-
Clinical Autonomic Research : Official... Dec 2023Increasing evidence demonstrates that gender-related factors, and not only biological sex, are relevant in the physiological and pathophysiological mechanisms of the... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Increasing evidence demonstrates that gender-related factors, and not only biological sex, are relevant in the physiological and pathophysiological mechanisms of the cardiovascular system, including the cardiac autonomic regulation. Sex and gender may also affect daytime and night-time cardiac autonomic control. This meta-analysis aimed to provide a comparison between healthy women and men on heart rate variability using 24-h ECG recordings pointing out sex- and gender-related factors.
METHODS
A systematic search was conducted to include studies focusing on both sex and gender differences related to heart rate variability indices in the time and frequency domains. Descriptive data were extracted by two independent reviewers. For each index, standardized mean differences with 95% confidence intervals were computed and a pooled estimate using a fixed- or random-effects model was applied.
RESULTS
Twenty-seven studies were included in the meta-analysis. The results showed that only seven studies reported some information about gender-related factors. Concerning sex-related differences, women had a shorter mean RR interval and lower variability of the time domain indices than men. Sex-related differences concerning frequency domain indices were more evident during night-time compared to daytime.
CONCLUSION
The characterization of gender-related factors in the study of heart rate variability using 24-h ECG recordings is still sporadic and underexplored. The meta-analysis results could not conclusively support a significant increase of high frequency power in women, although women showed a reduced total power and low frequency to high frequency ratio. There is a strong need for considering heart rate variability in relation to gender-related variables.
Topics: Male; Humans; Female; Heart Rate; Heart; Autonomic Nervous System; Sex Factors; Electrocardiography
PubMed: 37541968
DOI: 10.1007/s10286-023-00969-3 -
International Journal of Molecular... Jul 2023The observation of neurogenic fever resulting from subarachnoid hemorrhage (SAH) in animal models is a useful tool for the interpretation of its pathophysiology in... (Review)
Review
The observation of neurogenic fever resulting from subarachnoid hemorrhage (SAH) in animal models is a useful tool for the interpretation of its pathophysiology in humans, which is still a major challenge in the management of neurocritical patients. This systematic review aims to identify the prognostic factors and pathophysiological elements that determine the onset of neurogenic fever and its severity in animal models. In addition, our study aims to analyze which pharmacological treatments are most effective. All the articles available in Pubmed, Embase, and the Biological Science Collection until August 2021 concerning in vivo experimental studies on SAH animal models, including full texts and abstracts written in English and Italian, were considered. The risk of bias was assessed with SYRCLE's Risk of Bias tool. In total, 81 records were retrieved; after excluding duplicates, 76 records were potentially relevant. A total of 64 articles was excluded after title and abstract screening. The remaining 12 studies were evaluated as full texts, and 6 other studies were excluded (SAH-induced animal studies without a body temperature assessment). In one study, body temperature was measured after SAH induction, but the authors did not report temperature recording. Therefore, only five studies met the search criteria. The high methodological heterogeneity (different animal species, different temperature measurement methods, and different methods of the induction of bleeding) prevented meta-analysis. Synthesis methodology without meta-analysis (SWiM) was used for data analysis. The total number of animals used as controls was 87 (23 rabbits, 32 mice, and 32 rats), while there were 130 animals used as interventions (54 rabbits, 44 mice, and 32 rats). The presence of blood in the subarachnoid space, particularly red blood cells, is responsible for neurogenic fever; the role of hemoglobin is unclear. The mechanism is apparently not mediated by prostaglandins. The autonomic nervous system innervating brown adipose tissue is undoubtedly implicated in the onset of neurogenic fever. The activation of the central adenosine-1 receptor is effective in controlling the temperature of animals with neurogenic fever (by inhibiting thermogenesis of brown adipose tissue).
Topics: Humans; Rats; Mice; Rabbits; Animals; Subarachnoid Hemorrhage; Autonomic Nervous System; Disease Models, Animal
PubMed: 37511267
DOI: 10.3390/ijms241411514 -
Pharmaceutical Biology Dec 2023Chaihu Jia Longgu Muli Decoction (CLMD) is a traditional Chinese medicine for treating depression. (Meta-Analysis)
Meta-Analysis Review
Effect-enhancing and toxicity-reducing effects of Chaihu Jia Longgu Muli decoction in the treatment of multimorbidity with depression: a systematic review and meta-analysis.
CONTEXT
Chaihu Jia Longgu Muli Decoction (CLMD) is a traditional Chinese medicine for treating depression.
OBJECTIVE
This study investigated the effect of CLMD combined with antidepressants on multimorbidity with depression (MMD).
METHOD
Published randomized controlled trials were collected from PubMed, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal, Wanfang and China Biomedical Literature Service System Databases. Participants were divided into study groups (CLMD combined with antidepressants) and control groups (antidepressants). RevMan5.4 software was used for data analysis.
