared with those without (risk ratio = 2.06 random-effects; 95 per cent CI = 1.35-3.15; p = 0.0008; I2 = 97 per cent); however; a high level of statistical heterogeneity was evident.
CONCLUSION
Most of the studies included in this systematic review observed a significant association between hearing loss and mild cognitive impairment.
Topics: Cognitive Dysfunction; Hearing Loss; Humans; Presbycusis; Prevalence; Risk Factors
PubMed: 34895373
DOI: 10.1017/S0022215121004114 -
Brain Injury 2015To systematically review existing empirical evidence concerning neuropsychological, psychosocial and academic outcomes following mild and moderate TBI during childhood... (Review)
Review
AIM
To systematically review existing empirical evidence concerning neuropsychological, psychosocial and academic outcomes following mild and moderate TBI during childhood and adolescence.
METHOD
The studies reviewed include data on 8553 children and adolescents from ages 0-18 that experienced mild and moderate TBIs. A literature search using MeSH terms for 'children' cross-referenced with terms associated with 'head injuries' and 'cognition' was conducted using Pubmed, CINAHL Plus and Scopus databases as well as other data sources to retrieve grey literature results. Articles published between 1 January 2008 and 22 April 2013 were included.
RESULTS
Fifty-five studies were included in the review, with multiple studies including information on both mild and moderate TBI; 46 studies focused on mild TBI outcomes and 22 studies focused on moderate TBI outcomes. The majority of outcomes were described as psychosocial (50%) or neuropsychological (40%); 51% of studies presented adverse outcomes.
CONCLUSIONS
The results suggest that not all children with mild or moderate TBI recover without long-term problems. Few studies followed children and adolescents with mild TBIs for extended periods of time, although it is clinically important to monitor patients over time.
Topics: Adolescent; Brain Injuries; Child; Female; Humans; Male; Neuropsychological Tests; Treatment Outcome
PubMed: 25790086
DOI: 10.3109/02699052.2014.1002003 -
Pain Medicine (Malden, Mass.) Feb 2014This study's objective was to determine if the literature supports use of the Minimally Invasive Lumbar Decompression (mild®) procedure (Vertos Medical, Aliso Viejo,... (Review)
Review
OBJECTIVES
This study's objective was to determine if the literature supports use of the Minimally Invasive Lumbar Decompression (mild®) procedure (Vertos Medical, Aliso Viejo, CA, USA) to reduce pain and improve function in patients with symptomatic degenerative lumbar spinal stenosis.
DESIGN/SETTINGS
The study was designed as an evidence-based review of available data. Studies were identified from PubMed, Embase, and the Cochrane Library. Articles were evaluated using the Grading of Recommendations Assessment, Development and Evaluation Working Group system. Results were compiled assessing short- (4-6 weeks), medium- (3-6 months), and long-term (>1 year) outcomes. The primary outcomes evaluated were pain, measured by the visual analog scale (VAS), and function, measured by the Oswestry Disability Index (ODI). Secondary outcomes included pain and patient satisfaction, measured by the Zurich Claudication Questionnaire, adverse effects/complications, and changes in utilization of co-interventions.
RESULTS
The literature search revealed one randomized controlled trial (RCT) and 12 other studies (seven prospective cohort, four retrospective, and one case series) that provided information on the use of mild® in patients with degenerative lumbar spinal stenosis. All studies showed statistically significant improvements in VAS and ODI scores at all time frames compared with preprocedure levels; the RCT showed improvement over controls. Categorical data were not provided; thus, the proportion of patients who experienced minimal clinically meaningful outcomes is unknown.
CONCLUSION
The current body of evidence addressing mild® is of low quality. High-quality studies that are independent of industry funding and provide categorical data are needed to clarify the proportions of patients who benefit from mild® and the degree to which these patients benefit. Additional data at up to 2 years are needed to determine the overall utility of the procedure.
Topics: Decompression, Surgical; Humans; Lumbar Vertebrae; Minimally Invasive Surgical Procedures; Spinal Stenosis; Treatment Outcome
PubMed: 24308292
DOI: 10.1111/pme.12305