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Nutrition Reviews Jul 2024Previous research linked vitamin D deficiency in pregnancy to adverse pregnancy outcomes.
CONTEXT
Previous research linked vitamin D deficiency in pregnancy to adverse pregnancy outcomes.
OBJECTIVE
Update a 2017 systematic review and meta-analysis of randomized controlled trials (RCTs) on the effect of vitamin D supplementation during pregnancy, identify sources of heterogeneity between trials, and describe evidence gaps precluding a clinical recommendation.
DATA SOURCES
The MEDLINE, PubMed, Europe PMC, Scopus, Cochrane Database of Systematic Reviews, Web of Science, and CINAHL databases were searched. Articles were included that reported on RCTs that included pregnant women given vitamin D supplements as compared with placebo, no intervention, or active control (≤600 IU d-1). Risk ratios (RRs) and mean differences were pooled for 38 maternal, birth, and infant outcomes, using random effects models. Subgroup analyses examined effect heterogeneity. The Cochrane risk of bias tool was used.
DATA EXTRACTION
Included articles reported on a total of 66 trials (n = 17 276 participants).
DATA ANALYSIS
The median vitamin D supplementation dose was 2000 IU d-1 (range: 400-60 000); 37 trials used placebo. Antenatal vitamin D supplementation had no effect on the risk of preeclampsia (RR, 0.81 [95% CI, 0.43-1.53]; n = 6 trials and 1483 participants), potentially protected against gestational diabetes mellitus (RR, 0.65 [95% CI, 0.49-0.86; n = 12 trials and 1992 participants), and increased infant birth weight by 53 g (95% CI, 16-90; n = 40 trials and 9954 participants). No effect of vitamin D on the risk of preterm birth, small-for-gestational age, or low birth weight infants was found. A total of 25 trials had at least 1 domain at high risk of bias.
CONCLUSION
Additional studies among the general pregnant population are not needed, given the many existing trials. Instead, high-quality RCTs among populations with low vitamin D status or at greater risk of key outcomes are needed. Benefits of supplementation in pregnancy remain uncertain because current evidence has high heterogeneity, including variation in study context, baseline and achieved end-line 25-hydroxyvitamin D level, and studies with high risk of bias.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42022350057.
PubMed: 38950419
DOI: 10.1093/nutrit/nuae065 -
PloS One 2024This research aimed to assess the effectiveness of preventive home visits (PHVs) in enhancing resilience and health-related outcomes among older adults living in the...
BACKGROUND
This research aimed to assess the effectiveness of preventive home visits (PHVs) in enhancing resilience and health-related outcomes among older adults living in the community.
METHODS
A comprehensive literature search was conducted in nine databases (PubMed, MEDLINE, CINAHL, Embase, Emcare, Web of Science (WOS), Scopus, PsycINFO and Cochrane Library. The search was undertaken between March 15 and 31, 2022 with subsequent updates performed on October 15, 2023 and April 10, 2024. This review also included grey literature sourced via Google, Google Scholar and backward citation searches.
RESULTS
Out of 5,621 records, 20 articles were found to meet the inclusion criteria with a total of 8,035 participants involved and the mean age ranged from 74.0 to 84.4 years. Using McMaster Critical Review Form for Quantitative Studies, we ascertained that the studies included in our analysis had moderate to high levels of quality. In addition to health-related outcomes, PHV interventions were also conducted to evaluate psychological effects (16 studies) and social outcomes (seven studies). Five studies conducted financial assessment to evaluate the costs of health and social care utilisation during PHV interventions. Regarding the results of the review, seven studies showed favourable outcomes, five indicated no effect and eight had equivocal findings. Only one study assessed resilience and determined that PHV had no effect on the resilience of the subjects.
CONCLUSION
This review found that the effectiveness of PHV interventions was uncertain and inconclusive. PHV interventions often prioritise health-related objectives. The incorporation of a holistic approach involving psychosocial health into PHV interventions is relatively uncommon. Due to the paucity of research on resilience as PHV outcome, we are unable to draw a conclusion on the effectiveness of PHV on resilience. Resilience should be prioritised as a psychological assessment in the future development of comprehensive PHV interventions, as it enables older adults to adapt, manage, and respond positively to adversities that may arise with age. Performing financial analysis such as costs and benefits analysis to incorporate the return on investment of PHV interventions is an added value for future research on this topic.
