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Entropy (Basel, Switzerland) May 2018Asthma is a chronic respiratory disease featured with unpredictable flare-ups, for which continuous lung function monitoring is the key for symptoms control. To find new... (Review)
Review
Asthma is a chronic respiratory disease featured with unpredictable flare-ups, for which continuous lung function monitoring is the key for symptoms control. To find new indices to individually classify severity and predict disease prognosis, continuous physiological data collected from monitoring devices is being studied from different perspectives. Entropy, as an analysis method for quantifying the inner irregularity of data, has been widely applied in physiological signals. However, based on our knowledge, there is no such study to summarize the complexity differences of various physiological signals in asthmatic patients. Therefore, we organized a systematic review to summarize the complexity differences of important signals in patients with asthma. We searched several medical databases and systematically reviewed existing asthma clinical trials in which entropy changes in physiological signals were studied. As a conclusion, we find that, for airflow, heart rate variability, center of pressure and respiratory impedance, their entropy values decrease significantly in asthma patients compared to those of healthy people, while, for respiratory sound and airway resistance, their entropy values increase along with the progression of asthma. Entropy of some signals, such as respiratory inter-breath interval, shows strong potential as novel indices of asthma severity. These results will give valuable guidance for the utilization of entropy in physiological signals. Furthermore, these results should promote the development of management and diagnosis of asthma using continuous monitoring data in the future.
PubMed: 33265493
DOI: 10.3390/e20060402 -
The Cochrane Database of Systematic... Nov 2015Accelerating the rate of tooth movement may help to reduce the duration of orthodontic treatment and associated unwanted effects including root resorption and enamel... (Review)
Review
BACKGROUND
Accelerating the rate of tooth movement may help to reduce the duration of orthodontic treatment and associated unwanted effects including root resorption and enamel demineralisation. Several methods, including surgical and non-surgical adjuncts, have been advocated to accelerate the rate of tooth movement. Non-surgical techniques include low-intensity laser irradiation, resonance vibration, pulsed electromagnetic fields, electrical currents and pharmacological approaches.
OBJECTIVES
To assess the effect of non-surgical adjunctive interventions on the rate of orthodontic tooth movement and the overall duration of treatment.
SEARCH METHODS
We searched the following databases on 25 November 2014: the Cochrane Oral Health Group's Trials Register (November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2014, Issue 10), MEDLINE via OVID (1946 to November 2014), EMBASE via OVID (1980 to November 2014), LILACS via BIREME (1980 to November 2014), metaRegister of Controlled Trials (November 2014), the US National Institutes of Health Trials Register (ClinicalTrials.gov; November 2014) and the WHO International Clinical Trials Registry Platform (November 2014). We checked the reference lists of all trials identified for further studies. There were no restrictions regarding language or date of publication in the searches of the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) of people receiving orthodontic treatment using fixed appliances along with non-surgical adjunctive interventions to accelerate tooth movement. We excluded non-parallel design studies (for example, split-mouth) as we regarded them as inappropriate for assessment of the effects of this type of intervention.
DATA COLLECTION AND ANALYSIS
Two review authors were responsible for study selection, risk of bias assessment and data extraction; they carried out these tasks independently. Any disagreements were resolved by discussion amongst the review team to reach consensus. The review authors contacted the corresponding authors of trials to obtain missing information and data to allow calculation of mean differences (MD), 95% confidence intervals (CI) or risk ratios (RR) when these were not reported.
