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Alternative Therapies in Health and... Jun 2024Tai Chi is a common, reliable, and non-pharmacological treatment method used in COPD disease management. This review investigated the effect of Tai Chi on disease and...
OBJECTIVE
Tai Chi is a common, reliable, and non-pharmacological treatment method used in COPD disease management. This review investigated the effect of Tai Chi on disease and symptom management in COPD patients.
METHODOLOGY
This study was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P).
RESULTS
The results showed that the Qigong, Sun, and Yang styles of Tai Chi are used for COPD patients. Trials compared Tai Chi with routine care, pulmonary rehabilitation added to routine care, and mind-body breathing. Tai Chi interventions were usually administered for a duration of 12 to 24 weeks. The results indicate that Tai Chi positively affects lung functions, exercise capacity, multidimensional perceived social support, diaphragm strength, quadriceps strength in the legs, self-care, self-efficacy, dyspnea, fatigue, anxiety, and depression.
CONCLUSION
Tai Chi is a safe and effective exercise for COPD patients with comorbidities. It is superior to mind-body breathing and routine care and as good as pulmonary rehabilitation but is easier to practice. However, longer-term studies with larger samples are needed to validate the findings of the study.
PubMed: 38843416
DOI: No ID Found -
BMC Pregnancy and Childbirth May 2024Contraceptive use is the principal method by which women avoid unintended pregnancy. An unintended pregnancy can induce long-term distress related to the medical,...
BACKGROUND
Contraceptive use is the principal method by which women avoid unintended pregnancy. An unintended pregnancy can induce long-term distress related to the medical, emotional, and social consequences of carrying that pregnancy to term.
OBJECTIVES
This review investigates the effects of modern contraception techniques such as birth control pills, long-acting reversible contraceptives (e.g., intrauterine devices, implants), and condoms on mental health status.
METHODS
We searched multiple databases from inception until February 2022, with no geographical boundaries. RCTs underwent a quality assessment using the GRADE approach while the quality of observational studies was assessed using the Downs and Black scoring system. Data were analyzed through meta-analysis and relative risk and mean difference were calculated and forest plots were created for each outcome when two or more data points were eligible for analysis.
MAIN RESULTS
The total number of included studies was 43. In women without previous mental disorders, both RCTs (3 studies, SMD 0.18, 95% CI [0.02, 0.34], high quality of evidence) and cohort studies (RR 1.04 95% CI [1.03, 1.04]) detected a slight increase in the risk of depression development. In women with previous mental disorders, both RCTs (9 studies, SMD - 0.15, 95% CI [-0.30, -0.00], high quality of evidence) and cohort studies (SMD - 0.26, 95% CI [-0.37, -0.15]) detected slight protective effects of depression development. It was also noticed that HC demonstrated protective effects for anxiety in both groups (SMD - 0.20, 95% CI [-0.40, -0.01]).
CONCLUSIONS
Among women with pre-existing mental disorders who use hormonal contraceptives, we reported protective association with decreased depressive symptoms. However, the study also draws attention to some potential negative effects, including an increase in the risk of depression and antidepressant use among contraceptive users, a risk that is higher among women who use the hormonal IUD, implant, or patch/ring methods. Providers should select contraceptive methods taking individual aspects into account to maximize benefits and minimize risks.
Topics: Humans; Female; Mental Health; Contraception; Pregnancy; Depression; Pregnancy, Unplanned; Adult; Contraception Behavior; Mental Disorders; Anxiety
PubMed: 38816797
DOI: 10.1186/s12884-024-06587-9 -
Clinical Neurology and Neurosurgery Jul 2024The Liliequist membrane (LM) represents a crucial yet challenging anatomical structure in neuroanatomy. First observed in 1875 and later elucidated by Bengt Liliequist... (Review)
Review
BACKGROUND
The Liliequist membrane (LM) represents a crucial yet challenging anatomical structure in neuroanatomy. First observed in 1875 and later elucidated by Bengt Liliequist in 1956, the LM's precise anatomical description and boundaries remain complex. Its significance extends to neurosurgery, impacting various procedures like endoscopic third ventriculocisternostomies, aneurysm and tumor surgeries, treatment of suprasellar arachnoid cysts, and managing perimesencephalic hemorrhages. However, a comprehensive understanding of the LM is hindered by inconsistent anatomical descriptions and limitations in available literature, warranting a systematic review.
