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Rheumatology International Jun 2024This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions for managing osteoarthritis symptoms,...
This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions for managing osteoarthritis symptoms, including joint pain and joint function. JBI guidelines were followed. 17 databases were searched for randomised controlled trials (RCTs) assessing yoga's effectiveness on osteoarthritis symptoms. Meta-analyses and a narrative synthesis were conducted to address the objective. The systematic review and meta-analysis included 18 and 16 articles (representing 16 and 14 RCTs), respectively. Overall, the included studies had low methodological quality scores. 10 of 14 yoga interventions effectively reduced pain (standardised mean difference (SMD) - 0.70; 95% confidence interval (CI) - 1.08, - 0.32) and/or improved function (- 0.40; - 0.75, - 0.04). Notably, 8 effective interventions had centre-based (supervised, group) sessions, and 6 included additional home-based (unsupervised, individual) sessions. Effective interventions included 34 yogic poses (12 sitting, 10 standing, 8 supine, 4 prone), 8 breathing practices, and 3 meditation and relaxation practices. 8 interventions included yogic poses, and 7 also incorporated breathing practices and/or meditation and relaxation practices. 4 interventions included yogic pose modifications for osteoarthritis. The median duration of centre-based sessions was 8 weeks and each session was around 53 min, mostly delivered once a week. The median duration of home-based sessions was 10 weeks and each session was 30 min, usually instructed to practice 4 times a week. Given previous studies' limitations, a high-quality long-term RCT should be conducted using synthesised findings of previous effective yoga interventions.
PubMed: 38935121
DOI: 10.1007/s00296-024-05652-y -
Journal of Diabetes and Metabolic... Jun 2024fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples`... (Review)
Review
INTRODUCTION
fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples` relationship or satisfaction. Thus, this systematic review and meta-analysis study was aimed to investigate the global prevalence of sexual dysfunction in men with thyroid gland disorders (TGD).
METHODS
this systematic review and meta-analysis study conducted based on PRISMA statement criteria regarding the available evidences representing the prevalence of sexual dysfunction in men with TGD. The initial searching process was applied on July, 2023. In this era, the main keywords of "Prevalence", "Sexual disorders", "Sexual disorder", "Sexual dysfunction", "Male sexual dysfunction", "Erectile dysfunction", "Males", "Men", "Thyroid disorders", "Thyroid diseases", "Hyperthyroidism", "Thyroid", and "Thyroiditis" were hired. Also, "AND" and "OR" operators were used for keywords combination. All intended studies were searched using the databases of Web of Science, Google Scholar, Scopus, ScienceDirect, PubMed, and Embase. Random effects model was used to perform the analysis and the heterogeneity of the studies was assessed through I index. Data analysis was applied with CMA software (v.2).
RESULTS
following the assessment of 17 eligible studies with a sample size of 501 individuals, the global prevalence of male sexual dysfunction with TGD was found 51.5% (95% CI:38.7-64). Also, the prevalence of male sexual dysfunction in hypothyroidism and hyperthyroidism cases was 59.1% (95% CI:37.2-77.8) and 41.5% (95% CI:25.9-59.1), respectively. The meta-regression analysis showed that following incremental trend in sample size, the global prevalence of male sexual dysfunction with TGD decreases. This assessment also revealed that the prevalence of male sexual dysfunction increases with the year of study conduction, significantly ( < 0.05).
CONCLUSION
the global prevalence of sexual dysfunction in men with TGD was found relatively high. also, the highest prevalence of sexual disorders was reported in hypothyroid cases. Thus, health policymakers are suggested to inform the individuals prone to this pathology regarding the negative effects of TGD on sexual dysfunction. Besides, TGD-affected cases can prevent sexual disorders and unpleasant consequences through timely medical treatments.