MAIN RESULTS
We included two studies in this review, which were both assessed as being at high risk of bias. The two studies, involving a total of 111 participants, compared the use of Tooth Masseuse and OrthoAccel with conventional treatment mechanics during orthodontic alignment and canine retraction phases, respectively. Both studies included objective assessment of the amount or rate of tooth movement, but we were not able to meta-analyse this data as they used different outcome measurements at different stages of the orthodontic treatment process. One study measured subjective evaluation of pain and discomfort and the other evaluated adverse effects. The studies did not directly report either the duration of orthodontic treatment or the number of visits during active treatment.Using the Tooth Masseuse with 111 Hz at 0.06 Newtons (N) for 20 minutes daily resulted in greater reduction in irregularity in the lower incisor region over 10 weeks, assessed using Little's Irregularity Index (LII) with a mean difference (MD) of 0.6 mm (95% confidence interval (CI) -0.94 to 2.34) when compared to the control group. Pain and discomfort increased at six to eight hours after arch wire placement and after seven days, with minimal difference between the intervention and control groups. No statistical tests were provided for either variable and the differences between the two groups were not clinically important.Using OrthoAccel with 30 Hz at 0.25 N for 20 minutes daily produced a higher rate of maxillary canine distalisation in comparison to the control group (MD 0.37 mm/month; 95% CI -0.07 to 0.81; P = 0.05). Whilst this difference suggested 50% faster tooth movement using the vibrational appliance, the absolute differences were marginal and deemed clinically unimportant. Similar levels of non-serious adverse effects were reported in the intervention and control groups with a risk ratio of 0.96 (95% CI 0.32 to 2.85).Overall, the quality of the evidence was very low and therefore we cannot rely on the findings.
AUTHORS' CONCLUSIONS
There is very little clinical research concerning the effectiveness of non-surgical interventions to accelerate orthodontic treatment. The available evidence is of very low quality and so it is not possible to determine if there is a positive effect of non-surgical adjunctive interventions to accelerate tooth movement. Although there have been claims that there may be a positive effect of light vibrational forces, results of the current studies do not reach either statistical or clinical significance. Further well-designed and rigorous RCTs with longer follow-up periods are required to determine whether non-surgical interventions may result in a clinically important reduction in the duration of orthodontic treatment, without any adverse effects.
Topics: Adolescent; Child; Cuspid; Female; Humans; Male; Pain Measurement; Randomized Controlled Trials as Topic; Time Factors; Tooth Movement Techniques; Vibration; Young Adult
PubMed: 26576758
DOI: 10.1002/14651858.CD010887.pub2 -
Journal of Human Hypertension Feb 2019Due to systolic blood pressure (SBP) amplification, brachial SBP may not accurately reflect central SBP, the pressure the organs are exposed to. Patients with type 2... (Meta-Analysis)
Meta-Analysis
Due to systolic blood pressure (SBP) amplification, brachial SBP may not accurately reflect central SBP, the pressure the organs are exposed to. Patients with type 2 diabetes (T2D) have vascular irregularities that may affect blood pressure (BP) amplification and central BP indices (i.e. augmentation index [AIx] and augmentation pressure [AP]). By systematic review and meta-analysis, this study aimed firstly to determine the magnitude of central-to-brachial SBP and pulse pressure (PP) amplification in T2D compared to healthy controls and secondly, the difference in AIx and AP between the groups. Online databases were searched for published studies reporting invasive or non-invasive central and brachial SBP in T2D and healthy controls up to the 20th of February 2018. Random effects meta-analyses and meta-regression were used to analyze the studies. Eighteen studies (all non-invasive: 17 radial tonometry, 1 carotid tonometry, 2 brachial oscillometry) with a total of 2758 patients with T2D and 10,561 healthy controls were identified. There was no significant difference in SBP amplification between groups (T2D = 9.9 ± 4.7, healthy controls = 9.6 ± 4.5 mmHg, p = 0.84; pooled difference = 0.64 mmHg, 95%CI -0.27 1.54, p = 0.17) or PP amplification ratio (p = 0.16). However, among these studies, central BP indices (AIx corrected for heart rate and AP) were significantly higher in T2D (p < 0.05 for both). Despite a similar magnitude of central-to-brachial SBP amplification, patients with T2D have increased central systolic loading (AIx and AP) that cannot be discerned from brachial BP alone.