METHODS
A systematic review was conducted by searching PubMed, Science Direct, and Google Scholar for articles pertaining to Liliequist's membrane. The search employed Mesh terms like "Liliequist membrane," "Liliequist's diaphragm," and related variations. Inclusion criteria encompassed studies exploring the historical evolution, anatomical structure, radiological characteristics, and clinical implications of the LM in neurosurgery.
RESULTS
The search yielded 358 articles, with 276 unique articles screened based on relevance. Following a meticulous screening process, 72 articles underwent full-text assessment, resulting in the inclusion of 5 articles meeting the eligibility criteria. The selected studies varied in methodology, including anatomical dissections, radiological evaluations, and clinical significance in neurosurgical procedures. Insights were derived on LM's anatomical variations, radiological visualization, and its critical role in guiding neurosurgical interventions.
CONCLUSIONS
Despite advancements in understanding its clinical significance and radiological visualization, challenges persist in precisely delineating its boundaries. Further research, especially on embryological development and histological characterization, is essential. Enhancing comprehension of LM-related pathologies is crucial for accurate preoperative planning and optimizing patient outcomes in neurosurgery.
Topics: Humans; Neurosurgical Procedures; History, 20th Century; History, 19th Century; Clinical Relevance
PubMed: 38795689
DOI: 10.1016/j.clineuro.2024.108322 -
Ethiopian Journal of Health Sciences Sep 2023Diaphragmatic ultrasound is increasingly used to assess patients with Chronic Obstructive Pulmonary Disease (COPD). The present study aims to investigate diaphragmatic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Diaphragmatic ultrasound is increasingly used to assess patients with Chronic Obstructive Pulmonary Disease (COPD). The present study aims to investigate diaphragmatic dysfunction in COPD patients through a systematic review and meta-analysis.
METHODS
In December 2022,The researchers studied four international databases such as Medline/PubMed, ProQuest, ISI/WOS, and Scopus. Joanna Briggs Institute (JBI) checklist was used to review and control the quality of articles.
RESULTS
Finally, 6 articles were included in the analysis. Based on the meta-analysis results, forced expiratory volume (FEV1) was significantly lower in COPD patients compared to the control group (Hedges's g= -2.99, 95 % CI -4.78, -1.19; P =0.001). Forced vital capacity (FVC) was significantly lower in COPD patients compared to the control group (Hedges's g= -1.12, 95 % CI -1.91, - 0.33; P =0.005). COPD patients had significantly lower FEV1/FVC than the control group (Hedges's g= -1.57, 95 % CI -2.33, -0.81; P <0.001).
CONCLUSION
The present study showed that the diaphragm ultrasound (DUS) method could identify the difference in FEV1, FVC, and FEV1/FVC indices in two groups of COPD patients and healthy people.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Diaphragm; Ultrasonography; Forced Expiratory Volume; Vital Capacity; Male
PubMed: 38784513
DOI: 10.4314/ejhs.v33i5.20 -
Journal of Bodywork and Movement... Apr 2024The aim of this systematic review was to investigate the effectiveness of physiotherapy interventions on chest mobility in obstructive lung diseases.
PURPOSE
The aim of this systematic review was to investigate the effectiveness of physiotherapy interventions on chest mobility in obstructive lung diseases.
METHODS
Searches were performed in PEDro, Pubmed and Cochrane Central Register of Controlled Trials databases without language restrictions between 2010 and 25th December 2020. Randomized controlled trials (RCTs) investigating physiotherapy interventions on chest wall mobility were included. Two independent reviewers screened studies, extracted data, and assessed methodological quality of included studies. The assessment of risk of bias was conducted using the PEDro scale for RCTs. The articles were excluded if they have less than 5 out of 10 score.
RESULTS
Five studies included had good to excellent quality. A total of 139 patients were included in all RCTs. Intervention duration ranged from a single session to 12 weeks and the intervention schedules varied, consisting of 1-24 sessions, lasting 5-45 min per sessions. Three studies used respiratory muscle stretching and releasing techniques, one study combined respiratory muscle stretching with aerobic training, and one study planned diaphragmatic breathing. Four studies assessed chest wall mobility with optoelectronic plethysmography, whereas one study used measuring tape.
CONCLUSIONS
The result of this first systematic review that investigates the effects of physiotherapy interventions on chest wall mobility in obstructive lung diseases suggests that more and better quality RCTs with objective measurement tools are required.