CLINICAL TRIAL REGISTRATION
PROSPERO registration number: CRD42022296919.
Topics: Humans; Aged; Independent Living; Resilience, Psychological; House Calls; Aged, 80 and over; Female; Male
PubMed: 38950029
DOI: 10.1371/journal.pone.0306188 -
EFORT Open Reviews Jul 2024The aim of this study was to investigate the efficacy of calcitonin (CT) in animal models of experimental osteoarthritis (OA) and rheumatoid arthritis (RA), as new...
PURPOSE
The aim of this study was to investigate the efficacy of calcitonin (CT) in animal models of experimental osteoarthritis (OA) and rheumatoid arthritis (RA), as new stabilized CT formulations are currently being introduced.
METHODS
A comprehensive and systemic literature search was conducted in PubMed/MEDLINE and Embase databases to identify articles with original data on CT treatment of preclinical OA and RA. Methodological quality was assessed using the Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool for animal intervention studies. To provide summary estimates of efficacy, a meta-analysis was conducted for outcomes reported in four or more studies, using a random-effects model. Subgroup analyses were employed to correct for study specifics.
RESULTS
Twenty-six studies were ultimately evaluated and data from 16 studies could be analyzed in the meta-analysis, which included the following outcomes: bone mineral density, bone volume, levels of cross-linked C-telopeptide of type I collagen, histopathological arthritis score, and mechanical allodynia. For all considered outcome parameters, CT-treated groups were significantly superior to control groups (P = 0.002; P = 0.01; P < 0.00001; P < 0.00001; P = 0.04). For most outcomes, effect sizes were significantly greater in OA than in RA (P ≤ 0.025). High in-between study heterogeneity was detected.
CONCLUSION
There is preclinical evidence for an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of CT in RA and OA. Given these effects, CT presents a promising agent for the treatment of both diseases, although the potential seems to be greater in OA.
PubMed: 38949173
DOI: 10.1530/EOR-23-0133 -
EFORT Open Reviews Jul 2024This systematic review aims to investigate the management and outcomes of pelvic ring fractures (PRFs) during pregnancy, emphasizing maternal and fetal mortality rates,...
PURPOSE
This systematic review aims to investigate the management and outcomes of pelvic ring fractures (PRFs) during pregnancy, emphasizing maternal and fetal mortality rates, mechanisms of injury, and treatment modalities.
METHODS
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive search of databases from 2000 to 2023, identifying 33 relevant studies. Data extraction included demographics, fracture types, treatment methods, and outcomes. Risk of bias was assessed using the JBI criteria.
RESULTS
Maternal mortality stood at 9.1%, with fetal mortality at 42.4%. Maternal factors impacting mortality included head trauma and hemodynamic instability. Fetal mortality correlated with mechanisms like motor vehicle accidents and maternal vital signs. Surgical and conservative treatments were applied, with a majority of pelvic surgeries performed before delivery. External fixators proved effective in fracture stabilization.
CONCLUSION
Pelvic ring fractures during pregnancy present significant risks to maternal and fetal health. Early stabilization and vigilant monitoring of maternal vital signs are crucial. Vaginal bleeding/discharge serves as a critical fetal risk indicator. The choice between surgical and conservative treatment minimally influenced outcomes. Multidisciplinary collaboration and tailored interventions are essential in managing these complex cases.
PubMed: 38949162
DOI: 10.1530/EOR-23-0164 -
Journal of Cardiovascular Medicine... Aug 2024To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure. (Meta-Analysis)
Meta-Analysis
AIMS
To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure.
METHODS
The literature search was conducted in PubMed, Web of Science, the Cochrane Library databases, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database and China Scientific Journal Database (VIP). The retrieval period was from the establishment of the database to May 2023. The included studies were trials to explore the effectiveness of mHealth interventions on medication adherence in patients with heart failure. Cochrane collaboration's tool was used for assessing risk of bias in randomized controlled trials. Stata 17.0 software was used to conduct data analysis. Continuous data were expressed as standard mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals (CIs).