Topics: Blood Pressure; Brachial Artery; Diabetes Mellitus, Type 2; Humans
PubMed: 30425327
DOI: 10.1038/s41371-018-0124-4 -
Medicine Dec 2017The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility during stimulation of sensory branches of the trigeminal nerve. Since the first description of the TCR 1999, there is an ongoing discussion about a more flexible than the existing clinical definition. Aim of this work was to create a clinical surrogate definition through a systematic review of the literature.
METHODS
In this meta-analysis study, literature about TCR occurrences was, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, systematically identified through various search engines including PubMed (Medline), Embase (Ovid SP), and ISI Web of Sciences databases from January 2005 to August 2015. TCR was defined as a drop of heart rate (HR) below 60 bpm or 20% to the baseline. We extracted detailed data about hemodynamic changes and searched for connections between arterial blood pressure (BP) and HR changes during such episodes.
RESULTS
Overall 45 studies harboring 57 patients were included in the study but only 32 patients showed sufficient data for final analyze. HR showed a nonlinear behavior with a "tipping point" phenomena that differs in variance from the central/peripheral (20-30% drop) to ganglion (40-49% drop). BP showed a linear behavior with a "central limit" phenomena not differing in variance in the whole subgroup (30-39% drop). An analyzation of the correlation between BP and HR showed a trend to a linear correlation.
CONCLUSIONS
We can show for the first time that HR is the dominant variable in the TCR and present a new surrogate definition model. This model and the role of BP must be better investigated in further studies.
Topics: Adolescent; Adult; Aged; Analysis of Variance; Arterial Pressure; Child; Child, Preschool; Female; Heart Rate; Humans; Male; Middle Aged; Models, Theoretical; Reflex, Trigeminocardiac; Young Adult
PubMed: 29245296
DOI: 10.1097/MD.0000000000009033 -
The Cochrane Database of Systematic... Jan 2015Infants in the neonatal intensive care unit (NICU) are subjected to stress, including sound of high intensity. The sound environment in the NICU is louder than most home... (Review)
Review
BACKGROUND
Infants in the neonatal intensive care unit (NICU) are subjected to stress, including sound of high intensity. The sound environment in the NICU is louder than most home or office environments and contains disturbing noises of short duration and at irregular intervals. There are competing auditory signals that frequently challenge preterm infants, staff and parents. The sound levels in NICUs often exceed the maximum acceptable level of 45 decibels (dB), recommended by the American Academy of Pediatrics. Hearing impairment is diagnosed in 2% to 10% of preterm infants versus 0.1% of the general paediatric population. Noise may cause apnoea, hypoxaemia, alternation in oxygen saturation, and increased oxygen consumption secondary to elevated heart and respiratory rates and may, therefore, decrease the amount of calories available for growth. Elevated levels of speech are needed to overcome the noisy environment in the NICU, thereby increasing the negative impacts on staff, newborns, and their families. High noise levels are associated with an increased rate of errors and accidents, leading to decreased performance among staff. The aim of interventions included in this review is to reduce sound levels to 45 dB or less. This can be achieved by lowering the sound levels in an entire unit, treating the infant in a section of a NICU, in a 'private' room, or in incubators in which the sound levels are controlled, or reducing the sound levels that reaches the individual infant by using earmuffs or earplugs. By lowering the sound levels that reach the neonate, the resulting stress on the cardiovascular, respiratory, neurological, and endocrine systems can be diminished, thereby promoting growth and reducing adverse neonatal outcomes.
OBJECTIVES
Primary objectiveTo determine the effects of sound reduction on growth and long-term neurodevelopmental outcomes of neonates. Secondary objectives1. To evaluate the effects of sound reduction on short-term medical outcomes (bronchopulmonary dysplasia, intraventricular haemorrhage, periventricular leukomalacia, retinopathy of prematurity).2. To evaluate the effects of sound reduction on sleep patterns at three months of age.3. To evaluate the effects of sound reduction on staff performance.4. To evaluate the effects of sound reduction in the neonatal intensive care unit (NICU) on parents' satisfaction with the care.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, CINAHL, abstracts from scientific meetings, clinical trials registries (clinicaltrials.gov; controlled-trials.com; and who.int/ictrp), Pediatric Academic Societies Annual meetings 2000 to 2014 (Abstracts2View(TM)), reference lists of identified trials, and reviews to November 2014.
