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Critical Care Medicine Jun 2016ICU-acquired weakness is a common complication of critical illness and can have significant effects upon functional status and quality of life. As part of preliminary... (Review)
Review
OBJECTIVES
ICU-acquired weakness is a common complication of critical illness and can have significant effects upon functional status and quality of life. As part of preliminary work to inform the design of a randomized trial of a complex intervention to improve recovery from critical illness, we sought to identify pharmacological interventions that may play a role in this area.
DATA SOURCES
We systematically reviewed the published literature relating to pharmacological intervention for the treatment and prevention of ICU-acquired weakness.
STUDY SELECTION
We searched MEDLINE, EMBASE, CINAHL+, Web of Science, and both U.S. and European trial registries up to July 2014 alongside reviews and reference lists from populations with no age or language restrictions. We included studies that reported a measure of muscle structure or physical function as an outcome measure.
DATA EXTRACTION
We estimated pooled odds ratios and 95% CI using data extracted from published articles or where available, original data provided by the authors. Assessment of bias was performed using the Cochrane Collaboration's risk of bias tool.
DATA SYNTHESIS
Ten studies met the inclusion criteria. The current body of evidence does not support the use of any pharmacological agent in this setting, although maintaining euglycemia may reduce the prevalence of critical illness polyneuropathy.
CONCLUSIONS
At present, no pharmacological intervention can be recommended to prevent or treat ICU-acquired weakness. Further research is required into this field to include more novel agents such as myostatin inhibitors. Challenges in the conduct of research in this area are highlighted.
Topics: Adrenergic beta-Antagonists; Anabolic Agents; Critical Illness; Glutamine; Growth Hormone; Humans; Hyperglycemia; Hypoglycemic Agents; Immunoglobulins, Intravenous; Immunologic Factors; Insulin; Muscle Weakness; Oxandrolone; Polyneuropathies; Propranolol
PubMed: 26958749
DOI: 10.1097/CCM.0000000000001652 -
Stem Cell Research & Therapy Jun 2022Primary Sjögren's syndrome (pSS) is a diffuse connective tissue disease characterized by the invasion of exocrine glands such as lacrimal and salivary glands, abnormal... (Review)
Review
Primary Sjögren's syndrome (pSS) is a diffuse connective tissue disease characterized by the invasion of exocrine glands such as lacrimal and salivary glands, abnormal proliferation of T and B lymphocytes, and infiltration of tissue lymphocytes. With the development of modern medicine, although research on the pathogenesis, diagnosis, and treatment of pSS has made significant progress, its pathogenesis has not been fully understood. Meanwhile, in the era of individualized treatment, it remains essential to further explore early diagnosis and treatment methods. Exosomes, small vesicles containing proteins and nucleic acids, are a subtype of extracellular vesicles secreted by various cells and present in various body fluids. Exosomes contribute to a variety of biological functions, including intercellular signal transduction and pathophysiological processes, and may play a role in immune tolerance. Therefore, exosomes are key to understanding the pathogenesis of diseases. Exosomes can also be used as a therapeutic tool for pSS because of their biodegradability, low immunogenicity and toxicity, and the ability to bypass the blood-brain barrier, implying the prospect of a broad application in the context of pSS. Here, we systematically review the isolation, identification, tracing, and mode of action of extracellular vesicles, especially exosomes, as well as the research progress in the pathogenesis, diagnosis, and treatment of pSS.
Topics: B-Lymphocytes; Exosomes; Extracellular Vesicles; Humans; Salivary Glands; Sjogren's Syndrome
PubMed: 35659085
DOI: 10.1186/s13287-022-02912-1 -
Children (Basel, Switzerland) Jan 2021The implications of cancer and its medical treatment are traumatic, highly stressful and have great psychosocial impact. Therefore, a comprehensive treatment is... (Review)
Review
BACKGROUND
The implications of cancer and its medical treatment are traumatic, highly stressful and have great psychosocial impact. Therefore, a comprehensive treatment is essential and music-based interventions can play an important role. The objective of this study is to summarise research that assesses the effects of music therapy in paediatric and adolescent patients with cancer during the process of the disease.
METHODS
A systematic review conducted following PRISMA's statements. An electronic search of the literature was carried out in the following databases: PubMed, Cochrane, Dialnet, Scopus, IDICEs CSIC and Science Direct. Original studies that conducted music-based interventions with oncology patients between 0 to 18 years old were included.
RESULTS
11 studies were finally included in the review. The sample consisted of two quasi-experimental studies, five randomised clinical controlled trials, one non-randomised controlled trial, one study that involved qualitative and quantitative analysis methods, one descriptive study and one observational study.
