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Global Epidemiology Jun 2024Today, vasovagal syncope is a common problem that has become a significant health and social challenge. The present study investigated the global prevalence of vasovagal... (Review)
Review
BACKGROUND
Today, vasovagal syncope is a common problem that has become a significant health and social challenge. The present study investigated the global prevalence of vasovagal syncope using a systematic review and meta-analysis.Methods: In this systematic review and meta-analysis study, the global prevalence of vasovagal syncope using the keywords Prevalence, Epidemiology, Vasovagal syncope, and Reflex syncope in PubMed, WoS, Scopus, ScienceDirect databases, and Google scholar search engine without time limit until July 20, 2022, was extracted and transferred to the information management software (EndNote). Then the repeated studies were excluded, and researchers evaluated the remaining studies during three stages (i.e., screening, eligibility, and qualitative assessment). The heterogeneity of studies was investigated using the I index, and the analysis of eligible studies was performed using the random effects model.
RESULTS
In the review of 12 studies with a sample size of 36,156 people, the global prevalence of vasovagal syncope was reported as 16.4 (95%CI: 6-37.5), and the study of publication bias in the studies through the Egger test shows the absence of publication bias in the studies.
CONCLUSION
The prevalence reported in the studies shows a high prevalence of vasovagal syncope, which requires serious intervention and preventive, diagnostic, and therapeutic measures. It is necessary for health policymakers to take effective measures in this field.
PubMed: 38283939
DOI: 10.1016/j.gloepi.2024.100136 -
Critical Care Medicine Oct 2021An automated infrared pupillometer measures quantitative pupillary light reflex using a calibrated light stimulus. We examined whether the timing of performing... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
An automated infrared pupillometer measures quantitative pupillary light reflex using a calibrated light stimulus. We examined whether the timing of performing quantitative pupillary light reflex or standard pupillary light reflex may impact its neuroprognostic performance in postcardiac arrest comatose patients and whether quantitative pupillary light reflex may outperform standard pupillary light reflex in early postresuscitation phase.
DATA SOURCES
PubMed and Embase databases from their inception to July 2020.
STUDY SELECTION
We selected studies providing sufficient data of prognostic values of standard pupillary light reflex or quantitative pupillary light reflex to predict neurologic outcomes in adult postcardiac arrest comatose patients.
DATA EXTRACTION
Quantitative data required for building a 2 × 2 contingency table were extracted, and study quality was assessed using standard criteria.
DATA SYNTHESIS
We used the bivariate random-effects model to estimate the pooled sensitivity and specificity of standard pupillary light reflex or quantitative pupillary light reflex in predicting poor neurologic outcome during early (< 72 hr), middle (between 72 and 144 hr), and late (≧ 145 hr) postresuscitation periods, respectively. We included 39 studies involving 17,179 patients. For quantitative pupillary light reflex, the cut off points used in included studies to define absent pupillary light reflex ranged from 0% to 13% (median: 7%) and from zero to 2 (median: 2) for pupillary light reflex amplitude and Neurologic Pupil index, respectively. Late standard pupillary light reflex had the highest area under the receiver operating characteristic curve (0.98, 95% CI [CI], 0.97-0.99). For early standard pupillary light reflex, the area under the receiver operating characteristic curve was 0.80 (95% CI, 0.76-0.83), with a specificity of 0.91 (95% CI, 0.85-0.95). For early quantitative pupillary light reflex, the area under the receiver operating characteristic curve was 0.83 (95% CI, 0.79-0.86), with a specificity of 0.99 (95% CI, 0.91-1.00).
CONCLUSIONS
Timing of pupillary light reflex examination may impact neuroprognostic accuracy. The highest prognostic performance was achieved with late standard pupillary light reflex. Early quantitative pupillary light reflex had a similar specificity to late standard pupillary light reflex and had better specificity than early standard pupillary light reflex. For postresuscitation comatose patients, early quantitative pupillary light reflex may substitute for early standard pupillary light reflex in the neurologic prognostication algorithm.
Topics: Adult; Heart Arrest; Humans; Prognosis; Reflex, Pupillary; Sensitivity and Specificity; Time
PubMed: 34259437
DOI: 10.1097/CCM.0000000000005045 -
Journal of Dental Education Mar 2023Participating in recreational activities from a young age may have the potential enhance psychomotor skills early on, and conversely, low levels of participation in... (Review)
Review
BACKGROUND
Participating in recreational activities from a young age may have the potential enhance psychomotor skills early on, and conversely, low levels of participation in these activities may predict slower development of preclinical hand skills.
