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Biology of Sport Jul 2024This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and... (Review)
Review
This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and performance. Four databases (PubMed, SPORTDiscus, Web Of Science and MEDLINE) were searched using relevant terms for studies involving healthy (e.g. no chronic diseases or conditions) male or female adults of any training status (athletes, physically active and non-athletes) and that investigated BA and SB in isolation and combination at any dose on an exercise outcome. Ten studies, totalling 243 individuals, met the criteria with 12 outcomes for each nutritional supplement. No ergogenic effect was detected in this meta-analysis for BA (SMD = 0.18, 95% CI: -0.06; 0.43, p = 0.13, tau = 0, tau = 0, I = 0.0%) or SB (SMD = 0.17, 95% CI: -0.08; 0.41, p = 0.16, tau = 0, tau = 0, I = 0.0%) in isolation. However, there was a beneficial effect for the combination of BA and SB (SMD = 0.32, 95% CI: 0.07; 0.57, p = 0.02, tau = 0, tau = 0, I = 0.0%). Meta-regression identified no differences between supplementing with BA or SB separately (F = 0.58; p = 0.57). Combining BA and SB improved exercise performance, however, there was no benefit in taking these supplements individually.
PubMed: 38952910
DOI: 10.5114/biolsport.2024.132997 -
Can transcranial photobiomodulation improve cognitive function in TBI patients? A systematic review.Frontiers in Psychology 2024Transcranial photobiomodulation (tPBM) is a non-invasive neuromodulation technology which has become a promising therapy for treating many brain diseases. Although it...
INTRODUCTION
Transcranial photobiomodulation (tPBM) is a non-invasive neuromodulation technology which has become a promising therapy for treating many brain diseases. Although it has been confirmed in studies targeting neurological diseases including Alzheimer's and Parkinson's that tPBM can improve cognitive function, the effectiveness of interventions targeting TBI patients remains to be determined. This systematic review examines the cognitive outcomes of clinical trials concerning tPBM in the treatment of traumatic brain injury (TBI).
METHODS
We conducted a systematic literature review, following the PRISMA guidelines. The PubMed, Web of Science, Scopus, EMBASE, and Cochrane Library databases were searched before October 31, 2023.
RESULTS
The initial search retrieved 131 articles, and a total of 6 studies were finally included for full text-analysis after applying inclusion and exclusion criteria.
CONCLUSION
Results showed improvements in cognition for patients with chronic TBI after tPBM intervention. The mechanism may be that tPBM increases the volume of total cortical gray matter (GM), subcortical GM, and thalamic, improves cerebral blood flow (CBF), functional connectivity (FC), and cerebral oxygenation, improving brain function. However, due to the significant heterogeneity in application, we cannot summarize the optimal parameters for tPBM treatment of TBI. In addition, there is currently a lack of RCT studies in this field. Therefore, given this encouraging but uncertain finding, it is necessary to conduct randomized controlled clinical trials to further determine the role of tPBM in cognitive rehabilitation of TBI patients.
PubMed: 38952831
DOI: 10.3389/fpsyg.2024.1378570 -
Pakistan Journal of Medical Sciences Jul 2024Ambulatory surgeries are increasingly prevalent, yet they often result in postoperative pain and anxiety, impacting patient recovery and satisfaction. Effective... (Review)
Review
Effectiveness of nursing care intervention for alleviation of anxiety, pain and functional improvement amongst patients undergoing ambulatory surgery: A systematic review and meta-analysis.
BACKGROUND & OBJECTIVE
Ambulatory surgeries are increasingly prevalent, yet they often result in postoperative pain and anxiety, impacting patient recovery and satisfaction. Effective management of these complications is crucial, and nursing care interventions have been proposed as a potential solution. This meta-analysis aims to evaluate the effectiveness of nursing care interventions in reducing pain and anxiety and improving functional status among patients undergoing ambulatory surgery.