CONCLUSIONS
Music-based interventions decrease anxiety, perceived pain and depression symptoms and improve state of mind, self-esteem and quality of life of paediatric and adolescent patients with cancer. Moreover, they decrease heart rate, respiratory rate and blood pressure and encourage patients to use adaptive coping strategies.
PubMed: 33561089
DOI: 10.3390/children8020073 -
Iranian Journal of Public Health May 2019Physical rehabilitation, as one of the rehabilitation disciplines, can play a great role in humanitarian reliefs. The effectiveness of physical rehabilitation services... (Review)
Review
BACKGROUND
Physical rehabilitation, as one of the rehabilitation disciplines, can play a great role in humanitarian reliefs. The effectiveness of physical rehabilitation services is completely dependent on time of intervention, the importance of good timing in providing services during disasters is not well understood. The objective of this study was to systematically review the physical rehabilitation services provided in disasters and emergencies.
METHODS
An electronic search of PubMed, Scopus, Cochrane, and PEDro (Physiotherapy Evidence Database) was undertaken from Jan 2000 to Sep 2017. All English studies reporting physical rehabilitation services in natural and man-made disasters were selected regardless of study design. The included studies were analyzed by descriptive and analytical method.
RESULTS
Thirteen studies were included after reviewing by title, abstract and full text in this study. Most of the physical rehabilitation studies come back to recent years. Most of the disaster physical rehabilitation services were physiotherapy and occupational therapy. The physical rehabilitation experts have been attended in the affected area from the few first hours until several months after disasters in order to provide the required services to the affected population.
CONCLUSION
There are few studies about physical rehabilitation services provided in the disaster-affected areas and this study showed that the services were limited and at different times. Physical rehabilitation services post disasters should have a comprehensive service model, like other health services. Therefore, it is necessary to conduct further studies to achieve this aim.
PubMed: 31523636
DOI: No ID Found -
The Cochrane Database of Systematic... 2003There is pre-clinical evidence, involving several animal species, suggesting that opioid peptides play a role in the physiopathology of shock (endotoxic, hypovolemic,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is pre-clinical evidence, involving several animal species, suggesting that opioid peptides play a role in the physiopathology of shock (endotoxic, hypovolemic, cardiogenic, spinal, anaphylactic). Many case reports have suggested that naloxone (an opiate antagonist) might be an effective treatment for shock in humans, but others have not supported such a point of view. This controversy led us to undertake a meta-analysis of the available evidence on the efficacy of naloxone as a treatment measure of shock in humans.
OBJECTIVES
To evaluate the effectiveness and safety of naloxone in human shock and to estimate the methodological quality of the clinical trials.
SEARCH STRATEGY
Computerized bibliographic search up to December 2002, review of references of all papers found on the subject and contact with primary investigators of eligible studies.
SELECTION CRITERIA
Randomized controlled trials evaluating naloxone in human shock, regardless of the patient's age (adult, child or neonate).
DATA COLLECTION AND ANALYSIS
Three independent reviewers extracted data on study design, intervention, outcome and methodological quality.
MAIN RESULTS
Three independent readers reviewed 80 human publications and selected six clinical trials. Overall agreement on study selection was perfect (concordance: 100%). This meta-analysis includes six studies involving 126 patients with septic, cardiogenic, hemorrhagic or spinal shock. Naloxone therapy was associated with statistically significant hemodynamic improvement (odds ratio 0.24; 95% confidence interval [95%CI] 0.09-0.68). The mean arterial pressure was significantly higher in the naloxone groups than in the placebo groups (weighted mean difference: +9.33 mmHg; 95%CI 7.07-11.59). No heterogeneity was found for this outcome. The death rate was lower in the naloxone group (odds ratio 0.59; 95%CI 0.21-1.67) but this was consistent with the play of chance. A significant heterogeneity for the latter outcome was detected (p<0.05).
REVIEWER'S CONCLUSIONS
Naloxone improves blood pressure, especially mean arterial blood pressure. However, the clinical usefulness of naloxone to treat shock remains to be determined, and additional randomized controlled trials are needed to assess its usefulness.
Topics: Adult; Child; Humans; Infant, Newborn; Naloxone; Narcotic Antagonists; Randomized Controlled Trials as Topic; Shock
PubMed: 14584016
DOI: 10.1002/14651858.CD004443 -
Journal of Alzheimer's Disease : JAD 2023Semantic and Phonological fluency (SF and PF) are routinely evaluated in patients with Alzheimer's disease (AD). There are disagreements in the literature regarding... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Semantic and Phonological fluency (SF and PF) are routinely evaluated in patients with Alzheimer's disease (AD). There are disagreements in the literature regarding which fluency task is more affected while developing AD. Most studies focus on SF assessment, given its connection with the temporoparietal amnesic system. PF is less reported, it is related to working memory, which is also impaired in probable and diagnosed AD. Differentiating between performance on these tasks might be informative in early AD diagnosis, providing an accurate linguistic profile.