RESULTS
A total of 13 studies and 2534 participants were included. One study was rated as Grade A, and the other 12 studies were Grade B. The results of meta-analysis indicate that mHealth interventions are effective in improving medication adherence [relative risk (RR) = 1.26, 95% CI 1.10-1.44, P < 0.05 and standard mean difference = 0.80, 95% CI 0.44-1.15, P < 0.05], and reducing readmission rates (RR = 0.63, 95% CI 0.53-0.76, P < 0.05) and mortality (RR = 0.63, 95% CI 0.43-0.94, P < 0.05) of patients with heart failure.
CONCLUSION
mHealth interventions are beneficial to improve medication adherence in patients with heart failure, and could effectively reduce the readmission rates and mortality of patients in the studies. There is a need to continuously improve the professional abilities of intervention personnel, carry out teamwork, and extend intervention and follow-up time. Convenient, fast and low-cost mobile medical devices should be adopted to reduce the cost of medical treatment. Scientific and reasonable intervention content will be formulated according to evidence-based guidelines and theoretical basis to enhance patients' ability at self-management and understanding of heart failure knowledge.
Topics: Humans; Heart Failure; Telemedicine; Medication Adherence; Female; Male; Middle Aged; Aged; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38949146
DOI: 10.2459/JCM.0000000000001631 -
Collaborative assessment as an intervention in the treatment of mental Illness: a systematic review.Nordic Journal of Psychiatry Jul 2024Three meta-analyses suggested that the psychological assessment as a therapeutic intervention approach might have therapeutic effects but had unspecific inclusion... (Review)
Review
BACKGROUND
Three meta-analyses suggested that the psychological assessment as a therapeutic intervention approach might have therapeutic effects but had unspecific inclusion criteria.
METHODS
We searched four databases for RCTs that reported on the use of psychological assessment as an intervention. Two reviewers independently selected papers, extracted data, and assessed study quality.We conducted and reported the systematic review following the PRISMA statement. We assessed the Risk of bias in included studies using the Risk of Bias tool and graded the strength of the evidence with GRADE.
RESULTS
We included two RCTs: The first study investigated Therapeutic Assessment (TA) combined with Manual-Assisted Cognitive Behavior Therapy (MACT) compared with MACT only in 16 outpatients with personality disorders. The trial found among completers ( = 7) no difference in borderline symptomatology but a possible difference regarding suicidality favoring MACT + TA. The trial did not provide any outcomes relating to readiness for treatment. The other trial investigated TA compared with a Goal-focused Pretreatment Intervention in a sample of 74 outpatients with personality disorders. The results found no intervention effects on symptomatology but suggested that TA might improve patient expectancy for future treatment among completers of the intervention. Both trials were judged at a high risk of bias and with very low certainty of evidence.
DISCUSSION
We found no support for the clinical effect of psychological assessment as a therapeutic intervention due to the high risk of bias and low certainty of the evidence.
PubMed: 38949105
DOI: 10.1080/08039488.2024.2357565 -
Journal of Neurosurgical Sciences Aug 2024Arachnoid cysts are primarily dysembryogenetic splitting or duplication of the embryonic meningeal mesenchyme, hence the paediatric preponderance. Neuroendoscopic...
INTRODUCTION
Arachnoid cysts are primarily dysembryogenetic splitting or duplication of the embryonic meningeal mesenchyme, hence the paediatric preponderance. Neuroendoscopic cysto-cisternostomy is now the favoured treatment option. We pooled data on middle fossa arachnoid cysts (MCFAC) demographics, clinical presentations, cyst characteristics, neuro-endoscopic cysto-cisternostomy and its outcomes.
EVIDENCE ACQUISITION
Using search words (from the keywords; 'endoscopic treatment' and 'middle fossa arachnoid cysts') combined using Boolean operators, a systematic review of the PubMed and Cochrane CENTRAL was started on 1 February 2023, as per protocol (PROSPERO CRD42023394345); 65 records and then 46 reports were screened, 169 cases were pooled from the 19 recruited reports for the qualitative and quantitative syntheses, after methodological assessment (significantly excellent 57.9% quality) using the Joanna Briggs Institute critical appraisal tools.
