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Urologia Nov 2023Most genitourinary tract cancers have a negative impact on male fertility. Although testicular cancers have the worst impact, other tumors such as prostate, bladder, and... (Review)
Review
Most genitourinary tract cancers have a negative impact on male fertility. Although testicular cancers have the worst impact, other tumors such as prostate, bladder, and penis are diagnosed early and treated in relatively younger patients in which couple fertility can be an important concern. The purpose of this review is to highlight both the pathogenetic mechanisms of damage to male fertility in the context of the main urological cancers and the methods of preserving male fertility in an oncological setting, in light of the most recent scientific evidence. A systematic review of available literature was carried out on the main scientific search engines, such as PubMed, Clinicaltrials.Gov, and Google scholar. Three hundred twenty-five relevant articles on this subject were identified, 98 of which were selected being the most relevant to the purpose of this review. There is a strong evidence in literature that all of the genitourinary oncological therapies have a deep negative impact on male fertility: orchiectomy, partial orchiectomy, retroperitoneal lymphadenectomy (RPLND), radical cystectomy, prostatectomy, penectomy, as well as radiotherapy, chemotherapy, and hormonal androgen suppression. Preservation of fertility is possible and includes cryopreservation, hormonal manipulation with GnRH analogs before chemotherapy, androgen replacement. Germ cell auto transplantation is an intriguing strategy with future perspectives. Careful evaluation of male fertility must be a key point before treating genitourinary tumors, taking into account patients' age and couples' perspectives. Informed consent should provide adequate information to the patient about the current state of his fertility and about the balance between risks and benefits in oncological terms. Standard approaches to genitourinary tumors should include a multidisciplinary team with urologists, oncologists, radiotherapists, psycho-sexologists, andrologists, gynecologists, and reproductive endocrinologists.
Topics: Humans; Male; Fertility Preservation; Androgens; Infertility, Male; Testicular Neoplasms; Urologic Neoplasms
PubMed: 37491831
DOI: 10.1177/03915603221146147 -
Translational Psychiatry Jul 2023N-of-1 trials, a special case of Single Case Experimental Designs (SCEDs), are prominent in clinical medical research and specifically psychiatry due to the growing...
N-of-1 trials, a special case of Single Case Experimental Designs (SCEDs), are prominent in clinical medical research and specifically psychiatry due to the growing significance of precision/personalized medicine. It is imperative that these clinical trials be conducted, and their data analyzed, using the highest standards to guard against threats to validity. This systematic review examined publications of medical N-of-1 trials to examine whether they meet (a) the evidence standards and (b) the criteria for demonstrating evidence of a relation between an independent and an outcome variable per the What Works Clearinghouse (WWC) standards for SCEDs. We also examined the appropriateness of the data analytic techniques in the special context of N-of-1 designs. We searched for empirical journal articles that used N-of-1 design and published between 2013 and 2022 in PubMed and Web of Science. Protocols or methodological papers and studies that did not manipulate a medical condition were excluded. We reviewed 115 articles; 4 (3.48%) articles met all WWC evidence standards. Most (99.1%) failed to report an appropriate design-comparable effect size; neither did they report a confidence/credible interval, and 47.9% reported neither the raw data rendering meta-analysis impossible. Most (83.8%) ignored autocorrelation and did not meet distributional assumptions (65.8%). These methodological problems could lead to significantly inaccurate effect sizes. It is necessary to implement stricter guidelines for the clinical conduct and analyses of medical N-of-1 trials. Reporting neither raw data nor design-comparable effect sizes renders meta-analysis impossible and is antithetical to the spirit of open science.
Topics: Biomedical Research; Research Design
PubMed: 37463877
DOI: 10.1038/s41398-023-02562-8 -
Sports Medicine - Open Jul 2023Sleep is essential for maximal performance in the athletic population. Despite that, the sport context has many factors that can negatively influence athletes' sleep and...
BACKGROUND
Sleep is essential for maximal performance in the athletic population. Despite that, the sport context has many factors that can negatively influence athletes' sleep and subsequent recovery.
OBJECTIVES
The purpose of this systematic review was to synthesize the most recent literature regarding sleep interventions aimed at improving sleep and subsequent performance in athletes.
METHODS
The present systematic review was conducted based on the PRISMA guidelines and the PICOS approach. The search was conducted in May 2022 using the electronic database PubMed, SPORTDiscus via EBSCOhost, and Web of Science. Once extracted, studies were included if they met the following criteria: (1) participants were athletes of individual or team sports; (2) implemented an intervention aimed at improving sleep; (3) measured at least one objective performance/recovery outcome; and (4) reported the relationship between sleep and performance.
