-
East Asian Archives of Psychiatry :... Jun 2024We conducted a systematic review evaluating the efficacy of rivastigmine augmentation for treatment-refractory posttraumatic stress disorder (PTSD). The Preferred... (Review)
Review
We conducted a systematic review evaluating the efficacy of rivastigmine augmentation for treatment-refractory posttraumatic stress disorder (PTSD). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The databases Ovid MEDLINE, PubMed, CINAHL, and EMBASE were searched using key words: 'rivastigmine' OR 'Exelon' OR 'rivastigmine augmentation' OR 'Exelon augmentation' AND 'posttraumatic stress disorder*' OR 'post-traumatic stress disorder*' OR 'PTSD' OR 'combat disorder*' OR 'post-traumatic symptoms'. The asterisk specified plural forms of the relevant word. Four papers were identified, comprising one double-blind randomised controlled trial, one non-controlled open trial, one case series (presenting three case studies), and one paper with two case studies. The randomised controlled trial found no statistically significant difference in efficacy, using the PTSD CheckList-Military Version as the relevant outcomes measure, between the active add-on rivastigmine interventions and placebo or treatment as usual. The open trial, although reporting relatively positive outcomes, had a weak study design and lacked reporting of key information, including participant sex and age and pre-rivastigmine PTSD measures. The assessment of efficacy was based on participants' reporting of subjective benefits, and clinician-rating using a Clinical Global Impression, rather than established PTSD assessments scales. Although the five case studies reported improvement in PTSD symptoms, there were confounding factors and limitations in clinical and demographic data, warranting caution regarding attributed benefits. There is a lack of methodologically robust evidence supporting the efficacy of add-on rivastigmine for the treatment of refractory PTSD. Additional research may help in further evaluating its possible clinical efficacy.
Topics: Rivastigmine; Humans; Stress Disorders, Post-Traumatic; Neuroprotective Agents; Cholinesterase Inhibitors
PubMed: 38955788
DOI: 10.12809/eaap2353 -
Journal of Pediatric Nursing Jul 2024Children with disabilities (CWDs) constitute a substantial segment of the population who encounter abuse, emphasizing the need to comprehend the influence of...
BACKGROUND
Children with disabilities (CWDs) constitute a substantial segment of the population who encounter abuse, emphasizing the need to comprehend the influence of school-based interventions on this susceptible group.
AIM
This systematic review and meta-analysis aimed to identify and evaluate the effectiveness of school-based interventions in enhancing child sexual abuse (CSA) knowledge among CWDs.
PARTICIPANTS
This meta-analysis incorporated seven published studies, encompassing 387 CWDs.
METHODS
Our study synthesizes findings from seven experimental and quasi-experimental studies, adhering to the PRISMA guidelines. The study was registered in PROSPERO. The literature search, conducted between September 25, 2023, and October 2, 2023, employed various databases and keywords relevant to the study's scope. The research question and articles' eligibility were assessed using the Population, Intervention, Comparison, Outcomes, and Study type (PICOs). The meta-analysis was conducted using the Comprehensive Meta-Analysis (CMA) software.
RESULTS
The school-based intervention greatly impacted CWDs' CSA knowledge scores (Hedges's g = 1.026 [95% CI: 0.845; 1.208], z = 11.074, p = 0.000). The findings of this meta-analysis demonstrate that Questionnaire/scale-based knowledge measurement (Hedges's g = 2.586 [95% CI: 0.920; 4.252], z = 3.043, P = 0.002) and Vignette-based knowledge measurement (Hedges's g = 1.065 [95% CI: 0.655; 1.474], z = 5.100, p = 0.000) are effective in assessing CWDs' knowledge of CSA.
CONCLUSION
This systematic review and meta-analysis of seven randomized controlled studies and quasi-experimental studies provide robust evidence supporting the effectiveness of school-based interventions in significantly enhancing CSA knowledge among CWDs.
IMPLICATIONS TO PRACTICE
These findings are potentially significant evidence for education professionals, including educators and school health nurses.
PubMed: 38955613
DOI: 10.1016/j.pedn.2024.06.024 -
Neurospine Jun 2024Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging...
Magnetic Resonance Imaging-Related Anatomic and Functional Parameters for the Diagnosis and Prognosis of Chiari Malformation Type I: A Systematic Review and Meta-analysis.
OBJECTIVE
Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
METHODS
A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
RESULTS
Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard's angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
CONCLUSION
We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients' PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
PubMed: 38955528
DOI: 10.14245/ns.2347150.575 -
Clinical Nutrition ESPEN Jun 2024There is a lack of evidence to support the hypothesis that malnutrition may promote cognitive decline. This study aimed to explore the available literature on this topic.
BACKGROUND
There is a lack of evidence to support the hypothesis that malnutrition may promote cognitive decline. This study aimed to explore the available literature on this topic.
METHODS
A systematic review was undertaken of studies investigating the effect of nutritional status on cognitive function in adults of any age, using Medline, Embase, PsycINFO and Global Health via OvidSP from earliest available dates to January 2024. Studies were excluded if they were conducted in animal or paediatric populations, or if they did not include measurements of baseline nutritional status or follow-up assessment of cognitive function. Selected studies were assessed for quality, and data extracted. A meta-analysis was not conducted due to the heterogeneity of the data.