PubMed: 38932831
DOI: 10.1007/s40200-024-01408-4 -
Diagnostics (Basel, Switzerland) May 2024Neck infections are often prone to being underestimated and can manifest insidiously. The spread of infection can lead to translocation into thoracic areas, causing... (Review)
Review
Neck infections are often prone to being underestimated and can manifest insidiously. The spread of infection can lead to translocation into thoracic areas, causing descending necrotizing mediastinitis (DNM). However, the application of the post-mortem approach in such cases is not well-described in the literature. A literature review was carried out according to the PRISMA methods. Nine papers were included in the final review, revealing different levels of involvement of neck layers that can be linked to different causes. Expertise with respect to the anatomy of the fasciae and spaces of the neck enables an understanding of the pathogenesis of DNM. However, a clear autoptic description was not provided in any of the articles. Therefore, we also employed a practical post-mortem approach to cases of death due to DNM. It is fundamental for pathologists to identify the exact head and neck structures involved. Providing dissectors with support from an otolaryngologist could be useful. This paper could help address such difficult cases.
PubMed: 38893677
DOI: 10.3390/diagnostics14111150 -
Otolaryngology--head and Neck Surgery :... Jun 2024To compare the postoperative complications of the fibular free flap (FFF), scapula free flap (SFF), and osteocutaneous radial forearm free flap (OCRFFF) following... (Review)
Review
OBJECTIVE
To compare the postoperative complications of the fibular free flap (FFF), scapula free flap (SFF), and osteocutaneous radial forearm free flap (OCRFFF) following osseous reconstruction in the head and neck.
DATA SOURCES
PUBMED, EMBASE, Cochrane.
REVIEW METHODS
A literature search and systematic review were performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A meta-analysis of proportions was conducted using a random effects model to compare operative time and postoperative complications.
RESULTS
The systematic review identified 26 studies comparing at least 1 variable of interest. The odds ratio estimates favored reduced rates of flap failure with the OCRFFF when compared to FFF (0.7, confidence interval [CI]: 0.29-1.11, P < .001), while FFF and SFF were similar. The mean difference estimates for operative time significantly favored FFF over SFF (-51.04 minutes, CI: -92.73 to -9.35, P = .016) and OCRFFF over FFF (66.77 minutes, CI: 52.74-80.8, P < .001). The FFF was more prone to hardware exposure, longer hospital stays, and donor site complications. Recipient wound complications and fistula rates were similar for all flap types.
CONCLUSION
Depending on the clinical context, the OCRFFF, FFF, and SFF are all robust options for reconstruction in the head and neck. The OCRFFF is associated with a reduced rate of flap failure and shorter operative times. The SFF requires longer operative times, although significant variation was observed between institutions. The FFF has broad reconstructive indications but is associated with more perioperative and long-term complications.
PubMed: 38881407
DOI: 10.1002/ohn.793 -
Scientific Reports Jun 2024To elucidate the correlation of HIF1A with clinicopathologic characteristics in patients with gastric cancer (GC), we conducted a systematic review and meta-analysis. We... (Meta-Analysis)
Meta-Analysis
To elucidate the correlation of HIF1A with clinicopathologic characteristics in patients with gastric cancer (GC), we conducted a systematic review and meta-analysis. We searched PubMed, Embase and Web of Science for studies on GC and HIF1A, covering studies published until January 31st, 2022. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for clinical characteristics based on high and low HIF1A protein levels. We used random-effects and fixed-effects meta-analysis methods to determine mean effect sizes of ORs and evaluated publication heterogeneity with τ, I, and Q values. Additionally, we generated funnel plots to inspect publication bias. Our meta-analysis included 20 publications with 3416 GC patients to estimate the association between high or low HIF1A expression and clinical characteristics. Positive HIF1A expression was significantly associated with T stage progression (OR: 2.46; 95% CI 1.81-3.36; P < 0.01), TNM stage progression (OR: 2.50; 95% CI 1.61-3.87; P < 0.01), lymph node metastasis (OR: 2.06; 95% CI 1.44-2.94; P < 0.01), undifferentiated status (OR: 1.83; 95% CI 1.45-2.32; P < 0.01), M stage progression (OR: 2.34; 95% CI 1.46-3.77; P < 0.01), Borrmann stage progression (OR: 1.48; 95% CI 1.02-2.15; P = 0.04), larger tumor size (OR: 1.27; 95% CI 1.06-1.52; P < 0.01), vascular invasion (OR: 1.94; 95% CI 1.38-2.72; P < 0.01), and higher vascular endothelial growth factor (VEGF) protein expression (OR: 2.61; 95% CI 1.79-3.80; P < 0.01) in our meta-analysis. GC Patients highly expressing HIF1A protein might be prone to tumor progression, poorly differentiated GC cell types, and a high VEGF expression.