Topics: Humans; Thoracic Wall; Physical Therapy Modalities; Lung Diseases, Obstructive; Randomized Controlled Trials as Topic; Respiratory Muscles; Pulmonary Disease, Chronic Obstructive
PubMed: 38763581
DOI: 10.1016/j.jbmt.2023.11.046 -
Scientific Reports May 2024This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate... (Meta-Analysis)
Meta-Analysis
This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate placement of intrauterine devices (IUDs) versus delayed placement after artificial abortion. PubMed, Embase, Cochrane, Web of Science, CNKI, and Wanfang databases were comprehensively searched up to January 12, 2024 for studies that compared immediate versus delayed insertion of IUDs after abortion. The evaluation metrics included the number of IUD insertion after surgical or medical abortions, the frequency of expulsion and removal at 6 months or 1 year, the number of continued usage, pain intensity scores, the number of infections, the duration of bleeding, and instances of uterine perforation during or after IUD insertion. Ten randomized controlled articles were eligible, comprising 11 research projects, of which 3 projects involved the placement of an IUD after surgical abortion, and 8 projects involved the placement of an IUD after medical abortion. This included 2025 patients (977 in the immediate insertion group and 1,048 in the delayed insertion group). We summarized all the extracted evidence. The meta-analysis results indicated that for post-surgical abortions, the immediate insertion group exhibited a higher IUD placement rate than the delayed insertion group. After medical abortions, the immediate insertion group showed higher rates of IUD placement, utilization, and expulsion at 6 months or 1 year. The two groups showed no statistically significant differences in the removal rate, post-insertion infection rate, pain scores during insertion, and days of bleeding during the follow-up period. Compared to delayed placement, immediate insertion of IUDs can not only increase the usage rate at 6 months or 1 year but also enhance the placement rate.
Topics: Humans; Female; Intrauterine Devices; Abortion, Induced; Pregnancy; Time Factors; Device Removal
PubMed: 38762680
DOI: 10.1038/s41598-024-62327-1 -
Annals of Anatomy = Anatomischer... Jun 2024The aim of this systematic review is to study the subdiaphragmatic anatomy of the phrenic nerve. (Review)
Review
OBJECTIVE
The aim of this systematic review is to study the subdiaphragmatic anatomy of the phrenic nerve.
MATERIALS AND METHODS
A computerised systematic search of the Web of Science database was conducted. The key terms used were phrenic nerve, subdiaphragmat*, esophag*, liver, stomach, pancre*, duoden*, intestin*, bowel, gangli*, biliar*, Oddi, gallbladder, peritone*, spleen, splenic, hepat*, Glisson, falciform, coronary ligament, kidney, suprarenal, and adrenal. The 'cited-by' articles were also reviewed to ensure that all appropriate studies were included.
RESULTS
A total of one thousand three hundred and thirty articles were found, of which eighteen met the inclusion and exclusion criteria. The Quality Appraisal for Cadaveric Studies scale revealed substantial to excellent methodological quality of human studies, while a modified version of the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool denoted poor methodological quality of animal studies. According to human studies, phrenic supply has been demonstrated for the gastro-esophageal junction, stomach, celiac ganglia, liver and its coronary ligament, inferior vena cava, gallbladder and adrenal glands, with half of the human samples studied presenting phrenic nerve connections with any subdiaphragmatic structure.
CONCLUSIONS
This review provides the first systematic evidence of subdiaphragmatic phrenic nerve supply and connections. This is of interest to professionals who care for people suffering from neck and shoulder pain, as well as patients with peridiaphragmatic disorders or hiccups. However, there are controversies about the autonomic or sensory nature of this supply.
Topics: Phrenic Nerve; Humans; Diaphragm; Animals
PubMed: 38692333
DOI: 10.1016/j.aanat.2024.152269 -
Contraception Jul 2024Inherited bleeding disorders may cause heavy menstrual bleeding in women, impacting quality of life and impairing daily and social activities. The... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Inherited bleeding disorders may cause heavy menstrual bleeding in women, impacting quality of life and impairing daily and social activities. The levonorgestrel-releasing intrauterine system is a potential treatment for these women, which might reduce menstrual blood loss.
STUDY DESIGN
We performed a systematic review and single-arm meta-analysis to examine the levonorgestrel-releasing intrauterine system in women with inherited bleeding disorders and heavy menstrual bleeding.
