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Frontiers in Sports and Active Living 2022Type II diabetes mellitus (T2DM) has become a worldwide public health problem. Although it has been empirically established that physical activity is a promising...
BACKGROUND
Type II diabetes mellitus (T2DM) has become a worldwide public health problem. Although it has been empirically established that physical activity is a promising therapeutical approach to the prevention and management of T2DM, the effectiveness of yoga on T2DM has not yet reached an agreement across studies and also needs an updated synthetic examination.
PURPOSE
The purpose of this study was to examine the effect of yoga training on diabetes-related indicators compared with usual care.
METHODS
The review protocol of this study has been registered in the PROSPERO with a registration number CRD42021267868. A systematic literature search through electronic databases was conducted to identify yoga-based intervention (i.e., randomized controlled trial [RCT]; e.g., yogic postures, movements, breathing, and meditation) studies reporting outcomes on glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), and body mass index (BMI). A number of two researchers manually reviewed and assessed each article using the Cochrane Risk of Bias Tool 2.0. The literature search identified 296 eligible entries, of which 13 were finalized after screening using predefined inclusion and exclusion criteria. The extracted data (group mean and standard deviation at posttest) were synthesized using random-effects meta-analyses. Finally, potential moderators were explored using subgroup analysis and sensitivity analysis.
RESULTS
The standardized mean difference for the effects of yoga was significant on HbA1c (MD = -0.47; 95%CI: -0.77, -0.16; = 3.02, = 0.003), FBG (SMD = -0.92; 95%CI: -1.55, -0.29; = 2.87, = 0.004), PPBG (SMD = -0.53; 95%CI: -0.86, -0.21; = 3.20, = 0.001), and TG (SMD = -0.32; 95%CI: -0.54, -0.10; = 2.86, = 0.004). However, yoga effect was not observed on TC (SMD = -0.84; 95%CI: -1.71, 0.04; = 1.87, = 0.06) and BMI (MD = -0.63; 95%CI: -1.42, 0.16; = 1.57, = 0.12).
CONCLUSION
The findings suggest that yoga can improve the biochemical indices of blood glucose and the lipid profile of patients with T2DM. Therefore, yoga can be prescribed as an effective and active complementary treatment for T2DM. However, this study only tested yoga as a short-term treatment. In the future, rigorous RCTs with a larger sample size may be carried out to examine the long-term effect of yoga on T2DM.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=267868, identifier: CRD42021267868.
PubMed: 35813055
DOI: 10.3389/fspor.2022.900815 -
Critical Care (London, England) Jul 2022The prognostic value of extravascular lung water (EVLW) measured by transpulmonary thermodilution (TPTD) in critically ill patients is debated. We performed a systematic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The prognostic value of extravascular lung water (EVLW) measured by transpulmonary thermodilution (TPTD) in critically ill patients is debated. We performed a systematic review and meta-analysis of studies assessing the effects of TPTD-estimated EVLW on mortality in critically ill patients.
METHODS
Cohort studies published in English from Embase, MEDLINE, and the Cochrane Database of Systematic Reviews from 1960 to 1 June 2021 were systematically searched. From eligible studies, the values of the odds ratio (OR) of EVLW as a risk factor for mortality, and the value of EVLW in survivors and non-survivors were extracted. Pooled OR were calculated from available studies. Mean differences and standard deviation of the EVLW between survivors and non-survivors were calculated. A random effects model was computed on the weighted mean differences across the two groups to estimate the pooled size effect. Subgroup analyses were performed to explore the possible sources of heterogeneity.
RESULTS
Of the 18 studies included (1296 patients), OR could be extracted from 11 studies including 905 patients (464 survivors vs. 441 non-survivors), and 17 studies reported EVLW values of survivors and non-survivors, including 1246 patients (680 survivors vs. 566 non-survivors). The pooled OR of EVLW for mortality from eleven studies was 1.69 (95% confidence interval (CI) [1.22; 2.34], p < 0.0015). EVLW was significantly lower in survivors than non-survivors, with a mean difference of -4.97 mL/kg (95% CI [-6.54; -3.41], p < 0.001). The results regarding OR and mean differences were consistent in subgroup analyses.