SELECTION CRITERIA
Preterm infants (< 32 weeks' postmenstrual age (PMA) or < 1500 g birth weight) cared for in the resuscitation area, during transport, or once admitted to a NICU or a stepdown unit.
DATA COLLECTION AND ANALYSIS
We performed data collection and analyses according to the Cochrane Neonatal Review Group.
MAIN RESULTS
One small, high quality study assessing the effects of silicone earplugs versus no earplugs qualified for inclusion. The original inclusion criteria in our protocol stipulated an age of < 48 hours at the time of initiating sound reduction. We made a deviation from our protocol and included this study in which some infants would have been > 48 hours old. There was no significant difference in weight at 34 weeks postmenstrual age (PMA): mean difference (MD) 111 g (95% confidence interval (CI) -151 to 374 g) (n = 23). There was no significant difference in weight at 18 to 22 months corrected age between the groups: MD 0.31 kg, 95% CI -1.53 to 2.16 kg (n = 14). There was a significant difference in Mental Developmental Index (Bayley II) favouring the silicone earplugs group at 18 to 22 months corrected age: MD 14.00, 95% CI 3.13 to 24.87 (n = 12), but not for Psychomotor Development Index (Bayley II) at 18 to 22 months corrected age: MD -2.16, 95% CI -18.44 to 14.12 (n =12).
AUTHORS' CONCLUSIONS
To date, only 34 infants have been enrolled in a randomised controlled trial (RCT) testing the effectiveness of reducing sound levels that reach the infants' ears in the NICU. Based on the small sample size of this single trial, we cannot make any recommendations for clinical practice. Larger, well designed, conducted and reported trials are needed.
Topics: Ear Protective Devices; Employee Performance Appraisal; Health Personnel; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Noise; Parents; Randomized Controlled Trials as Topic; Sound; Stress, Physiological
PubMed: 25633155
DOI: 10.1002/14651858.CD010333.pub2 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jan 2014A 25-year-old man was bitten in the neck by an aggressive camel, causing three small puncture wounds. The left carotid pulse of the patient was weakly palpated.... (Review)
Review
A 25-year-old man was bitten in the neck by an aggressive camel, causing three small puncture wounds. The left carotid pulse of the patient was weakly palpated. Angiography showed irregular dissection of the distal part of the left common carotid artery. Neck exploration confirmed the findings. An interposition autogenous saphenous vein graft was performed successfully. The patient was discharged home in good condition. We have systematically reviewed the literature on this topic, and only four other similar cases were reported previously. Although camel bite wounds are small, they may penetrate deeply, causing serious injuries to the neck structures including the major vessels. Care should be taken when approaching male camels during the rutting season.
Topics: Adult; Animals; Bites and Stings; Camelus; Carotid Artery Injuries; Humans; Male; Young Adult
PubMed: 24639318
DOI: 10.5505/tjtes.2014.69822 -
Journal of Obstetrics and Gynaecology... Jun 2024Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga... (Review)
Review
OBJECTIVE
Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga activity lowers harmful inflammatory secretions that provide comfort for premenstrual syndrome (PMS) sufferers.
DATA SOURCES
The following worldwide databases were searched for this systematic review: Scopus, PubMed, Cochrane Library, PEDro, and Google Scholar from inception to August 2022.
STUDY SELECTION
A PICOS framework (Population, Intervention, Comparison, Outcome, and Study Design) was used for searching. Population included those with premenstrual syndrome or premenstrual tension syndromes, intervention included yoga therapy, comparator was with control group, and outcome measures included blood pressure (SBP, DBP) and heart rate (HR).