RESULTS
Hamilton's Depression Scale score was significantly lower (MD = -5.62, 95%CI [-5.86, -5.37], < 0.00001), and the effective rate was significantly higher (RR = 1.23, 95%CI [1.17, 1.29], < 0.00001) in study groups. National Institute of Health Stroke Scale score and Pittsburgh Sleep Quality Index score of study groups were significantly lower (MD = -2.82, 95%CI [-3.84, -1.81], < 0.00001; MD = -2.26, 95%CI [-3.19, -1.34], < 0.00001). 5-HT, DA, NE and IL-1β level were significantly lower (SMD = 1.99, = 0.003; SMD = 1.99, < 0.00001; SMD = 0.86, < 0.00001; MD = -14.64, = 0.003) in study groups. Adverse reaction rate in study groups was significantly lower (RR = 0.47, 95%CI [0.24, 0.91], = 0.03). The gastrointestinal tract and autonomic nervous system disorders were reduced in study groups.
DISCUSSION AND CONCLUSIONS
CLMD combined with antidepressants enhances the effect of antidepressants and reduces their adverse reactions, performing a synergistic effect; it may be considered as an effective option in the treatment of MMD.
Topics: Humans; Depression; Medicine, Chinese Traditional; Multimorbidity
PubMed: 37439185
DOI: 10.1080/13880209.2023.2228356 -
Neurosurgical Review Jul 2023Proton beam therapy is considered, by some authors, as having the advantage of delivering dose distributions more conformal to target compared with stereotactic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Proton beam therapy is considered, by some authors, as having the advantage of delivering dose distributions more conformal to target compared with stereotactic radiosurgery (SRS). Here, we performed a systematic review and meta-analysis of proton beam for VSs, evaluating tumor control and cranial nerve preservation rates, particularly with regard to facial and hearing preservation.
METHODS
We reviewed, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) articles published between 1968 and September 30, 2022. We retained 8 studies reporting 587 patients.
RESULTS
Overall rate of tumor control (both stability and decrease in volume) was 95.4% (range 93.5-97.2%, p heterogeneity= 0.77, p<0.001). Overall rate of tumor progression was 4.6% (range 2.8-6.5%, p heterogeneity < 0.77, p<0.001). Overall rate of trigeminal nerve preservation (absence of numbness) was 95.6% (range 93.5-97.7%, I = 11.44%, p heterogeneity= 0.34, p<0.001). Overall rate of facial nerve preservation was 93.7% (range 89.6-97.7%, I = 76.27%, p heterogeneity<0.001, p<0.001). Overall rate of hearing preservation was 40.6% (range 29.4-51.8%, I = 43.36%, p heterogeneity= 0.1, p<0.001).
CONCLUSION
Proton beam therapy for VSs achieves high tumor control rates, as high as 95.4%. Facial rate preservation overall rates are 93%, which is lower compared to the most SRS series. Compared with most currently reported SRS techniques, proton beam radiation therapy for VSs does not offer an advantage for facial and hearing preservation compared to most of the currently reported SRS series.
Topics: Humans; Neuroma, Acoustic; Proton Therapy; Hearing; Cranial Nerves; Facial Nerve; Radiosurgery; Treatment Outcome; Follow-Up Studies; Retrospective Studies
PubMed: 37402894
DOI: 10.1007/s10143-023-02060-x -
Brain Sciences May 2023In recent years, there has been an increase in the prevalence of mental disorders connected with affective dysregulation and insecure attachment. Therefore, it is even... (Review)
Review
In recent years, there has been an increase in the prevalence of mental disorders connected with affective dysregulation and insecure attachment. Therefore, it is even more important to understand the interplay between an individual's attachment representation and patterns of emotion regulation. To our knowledge, this is the first systematic review to examine this association. PsycInfo, PsyArticles, and PubMed were searched for studies that examined attachment-related differences in emotion regulation in adults. To examine the unconscious attachment representation, only studies using the Adult Attachment Interview or the Adult Attachment Projective Picture System were included. Thirty-seven peer-reviewed studies (with a total of 2006 subjects) matched the PICO criteria. Emotion regulation was measured via four objective approaches: autonomic nervous system, brain activity, biochemistry, or nonverbal behavior. Across all measurements, results reveal a significant correlation between attachment representation and emotion regulation. Secure attachment correlates consistently with balanced emotion regulation, whereas it is impaired in insecure and dysfunctional in unresolved attachment. Specifically, unresolved individuals display counterintuitive responses and fail to use attachment as a resource. Insecure-dismissing attachment is associated with an emotionally deactivating strategy, while on a physiological, biochemical, and nonverbal level, emotional stress is still present. There is still a lack of studies examining preoccupied individuals. In addition to interpreting the results, we also discuss the risk of bias, implications for psychotherapy and coaching, and an outlook for future research.
