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Nutrients Feb 2018Whey protein (WP) is a widely consumed nutritional supplement, known to enhance strength and muscle mass during resistance training (RT) regimens. Muscle protein... (Meta-Analysis)
Meta-Analysis Review
Whey protein (WP) is a widely consumed nutritional supplement, known to enhance strength and muscle mass during resistance training (RT) regimens. Muscle protein anabolism is acutely elevated following RT, which is further enhanced by WP. As a result, there is reason to suggest that WP supplementation may be an effective nutritional strategy for restoring the acute loss of contractile function that occurs following strenuous RT. This systematic review and meta-analysis provides a synthesis of the literature to date, investigating the effect of WP supplementation on the recovery of contractile function in young, healthy adults. Eight studies, containing 13 randomised control trials (RCTs) were included in this review and meta-analysis, from which individual standardised effect sizes (ESs) were calculated, and a temporal overall ES was determined using a random-effects model. Whilst only half of the individual studies reported beneficial effects for WP, the high-quality evidence taken from the 13 RCTs was meta-analysed, yielding overall positive small to medium effects for WP from < 24 to 96 h (ES range = 0.4 to 0.7), for the temporal restoration of contractile function compared to the control treatment. Whilst the effects for WP were shown to be consistent over time, these results are limited to 13 RCTs, principally supporting the requirement for further comprehensive research in this area.
Topics: Dietary Supplements; Female; Humans; Male; Muscle Contraction; Muscle Fatigue; Muscle Strength; Muscle, Skeletal; Recovery of Function; Resistance Training; Time Factors; Whey Proteins
PubMed: 29462923
DOI: 10.3390/nu10020221 -
Journal of the American Board of Family... 2010Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain... (Review)
Review
Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain complaints. In this clinical narrative review we have attempted to introduce dry needling, a relatively new method for the management of musculoskeletal pain, to the general medical community. Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. Its effectiveness has been confirmed in numerous studies and 2 comprehensive systematic reviews. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective, albeit to a lesser extent. Additional studies are needed to evaluate the effectiveness of dry needling. There also is a great need for further investigation into the development of pain at myofascial trigger points.
Topics: Acupuncture Therapy; Adult; Chronic Disease; Humans; Musculoskeletal Diseases; Myofascial Pain Syndromes; Pain Management
PubMed: 20823359
DOI: 10.3122/jabfm.2010.05.090296 -
International Wound Journal Apr 2018The aim of this study was to identify current research on turning frequencies of adult bed-bound patients and inform future turning practices for hospitals based on...
The aim of this study was to identify current research on turning frequencies of adult bed-bound patients and inform future turning practices for hospitals based on evidence-based practice. We undertook a scoping review framework that provided a transparent and systematic methodology using 8 electronic databases (CINAHL, PubMed, Cochrane Library, ScienceDirect, PsycINFO, Scopus, ProQuest, and Web of Science) to identify articles published from 2000 to 2016. Articles were included if they focused on the prevention of hospital-acquired pressure ulcers related to the frequency of turning or repositioning of bed-bound patients. Literature search and data extraction were performed independently by 3 authors. The study followed the PRISMA guidelines. In total, 911 articles were identified, of which 10 were eligible. Of the eligible articles, 8 studies could not reach a conclusion on the effective frequency of turning and duration for repositioning patients to prevent the development of pressure ulcers. Only 2 studies found significant differences among the intervention and control groups. Results regarding turning and repositioning schedules are inconclusive; however, the topic needs further exploration to improve the outdated guidelines surrounding pressure ulcer prevention. This may, in turn, make the work of nurses more efficient and make treatment cost-effective for both the patients and the hospitals.
Topics: Adult; Aged; Aged, 80 and over; Bedridden Persons; Female; Humans; Male; Middle Aged; Moving and Lifting Patients; Patient Positioning; Practice Guidelines as Topic; Pressure Ulcer; Skin Care
PubMed: 29243356
DOI: 10.1111/iwj.12855 -
Biometrics Mar 2024A crossover trial is an efficient trial design when there is no carry-over effect. To reduce the impact of the biological carry-over effect, a washout period is often...