RESULTS
The search returned 1584 records. Following the screening, a total of 25 studies met our inclusion criteria. All the included articles were intervention studies published between 2011 and 2021. The included studies implemented various sleep interventions, such as sleep hygiene, naps, sleep extension, light manipulation, cold water immersion, mindfulness, or a combination of two or more strategies. Sleep extension and naps were the most representative and most effective strategies to improve sleep and performance. Mindfulness and light manipulation demonstrated promising results, but more studies are needed to confirm these findings. Sleep hygiene, removing electronic devices at night, and cold water immersion had no effects on sleep and subsequent performance/recovery, but these results are based on a few studies only.
CONCLUSION
While acknowledging the limited amount of high-quality evidence reviewed, it appears that increasing sleep duration at night or through napping was the most effective interventions to improve physical and/or cognitive performance. Protocol Registration This protocol was registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on May 11, 2022, with the registration number INPLASY202250069.
PubMed: 37462808
DOI: 10.1186/s40798-023-00599-z -
Medical Ultrasonography Sep 2023Flexibility and dynamic perspective of ultrasound imaging allow for a targeted/focused examination, yielding extra find-ings. Sonopalpation - also referred as sono-Tinel...
Flexibility and dynamic perspective of ultrasound imaging allow for a targeted/focused examination, yielding extra find-ings. Sonopalpation - also referred as sono-Tinel for nerves - is one of those particular features of ultrasound examination whereby the ultrasound probe is actively 'manipulated'. It is paramount to ascertain the painful structure/pathology during the evaluation of a patient and it is not possible with other imaging techniques other than ultrasonography. In this aspect, the cur-rent review aims to provide an analysis of the literature regarding the use of sonopalpation for clinical and research purposes respectively.
Topics: Humans; Ultrasonography; Musculoskeletal System
PubMed: 37369030
DOI: 10.11152/mu-4060 -
The Journal of Pain Oct 2023This systematic review and meta-analysis investigated the effects of non-pharmacological manipulations on experimentally induced secondary hypersensitivity in pain-free... (Review)
Review
This systematic review and meta-analysis investigated the effects of non-pharmacological manipulations on experimentally induced secondary hypersensitivity in pain-free humans. We investigated the magnitude (change/difference in follow-up ratings from pre-manipulation ratings) of secondary hypersensitivity (primary outcome), and surface area of secondary hypersensitivity (secondary outcome), in 27 studies representing 847 participants. Risk of bias assessment concluded most studies (23 of 27) had an unclear or high risk of performance and detection bias. Further, 2 (of 27) studies had a high risk of measurement bias. Datasets were pooled by the method of manipulation and outcome. The magnitude of secondary hypersensitivity was decreased by diverting attention, anodal transcranial direct current stimulation, or emotional disclosure; increased by directing attention toward the induction site, nicotine deprivation, or negative suggestion; and unaffected by cathodal transcranial direct current stimulation or thermal change. Area of secondary hypersensitivity was decreased by anodal transcranial direct current stimulation, emotional disclosure, cognitive behavioral therapy, hyperbaric oxygen therapy, placebo analgesia, or spinal manipulation; increased by directing attention to the induction site, nicotine deprivation, or sleep disruption (in males only); and unaffected by cathodal transcranial direct current stimulation, thermal change, acupuncture, or electroacupuncture. Meta-analytical pooling was only appropriate for studies that used transcranial direct current stimulation or hyperbaric oxygen therapy, given the high clinical heterogeneity among the studies and unavailability of data. The evidence base for this question remains small. We discuss opportunities to improve methodological rigor including manipulation checks, structured blinding strategies, control conditions or time points, and public sharing of raw data. PERSPECTIVE: We described the effects of several non-pharmacological manipulations on experimentally induced secondary hypersensitivity in humans. By shedding light on the potential for non-pharmacological therapies to influence secondary hypersensitivity, it provides a foundation for the development and testing of targeted therapies for secondary hypersensitivity.
PubMed: 37356604
DOI: 10.1016/j.jpain.2023.06.013 -
Nutricion Hospitalaria Oct 2023The body composition determination is carried out through measurement methods that require the use of specialized equipment that is difficult to acquire and manipulate....
The body composition determination is carried out through measurement methods that require the use of specialized equipment that is difficult to acquire and manipulate. Therefore, different authors have developed mathematical models for its calculation. The target of this review was to analyze the work carried out on mathematical models of body composition variables from different anthropometric measurements, answering the following questions: what is the corporal variable that the model predicts?, what are the input variables for model development?, how is the patients typification in each model?, what data analysis method has been used?, and how has been the model evaluated? The search was limited to journals found in repositories in the areas of Medicine, Nursing, Biochemistry, Biology, Health, Pharmacology, Immunology, Engineering, and Mathematics. Four hundred and twenty-four articles were found, which were reduced to 30 by applying the systematic literature review process. The analyzed studies are oriented to the prediction of variables related to body fat mass. The evaluation results found for fat-free mass, fat mass and metabolic rate differ according to the comparison technique and the body segments analyzed. The evaluation is mainly based on the intraclass correlation, the Pearson correlation and the coefficient of determination (r2), and they present a good correlation for the population under study.