PURPOSE
This study aims to evaluate the eye-hand coordination benefits of leisure and reflex-based activities to those of typical instructional techniques among dental students.
DATA SOURCES
The databases used were PubMed, EBSCOhost, and Scopus.
STUDY SELECTION
Ten articles were selected from a total of 1135 articles found across three databases.
DATA EXTRACTION
The articles were screened by four investigators through a series of steps in accordance to inclusion and exclusion criteria and rid of any duplicates.
DATA SYNTHESIS
The majority of the 10 featured articles were conducted in the United States. All of the research included was cohort observational studies. This systematic review includes a total of 1975 participants from the publications selected for this purpose.
RESULTS
Manual dexterity may be taught and improved by practice, and tests designed to measure it should be used primarily to pinpoint which students would benefit most from individualized, close supervision during their education.
CONCLUSION
Researchers found that reflex-based activities helped students develop better hand-eye coordination in a classroom setting. However, more precise dental-related tests and questionnaires can always be developed through further study; doing so would yield a wealth of information that would be immensely useful to the dental sector.
Topics: Humans; Educational Measurement; Education, Dental; Reflex; Students; Educational Status
PubMed: 36326571
DOI: 10.1002/jdd.13126 -
Seizure Mar 2023New-onset epileptic seizures and status epilepticus (SE) are the most frequent neurological manifestations of non-ketotic hyperglycemia (NKH), an acute complication of... (Meta-Analysis)
Meta-Analysis Review
New-onset epileptic seizures and status epilepticus (SE) are the most frequent neurological manifestations of non-ketotic hyperglycemia (NKH), an acute complication of diabetes mellitus (DM). Treatment consists of the correction of the underlying metabolic disorder, whereas anti-seizure medications (ASMs) may even worsen seizures. Evidence on NKH-related seizures is currently restricted to case reports and small case-series. We conducted a systematic review of the PubMed, Embase, and Cochrane Library databases to provide a comprehensive description of NKH-related seizures. Statistical analyses were performed to explore possible associations of glycemic and osmolarity levels with clinical variables. We selected 130 publications and 332 patients (186 males, mean age: 61.1 years). DM was newly-diagnosed in 40%. Mean glycemia and osmolarity levels at presentation were 529.7 mg/dL and 309.6 mmol/mol, respectively; 22.6% showed other neurological symptoms besides seizures. Focal motor seizures were the prominent seizure type (49.4%); non-motor focal seizures (23.2%) most commonly manifested as visual symptoms. Reflex seizures occurred in 10.5%. Brain MRI in 48.7% of cases showed focal T2 subcortical hypodensity and/or overlying cortical T2 hyperintensity with DWI restriction. ASMs were administered in 54.2% of cases, achieving seizure control in just 18.3%. Higher osmolarity levels were associated with newly-diagnosed DM (p = 0.002) and other symptoms at presentation (p < 0.001). Glycemic values were higher in patients with focal aware seizures with motor onset compared to those with focal seizures without motor onset (p = 0.0046) or focal seizures with impaired awareness (p = 0.0306). Lower glycemic values were associated with reflex seizures (p = 0.036) and ASM administration (p < 0.001). NKH-related seizures should be suspected in adults with new-onset clustering focal seizures arising from the motor or posterior cortices, even in the absence of a history of DM. Typical focal changes on brain MRI, while not pathognomonic, can drive the clinical diagnosis. Statistical associations suggest a key role of hyperglycemia in the excitability of higher-energy-demanding cortical areas.
Topics: Male; Adult; Humans; Middle Aged; Epilepsy; Hyperglycemia; Epilepsies, Partial; Status Epilepticus; Ketosis
PubMed: 36773573
DOI: 10.1016/j.seizure.2023.01.018 -
International Journal of... Sep 2022This paper provides an accessible review of the biological and psychological evidence to guide new and experienced researchers in the study of emotional piloerection in... (Review)
Review
This paper provides an accessible review of the biological and psychological evidence to guide new and experienced researchers in the study of emotional piloerection in humans. A limited number of studies have attempted to examine the physiological and emotional correlates of piloerection in humans. However, no review has attempted to collate this evidence to guide the field as it moves forward. We first discuss the mechanisms and function of non-emotional and emotional piloerection in humans and animals. We discuss the biological foundations of piloerection as a means to understand the similarities and differences between emotional and non-emotional piloerection. We then present a systematic qualitative review (k = 24) in which we examine the physiological correlates of emotional piloerection. The analysis revealed that indices of sympathetic activation are abundant, suggesting emotional piloerection occurs with increased (phasic) skin conductance and heart rate. Measures of parasympathetic activation are lacking and no definite conclusions can be drawn. Additionally, several studies examined self-reported emotional correlates, and these correlates are discussed in light of several possible theoretical explanations for emotional piloerection. Finally, we provide an overview of the methodological possibilities available for the study of piloerection and we highlight some pressing questions researchers may wish to answer in future studies.