CONCLUSIONS
The value of EVLW measured by TPTD is associated with mortality in critically ill patients and is significantly higher in non-survivors than in survivors. This finding may also be interpreted as an indirect confirmation of the reliability of TPTD for estimating EVLW at the bedside. Nevertheless, our results should be considered cautiously due to the high risk of bias of many studies included in the meta-analysis and the low rating of certainty of evidence. Trial registration the study protocol was prospectively registered on PROSPERO: CRD42019126985.
Topics: Critical Illness; Extravascular Lung Water; Humans; Prognosis; Reproducibility of Results; Thermodilution
PubMed: 35794612
DOI: 10.1186/s13054-022-04061-6 -
European Archives of Paediatric... Aug 2022The present systematic review aims to describe the incidence and severity of chemotherapy-related oral mucositis in children and adolescents affected by hematologic and...
PURPOSE
The present systematic review aims to describe the incidence and severity of chemotherapy-related oral mucositis in children and adolescents affected by hematologic and solid tumors.
METHODS
An electronic search was performed on PubMed, Scopus, Web of Science, Cochrane Library, and EBSCO up to the 8th November 2020. The PRISMA protocol was followed for the article selection and inclusion. The risk of bias in individual studies was evaluated through the Newcastle-Ottawa Scale. Data were summarized using mean and standard deviation for continuous variables, while categorical ones were described with frequency and percentage.
RESULTS
A number of 9940 records were obtained after the electronic search. Seventeen of them were included in the qualitative analysis after the two stages of screening, while none of these articles was considered eligible for the quantitative analysis. The mean incidence of oral mucositis was 53.6% and it ranged from 16.7 to 91.5%, while severe oral mucositis accounted for the 15.8% (0.0-35.2%) among selected studies. Most of the articles included both patients with solid and hematologic tumors, while only five of them described oral mucositis in children with acute lymphoblastic leukemia. Even the kinds of chemotherapy administered were extremely variable.
CONCLUSION
In conclusion, about half of the patients submitted to cancer chemotherapy developed oral mucositis with an incidence and severity that varies depending on the primary disease and the kind of drugs administered.
Topics: Adolescent; Antineoplastic Agents; Child; Humans; Incidence; Neoplasms; Stomatitis
PubMed: 35779225
DOI: 10.1007/s40368-022-00727-5 -
Clinical Nutrition ESPEN Jun 2022Some studies conducted on soy isoflavones and soy protein reflected that leptin can be reduced by soy isoflavones or soy protein. The aim of present study is to assess... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Some studies conducted on soy isoflavones and soy protein reflected that leptin can be reduced by soy isoflavones or soy protein. The aim of present study is to assess the effect of soy isoflavones plus soy protein on serum concentration of leptin among adults.
METHODS
To find randomized clinical trails (RCTs) assessing the effect of soy isoflavones containing soy protein on serum concentration of leptin in participants with age ≥18 years old, databases including PubMed, Scopus, ISI Web of Science, Cochrane and ClinicalTrials.gov were searched up to March 2021. We calculated the effect size by the mean change from baseline of leptin concentrations and its standard deviation for intervention and comparison groups. DerSimonian and Laird random effects model was used to estimate the overall summary effect and the heterogeneity. Risk of bias was conducted by Cochrane Collaboration's tool. Study protocol was registered in PROSPERO (No. CRD42021228366).
RESULTS
Eight articles with 421 participants and six articles with 336 participants were known to be eligible for systematic review and meta-analysis, respectively. A pooled analysis revealed that the combination of soy isoflavones and soy protein had a borderline non-significant on serum concentration of leptin (weighted mean difference (WMD): -1.03 ng/ml, 95% confidence interval (CI): -2.11, 0.05 ng/ml). This combination reduced serum leptin levels in studies with baseline levels of leptin ≤22 ng/ml, in short-term trials (≤56 days), studies that used soy isoflavones with dose ≤96 mg/day and among subjects with health risk factors or diseases.