DATA EXTRACTION AND SYNTHESIS
To evaluate the study, we employed the Methodological Index for Randomised Controlled Trials. Fixed effects meta-analysis and qualitative synthesis were conducted. A total of 14 studies out of 224 were included. The main outcome measures included in this review were SBP, DBP, HR, and Moos Menstrual Distress Questionnaire (MMDQ). For the meta-analysis, 7 studies were considered. 3 studies contributed data of SBP (mean difference (MD) = -0.30; 95% CI: -2.29 to 1.69; heterogenicity (I) = 96%; P = 0.00001) and DBP (MD = -0.25; 95% CI: -0.99 to 0.49; I = 79%; P = 0.009). HR results from 4 studies were included (MD = 0.08; 95% CI: -0.83 to 0.99; I = 89%; P = 0.00001). 3 studies contributed data of MMDQ (MD = 1.50; 95% CI: 0.91 to 2.10; I = 92%; P = 0.00001.
CONCLUSION
Yoga can help people with both medical and psychological conditions including menstrual pain, irregular periods, stress, tension, and anxiety. It has been shown to lessen women's emotional, behavioural, and physical PMS symptoms, which has enhanced their quality of life.
OBJECTIF
Jusqu'à 80 % des femmes en âge de procréer connaîtraient un syndrome prémenstruel (SPM), qui se caractérise par des changements physiques, psychologiques et comportementaux. Les activités de yoga réduisent les sécrétions inflammatoires nocives et soulagent les symptômes du syndrome prémenstruel. SOURCE DES DONNéES: Pour cette revue systématique, des recherches ont été effectuées dans les bases de données mondiales Scopus, PubMed, Cochrane Library, PEDro et Google Scholar pour la période allant de leur création au mois d'août 2022. SéLECTION DES éTUDES: Une méthode PICOS (population, intervention, comparaison, résultat et conception de l'étude) a été utilisée pour la recherche. La population à l'étude incluait les personnes souffrant du syndrome prémenstruel ou d'une tension prémenstruelle, l'intervention incluait la thérapie par le yoga, le comparateur était le groupe témoin, et les critères de jugement comprenaient la pression artérielle (systolique et diastolique) et la fréquence cardiaque. EXTRACTION DES DONNéES ET SYNTHèSE: Pour évaluer l'étude, nous avons utilisé l'indice méthodologique pour les essais cliniques randomisés. Une méta-analyse à effet fixe et une synthèse qualitative ont été réalisées. Au total, 14 des 224 études relevées ont été retenues. Les critères de jugement principaux de cette revue étaient les pressions artérielles systolique et diastolique, la fréquence cardiaque et le questionnaire de détresse menstruelle de Moos. Dans la méta-analyse, 7 études ont été prises en compte. Au total, 3 études avaient des données sur la pression systolique (différence moyenne [DM] = -0,30; IC à 95 % : -2,29 à 1,69; hétérogénéité [I] = 96 %; P = 0,00001) et la pression diastolique (DM = -0,25; IC à 95 % : -0,99 à 0,49; I = 79 %; P = 0,009). Les données de fréquence cardiaque de 4 études ont été incluses (DM = 0,08; IC à 95 % : -0,83 à 0,99; I = 89 %; P = 0,00001). Des données du questionnaire de Moos étaient disponibles pour 3 études (DM = 1,50; IC à 95 % : 0,91 à 2,10; I = 92 %; P = 0,00001).
CONCLUSION
Le yoga peut aider les personnes souffrant de troubles médicaux ou psychologiques, notamment les douleurs menstruelles, les menstruations irrégulières, le stress, les tensions et l'anxiété. Les données montrent que le yoga atténue les symptômes émotionnels, comportementaux et physiques du syndrome prémenstruel chez les femmes, ce qui améliore leur qualité de vie.
PubMed: 38871120
DOI: 10.1016/j.jogc.2024.102579