OBJECTIVE
Compare SF and PF performance in healthy volunteers, volunteers with probable AD, and patients with AD diagnosis, considering the heterogeneity of age, gender, and educational level variables.
METHODS
A total of 8 studies were included for meta-analysis, reaching a sample size of 1,270 individuals (568 patients diagnosed with AD, 340 with probable AD diagnosis, and 362 healthy volunteers).
RESULTS
The three groups consistently performed better on SF than PF. When progressing to a diagnosis of AD, we observed a significant difference in SF and PF performance across our 3 groups of interest (p = 0.04). The age variable explained a proportion of this difference in task performance across the groups, and as age increases, both tasks equally worsen.
CONCLUSION
The performance of SF and PF might play a differential role in early AD diagnosis. These tasks rely on partially different neural bases of language processing. They are thus worth exploring independently in diagnosing normal aging and its transition to pathological stages, including probable and diagnosed AD.
Topics: Humans; Semantics; Alzheimer Disease; Verbal Behavior; Neuropsychological Tests; Linguistics
PubMed: 37482994
DOI: 10.3233/JAD-221272 -
Journal of Oral Biology and... 2020The mainstay of oral submucous fibrosis (OSF) management is to increase the mouth opening; thereby improving oral functionalities. In modernized dentistry, laser therapy... (Review)
Review
BACKGROUND
The mainstay of oral submucous fibrosis (OSF) management is to increase the mouth opening; thereby improving oral functionalities. In modernized dentistry, laser therapy (LT) could play a major role for trismus relief in OSF patients. The present review was performed to systematically analyze the published literature on LT for OSF management.
METHODS
PubMed, Scopus, Web of Science and CINAHL databases were searched until June 2019 using suitable key words and the information was extracted according to the PRISMA guidelines. All full text papers that assessed efficacy of LT for OSF management without limitations on age, gender, ethnicity, or socioeconomic status of the participants were considered eligible. Participants were allocated to the LT alone or in adjunct to oral physiotherapy and medicinal treatment. Outcome parameters included the reduction in trismus. Review articles, case reports, editorial, conference abstracts and in vitro studies were excluded. No restriction was applied on date and language of the publications.
RESULTS
Out of 97 published papers, 7 studies met the inclusion criteria and were included for the analysis. All the studies were clinical and mainly included stage II and III OSF patients. Although different laser types and other parameters were used, all the studies reported improvement in mouth opening in the range of 6.84 mm and 23.7 mm. Additionally, two studies noticed reduced burning sensation and increased tongue protrusion and cheek flexibility. : The LT can provide a promising and better means for relieving trismus and probably OSF-related other symptoms in moderate stages of the disease.
PubMed: 32509514
DOI: 10.1016/j.jobcr.2020.05.004 -
International Journal of Molecular... Dec 2023The objective of this review is to systematically analyze the potential correlation between gut microbiota and osteoarthritis (OA) as well as to evaluate the feasibility... (Review)
Review
The objective of this review is to systematically analyze the potential correlation between gut microbiota and osteoarthritis (OA) as well as to evaluate the feasibility of microbiota-targeted therapies for treating OA. Studies conducted from October 2013 to October 2023 were identified via a search on electronic databases such as PubMed, Web of Science, and Scopus, following established PRISMA statement standards. Two reviewers independently screened, assessed, and extracted relevant data, and then they graded the studies using the ROBINS I tool for non-randomized interventions studies and SYRCLE's risk-of-bias tool for animal studies. A search through 370 studies yielded 38 studies (24 preclinical and 14 clinical) that were included. In vivo research has predominantly concentrated on modifying the gut microbiota microenvironment, using dietary supplements, probiotics, and prebiotics to modify the OA status. are the most thoroughly examined with found to effectively reduce cartilage damage, inflammatory factors, and pain. Additionally, inhibits the development of OA by preventing high-fat diet (HFD)-induced obesity and protecting cartilage from damage. Although there are limited clinical studies, certain compositions of intestinal microbiota may be associated with onset and progression of OA, while others are linked to pain reduction in OA patients. Based on preclinical studies, there is evidence to suggest that the gut microbiota could play a significant role in the development and progression of OA. However, due to the scarcity of clinical studies, the exact mechanism linking the gut microbiota and OA remains unclear. Further research is necessary to evaluate specific gut microbiota compositions, potential pathogens, and their corresponding signaling pathways that contribute to the onset and progression of OA. This will help to validate the potential of targeting gut microbiota for treating OA patients.