CONCLUSION
Soy isoflavones plus soy protein had a non-significant decreasing effect on the serum concentration of leptin. However, making firm conclusion needs more studies on participants with different health condition, and different soy isoflavones doses and intervention duration.
Topics: Adolescent; Adult; Humans; Isoflavones; Leptin; Randomized Controlled Trials as Topic; Risk Factors; Soybean Proteins
PubMed: 35623806
DOI: 10.1016/j.clnesp.2022.03.015 -
International Journal of Infectious... Sep 2022This study aimed to describe the prevalence of risks of bias in randomized trials of therapeutic interventions for COVID-19.
OBJECTIVES
This study aimed to describe the prevalence of risks of bias in randomized trials of therapeutic interventions for COVID-19.
METHODS
Systematic review and risk of bias assessment performed by two independent reviewers of a random sample of 40 randomized trials of therapeutic interventions for moderate-severe COVID-19. We used the RoB 2.0 tool to assess the risk of bias, which evaluates bias under five domains as well as an overall assessment of each trial as high or low risk of bias.
RESULTS
Of the 40 included trials, 19 (47%) were at high risk of bias, and this was particularly frequent in trials from low-middle income countries (11/14, 79%). Potential deviations to intended interventions (i.e., control participants accessing experimental treatments) were considered a potential source of bias in some studies (14, 35%), as was the risk due to selective reporting of results (6, 15%). The randomization process was considered at low risk of bias in most studies (34, 95%), as were missing data (36, 90%) and measurement of the outcome (35, 87%).
CONCLUSION
Many randomized trials evaluating COVID-19 interventions are at risk of bias, particularly those conducted in low-middle income countries. Biases are mostly due to deviations from intended interventions and partly due to the selection of reported results. The use of placebo control and publicly available protocol can mitigate many of these risks.
Topics: Bias; COVID-19; Humans; Randomized Controlled Trials as Topic; Research Design
PubMed: 35597556
DOI: 10.1016/j.ijid.2022.05.034 -
Pain and Therapy Sep 2022This systematic review aimed to investigate variations of reference scores for the Pain Catastrophizing Scale (PCS) between language versions and between countries in... (Review)
Review
A Systematic Review of the Variation in Pain Catastrophizing Scale Reference Scores Based on Language Version and Country in Patients with Chronic Primary (Non-specific) Pain.
INTRODUCTION
This systematic review aimed to investigate variations of reference scores for the Pain Catastrophizing Scale (PCS) between language versions and between countries in patients with chronic primary pain (CPP) or chronic primary pain, not otherwise specified (CPP-NOS).
METHODS
Electronic searches of the Ovid/Embase, Ovid/MEDLINE, and Ovid/PsycINFO databases were conducted to retrieve studies assessing PCS scores in adults with CPP or CPP-NOS proposed by the International Classification of Diseases, Eleventh Revision for any country where the translated PCS was available. The protocol for this systematic review was prospectively registered on the International Prospective Register of Systematic Reviews 2018 (registration number: CRD 42018086719).
RESULTS
A total of 3634 articles were screened after removal of duplicates. From these, 241 articles reporting on 32,282 patients with chronic pain were included in the review. The mean (± standard deviation) weighted PCS score across all articles was 25.04 ± 12.87. Of the 12 language versions and 21 countries included in the review, the weighted mean PCS score in Asian languages or Asian countries was significantly higher than that in English, European, and other languages or Western and other countries. The highest mean score of the weighted PCS based on language was in Japanese (mean 33.55), and the lowest was in Russian (mean 20.32). The highest mean score of the weighted PCS based on country was from Japan (mean 33.55), and the lowest was from Australia (mean 19.80).
CONCLUSION
The weighted PCS scores for people with CPP or CPP-NOS were significantly higher in Asian language versions/Asian countries than in English, European and other language versions or Western and other countries.