RESULTS
A total of nine studies (three randomised and six observational) was retrieved, including total 8697 subjects who were all in older age groups. Study quality was generally poor. Seven of the nine studies supported the hypothesis that baseline nutritional status is predictive of change in cognitive function at later assessment, but all studies failed to control for significant confounders and six of the nine had large amounts of missing data at follow-up, so that it remains unclear whether nutrition is independently associated with later cognitive function.
CONCLUSION
Malnutrition may be associated with subsequent development of cognitive dysfunction in older adults. Higher quality studies in a wider range of age groups are needed to investigate whether nutritional status has an independent impact on cognitive function, and whether this is related to specific nutrient deficiencies.
PubMed: 38954515
DOI: 10.1016/j.clnesp.2024.06.014 -
Graefe's Archive For Clinical and... Jul 2024In the context of ophthalmologic practice, there has been a rapid increase in the amount of data collected using electronic health records (EHR). Artificial intelligence... (Review)
Review
Adherence of studies involving artificial intelligence in the analysis of ophthalmology electronic medical records to AI-specific items from the CONSORT-AI guideline: a systematic review.
PURPOSE
In the context of ophthalmologic practice, there has been a rapid increase in the amount of data collected using electronic health records (EHR). Artificial intelligence (AI) offers a promising means of centralizing data collection and analysis, but to date, most AI algorithms have only been applied to analyzing image data in ophthalmologic practice. In this review we aimed to characterize the use of AI in the analysis of EHR, and to critically appraise the adherence of each included study to the CONSORT-AI reporting guideline.
METHODS
A comprehensive search of three relevant databases (MEDLINE, EMBASE, and Cochrane Library) from January 2010 to February 2023 was conducted. The included studies were evaluated for reporting quality based on the AI-specific items from the CONSORT-AI reporting guideline.
RESULTS
Of the 4,968 articles identified by our search, 89 studies met all inclusion criteria and were included in this review. Most of the studies utilized AI for ocular disease prediction (n = 41, 46.1%), and diabetic retinopathy was the most studied ocular pathology (n = 19, 21.3%). The overall mean CONSORT-AI score across the 14 measured items was 12.1 (range 8-14, median 12). Categories with the lowest adherence rates were: describing handling of poor quality data (48.3%), specifying participant inclusion and exclusion criteria (56.2%), and detailing access to the AI intervention or its code, including any restrictions (62.9%).
CONCLUSIONS
In conclusion, we have identified that AI is prominently being used for disease prediction in ophthalmology clinics, however these algorithms are limited by their lack of generalizability and cross-center reproducibility. A standardized framework for AI reporting should be developed, to improve AI applications in the management of ocular disease and ophthalmology decision making.
PubMed: 38953984
DOI: 10.1007/s00417-024-06553-3 -
Pediatric Pulmonology Jul 2024Several techniques can be used to assess bronchodilator response (BDR) in preschool-aged children, including spirometry, respiratory oscillometry, the interrupter... (Review)
Review
BACKGROUND
Several techniques can be used to assess bronchodilator response (BDR) in preschool-aged children, including spirometry, respiratory oscillometry, the interrupter technique, and specific airway resistance. However, there has not been a systematic comparison of BDR thresholds across studies yet.
METHODS
A systematic review was performed on all studies up to May 2023 measuring a bronchodilator effect in children 2-6 years old using one of these techniques (PROSPERO CRD42021264659). Studies were identified using MEDLINE, Cochrane, EMBASE, CINAHL via EBSCO, Web of Science databases, and reference lists of relevant manuscripts.
RESULTS
Of 1224 screened studies, 43 were included. Over 85% were from predominantly European ancestry populations, and only 22 studies (51.2%) calculated a BDR cutoff based on a healthy control group. Five studies included triplicate testing with a placebo to account for the within-subject intrasession repeatability. A relative BDR was most consistently reported by the included studies (95%) but varied widely across all techniques. Various statistical methods were used to define a BDR, with six studies using receiver operating characteristic analyses to measure the discriminative power to distinguish healthy from wheezy and asthmatic children.
CONCLUSION
A BDR in 2- to 6-year-olds cannot be universally defined based on the reviewed literature due to inconsistent methodology and cutoff calculations. Further studies incorporating robust methods using either distribution-based or clinical anchor-based approaches to define BDR are required.
PubMed: 38953717
DOI: 10.1002/ppul.27112 -
Knee Surgery, Sports Traumatology,... Jul 2024This study addresses the gap in the current literature by evaluating the combined treatment of autologous bone grafting and autologous chondrocyte implantation (ABCI)...
Autologous bone grafting in combination with autologous chondrocyte implantation yields favourable outcomes in the treatment of osteochondral defects of the knee: A systematic literature review.