EVIDENCE SYNTHESIS
The male-to-female ratio was 2.4:1, with a weighted average-age of 11.25 years in the modal childhood (32.0%) age-group. Headaches (53/29.3%), seizures (30/16.6%) and macrocephaly (25/13.8%) were the commonest presentations. Right-sided (30/55.6%) and Galassi II (55/48.3%) and III (53/46.5%) lesions were common. Rigid (124/93.9%) endoscopes aided cysto-cisternostomy using mostly bipolar diathermy (31/43.7%) and ventriculostomy forceps (18/25.4%); creating one (22/18.3%), two (14/11.6%) or more (78/65.0%) stomas. Fenestration sites were specifically CNIII&ICA (32/25.8%), CNII&ICA (27/21.8%), CNIII&tentorium cerebelli (23/18.6%), CNIII&PCA (1/0.8%) and through the side of CNVI (1/0.8%) into the pre-pontine cistern. Good clinical and radiological outcomes were reported.
CONCLUSIONS
Largely excellent-to-good quality, low-level evidence reported MCFACs presenting in childhood with headaches, seizures and macrocephaly. At least two fenestrations using bipolar-diathermy/forceps and balloon-catheter expansion were used for cysto-cisternostomy, with good outcomes.
Topics: Humans; Arachnoid Cysts; Neuroendoscopy; Cranial Fossa, Middle; Male; Female; Child; Treatment Outcome
PubMed: 38949058
DOI: 10.23736/S0390-5616.24.06240-4 -
Frontiers in Pharmacology 2024Inflammatory bowel disease (IBD) is a chronic condition that can be managed with treatment, but it is challenging to get IBD cured. Resveratrol, a non-flavonoid...
Inflammatory bowel disease (IBD) is a chronic condition that can be managed with treatment, but it is challenging to get IBD cured. Resveratrol, a non-flavonoid polyphenolic organic compound derived from various plants, has a potential effect on IBD. The current research was set out to investigate the therapeutic effects of resveratrol on animal models of IBD. A comprehensive search of PubMed, Embase, Web of Science, and Chinese databases was performed. The literature search process was completed independently by two people and reviewed by a third person. The risk of bias in the included literature was assessed using the Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Stroke (CAMARADES) 10-point quality checklist. The meta-analysis utilized Review Manager 5.4 software to evaluate the efficacy of resveratrol, with histopathological index as the primary outcome measure. Subgroup analysis was conducted based on this indicator. Additionally, meta-analyses were carried out on different outcomes reported in the literature, including final disease activity index, final body weight change, colon length, splenic index, and inflammatory factors. After conducting a thorough literature search and selection process, a total of 28 studies were ultimately included in the analysis. It was found that over half of the selected studies had more than five items with low risk of bias in the bias risk assessment. Relevant datas from included literature indicated that the histopathological index of the resveratrol group was significantly lower than that of the control group (WMD = -2.58 [-3.29, -1.87]). Subgroup analysis revealed that higher doses of resveratrol (>80 mg/kg) had a better efficacy (WMD = -3.47 [-4.97, -1.98]). Furthermore, The data summary and quantitative analysis results of SI and colon length also showed that resveratrol was effective in alleviating intestinal mucosal pathological injury of IBD. In terms of biochemical indicators, the summary analysis revealed that resveratrol affected interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), interferon-γ (IFN-γ), malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), and prostaglandin E2 (PGE2) significantly. These effects may be attributed to the mechanism of resveratrol in regulating immune response and inhibiting oxidative stress. This review suggests that resveratrol demonstrated a notable therapeutic impact in preclinical models of IBD, particularly at doses exceeding 80 mg/kg. This efficacy is attributed to the protective mechanisms targeting the intestinal mucosa involved in the pathogenesis of IBD through various pathways. As a result, resveratrol holds promising prospects for potential clinical use in the future.