Topics: Animals; Humans; Gastrointestinal Microbiome; Osteoarthritis; Microbiota; Databases, Factual; Lactobacillus; Pain
PubMed: 38203314
DOI: 10.3390/ijms25010143 -
BMC Infectious Diseases Feb 2018The exponential growth in the reach and development of new technologies over the past decade means that mobile technologies and social media play an increasingly... (Review)
Review
BACKGROUND
The exponential growth in the reach and development of new technologies over the past decade means that mobile technologies and social media play an increasingly important role in service delivery models to maximise HIV testing and access to treatment and care. This systematic review examines the impact of electronic and mobile technologies in medical care (eHealth) in the linkage to and retention of priority populations in the HIV treatment and care cascade, focussing on the Asia-Pacific region.
METHODS
The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement from the Cochrane Collaboration guidelines. Both grey and published scientific literature from five different databases were searched for all original articles in English published from 2010 to 2017. Studies conducted outside the Asia-Pacific region or not including HIV priority populations were excluded. The methodological quality of studies included in the review was assessed using the Quality Assessment Tool for Quantitative Studies.
RESULTS
The database search identified 7309 records. Of the 224 peer-reviewed articles identified for full text review, 16 studies from seven countries met inclusion criteria. Six cross sectional studies found evidence to support the use of eHealth, via text messages, instant messaging, social media and health promotion websites, to increase rates of HIV testing and re-testing among men who have sex with men (MSM). Evidence regarding the efficacy of eHealth interventions to improve antiretroviral treatment (ART) adherence was mixed, where one randomised controlled trial (RCT) showed significant benefit of weekly phone call reminders on improving ART adherence. Three further RCTs found that biofeedback eHealth interventions that provided estimated ART plasma concentration levels, showed promising results for ART adherence.
CONCLUSIONS
This review found encouraging evidence about how eHealth can be used across the HIV treatment and care cascade in the Asia-Pacific region, including increasing HIV testing and re-testing in priority populations as well as ART adherence. eHealth interventions have an important role to play in the movement towards the end of AIDS, particularly to target harder-to-reach HIV priority populations, such as MSM.
Topics: Asia; Cross-Sectional Studies; HIV Infections; Health Promotion; Homosexuality, Male; Humans; Male; Telemedicine; Text Messaging
PubMed: 29454322
DOI: 10.1186/s12879-018-2972-5 -
EClinicalMedicine Apr 2021Tubercular meningitis (TBM) is associated with high mortality and stroke with chronic neurological sequelae even with best of care and antitubercular therapy. Studies...
BACKGROUND
Tubercular meningitis (TBM) is associated with high mortality and stroke with chronic neurological sequelae even with best of care and antitubercular therapy. Studies have shown that aspirin as an adjunctive therapy might play some role in management of TBM. This systematic review and meta-analysis has been planned to evaluate the efficacy and safety of aspirin as an adjunctive therapy in TBM patients.
METHODS
We conducted a systematic search of randomized controlled trials in patients with tubercular meningitis published till October 2019 in all major clinical journals. Study was registered with PROSPERO with registration number: CRD42019136689. Articles were tested for eligibility and assessed for quality and various bias. Data synthesis and analysis was done using Review manager 5.3. The primary end point for assessment of efficacy was mortality at three months. The secondary end point was stroke or composite outcome of stroke and mortality at three months. Adverse effects were also assessed as secondary safety end point.
FINDINGS
Overall, three eligible randomized controlled trials with 365 participants were included that provided quantitative data for this meta-analysis. The analysis of primary and secondary end points was done using fixed effect model. There was not significant reduction in mortality [hazard ratio 0.78 (95% CI 0.45-1.35, = 0.37)] and composite outcome of mortality and new onset stroke [hazard ratio 0.86 (95% CI 0.60-1.24, = 0.43)] in aspirin group as compared to placebo. However, aspirin as compared to placebo significantly reduced new onset stroke [hazard ratio of 0.51 (95% CI 0.29-0.87, = 0.01)].
INTERPRETATION
We did not find significant reduction in mortality and composite outcome (mortality and new onset stroke) with aspirin as compared to placebo but there was significant reduction in new onset stroke in aspirin group as compared to placebo with Number Needed to Treat (NNT) = 10, which might be of clinical importance since stroke is responsible for high mortality and morbidity in these subset of patients. However, a large well conducted randomized controlled trial is required to put more light on the available evidence.
PubMed: 33948560
DOI: 10.1016/j.eclinm.2021.100819