METHODS
A comprehensive literature search done on December 2023 of PubMed Central, MEDLINE, Scopus, Google Scholar, Cochrane library, CINAHL, and trial registries was done for studies from inception till November 2023, that met predefined eligibility criteria. Standardized mean differences (SMD) for continuous outcomes and odds ratios (OR) for binary outcomes were calculated using a random-effects inverse-variance model. Sensitivity analysis was performed to assess the robustness of the findings, and heterogeneity was evaluated using I² statistics.
RESULTS
Nine studies were included. Pooled analysis revealed a significant reduction in pain (SMD = -1.224, 95% CI: -2.445 to -0.003, p=0.049) and anxiety (SMD = -1.53, 95% CI: -2.77 to -0.28, p=0.016) among patients receiving nursing care interventions, with substantial heterogeneity (I² = 98.2% for pain and 96.6% for anxiety). However, no significant improvement was observed in the functional status (SMD = -0.28, 95% CI: -0.35 to 0.91, p=0.385). Sensitivity analysis confirmed the stability of these results.
CONCLUSION
Nursing care interventions are effective in significantly reducing pain and anxiety in patients undergoing ambulatory surgery. However, their impact on improving functional status remains inconclusive. Our findings underscore the importance of integrating nursing care into postoperative management protocols in ambulatory surgeries and highlight areas for future research, particularly concerning functional recovery.
PubMed: 38952508
DOI: 10.12669/pjms.40.6.9472 -
Frontiers in Neurology 2024Mechanical thrombectomy is a time-sensitive treatment, with rapid initiation and reduced delays being associated with better patient outcomes. Several systematic reviews...
BACKGROUND
Mechanical thrombectomy is a time-sensitive treatment, with rapid initiation and reduced delays being associated with better patient outcomes. Several systematic reviews reported on various interventions to address delays. Hence, we performed an umbrella review of systematic reviews to summarise the current evidence.
METHODS
Medline, Embase, Cochrane Library and JBI were searched for published systematic reviews. Systematic Reviews that detailed outcomes related to time-to-thrombectomy or functional independence were included. Methodological quality was assessed using the JBI critical appraisal tool by two independent reviewers.
RESULTS
A total of 17 systematic reviews were included in the review. These were all assessed as high-quality reviews. A total of 13 reviews reported on functional outcomes, and 12 reviews reported on time-to-thrombectomy outcomes. Various interventions were identified as beneficial. The most frequently reported beneficial interventions that improved functional and time-related outcomes included: direct-to-angio-suite and using a mothership model (compared to drip-and-ship). Only a few studies investigated other strategies including other pre-hospital and teamwork strategies.
CONCLUSION
Overall, there were various strategies that can be used to reduce delays in the delivery of mechanical thrombectomy with different effectiveness. The mothership model appears to be superior to the drip-and-ship model in reducing delays and improving functional outcomes. Additionally, the direct-to-angiosuite approach appears to be beneficial, but further research is required for broader implementation of this approach and to determine which groups of patients would benefit the most.
PubMed: 38952471
DOI: 10.3389/fneur.2024.1390482 -
Frontiers in Pediatrics 2024Two significant etiological factors contributing to iron deficiency anemia, and undernutrition posing substantial public health challenges in Sub-Saharan Africa, are...
Impact of weekly iron-folic acid supplementation on nutritional status and parasitic reinfection among school-age children and adolescents in Sub-Saharan Africa: a systematic review and meta-analysis.
BACKGROUND
Two significant etiological factors contributing to iron deficiency anemia, and undernutrition posing substantial public health challenges in Sub-Saharan Africa, are soil-transmitted helminths and malaria. This study carried out the effect of weekly iron-folic acid supplementation (WIFAS) on the nutrition and general health of school-age children and adolescents in Sub-Saharan Africa, a systematic review and meta-analysis have been conducted.