PubMed: 35567720
DOI: 10.1007/s40122-022-00390-0 -
World Neurosurgery May 2022Classic randomized controlled trials (RCTs) form the cornerstone for medical guidelines and protocols. However, in neurosurgery, RCTs are not always applicable to...
BACKGROUND
Classic randomized controlled trials (RCTs) form the cornerstone for medical guidelines and protocols. However, in neurosurgery, RCTs are not always applicable to everyday clinical practice. Pragmatic controlled trials aim to incorporate real-life data with the preservation of the methodologic quality. This study is a systematic literature review of all pediatric neurosurgical RCTs published between 2000 and 2020 and an analysis of their pragmatism.
METHODS
An electronic database search was performed in PubMed, EMBASE, and the Cochrane Library to identify all relevant trials. Pragmatism was evaluated retrospectively on 9 domains: eligibility, recruitment, setting, organization, flexibility (delivery and adherence), follow-up, primary outcome, and primary analysis.
RESULTS
Of the 1862 studies included, 15 met the inclusion criteria. On average, studies scored between equally pragmatic/explanatory and rather pragmatic (M = 3.59, standard deviation [SD] = 0.56). Lowest ratings were seen for setting (M = 2.80, SD = 1.66) and eligibility (M = 3.20, SD = 1.66). Highest scores of pragmatism were given to analysis (M = 4.67, SD = 0.82) and intervention organization (M = 4.60, SD = 1.06). There was no significant difference between studies based on number of patients included, main subject, or publication year.
CONCLUSIONS
Pediatric neurosurgical RCTs scored reasonably well on overall pragmatism. In the future, there will be a greater need for pragmatic controlled trials in pediatric neurosurgery to bridge the divide between real-life data and reliable methodological quality. There is an opportunity to develop further applications of pragmatism tailored to surgical interventions.
Topics: Child; Databases, Factual; Humans; Neurosurgery; Neurosurgical Procedures; PubMed
PubMed: 35505562
DOI: 10.1016/j.wneu.2021.09.124 -
The Lancet. Digital Health May 2022Containing the COVID-19 pandemic requires rapidly identifying infected individuals. Subtle changes in physiological parameters (such as heart rate, respiratory rate, and... (Review)
Review
Containing the COVID-19 pandemic requires rapidly identifying infected individuals. Subtle changes in physiological parameters (such as heart rate, respiratory rate, and skin temperature), discernible by wearable devices, could act as early digital biomarkers of infections. Our primary objective was to assess the performance of statistical and algorithmic models using data from wearable devices to detect deviations compatible with a SARS-CoV-2 infection. We searched MEDLINE, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (known as CENTRAL), International Clinical Trials Registry Platform, and ClinicalTrials.gov on July 27, 2021 for publications, preprints, and study protocols describing the use of wearable devices to identify a SARS-CoV-2 infection. Of 3196 records identified and screened, 12 articles and 12 study protocols were analysed. Most included articles had a moderate risk of bias, as per the National Institute of Health Quality Assessment Tool for Observational and Cross-Sectional Studies. The accuracy of algorithmic models to detect SARS-CoV-2 infection varied greatly (area under the curve 0·52-0·92). An algorithm's ability to detect presymptomatic infection varied greatly (from 20% to 88% of cases), from 14 days to 1 day before symptom onset. Increased heart rate was most frequently associated with SARS-CoV-2 infection, along with increased skin temperature and respiratory rate. All 12 protocols described prospective studies that had yet to be completed or to publish their results, including two randomised controlled trials. The evidence surrounding wearable devices in the early detection of SARS-CoV-2 infection is still in an early stage, with a limited overall number of studies identified. However, these studies show promise for the early detection of SARS-CoV-2 infection. Large prospective, and preferably controlled, studies recruiting and retaining larger and more diverse populations are needed to provide further evidence.