Topics: Animals; Emotions; Heart Rate; Humans; Piloerection
PubMed: 35764195
DOI: 10.1016/j.ijpsycho.2022.06.010 -
Journal of Oral and Maxillofacial... Jun 2024Temporomandibular joint (TMJ) surgery is being increasingly performed globally with considerable success leading to improved quality of life for patients affected with...
PURPOSE
Temporomandibular joint (TMJ) surgery is being increasingly performed globally with considerable success leading to improved quality of life for patients affected with disabling temporomandibular disorders. One of the most unusual phenomena noted during maxillofacial surgery due to stimulation of the trigeminal nerves is the Trigeminocardiac reflex (TCR), which causes sudden bradycardia and hypotension causing alarm and distress to the surgical and anesthetic team. The purpose of this systematic review is to identify the frequency and discuss the pathophysiology of the TCR especially during TMJ surgery.
METHODS
The authors performed a systematic review by searching PubMed, Embase, Ovid, and Cochrane databases between 1946 and 2023 to identify studies that reported on the development of TCR during TMJ surgery. Non-English publications and those with inadequate details were excluded.
RESULTS
Thirty-six papers reporting on the development of the TCR during oral and maxillofacial procedures were noted. Six papers reported specifically on TCR during TMJ surgery. A total of 25 subjects developed TCR during TMJ surgery. The mean age of the subjects was 31 (standard deviation 17.16) years. Twenty-three subjects (92%) developed bradycardia while 2 subjects (8%) developed asystole. All subjects recovered. The most common stimulant noted in these papers leading to TCR was manipulation and distraction of the TMJ.
CONCLUSION
Although TCR is uncommon, it can occur during TMJ surgery, and it behooves the surgeon and anesthesia team to be aware of the potential for TCR to ensure adequate and timely treatment.
Topics: Humans; Bradycardia; Intraoperative Complications; Oral Surgical Procedures; Reflex, Trigeminocardiac; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 38547928
DOI: 10.1016/j.joms.2024.03.005 -
Journal of Dentistry (Shiraz, Iran) Dec 2023Management of gag reflex is a challenging process during many dental treatments. Various studies have been carried out to evaluate different pharmacological and... (Review)
Review
STATEMENT OF THE PROBLEM
Management of gag reflex is a challenging process during many dental treatments. Various studies have been carried out to evaluate different pharmacological and non-pharmacological techniques to control gagging.
PURPOSE
The aim of this study is to review the available evidence on methods proposed for managing the gag reflex.
MATERIALS AND METHOD
This systematic review adheres to the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A comprehensive search was conducted in English and Persian based on articles published from 2015 to 2022 (February) in PubMed, Scopus, Science Direct, Web of Science, Google Scholar, ISC and SID. All studies were first screened based on their title and abstract. The quality assessment of articles was carried out by two independent authors. Then, risk of bias evaluation was conducted according to Cochrane parameters.
RESULTS
In total, 1704 studies were identified via search. After reviewing title and abstract, 16 studies found eligible based on inclusion and exclusion criteria. Following quality and risk of bias assessment, 9 studies included in the systematic review.
CONCLUSION
Based on the finding of this review, distraction techniques, nitrous oxide, and low-level laser therapy were found effective in management of gag reflex. The dentist should consider gag reflex management based on the type of dental treatment, gag severity, patient's age, and available capabilities.
PubMed: 38149230
DOI: 10.30476/dentjods.2022.96360.1934 -
PloS One 2018This systematic review examines the relationship between sympathetic and parasympathetic activity on the one hand and job stress and burnout on the other, and is...
UNLABELLED
This systematic review examines the relationship between sympathetic and parasympathetic activity on the one hand and job stress and burnout on the other, and is registered at PROSPERO under CRD42016035918.
BACKGROUND
Previous research has shown that prolonged job stress may lead to burnout, and that differences in heart rate variability are apparent in people who have heightened job stress.
AIMS
In this systematic review, the associations between job stress or burnout and heart rate (variability) or skin conductance are studied. Besides, it was investigated which-if any-guidelines are available for ambulatory assessment and reporting of the results.