METHODS
To find pertinent publications for this study, a thorough search was carried out on May 20, 2023, across five databases: Pubmed (MEDLINE), Web of Science, Scopus, Cochrane Library, and Google Scholar. In addition, a search was conducted on August 23, 2023, to capture any new records. The inclusion criteria for the studies were based on school-age children and adolescent populations, randomized controlled trials, and investigations into the effects of WIFAS. The outcomes of interest were measured through anthropometric changes, malaria, and helminthic reinfection
RESULTS
A systematic review of 11 articles revealed that WIFAS significantly decreased the risk of schistosomiasis reinfection by 21% among adolescents (risk ratio = 0.79, 95%CI: 0.66, 0.97; heterogeneity = 0.00%, = 0.02). However, no significant impact was observed on the risk of malaria reinfection (risk ratio = 1.02, 95%CI: 0.92, 1.13; heterogeneity = 0.00%, = 0.67) or A. Lumbricoides reinfection (risk ratio = 0.95, 95%CI: 0.75, 1.19; heterogeneity = 0.00%, = 0.65). Moreover, the analysis demonstrated that there is no significant effect of iron-folic acid supplementation in measured height and height for age -score (HAZ) of the school-age children (Hedge's g -0.05, 95%CI: -0.3, 0.2; test for heterogeneity = 0.00%, = 0.7) and (Hedge's g 0.12, 95%CI: -0.13, 0.37; test for heterogeneity = 0.00%, = 0.36) respectively.
CONCLUSION
The effectiveness of WIFAS in reducing the risk of schistosomiasis reinfection in adolescents has been demonstrated to be greater than that of a placebo or no intervention. Additionally, the narrative synthesis of iron-folic acid supplementation has emerged as a potential public health intervention for promoting weight change. However, there was no significant association between WIFAS and Ascariasis, trichuriasis, and hookworm. Moreover, the certainty of the evidence for the effects of WIFAS on height and malaria is low and therefore inconclusive. Whereas, the certainty of the evidence for the effectiveness of WIFAS on Schistosomiasis is moderate. Even though the mechanisms need further research WIFAS may be implemented as part of a comprehensive public health strategy to address schistosomiasis in adolescents.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023397898, PROSPERO (CRD42023397898).
PubMed: 38952434
DOI: 10.3389/fped.2024.1366540 -
Journal of Obstetrics and Gynaecology :... Dec 2024The relationship between amniotic fluid inflammatory biomarkers and preterm birth in second- or third-trimester pregnancy has been a focus, and understanding the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The relationship between amniotic fluid inflammatory biomarkers and preterm birth in second- or third-trimester pregnancy has been a focus, and understanding the correlation between these markers and preterm birth is important for early identification and intervention in preterm birth. The aim of this study was to explore potential inflammatory biomarkers in second- or third-trimester pregnancy amniotic fluid associated with preterm birth.
METHODS
On November 30, 2023, we searched literature involved the influence of second- or third-trimester pregnancy amniotic fluid inflammatory biomarkers on preterm birth through PubMed, Web of Science, Embase, Scope, CNKI, WanFang, VIP and China Biomedical Databases. The search languages were Chinese and English. Included outcomes indexes were combined utility analysis via R software.
RESULTS
A total of 11 articles were included in the combined utility analysis. This combined analysis revealed significant differences in several inflammatory biomarkers in amniotic fluid between the two groups (MD = 6.87, 95%CI: 0.26 - 13.47, P < 0.01); the difference in amniotic fluid IL-6 between the two groups (MD = 5.73, 95%CI: 3.13-8.32, P < 0.01); the difference in amniotic fluid IL-10 between the two groups (MD = 0.11, 95%CI: -3.26-3.48, P < 0.01); the difference in amniotic fluid CRP between the two groups (MD = 21.34, 95%CI: 11.69-30.89, P < 0.01); the difference in amniotic fluid MCP-1 between the two groups (MD = 312.14, 95%CI: 211.34-412.97, P < 0.01); the difference in the amniotic fluid MMP-9 between the two groups (MD = 0.86, 95%CI: -0.10-1.82, P < 0.01); and the difference in TNF-α in amniotic fluid between the two groups (MD = 22.78, 95%CI: -5.05-50.61, P < 0.01).
CONCLUSIONS
The inflammatory biomarkers IL-1β, IL-6, IL-10, CRP, TNFα, MCP-1 and MMP-9 in the amniotic fluid of patients in the second- or third-trimester pregnancy were all correlated with preterm birth.