PURPOSE
This study addresses the gap in the current literature by evaluating the combined treatment of autologous bone grafting and autologous chondrocyte implantation (ABCI) for osteochondral defects of the knee. It aims to evaluate clinical outcomes against methodological quality and to summarize histological results and surgical techniques.
METHODS
A thorough search was conducted across Pubmed, Cochrane and Embase databases. Studies reporting clinical outcomes of ABCI for osteochondral defects of the knee were included. Patient-reported outcome measures (PROMs), failure rates, methodological quality and potential conflicts of interest were evaluated. Histological results and surgical techniques were summarized.
RESULTS
Eighteen studies with 344 analyzed patients met the eligibility criteria for inclusion. All studies showed a significant improvement (p < 0.05) across different PROMs (subjective International Knee Documentation Committee score, Cincinnati Knee Rating System, Visual Analogue Scale, Lysholm Score, Tegner Activity Scale, Knee injury and Osteoarthritis Outcome Score and Knee Society Score) compared to the preoperative status. Failure rates ranged from 0% to 17.6%, with a mean follow-up of 73.2 months (range: 9.0-143.6 months). Methodological quality was low to medium, including only one comparative study. Six studies reviewed reported a potential conflict of interest. The histological assessment showed effective bonding between autologous chondrocytes and bone graft. A large degree of variability was observed in the operative technique used.
CONCLUSION
The current literature suggests that ABCI yields good clinical outcomes at mid- to long-term follow-up with favourable histological results for osteochondral defects of the knee. However, future research should focus on high-quality comparative studies to better guide treatment choices. Introducing ABCI as the standard abbreviation may enhance clarity in future research.
LEVEL OF EVIDENCE
Level IV.
PubMed: 38953161
DOI: 10.1002/ksa.12342 -
Sexual Medicine Jun 2024Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals. (Review)
Review
BACKGROUND
Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.
AIM
To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.
METHODS
This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis.
OUTCOMES
The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function.
RESULTS
A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity ( = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue.
CLINICAL TRANSLATION
CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group.
STRENGTHS AND LIMITATIONS
The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment.
CONCLUSION
The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).
PubMed: 38953013
DOI: 10.1093/sexmed/qfae043 -
Biology of Sport Jul 2024To observe overall, training, and match injury incidence in female youth football. We also aimed to quantify the incidence of injuries by affected tissue and body... (Review)
Review
To observe overall, training, and match injury incidence in female youth football. We also aimed to quantify the incidence of injuries by affected tissue and body location. The following databases were examined: PubMed, Web of Science, Scopus, SPORTDiscus, Cochrane and PEDro. Papers that reported overall injury incidence, training or match injury incidence were included. Additionally, studies had to be performed in adolescent female football players (13-19 years of age). The Newcastle-Ottawa Scale and the checklist of items that must be included in epidemiological football reports were used to assess methodological quality of the included articles. For the meta-analyses, a random effect model was used. A total of 13 studies were included. There were 2,333 injuries; incidence was higher during games (12.7/1000 h) compared to training sessions (2.3/1000 h). The injury match-to-training ratio was 5.8. The lower limbs were the region in which the greatest number of injuries occurred, with the ankle (1.2/1000 h) and knee (0.8/1000 h) having the most injuries. In relation to injured tissue, ligament injuries represented an incidence of 1.3/1000 h, followed by muscle injuries (0.9/1000 h). This study represents the first step towards the creation and implementation of preventative measures in female youth football. The results suggest that attention should be focused on ankle and knee injuries, since they are the most frequent and can lead to sport retirement in some cases depending on the severity.
PubMed: 38952921
DOI: 10.5114/biolsport.2024.132996 -
Biology of Sport Jul 2024The aim of this study is to determine the acute effects of resistance and plyometric training on sprint and change of direction (COD) performance in healthy adults and... (Review)
Review
The aim of this study is to determine the acute effects of resistance and plyometric training on sprint and change of direction (COD) performance in healthy adults and adolescents. A systematic literature search was conducted via Medline, Cinahl, Scopus and SportDiscus databases for studies that investigated: 1) healthy male, female adults, or adolescents; and 2) measured sprint or change of direction performance following resistance and plyometric exercises. Studies were excluded if: 1) resistance or plyometric exercises was not used to induce muscle damage; 2) conducted in animals, infants, elderly; 3) sprint performance and/or agility performance was not measured 24 h post muscle damaging protocol. Study appraisal was completed using the Kmet Quality Scoring for Quantitative Study tool. Forest plots were generated to quantitatively analyse data and report study statistics for statistical significance and heterogeneity. The included studies ( = 20) revealed sprint and COD performance was significantly impaired up to 72 hr following resistance and plyometric exercises; both protocols significantly increased creatine kinase (CK), delayed-onset muscle soreness (DOMS) and decreased countermovement jump (CMJ) up to 72 hr. The systematic review of 20 studies indicated that resistance and plyometric training significantly impaired sprint and COD performance up to 72 hours post-exercise. Both training protocols elevated exercise-induced muscle damage (EIMD) markers (CK, DOMS) and decreased CMJ performance within the same timeframe.
PubMed: 38952917
DOI: 10.5114/biolsport.2024.131823