Topics: Stomach Neoplasms; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Lymphatic Metastasis; Biomarkers, Tumor; Neoplasm Staging; Vascular Endothelial Growth Factor A; Gene Expression Regulation, Neoplastic
PubMed: 38877062
DOI: 10.1038/s41598-024-63019-6 -
Intensive Care Medicine Jun 2024Severe acute respiratory distress syndrome (ARDS) with PaO/FiO < 80 mmHg is a life-threatening condition. The optimal management strategy is unclear. The aim of...
Comparison of venovenous extracorporeal membrane oxygenation, prone position and supine mechanical ventilation for severely hypoxemic acute respiratory distress syndrome: a network meta-analysis.
PURPOSE
Severe acute respiratory distress syndrome (ARDS) with PaO/FiO < 80 mmHg is a life-threatening condition. The optimal management strategy is unclear. The aim of this meta-analysis was to compare the effects of low tidal volumes (V), moderate V, prone ventilation, and venovenous extracorporeal membrane oxygenation (VV-ECMO) on mortality in severe ARDS.
METHODS
We performed a frequentist network meta-analysis of randomised controlled trials (RCTs) with participants who had severe ARDS and met eligibility criteria for VV-ECMO or had PaO/FiO < 80 mmHg. We applied the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology to discern the relative effect of interventions on mortality and the certainty of the evidence.
RESULTS
Ten RCTs including 812 participants with severe ARDS were eligible. VV-ECMO reduces mortality compared to low V (risk ratio [RR] 0.77, 95% confidence interval [CI] 0.59-0.99, moderate certainty) and compared to moderate V (RR 0.75, 95% CI 0.57-0.98, low certainty). Prone ventilation reduces mortality compared to moderate V (RR 0.78, 95% CI 0.66-0.93, high certainty) and compared to low V (RR 0.81, 95% CI 0.63-1.02, moderate certainty). We found no difference in the network comparison of VV-ECMO compared to prone ventilation (RR 0.95, 95% CI 0.72-1.26), but inferences were based solely on indirect comparisons with very low certainty due to very wide confidence intervals.
CONCLUSIONS
In adults with ARDS and severe hypoxia, both VV-ECMO (low to moderate certainty evidence) and prone ventilation (moderate to high certainty evidence) improve mortality relative to low and moderate V strategies. The impact of VV-ECMO versus prone ventilation remains uncertain.
PubMed: 38842731
DOI: 10.1007/s00134-024-07492-7 -
Minerva Cardiology and Angiology Jun 2024Lipoprotein(a) (Lp[a]) is a variant of low-density lipoprotein (LDL) and has been associated with increased risk of vascular inflammation and thrombosis. Coronary artery...
INTRODUCTION
Lipoprotein(a) (Lp[a]) is a variant of low-density lipoprotein (LDL) and has been associated with increased risk of vascular inflammation and thrombosis. Coronary artery bypass grafting (CABG) has been associated with local inflammation of the myocardium. It is plausible, therefore, that patients with elevated baseline Lp(a) may be prone to unfavorable clinical outcomes following CABG. We evaluate differences in outcomes between CABG patients with high and low serum Lp(a) in this meta-analysis.