Topics: Female; Humans; Pregnancy; Amniotic Fluid; Biomarkers; Inflammation; Interleukin-10; Interleukin-6; Matrix Metalloproteinase 9; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Premature Birth
PubMed: 38952221
DOI: 10.1080/01443615.2024.2368764 -
American Journal of Clinical Oncology Jul 2024Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug conjugate (ADC) promising in treating metastatic HER2+ and HER2-low breast cancer. This updated systematic review...
OBJECTIVES
Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug conjugate (ADC) promising in treating metastatic HER2+ and HER2-low breast cancer. This updated systematic review and meta-analysis, integrating data from the latest clinical trials, aimed to evaluate the safety and efficacy of T-DXd in this patient population.
METHODS
We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, Scopus, and Web of Science up to January 2024, focusing on clinical trials that assessed T-DXd's efficacy and safety. Eligibility criteria were based on the PICOS framework, and selected studies underwent rigorous quality assessment and data extraction. The primary outcomes were progression-free survival (PFS), overall survival (OS), and the incidence of adverse events. A random-effects meta-analysis was performed to synthesize the data.
RESULTS
Seven studies involving 2,201 patients met the inclusion criteria. The pooled analysis revealed that T-DXd significantly improved PFS (OR=0.37, 95% CI: 0.27-0.52), indicating a robust efficacy in slowing disease progression. However, treatment was associated with an increased risk of anemia (OR=2.10, 95% CI: 1.36-3.25), fatigue (OR=1.56, 95% CI: 1.21-2.02), nausea (OR=6.42, 95% CI: 4.37-9.42), vomiting (OR=6.21, 95% CI: 3.14-12.25), constipation (OR=2.26, 95% CI: 1.53-3.34), and notably, drug-related interstitial lung disease (OR=10.89, 95% CI: 3.81-31.12). The efficacy outcomes demonstrated significant heterogeneity, which was addressed through sensitivity analysis.
CONCLUSIONS
T-DXd shows significant efficacy in treating metastatic HER2+ and HER2-low breast cancer, offering a valuable therapeutic option for patients with advanced disease. However, the treatment is associated with notable adverse events, including a heightened risk of ILD. These findings underscore the need for careful patient selection, monitoring, and management strategies to mitigate risks. Future research should focus on optimizing treatment protocols and exploring methods to enhance safety profiles.
PubMed: 38951994
DOI: 10.1097/COC.0000000000001126 -
Cardiovascular Diabetology Jul 2024The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine... (Meta-Analysis)
Meta-Analysis Review
The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine which interventions could provide the most significant benefits for the metabolic health of young individuals with type 1 diabetes mellitus. The aim of this study was to identify optimal nonpharmacological interventions on glycaemic control, measured by glycated haemoglobin (HbA1c), in children and adolescents with type 1 diabetes. Systematic searches were conducted in PubMed, Web of Science, Scopus, and SPORTDiscus from inception to July 1, 2023. Randomised clinical trials (RCT) investigating nonpharmacological interventions (e.g., physical activity, nutrition, and behavioural therapies) were included. Primary outcome was change in HbA1c levels. Secondary outcome was change in daily insulin dose requirement. Seventy-four RCT with 6,815 participants (49.43% girls) involving 20 interventions were analysed using a network meta-analysis. Most interventions showed greater efficacy than standard care. However, multicomponent exercise, which includes aerobic and strength training (n = 214, standardised mean difference [SMD] =- 0.63, 95% credible interval [95% CrI] - 1.09 to - 0.16) and nutritional supplements (n = 146, SMD =- 0.49, - 0 .92 to - 0.07) demonstrated the greatest HbA1c reductions. These interventions also led to the larger decreases in daily insulin needs (n = 119, SMD =- 0.79, 95% CrI - 1.19 to - 0.34) and (n = 57, SMD =- 0.62, 95% CrI - 1.18 to - 0.12, respectively). The current study underscores non-pharmacological options such as multicomponent exercise and nutritional supplements, showcasing their potential to significantly improve HbA1c in youth with type 1 diabetes. Although additional research to confirm their efficacy is required, these approaches could be considered as potential adjuvant therapeutic options in the management of type 1 diabetes among children and adolescents.