RESULTS
A systematic search on PubMed, Embase and Cochrane yielded 583 results, of which six observational studies (n = 156) met inclusion criteria. Levonorgestrel-releasing intrauterine system use in patients with inherited bleeding disorders and heavy menstrual bleeding was associated with amenorrhea in 60% of patients and a significant increase of 1.40 g/dL in hemoglobin and of 19.75 ng/mL in ferritin levels when comparing post- and pre-treatment levels. The post-treatment mean hemoglobin was 13.32 g/dL and the mean ferritin was 43.22 ng/dL. The rate of intrauterine device expulsion or removal due to mal position was low (13%), as was the need for intrauterine device removal due to lack of efficacy (14%).
CONCLUSION
The levonorgestrel-releasing intrauterine system may improve bleeding patterns and quality of life in patients with inherited bleeding disorders and heavy menstrual bleeding.
IMPLICATIONS
Women with inherited bleeding disorders could benefit from levonorgestrel-releasing intrauterine system, so its use should be an option for this women.
Topics: Female; Humans; Amenorrhea; Blood Coagulation Disorders, Inherited; Contraceptive Agents, Female; Contraceptive Agents, Hormonal; Ferritins; Hemoglobins; Intrauterine Device Expulsion; Intrauterine Devices, Medicated; Levonorgestrel; Menorrhagia; Quality of Life
PubMed: 38614274
DOI: 10.1016/j.contraception.2024.110450 -
Critical Care (London, England) Mar 2024Several bedside assessments are used to evaluate respiratory muscle function and to predict weaning from mechanical ventilation in patients on the intensive care unit.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several bedside assessments are used to evaluate respiratory muscle function and to predict weaning from mechanical ventilation in patients on the intensive care unit. It remains unclear which assessments perform best in predicting weaning success. The primary aim of this systematic review and meta-analysis was to summarize and compare the accuracy of the following assessments to predict weaning success: maximal inspiratory (PImax) and expiratory pressures, diaphragm thickening fraction and excursion (DTF and DE), end-expiratory (Tdi) and end-inspiratory (Tdi) diaphragm thickness, airway occlusion pressure (P0.1), electrical activity of respiratory muscles, and volitional and non-volitional assessments of transdiaphragmatic and airway opening pressures.
METHODS
Medline (via Pubmed), EMBASE, Web of Science, Cochrane Library and CINAHL were comprehensively searched from inception to 04/05/2023. Studies including adult mechanically ventilated patients reporting data on predictive accuracy were included. Hierarchical summary receiver operating characteristic (HSROC) models were used to estimate the SROC curves of each assessment method. Meta-regression was used to compare SROC curves. Sensitivity analyses were conducted by excluding studies with high risk of bias, as assessed with QUADAS-2. Direct comparisons were performed using studies comparing each pair of assessments within the same sample of patients.
RESULTS
Ninety-four studies were identified of which 88 studies (n = 6296) reporting on either PImax, DTF, DE, Tdi, Tdi and P0.1 were included in the meta-analyses. The sensitivity to predict weaning success was 63% (95% CI 47-77%) for PImax, 75% (95% CI 67-82%) for DE, 77% (95% CI 61-87%) for DTF, 74% (95% CI 40-93%) for P0.1, 69% (95% CI 13-97%) for Tdi, 37% (95% CI 13-70%) for Tdi, at fixed 80% specificity. Accuracy of DE and DTF to predict weaning success was significantly higher when compared to PImax (p = 0.04 and p < 0.01, respectively). Sensitivity and direct comparisons analyses showed that the accuracy of DTF to predict weaning success was significantly higher when compared to DE (p < 0.01).
CONCLUSIONS
DTF and DE are superior to PImax and DTF seems to have the highest accuracy among all included respiratory muscle assessments for predicting weaning success. Further studies aiming at identifying the optimal threshold of DTF to predict weaning success are warranted.
TRIAL REGISTRATION
PROSPERO CRD42020209295, October 15, 2020.
Topics: Adult; Humans; Ventilator Weaning; Respiration, Artificial; Respiratory Muscles; Diaphragm; ROC Curve
PubMed: 38454487
DOI: 10.1186/s13054-024-04823-4 -
Surgical Laparoscopy, Endoscopy &... Apr 2024Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly...
BACKGROUND
Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies.
METHODS
We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options.
RESULTS
In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years.
CONCLUSIONS
Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.
Topics: Humans; Pleura; Foreign Bodies; Pancreas; Thoracoscopy; Pancreatectomy
PubMed: 38450728
DOI: 10.1097/SLE.0000000000001275