Topics: Humans; Body Composition; Anthropometry
PubMed: 37334798
DOI: 10.20960/nh.04377 -
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 -
Sports Medicine (Auckland, N.Z.) Aug 2023Repeated-sprint training (RST) involves maximal-effort, short-duration sprints (≤ 10 s) interspersed with brief recovery periods (≤ 60 s). Knowledge about the... (Meta-Analysis)
Meta-Analysis
The Acute Demands of Repeated-Sprint Training on Physiological, Neuromuscular, Perceptual and Performance Outcomes in Team Sport Athletes: A Systematic Review and Meta-analysis.
BACKGROUND
Repeated-sprint training (RST) involves maximal-effort, short-duration sprints (≤ 10 s) interspersed with brief recovery periods (≤ 60 s). Knowledge about the acute demands of RST and the influence of programming variables has implications for training prescription.
OBJECTIVES
To investigate the physiological, neuromuscular, perceptual and performance demands of RST, while also examining the moderating effects of programming variables (sprint modality, number of repetitions per set, sprint repetition distance, inter-repetition rest modality and inter-repetition rest duration) on these outcomes.
METHODS
The databases Pubmed, SPORTDiscus, MEDLINE and Scopus were searched for original research articles investigating overground running RST in team sport athletes ≥ 16 years. Eligible data were analysed using multi-level mixed effects meta-analysis, with meta-regression performed on outcomes with ~ 50 samples (10 per moderator) to examine the influence of programming factors. Effects were evaluated based on coverage of their confidence (compatibility) limits (CL) against elected thresholds of practical importance.
RESULTS
From 908 data samples nested within 176 studies eligible for meta-analysis, the pooled effects (± 90% CL) of RST were as follows: average heart rate (HR) of 163 ± 9 bpm, peak heart rate (HR) of 182 ± 3 bpm, average oxygen consumption of 42.4 ± 10.1 mL·kg·min, end-set blood lactate concentration (B[La]) of 10.7 ± 0.6 mmol·L, deciMax session ratings of perceived exertion (sRPE) of 6.5 ± 0.5 au, average sprint time (S) of 5.57 ± 0.26 s, best sprint time (S) of 5.52 ± 0.27 s and percentage sprint decrement (S) of 5.0 ± 0.3%. When compared with a reference protocol of 6 × 30 m straight-line sprints with 20 s passive inter-repetition rest, shuttle-based sprints were associated with a substantial increase in repetition time (S: 1.42 ± 0.11 s, S: 1.55 ± 0.13 s), whereas the effect on sRPE was trivial (0.6 ± 0.9 au). Performing two more repetitions per set had a trivial effect on HR (0.8 ± 1.0 bpm), B[La] (0.3 ± 0.2 mmol·L), sRPE (0.2 ± 0.2 au), S (0.01 ± 0.03) and S (0.4; ± 0.2%). Sprinting 10 m further per repetition was associated with a substantial increase in B[La] (2.7; ± 0.7 mmol·L) and S (1.7 ± 0.4%), whereas the effect on sRPE was trivial (0.7 ± 0.6). Resting for 10 s longer between repetitions was associated with a substantial reduction in B[La] (-1.1 ± 0.5 mmol·L), S (-0.09 ± 0.06 s) and S (-1.4 ± 0.4%), while the effects on HR (-0.7 ± 1.8 bpm) and sRPE (-0.5 ± 0.5 au) were trivial. All other moderating effects were compatible with both trivial and substantial effects [i.e. equal coverage of the confidence interval (CI) across a trivial and a substantial region in only one direction], or inconclusive (i.e. the CI spanned across substantial and trivial regions in both positive and negative directions).
CONCLUSIONS
The physiological, neuromuscular, perceptual and performance demands of RST are substantial, with some of these outcomes moderated by the manipulation of programming variables. To amplify physiological demands and performance decrement, longer sprint distances (> 30 m) and shorter, inter-repetition rest (≤ 20 s) are recommended. Alternatively, to mitigate fatigue and enhance acute sprint performance, shorter sprint distances (e.g. 15-25 m) with longer, passive inter-repetition rest (≥ 30 s) are recommended.