A crossover trial is an efficient trial design when there is no carry-over effect. To reduce the impact of the biological carry-over effect, a washout period is often designed. However, the carry-over effect remains an outstanding concern when a washout period is unethical or cannot sufficiently diminish the impact of the carry-over effect. The latter can occur in comparative effectiveness research, where the carry-over effect is often non-biological but behavioral. In this paper, we investigate the crossover design under a potential outcomes framework with and without the carry-over effect. We find that when the carry-over effect exists and satisfies a sign condition, the basic estimator underestimates the treatment effect, which does not inflate the type I error of one-sided tests but negatively impacts the power. This leads to a power trade-off between the crossover design and the parallel-group design, and we derive the condition under which the crossover design does not lead to type I error inflation and is still more powerful than the parallel-group design. We also develop covariate adjustment methods for crossover trials. We evaluate the performance of cross-over design and covariate adjustment using data from the MTN-034/REACH study.
Topics: Cross-Over Studies; Research Design
PubMed: 38563531
DOI: 10.1093/biomtc/ujae023 -
Critical Care (London, England) Apr 2018In the ICU, out-of-bed rehabilitation is often delayed and in-bed exercises are generally low-intensity. Since the majority of rehabilitation is carried out in bed, it... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In the ICU, out-of-bed rehabilitation is often delayed and in-bed exercises are generally low-intensity. Since the majority of rehabilitation is carried out in bed, it is essential to carry out the exercises that have the highest intensity. The aim of this study was to compare the physiological effects of four common types of bed exercise in intubated, sedated patients confined to bed in the ICU, in order to determine which was the most intensive.
METHODS
A randomised, single-blind, placebo-controlled crossover trial was carried out to evaluate the effects of four bed exercises (passive range of movements (PROM), passive cycle-ergometry, quadriceps electrical stimulation and functional electrical stimulation (FES) cycling) on cardiac output. Each exercise was carried out for ten minutes in ventilated, sedated patients. Cardiac output was recorded using cardiac Doppler ultrasound. The secondary aims were to evaluate right heart function and pulmonary and systemic artery pressures during the exercises, and the microcirculation of the vastus lateralis muscle.
RESULTS
The results were analysed in 19 patients. FES cycling was the only exercise that increased cardiac output, with a mean increase of 1 L/min (15%). There was a concomitant increase in muscle oxygen uptake, suggesting that muscle work occurred. FES cycling thus constitutes an effective early rehabilitation intervention. No muscle or systemic effects were induced by the passive techniques.
CONCLUSION
Most bed exercises were low-intensity and induced low levels of muscle work. FES cycling was the only exercise that increased cardiac output and produced sufficient intensity of muscle work. Longer-term studies of the effect of FES cycling on functional outcomes should be carried out.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT02920684 . Registered on 30 September 2016. Prospectively registered.
Topics: Aged; Aged, 80 and over; Cardiac Output; Cross-Over Studies; Electric Stimulation; Exercise Therapy; Female; Humans; Intensive Care Units; Male; Middle Aged; Placebos; Quadriceps Muscle; Range of Motion, Articular; Respiration, Artificial; Single-Blind Method; Ultrasonography
PubMed: 29703223
DOI: 10.1186/s13054-018-2030-0 -
Osteoarthritis and Cartilage Jun 2007To evaluate the efficacy, safety and carry-over effect of diacerein, in comparison to piroxicam, in the treatment of Thai patients with symptomatic knee osteoarthritis... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the efficacy, safety and carry-over effect of diacerein, in comparison to piroxicam, in the treatment of Thai patients with symptomatic knee osteoarthritis (OA).
DESIGN
This was a double-blind, randomised, piroxicam-controlled, parallel-group study. A 7-day non-steroidal anti-inflammatory drug washout period was followed by a 16-week treatment period with either diacerein 100mg/day or piroxicam 20mg/day, and an 8-week treatment-free observation period. The primary efficacy criterion was pain on Western Ontario and McMaster University Osteoarthritis (WOMAC) A. The secondary criteria included WOMAC B, C and total WOMAC, paracetamol intake, Short Form-36 questionnaire and global judgements on efficacy and tolerability by patients and investigators.
RESULTS
Of 171 randomised patients, 150 completed the study and 161 were analysed in the intent-to-treat population (diacerein: 82, piroxicam: 79). Pain (WOMAC A) decreased to a similar extent in both groups at Week 16 (diacerein: -69.7%+/-31.5%; piroxicam: -74.1+/-26.2%; P=n.s.). On treatment discontinuation, pain increased in the piroxicam group at Weeks 20 (-47%+/-47.8%) and 24 (-26.8%+/-60.6%) while improvements persisted in the diacerein group at Weeks 20 (-66.9%+/-35.9%) and 24 (-69.5%+/-33.7%), with a significant difference in favour of diacerein at Weeks 20 and 24, demonstrating the carry-over effects of the drug. The incidence of adverse events was similar in both groups but more patients from the piroxicam group dropped out of the study due to these events.