METHODS
We extracted data from relevant databases following the PRESS checklist and contacted authors for additional resources. Participants included the employed adult population comparing validated job stress and burnout questionnaires examining heart rate and electrodermal activity. Synthesis followed the PRISMA guidelines of reporting systematic reviews.
RESULTS
The results showed a positive association between job stress and heart rate, and a negative association between job stress and heart rate variability measures. No definite conclusion could be drawn with regard to burnout and psychophysiological measures. No studies on electrodermal activity could be included based on the inclusion criteria.
CONCLUSIONS
High levels of job stress are associated with an increased heart rate, and decreased heart rate variability measures. Recommendations for ambulatory assessment and reporting (STROBE) are discussed in light of the findings.
Topics: Burnout, Professional; Galvanic Skin Response; Heart Rate; Humans; Job Satisfaction; Parasympathetic Nervous System; Stress, Psychological; Surveys and Questionnaires; Sympathetic Nervous System
PubMed: 30335812
DOI: 10.1371/journal.pone.0205741 -
Cureus May 2023Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental... (Review)
Review
Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental delays account for delayed skill development surrounding speech, social, emotional, behavioral, motor, and cognitive delays. NDD might affect the child's psychological and physical well-being, resulting in chronic disease and disabilities throughout adulthood. This review sought to investigate the implication of early diagnosis and intervention of NDD in children. In this regard, this research opted for a systematic meta-analysis that used keywords and Boolean operators to search through main databases, including the Web of Science, JStor, PsychINFO, Science Direct, Cochrane, Scopus, and ASSIA. The result identified that telehealth interventions improved the management of NDD in children. Also, the Early Start Denver Model (ESDM) model was determined to improve the quality of life for NDD children. Another model was LEAP (Learning Experience and Alternative Program for Preschoolers and Their Parents) and Leap (Learning, engaging, and Playing), which improved behavioral, education, and social interventions in NDD children. The study identified that technology could revolutionize NDD interventions in children, possibly improving the quality of life. The parent-children relationship was shown to enhance the management of this condition; thus, it is recommended as one of the best ways to intervene in the management of NDD. Most importantly, the integration of machine learning algorithms and technology can create models; while this may not be significant in the treatment of childhood NDD but instead might be ideal in improving the quality of life for NDD children. Moreover, their social and communication skills along with academic achievements will improve. The study proposes further research in order to understand the different types of NDDs and their intervention strategies to help the researchers identify the most accurate models to improve the conditions and support the parents and guardians in the management.
PubMed: 37303321
DOI: 10.7759/cureus.38745 -
BMC Psychiatry Jan 2018Electrodermal activity (EDA) and other peripheral autonomic electrical parameters have been used as indicators of emotional states, including depressive states and... (Review)
Review
BACKGROUND
Electrodermal activity (EDA) and other peripheral autonomic electrical parameters have been used as indicators of emotional states, including depressive states and suicidal state. We aimed to review EDA research systematically, focusing on EDA's usefulness as a biomarker for depression and suicidal behaviour.
METHODS
We searched MEDLINE, Scopus, Cochrane Library, and Web of Science databases, following PRISMA guidelines. The initial screening of articles was based on titles and abstracts; then the full text was reviewed. A preliminary synthesis of findings was developed using tables, thematic analysis and quality ratings.
RESULTS
1287 articles were screened and 77 relevant studies were identified and included in the systematic review. The studies were fairly consistent in maintaining that hypoactive electrodermal response is an established feature of patients affected by depression. There is also preliminary evidence that monitoring EDA may help to differentiate the phases of mood disorders. A few studies provided evidence that EDA can be used to differentiate acutely suicidal subjects from depressed patients who are not severely suicidal. Although EDA has been shown to be a valid, sensitive marker of suicidal ideation, suicide attempts and violent suicidal behaviour, it also seems to be influenced to some extent by antidepressant treatment.
CONCLUSIONS
Most of the studies summarised in this review are quite outdated and employed a variety of designs and methods to evaluate EDA. This limits the generalisability of the results and makes it difficult to draw clear conclusions about the role of EDA in real-world settings. Electrodermal hypoactivity seems to be a reliable feature of depression and a valid marker of suicidal risk. Nevertheless, the potential utility of EDA in diagnosis, prevention, and treatment planning for depression and suicidal behaviour, should be thoroughly studied.
Topics: Adult; Depression; Female; Galvanic Skin Response; Habituation, Psychophysiologic; Humans; Male; Narration; Self-Injurious Behavior; Suicidal Ideation; Suicide; Suicide, Attempted
PubMed: 29370787
DOI: 10.1186/s12888-017-1551-4