PubMed: 37371364
DOI: 10.3390/brainsci13060884 -
International Journal of Surgery... Jul 2023Thyroid disease is a common endocrine disorder, and thyroid surgeries and postoperative complications have increased recently. This study aimed to explore the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Thyroid disease is a common endocrine disorder, and thyroid surgeries and postoperative complications have increased recently. This study aimed to explore the effectiveness of intraoperative nerve monitoring (IONM) in endoscopic thyroid surgery using subgroup analysis and determine confounding factors.
MATERIALS AND METHODS
Two researchers individually searched for relevant studies published till November 2022 in the PubMed, Embase, Web of Science and Cochrane Library databases. Eventually, eight studies met the inclusion criteria. Heterogeneity was assessed using the Cochran's Q test, and a funnel plot was implemented to evaluate publication bias. The odds ratio or risk difference were calculated using fixed-effects models. The weighted mean difference of continuous variables was calculated. Subgroup analysis was performed according to the disease type.
RESULTS
Eight eligible papers included 915 patients and 1242 exposed nerves. The frequencies of transient, permanent and total recurrent laryngeal nerve (RLN) palsy were 2.64, 0.19 and 2.83%, respectively, in the IONM group and 6.15, 0.75 and 6.90%, respectively, in the conventional exposure group. In addition, analysis of the secondary outcome indicators for the average total length of surgery, localisation time of the RLN, recognition rate of the superior laryngeal nerve and length of incision revealed that IONM reduced the localisation time of the RLN and increased the identification rate of the superior laryngeal nerve. Subgroup analysis showed that IONM significantly reduced the incidence of RLN palsy in patients with malignancies.
CONCLUSIONS
The use of IONM significantly reduced the incidence of transient RLN palsy during endoscopic thyroid surgery, but it did not significantly reduce the incidence of permanent RLN palsy. However, the reduction in the total RLN palsy was statistically significant. In addition, IONM can effectively reduce the location time of the RLN and increase the recognition rate of the superior laryngeal nerve. Therefore, the application of IONM for malignant tumours is recommended.
Topics: Humans; Thyroid Gland; Thyroidectomy; Recurrent Laryngeal Nerve; Monitoring, Intraoperative; Recurrent Laryngeal Nerve Injuries; Vocal Cord Paralysis
PubMed: 37318897
DOI: 10.1097/JS9.0000000000000393 -
Journal of Occupational Health 2023To examine the effect of 24-h shift work on autonomic nervous system function via heart rate variability (HRV) methodologies. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To examine the effect of 24-h shift work on autonomic nervous system function via heart rate variability (HRV) methodologies.
METHODS
Electronic databases (indexed in either PubMed, MEDLINE, CINAHL, SPORTDiscus, or OpenDissertations) were searched from January 1964 to March 2023. A modified Downs and Black checklist was used for assessing methodological quality and the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the quality of evidence. Study design, study population, study sample, shift work description, and assessment of HRV metrics and methods were extracted from each study.
FINDINGS
A total of 58 478 study articles were identified, of which 12 articles met inclusion criteria. Sample sizes varied from eight to 60 participants, with the ratio of low- to high-frequency HRV (LF/HF) as the most common frequency-domain variable reported. Of the nine included studies that observed LF/HF, three (33.3%) demonstrated a significant increase after 24-h shift work. Moreover, of the five studies that reported HF, two (40%) noted a significant decrease after 24-h shift work. When observing risk of bias, two (16.6%) studies were low quality, five (41.7%) were moderate quality, and five (41.7%) were high quality.
INTERPRETATION
There were inconsistent findings demonstrating an effect of 24-h shift work on autonomic function, with a suggested shift away from parasympathetic dominance. Discrepancies in HRV methodologies, such as the duration of recordings and hardware used for measurement, may have contributed to the disparity in findings. In addition, differences in roles and responsibilities across occupations may explain the incongruence in findings across studies.
Topics: Humans; Shift Work Schedule; Occupations; Heart Rate
PubMed: 37287085
DOI: 10.1002/1348-9585.12409 -
Italian Journal of Dermatology and... Jun 2023The human skin barrier is structurally and functionally immature at birth, with elevated skin surface pH, lower lipid content, and lower resistance to chemicals and...