Topics: COVID-19; Cross-Sectional Studies; Humans; Pandemics; Prospective Studies; SARS-CoV-2; Wearable Electronic Devices
PubMed: 35461692
DOI: 10.1016/S2589-7500(22)00019-X -
Veterinary Surgery : VS Jul 2022To provide a systematic assessment of the efficacy of preoperative skin asepsis using chlorhexidine versus povidone-iodine based protocols for surgical site infection... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To provide a systematic assessment of the efficacy of preoperative skin asepsis using chlorhexidine versus povidone-iodine based protocols for surgical site infection (SSI) prevention in veterinary surgery.
STUDY DESIGN
Systematic meta-analytical review according to PRISMA-P guidelines.
SAMPLE POPULATION
Studies comparing preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery identified by systematic search between 1990 and 2020.
METHODS
A search using MEDLINE/Pubmed, Web of Science and CAB Abstracts was performed, followed by secondary searches of Google Scholar, Proquest Dissertation and Theses, and relevant bibliographic articles. Primary and secondary outcome measures were the efficacy of skin asepsis protocols using chlorhexidine versus povidone-iodine on SSI incidence and skin bacterial colonization, respectively. A meta-analysis was performed with a random-effect model, with effect size calculated as risk ratio (RR) or mean standard deviation (MSD) with 95% CI. Statistical significance was set at P < .05.
RESULTS
Among 1067 publications that met the initial search criteria, 9 relevant studies were eligible for analysis. No difference in the incidence of postoperative SSI or skin bacterial colonization between preoperative asepsis protocols using chlorhexidine versus povidone-iodine was found. Insufficient information and detail were frequent among studies and precluded a clear assessment of bias.
CONCLUSION
This study showed that asepsis protocols using chlorhexidine were comparable to povidone-iodine in preventing postoperative SSI and reducing skin bacterial colonization.
CLINICAL SIGNIFICANCE
Given the limitations of the studies that were included in terms of both quality and quantity, more high-quality randomized controlled trials are needed to confirm these conclusions.
Topics: Animals; Anti-Infective Agents, Local; Asepsis; Chlorhexidine; Clinical Protocols; Ethanol; Meta-Analysis as Topic; Povidone-Iodine; Preoperative Care; Surgery, Veterinary; Surgical Wound Infection
PubMed: 35437786
DOI: 10.1111/vsu.13810 -
Disability and Rehabilitation Apr 2023Some parents of children with DMD find their role challenging, affecting quality of life. To inform support methods, we aimed to understand the lived experiences of...
PURPOSE
Some parents of children with DMD find their role challenging, affecting quality of life. To inform support methods, we aimed to understand the lived experiences of parents and how these interact with disease progression.
MATERIALS AND METHODS
PRISMA informed protocol development. Qualitative and mixed methods studies were included. Four databases were searched and study quality was assessed using a standardised measure. Extracted data were analysed using thematic synthesis.
RESULTS
26 studies were included, comprising 362 parents. Seven descriptive themes were apparent: "Diagnostic Experiences", "Coping with the Caregiver Role", "Illness Trajectory and Associated Interventions", "Family Communication", "Network of Support", "Navigating Systems" and "Transition Experiences". Four analytical themes were then derived: "The Cyclical Nature of Grief", "Lifelong Expert in the Needs and Experiences of an Individual with DMD", "Navigating Deviation from Typical Life Course" and "Uncertainty as Ever Present".
CONCLUSION
The extant evidence suggests that the experience of parenting a child with DMD is often characterised by: a cycle of grief that begins at diagnosis, which runs parallel to the development of expertise in caregiving; within this parents notice deviations from their child's and their own expected life course and adjust to the emotions and uncertainty that this can bring.IMPLICATIONS FOR REHABILITATIONProfessionals should be cognisant to the complex grief process associated with DMD, which occurs from diagnosis onwards.There should be continued support for parents following bereavement.Peer support groups may also offer parents ways to maintain well-being.The necessity for parents to function effectively within an uncertain context that induces challenging emotions suggests a role for psychological therapies.
Topics: Child; Humans; Quality of Life; Muscular Dystrophy, Duchenne; Parents; Parenting; Adaptation, Psychological
PubMed: 35435109
DOI: 10.1080/09638288.2022.2060336