CONCLUSIONS
Diacerein was as effective as piroxicam in reducing pain and improving function but, unlike piroxicam, displayed a carry-over effect and a better safety profile.
Topics: Adult; Aged; Anthraquinones; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Middle Aged; Osteoarthritis, Knee; Piroxicam; Thailand
PubMed: 17448700
DOI: 10.1016/j.joca.2007.02.021 -
Canadian Family Physician Medecin de... Dec 2014Cough is a very common presentation among sick children in my clinic. There is almost no day without a child being examined for upper respiratory tract infection and... (Review)
Review
Cough is a very common presentation among sick children in my clinic. There is almost no day without a child being examined for upper respiratory tract infection and cough. While I understand that no medications are recommended for relief of cough—prescribed or over the counter—is it true that honey might help relieve cough symptoms in children? Most prescribed and over-the-counter preparations for cough in children are not effective and might carry the risk of adverse events. A single dose of honey before bedtime was shown in recent studies to diminish cough and the discomfort experienced by children and their parents. Recent evidence also supports administering a few daily doses, but this practice will need further study to assess its effectiveness and safety.
Topics: Antitussive Agents; Apitherapy; Child; Child, Preschool; Cough; Honey; Humans
PubMed: 25642485
DOI: No ID Found -
International Journal of Emergency... Mar 2021The COVID-19 pandemic has exposed a suboptimal response to this threatening global disaster, including the response to the psychological impact. Both the economic... (Review)
Review
BACKGROUND
The COVID-19 pandemic has exposed a suboptimal response to this threatening global disaster, including the response to the psychological impact. Both the economic hardship and the continuous media coverage of alarming news have exacerbated this effect which also includes increased domestic violence.
AIM
To address this important aspect of disaster management and provide recommendations on how to mitigate these effects.
METHODS
This is a narrative review written by three experts in community medicine, disaster medicine and psychiatry reflecting the interdisciplinary approach in managing disasters. Selected important papers, personal published papers, PUBMED articles and media news related to the disaster management of the psychological effects of COVID-19 pandemic were collected over the last year, critically appraised and used in writing this manuscript.
RESULTS
The COVID-19 pandemic causes major emotional distress. Lack of effective treatments and availability of the current vaccines for this virus increases the fear of being infected and infecting others. Negative emotions are common and are related to adjustment but may progress in the long term to anxiety, depression, and post-traumatic stress syndrome. The COVID-19 pandemic has a major impact on mental health. The most common distress reactions include anxiety, insomnia, perception of insecurity, anger, fear of illness, and risky behaviors. Patients having mental disorders are vulnerable during the pandemic because of (1) somatic vulnerability, (2) cognitive and behavioral vulnerability, (3) psychosocial vulnerability, and (4) disruption to psychiatric care. Psychiatric wards, which are commonly separate from main hospitals, should be included in the disaster management plans. Acute care physicians carry the psychological and ethical impact of difficult triage decisions when ending the support of some patients to save others. A combination of fear and guilt may overcome normal human tolerance levels in vulnerable health workers. The moral injuries can be carried for a long time.
CONCLUSIONS
Addressing the psychological effects is an essential component of disaster management of infectious pandemics. This should be implemented through the whole spectrum of disaster management including preparedness, mitigation, response, and recovery.
PubMed: 33761863
DOI: 10.1186/s12245-021-00342-z -
Annual Review of Plant Biology Jun 2021A surge in research focused on understanding the physical principles governing the formation, properties, and function of membraneless compartments has occurred over the... (Review)
Review
A surge in research focused on understanding the physical principles governing the formation, properties, and function of membraneless compartments has occurred over the past decade. Compartments such as the nucleolus, stress granules, and nuclear speckles have been designated as biomolecular condensates to describe their shared property of spatially concentrating biomolecules. Although this research has historically been carried out in animal and fungal systems, recent work has begun to explore whether these same principles are relevant in plants. Effectively understanding and studying biomolecular condensates require interdisciplinary expertise that spans cell biology, biochemistry, and condensed matter physics and biophysics. As such, some involved concepts may be unfamiliar to any given individual. This review focuses on introducing concepts essential to the study of biomolecular condensates and phase separation for biologists seeking to carry out research in this area and further examines aspects of biomolecular condensates that are relevant to plant systems.
Topics: Animals; Organelles; Plants
PubMed: 33684296
DOI: 10.1146/annurev-arplant-081720-015238