EVIDENCE ACQUISITION
A comprehensive literature search was performed to identify studies reporting outcomes in CABG patients stratified by preoperative Lp(a) level. When possible, the outcomes were pooled in a meta-analysis. We assessed post-operative mortality, major cardiovascular events, stroke occurrence and saphenous graft occlusion.
EVIDENCE SYNTHESIS
Eight studies involving 8681 patients were included. Articles used varying cut-offs for high versus low Lp(a), and outcomes varied. In the three studies evaluating mortality, two showed no statistically significant difference between groups while one reported increased mortality associated with high Lp(a) level. Both studies investigating major adverse cardiovascular events reported higher risk in patients with high Lp(a). A study-level meta-analysis of four studies reporting saphenous vein graft occlusion incidence after CABG was performed. High (≥30 mg/dL) preoperative Lp(a) was not associated with an increased risk of graft occlusion compared with low (<30 mg/dL) preoperative Lp(a) (OR=1.88, 95% CI: 0.66-5.36; P=0.15).
CONCLUSIONS
Studies evaluating the impact of Lp(a) on outcomes in CABG patients are few, with heterogenous cut-offs and outcomes. In the limited published studies, Lp(a) level was not associated with graft occlusion.
PubMed: 38842243
DOI: 10.23736/S2724-5683.24.06534-7 -
Heliyon Jun 2024In recent years, the combination of targeted drugs, such as Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, with endocrine therapy (ET), has emerged as a new research...
BACKGROUND
In recent years, the combination of targeted drugs, such as Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, with endocrine therapy (ET), has emerged as a new research focus in the treatment of hormone receptor-positive (HR+) human epidermal growth factor receptor 2 negative (HER2-) breast cancer. This network meta-analysis aimed to systematically evaluate the efficacy and safety of CDK4/6 inhibitors combined with ET for HR+/HER2-breast cancer.
METHODS
A systematic search was conducted across PubMed, Web of Science, Cochrane Library, and GeenMedical databases to identify randomized controlled trials investigating the use of CDK4/6 inhibitors in combination with endocrine therapy for the treatment of HR+/HER2-breast cancer. The search period spanned from the inception of each database up to February 29, 2024. Data analysis was conducted using Stata 14.0 and R 4.1.0 software.
RESULTS
A total of 20 randomized controlled trials (RCTs) were included in this study, investigating the effectiveness of four CDK4/6 inhibitors-Abemaciclib, Dalpiciclib, Ribociclib, and Palbociclib-when combined with ET for the treatment of HR+/HER2-breast cancer. The results indicated that Abemaciclib + ET, Dalpiciclib + ET, Palbociclib + ET, and Ribociclib + ET exhibited similar therapeutic effects in terms of improving objective response rate (ORR), disease control rate (DCR) and reducing the occurrence of fatigue, all of which were superior to ET alone. However, in terms of prolonging progression-free survival (PFS) and overall survival (OS), Dalpiciclib + ET significantly improved PFS compared to Ribociclib + ET, Palbociclib + ET, Abemaciclib and Palbociclib. Ribociclib + ET significantly improved OS compared to Palbociclib + ET. Regarding overall adverse reaction events (AREs), Dalpiciclib + ET had a higher incidence compared to Ribociclib + ET. The incidence of neutropenia caused by Dalpiciclib + ET was significantly higher compared to Palbociclib + ET, Ribociclib + ET, Abemaciclib, and Palbociclib. Abemaciclib + ET demonstrated the worst safety profile concerning diarrhea.
CONCLUSION
Abemaciclib + ET likely represents the most effective option in terms of therapeutic effects, but it is prone to causing diarrhea and fatigue. On the other hand, Dalpiciclib + ET likely demonstrates the best efficacy in terms of PFS but exhibits the poorest safety profile, particularly in relation to neutropenia. Therefore, clinicians should exercise increased vigilance in monitoring and managing adverse effects when prescribing Abemaciclib + ET and Dalpiciclib + ET.