Topics: Humans; Team Sports; Running; Fatigue; Athletes; Lactic Acid; Athletic Performance
PubMed: 37222864
DOI: 10.1007/s40279-023-01853-w -
The Journal of Manual & Manipulative... Dec 2023Neck pain is among the most prevalent and costly musculoskeletal disorders. Manual therapy and exercise are two standard treatment approaches to manage neck pain. In... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Neck pain is among the most prevalent and costly musculoskeletal disorders. Manual therapy and exercise are two standard treatment approaches to manage neck pain. In addition, clinical practice guidelines recommend a multi-modal approach, including both manual therapy and exercise for the treatment of neck pain; however, the specific effects of these combined interventions have not recently been reported in the literature.
OBJECTIVE
To perform a systematic review and meta-analysis to determine the effect of manual therapy combined with exercise on pain, disability, and quality of life in individuals with nonspecific neck pain.
DESIGN
Systematic Review and Meta-Analysis.
METHODS
Electronic database searches were completed in PubMed, CINAHL, Cochrane, EMBASE, Ovid, and SportDiscus, with publication dates of January 2000 to December 2022. The risk of bias in the included articles was completed using the Revised Cochrane Risk of Bias Tool (RoB 2). Raw data were pooled using standardized mean differences and mean differences for pain, disability, and quality of life outcomes, and forest plots were computed in the meta-analysis.
RESULTS
Twenty-two studies were included in the final review. With moderate certainty of evidence, three studies demonstrated no significant difference between manual therapy plus exercise and manual therapy alone in pain (SMD of -0.25 (95% CI: -0.52, 0.02)) or disability (-0.37 (95% CI: -0.92, 0.18)). With a low certainty of evidence, 16 studies demonstrated that manual therapy plus exercise is significantly better than exercise alone for reducing pain (-0.95 (95%CI: -1.38, -0.51)). Similarly, with low certainty of evidence, 13 studies demonstrated that manual therapy plus exercise is significantly better than exercise alone for reducing disability (-0.59 (95% CI: -0.90, -0.28)). Four studies demonstrated that manual therapy plus exercise is significantly better than a control intervention for reducing pain (moderate certainty) (-2.15 (95%CI: -3.58, -0.73)) and disability (low certainty) (-2.39 (95% CI: -3.80, -0.98)). With a high certainty of evidence, four studies demonstrated no significant difference between manual therapy plus exercise and exercise alone in quality of life (SMD of -0.02 (95% CI: -0.21, 0.18)).
CONCLUSION
Based on this systematic review and meta-analysis, a multi-modal treatment approach including exercise and manual therapy appears to provide similar effects as manual therapy alone, but is more effective than exercise alone or other interventions (control, placebo, 'conventional physical therapy', etc.) for the treatment of nonspecific neck pain and related disability. Some caution needs to be taken when interpreting these results given the general low to moderate certainty of the quality of the evidence.
Topics: Humans; Neck Pain; Quality of Life; Musculoskeletal Manipulations; Exercise Therapy; Musculoskeletal Diseases
PubMed: 37092822
DOI: 10.1080/10669817.2023.2202895 -
The Journal of Manual & Manipulative... Aug 2023To establish a 'trustworthy' living systematic review (SR) with a meta-analysis of manual therapy for treating non-radicular cervical impairments. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To establish a 'trustworthy' living systematic review (SR) with a meta-analysis of manual therapy for treating non-radicular cervical impairments.
DESIGN
SR with meta-analysis.
LITERATURE SEARCH
Articles published between January 2010 and September 2022 were included from: Cochrane Central Register of Controlled Trials (CENTRAL); CINAHL; MEDLINE; PubMed; PEDro, and ProQuest Nursing and Allied Health.
METHODS
This SR included English-language randomized clinical trials (RCTs) of manual therapy involving adults used to treat non-radicular cervical impairments. The primary outcomes were pain and region-specific outcome measures. Cervicogenic headaches and whiplash were excluded to improve homogeneity. Two reviewers independently assessed RCTs. The prospective plan was to synthesize results with high confidence in estimated effects using GRADE.
RESULTS
Thirty-five RCTs were screened for registration status. Twenty-eight were not registered or registered prospectively. In 5 studies, the discussion and conclusion did not match the registry, or this could not be determined. One study did not meet the external validity criterion, and another was rated as having a high risk of bias. One study met the inclusion and exclusion criteria, so practice recommendations could not be made. The remaining study did not identify any clinically meaningful group differences.
DISCUSSION
Only one prospectively registered RCT met this SR's strict, high-quality standards. The single identified paper provides initial high-quality evidence on this topic.
CONCLUSION
This SR establishes a foundation of trustworthiness and can be used to generate research agendas to determine the potential clinical utility of manual therapy directed at the cervical spine for non-radicular cervical complaints.
Topics: Humans; Cervical Vertebrae; Musculoskeletal Manipulations; Neck; Pain
PubMed: 37067434
DOI: 10.1080/10669817.2023.2201917