The human skin barrier is structurally and functionally immature at birth, with elevated skin surface pH, lower lipid content, and lower resistance to chemicals and pathogens. Infants at risk for atopic dermatitis (AD) may present with xerosis almost immediately after birth. The current algorithm on skincare for newborns and infants aims to promote a healthy skin barrier and potential mitigation of AD. The project used a modified Delphi hybrid process comprising face-to-face discussions followed by an online follow-up replacing a questionnaire. During the meeting, a panel of eight clinicians who treat newborns and infants discussed the systematic literature review results and a draft algorithm addressing non-prescription skincare for neonates and infants. Online the panel reviewed and adopted the algorithm using evidence coupled with the panel's expert opinion and clinical experience. The algorithm provides clinical information for pediatric dermatologists, dermatologists, and pediatric healthcare providers treating neonates and infants. The advisors adopted a scale based on clinical signs for the algorithm: 1) scaling/xerosis; 2) erythema; and 3) erosion/oozing. Skincare for newborns and infants includes: aim for a cool environment and soft cotton clothing, give lukewarm baths (~5 min, 2-3 x week) with consideration of a gentle cleanser (pH 4-6) and the application of a full-body moisturizing after bath, while avoiding products with toxic and irritating ingredients. A growing body of evidence recognizes the benefits of ongoing daily use of non-alkaline cleansers and moisturizers. Gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier when applied from birth onwards.
Topics: Humans; Infant; Infant, Newborn; Child; Dermatitis, Atopic; Skin; Skin Care; Erythema; Health Status; Autonomic Nervous System Diseases
PubMed: 37278500
DOI: 10.23736/S2784-8671.23.07336-X -
Interactive Journal of Medical Research Jun 2023The autonomic nervous system (ANS) is known as a critical regulatory system for pregnancy-induced adaptations. If it fails to function, life-threatening pregnancy... (Review)
Review
BACKGROUND
The autonomic nervous system (ANS) is known as a critical regulatory system for pregnancy-induced adaptations. If it fails to function, life-threatening pregnancy complications could occur. Hence, understanding and monitoring the underlying mechanism of action for these complications are necessary.
OBJECTIVE
We aimed to systematically review the literature concerned with the associations between heart rate variability (HRV), as an ANS biomarker, and pregnancy complications.
METHODS
We performed a comprehensive search in the PubMed, Medline Completion, CINAHL Completion, Web of Science Core Collection Classic, Cochrane Library, and SCOPUS databases in February 2022 with no time span limitation. We included studies concerned with the association between any pregnancy complications and HRV, with or without a control group. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used for the review of the studies, and Covidence software was used for the study selection process. For data synthesis, we used the guideline by Popay et al.
RESULTS
Finally, 12 studies with 6656 participants were included. Despite the methodological divergency that hindered a comprehensive comparison, our findings suggest that ANS is linked with some common pregnancy complications including fetal growth. However, existing studies do not support an association between ANS and gestational diabetes mellitus. Studies that linked pulmonary and central nervous system disorders with ANS function did not provide enough evidence to draw conclusions.
CONCLUSIONS
This review highlights the importance of understanding and monitoring the underlying mechanism of ANS in pregnancy-induced adaptations and the need for further research with robust methodology in this area.
PubMed: 37276013
DOI: 10.2196/44430 -
Scandinavian Journal of Pain Oct 2023Long-standing neck pain (LNP) is a clinical condition frequently encountered in the physical therapy clinic. LNP is a complex, multifactorial condition affecting...
OBJECTIVES
Long-standing neck pain (LNP) is a clinical condition frequently encountered in the physical therapy clinic. LNP is a complex, multifactorial condition affecting multiple body systems including the autonomic nervous system (ANS). Traditionally, research on the impact of physical therapy on LNP has focused on self-report measures and pain scales. Heart rate variability (HRV) is an objective measure of the ANS, allowing for quantification of effects of treatment. This systematic review is intended to evaluate if manual therapy acutely affects heart rate variability in adults with long-standing neck pain.
METHODS
Pubmed, Medline, CINAHL, Google Scholar, Web of Science, and Cochrane library were used to retrieve the randomized controlled trials for this review between the years 2010-2021. Search terms included: chronic neck pain, neck pain, cervical pain, manual therapy, mobilization, manipulation, osteopathy, osteopathic or chiropractic. Heart rate variability, HRV, heart rate variation, effects, outcomes, benefits, impacts or effectiveness.
RESULTS
Of 139 articles located and screened, three full-text articles were selected for full qualitative synthesis, with a combined population of 112 subjects, 91 of which were female, with an average age of 33.7 ± 6.8 years for all subjects. MT techniques in three studies were statistically significant in improving HRV in people with LNP; however, techniques were differed across studies, while one study showed no benefit. The studies were found to be of high quality with PEDro scores ≥6.
CONCLUSIONS
Although no clear cause and effect relationship can be established between improvement in HRV with manual therapy, results supported the use of MT for an acute reduction in HRV. No one particular method of MT has proven superior, MT has been found to produce a statistically significant change in HRV. These HRV changes are consistent with decreased sympathetic tone and subjective pain.
Topics: Adult; Female; Humans; Male; Neck Pain; Heart Rate; Musculoskeletal Manipulations; Neck; Chronic Pain
PubMed: 37261845
DOI: 10.1515/sjpain-2023-0006