PubMed: 38948464
DOI: 10.3389/fphar.2024.1411566 -
Indian Journal of Orthopaedics Jul 2024Meniscal injuries frequently require surgical intervention to restore knee joint function and stability. Intraoperative platelet-rich plasma (PRP) injection has emerged... (Review)
Review
BACKGROUND
Meniscal injuries frequently require surgical intervention to restore knee joint function and stability. Intraoperative platelet-rich plasma (PRP) injection has emerged as a potential adjunctive therapy to enhance tissue healing post-meniscal repair. This systematic review and meta-analysis aimed to evaluate the efficacy of PRP in terms of pain relief, functional recovery, and overall success rates in patients undergoing meniscal repair procedures
METHODS
A comprehensive search strategy was employed to identify relevant studies across Scopus, PubMed, Embase, and the Cochrane Library databases. The inclusion criteria encompassed human studies, including randomized controlled trials (RCTs), cohorts, and case-control studies, focusing on intraoperative platelet-rich plasma (PRP) use post-meniscal repair and reporting outcomes related to pain, functionality, and cure rates. Exclusion criteria comprised animal studies, non-English publications, studies lacking relevant outcome measures, and those with insufficient data. Two reviewers independently screened titles and abstracts, resolving disagreements through consensus or consultation with a third reviewer, followed by a full-text assessment for potentially eligible studies. Data extraction was conducted independently by two reviewers using a standardized form. The reliability of observational studies was evaluated using the Newcastle-Ottawa Scale. Subgroup analyses and pooled effect estimates for main outcomes were computed using RevMan 5.3, a meta-analysis tool.
RESULTS
The demographic analysis revealed that the PRP group had an average age of 41.39 years, while the control group had an average age of 42.1 years. In terms of gender distribution, the PRP group consisted of 61 men and 29 women, while the control group had 62 men and 34 women. Pain ratings showed a preference for PRP with a mean difference of 4.83 ( = 0.13). However, there was no significant difference in Lysholm scores (mean difference: - 0.44, p = 0.91) or IKDC scores (mean difference: 2.80, = 0.14) between the PRP and control groups. Similarly, ROM measures did not show a statistically significant difference, with a mean difference of 2.80 ( = 0.18). Additionally, there was no significant distinction in failure rates between the PRP and control groups, as indicated by a weighted mean difference of 0.71 ( = 0.52). These findings suggest that while PRP may offer some benefits in pain relief, its impact on functional recovery, range of motion, and failure rates following meniscal repair procedures is inconclusive.
CONCLUSION
The current evidence regarding the effect of intraoperative platelet-rich plasma (PRP) injection on patients undergoing meniscal repair remains inconclusive. While some studies suggest potential benefits in terms of pain relief and functional recovery, others show no significant differences compared to control groups. The impact of PRP therapy on overall success rates, including rates of re-tear and revision surgery, is also uncertain. Further well-designed randomized controlled trials with larger sample sizes are needed to provide more robust evidence and guide clinical practice in orthopedic surgery.
PubMed: 38948373
DOI: 10.1007/s43465-024-01155-x -
PeerJ 2024Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it...
INTRO
Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it possible to study sensory and cognitive processes in the brain. Previous reports have shown that aerobic exercise can have an impact on components of ERPs such as amplitude and latency. However, they focused on the measurement of ERPs after exercise.
OBJECTIVES
The aim of this systematic review was to investigate the feasibility of measuring ERPs during cycling, and to assess the impact of cycling on ERPs during cycling.
METHODS
We followed the PRISMA guidelines for new systematic reviews. To be eligible, studies had to include healthy adults and measure ERPs during cycling. All articles were found using Google Scholar and by searching references. Data extracted from the studies included: objectives of ERP studies, ERP paradigm, EEG system, study population data, exercise characteristics (duration, intensity, pedaling cadence), and ERP and behavioral outcomes. The Cochrane Risk of Bias 2 tool was used to assess study bias.
RESULTS
Twenty studies were selected. The effect of cycling on ERPs was mainly based on a comparison of P3 wave amplitude between cycling and resting states, using an attentional task. The ERP paradigm most often used was the auditory oddball task. Exercise characteristics and study methods varied considerably.
DISCUSSION
It is possible to measure ERPs during cycling under conditions that are likely to introduce more artifacts, including a 3-h athletic exercise session and cycling outdoors. Secondly, no assessment of the effect of cycling on ERPs was possible, because the methods differed too widely between studies. In addition, the theories proposed to explain the results sometimes seemed to contradict each other. Although most studies reported significant results, the direction of the effects was inconsistent. Finally, we suggest some areas for improvement for future studies on the subject.
Topics: Humans; Electroencephalography; Bicycling; Evoked Potentials; Exercise; Brain
PubMed: 38948229
DOI: 10.7717/peerj.17448