Topics: Humans; Diabetes Mellitus, Type 1; Glycated Hemoglobin; Adolescent; Child; Network Meta-Analysis; Female; Male; Treatment Outcome; Blood Glucose; Randomized Controlled Trials as Topic; Biomarkers; Bayes Theorem; Hypoglycemic Agents; Glycemic Control; Age Factors; Insulin; Dietary Supplements; Exercise Therapy; Exercise; Child, Preschool
PubMed: 38951907
DOI: 10.1186/s12933-024-02301-3 -
Journal of Orthopaedic Surgery and... Jun 2024It remains unclear whether the use of an orthopaedic traction table (TT) in direct anterior approach (DAA) total hip arthroplasty (THA) results in better outcomes. The... (Meta-Analysis)
Meta-Analysis Comparative Study
Indirect comparisons of traction table versus standard table in total hip arthroplasty through direct anterior approach: a systematic review and frequentist network meta-analysis.
BACKGROUND
It remains unclear whether the use of an orthopaedic traction table (TT) in direct anterior approach (DAA) total hip arthroplasty (THA) results in better outcomes. The aim of this systematic review and network meta-analysis was to compare the THA outcomes through DAA on a standard operating table and the THA outcomes through DAA on a TT.
METHODS
PubMed, Epistemonikos, and Google Scholar were searched for relevant randomized controlled trials (RCTs) up to 01 January 2024. An indirect comparison in network meta-analysis was performed to assess treatment effects between DAA on a TT and DAA on a standard table, using fixed-effects and random-effects models estimated with frequentist approach and consistency assumption. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated for continuous variables and odds ratios (ORs) with 95% CIs were estimated for binary variables.
RESULTS
The systematic review of the literature identified 43 RCTs with a total of 2,258 patients. DAA with TT had a 102.3 mL higher intraoperative blood loss and a 0.6 mmol/L lower Hb 3 days postoperatively compared with DAA without TT (SMD = 102.33, 95% CI 47.62 to 157.04; SMD = - 0.60, 95% CI - 1.19 to - 0.00). DAA with TT had a 0.15 lower periprosthetic fracture OR compared with DAA without TT (OR 0.15, 95% CI 0.03 to 0.86). There were no further significant differences in surgical, radiological, functional outcomes and in complication rates.
CONCLUSION
Based on our findings and taking into account the limitations, we recommend that particular attention be paid to the risk of periprosthetic fracture in DAA on a standard operating table and blood loss in DAA with TT. Since numerous other surgical, radiological, functional outcome parameters and other complication rates studied showed no significant difference between DAA on a standard operating table and DAA with TT, no recommendation for a change in surgical technique seems justified.
LEVEL OF EVIDENCE
Level I evidence, because this is a systematic review and meta-analysis of randomized controlled trials.
Topics: Humans; Arthroplasty, Replacement, Hip; Network Meta-Analysis; Traction; Treatment Outcome; Blood Loss, Surgical; Operating Tables; Randomized Controlled Trials as Topic; Postoperative Complications
PubMed: 38951886
DOI: 10.1186/s13018-024-04852-3 -
Reproductive Health Jun 2024Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence...
BACKGROUND
Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence interventions in reproductive health care settings. India has one of the highest maternal and child mortality rates. This review aimed to identify characteristics of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing domestic violence.
METHODS
A systematic review of intervention studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three research team members performed independent screening of title, abstracts and full-texts.
RESULTS
The search resulted in 633 articles, of which 13 articles met inclusion criteria for full text screening and analysis. Common components of integrated violence and reproductive health interventions that were effective in addressing domestic violence included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3).
CONCLUSIONS
Interventions in India for domestic violence that are integrated with reproductive health care remain few, and there are fewer with effective outcomes for domestic violence. Of those with effective outcomes, all of the interventions utilized psychoeducation/education, skill building, and counseling as part of the intervention.
Topics: Female; Humans; Pregnancy; Domestic Violence; India; Reproductive Health; Reproductive Health Services
PubMed: 38951870
DOI: 10.1186/s12978-024-01830-0