PubMed: 38832268
DOI: 10.1016/j.heliyon.2024.e31583 -
Age and Ageing Jun 2024Older adults make up half of those with cancer and are prone to mood disorders, such as depression and severe anxiety, resulting in negative repercussions on their... (Meta-Analysis)
Meta-Analysis
Educational interventions to reduce depression and anxiety in older adults with cancer in the community: a systematic review, meta-analysis and meta-regression of randomised controlled trials.
BACKGROUND
Older adults make up half of those with cancer and are prone to mood disorders, such as depression and severe anxiety, resulting in negative repercussions on their health-related quality-of-life (HRQOL). Educational interventions have been shown to reduce adverse psychological outcomes. We examined the effect of educational interventions on the severity of psychological outcomes in older adults with cancer (OAC) in the community.
METHOD
This PRISMA-adherent systematic review involved a search of PubMed, MedLine, Embase and PsycINFO for randomised controlled trials (RCTs) that evaluated educational interventions impacting the severity of depression, anxiety and HRQOL in OAC. Random effects meta-analyses and meta-regressions were used for the primary analysis.
RESULTS
Fifteen RCTs were included. Meta-analyses showed a statistically insignificant decrease in the severity of depression (SMD = -0.30, 95%CI: -0.69; 0.09), anxiety (SMD = -0.30, 95%CI: -0.73; 0.13) and improvement in overall HRQOL scores (SMD = 0.44, 95%CI: -0.16; 1.04). However, subgroup analyses revealed that these interventions were particularly effective in reducing the severity of depression and anxiety in specific groups, such as OAC aged 60-65, those with early-stage cancer, those with lung cancer and those treated with chemotherapy. A systematic review found that having attained a higher education and income level increased the efficacy of interventions in decreasing the severity of adverse psychological outcomes.
CONCLUSION
Although overall meta-analyses were statistically insignificant, subgroup meta-analyses highlighted a few specific subgroups that the educational interventions were effective for. Future interventions can be implemented to target these vulnerable groups.
Topics: Humans; Neoplasms; Depression; Randomized Controlled Trials as Topic; Anxiety; Aged; Quality of Life; Male; Patient Education as Topic; Female; Age Factors; Middle Aged; Treatment Outcome; Aged, 80 and over; Mental Health
PubMed: 38821857
DOI: 10.1093/ageing/afae111 -
Heliyon May 2024Seismic activities pose significant challenges to societies globally. Therefore, it is crucial to understand their occurrence, patterns, and impacts. By studying seismic...
Seismic activities pose significant challenges to societies globally. Therefore, it is crucial to understand their occurrence, patterns, and impacts. By studying seismic activities, including earthquakes, researchers can investigate their occurrence, distribution, and characteristics which can provide effective management and risk reduction strategies. The southern part of Ghana is prone to earthquakes and this study aims to shed more light into the nature of seismic events in the area and country at large. A systematic review was conducted using the PRISMA technique across three electronic databases (SCOPUS, Dimensions and Google Scholar) to identify relevant studies published between 2000 and 2023. Extraction of data and quality assessment were performed in order to ensure reliability and validity of included studies. Results identified only 17 papers from published records to meet the inclusion criteria. Despite the grave threat earthquakes pose to vital infrastructure and human life in Ghana, research in this area remains remarkably deficient. Our findings underscore the urgent need for further study given the catastrophic potential of seismic disasters in the region. Moreover, upon scrutinizing the methodologies deployed in extant literature concerning seismic activity in Ghana, a recurring constraint that emerged was the scarce availability of data. In essence, this study offers an indispensable panorama of earthquake research in Ghana, bridging the existing knowledge chasm on seismic phenomena in the region. The insights gleaned from this review promise to fortify our comprehension of Ghana's seismic activities, thereby bolstering the country's capabilities for more effective preparedness and response strategies.
PubMed: 38803987
DOI: 10.1016/j.heliyon.2024.e31536