Sildenafil does not reliably improve exercise performance in hypoxia: a systematic review

ObjectiveSildenafil is a pulmonary vasodilator that may reduce the decrement in endurance performance in moderate hypoxia. We assessed the efficacy of sildenafil to improve performance in hypoxia.Data sources/eligibility CriteriaWe systematically searched electronic databases (until August 2018) for randomised trials comparing sildenafil with placebo. We also examined the effect of sildenafil on pulmonary artery pressure (PAP), cardiac output (CO) and pulse oxygen saturation (SPO2) compared with placebo in hypoxia. Fourteen studies were included; 210 subjects received sildenafil 40, 50 or 100 mg/day.ResultsSildenafil showed a large effect for decreasing PAP during exercise and at rest, a small effect for increasing CO during exercise and a moderate effect at rest, a moderate effect for increasing SPO2and a small effect for improving performance. In a subgroup analysis, there was no statistically significant difference between 100 and 50 mg sildenafil dose on SPO2. Sildenafil had a moderate effect on increasing SPO2and performance at terrestrial hypobaric altitude but only a small effect on both in normobaric hypoxia. Regression analysis showed that hypoxic dose (PO2) and metabolic rate do not account for a significant portion of the variance in effect size for sildenafil on PAP, CO, SPO2and performance.ConclusionThis meta-analysis indicates that sildenafil reduces PAP, has a moderate to small effect on CO and SPO2, and no effect on performance.

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Replication of the Superstition and Performance Study by

Social Psychology ◽

10.1027/1864-9335/a000190 ◽

2014 ◽

Vol 45 (3) ◽

pp. 239-245 ◽

Cited By ~ 18

Author(s):

Robert J. Calin-Jageman ◽

Tracy L. Caldwell

Keyword(s):

Task Difficulty ◽

Statistical Power ◽

Meta Analysis ◽

A Priori ◽

Significant Heterogeneity ◽

Performance Study ◽

Improve Performance ◽

Research Designs ◽

Series Of Experiments ◽

And Performance

A recent series of experiments suggests that fostering superstitions can substantially improve performance on a variety of motor and cognitive tasks ( Damisch, Stoberock, & Mussweiler, 2010 ). We conducted two high-powered and precise replications of one of these experiments, examining if telling participants they had a lucky golf ball could improve their performance on a 10-shot golf task relative to controls. We found that the effect of superstition on performance is elusive: Participants told they had a lucky ball performed almost identically to controls. Our failure to replicate the target study was not due to lack of impact, lack of statistical power, differences in task difficulty, nor differences in participant belief in luck. A meta-analysis indicates significant heterogeneity in the effect of superstition on performance. This could be due to an unknown moderator, but no effect was observed among the studies with the strongest research designs (e.g., high power, a priori sampling plan).

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Laser Influence on Dental Sensitivity Compared to Other Light Sources Used During In-office Dental Bleaching: Systematic Review and Meta-analysis

Operative Dentistry ◽

10.2341/19-064-l ◽

2020 ◽

Vol 45 (6) ◽

pp. 589-597

Author(s):

BGS Casado ◽

EP Pellizzer ◽

JR Souto Maior ◽

CAA Lemos ◽

BCE Vasconcelos ◽

...

Keyword(s):

Randomized Clinical Trials ◽

Color Change ◽

Meta Analysis ◽

Present Review ◽

Cochrane Library ◽

Light Sources ◽

Eligibility Criteria ◽

Tooth Color ◽

Significant Difference ◽

Meta Analyses

Clinical Relevance The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources. Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible. Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: −1.60; confidence interval [CI]: −3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: −2.22; CI: −6.36 to 1.93; p=0.29). Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.

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Mortality Benefit From the Passive Leg Raise Maneuver in Guiding Resuscitation of Septic Shock Patients: A Systematic Review and Meta-Analysis of Randomized Trials

Journal of Intensive Care Medicine ◽

10.1177/08850666211019713 ◽

2021 ◽

pp. 088506662110197

Author(s):

Moosa Azadian ◽

Suyee Win ◽

Amir Abdipour ◽

Carolyn Krystal Kim ◽

H. Bryant Nguyen

Keyword(s):

Systematic Review ◽

Septic Shock ◽

Fluid Resuscitation ◽

Standard Care ◽

Meta Analysis ◽

Risk Of Bias ◽

Time Interval ◽

Eligibility Criteria ◽

Significant Difference ◽

Passive Leg Raise

Background: Fluid therapy plays a major role in the management of critically ill patients. Yet assessment of intravascular volume in these patients is challenging. Different invasive and non-invasive methods have been used with variable results. The passive leg raise (PLR) maneuver has been recommended by international guidelines as a means to determine appropriate fluid resuscitation. We performed this systematic review and meta-analysis to determine if using this method of volume assessment has an impact on mortality outcome in patients with septic shock. Methods: This study is a systematic review and meta-analysis. We searched available data in the MEDLINE, CINAHL, EMBASE, and CENTRAL databases from inception until October 2020 for prospective, randomized, controlled trials that compared PLR-guided fluid resuscitation to standard care in adult patients with septic shock. Our primary outcome was mortality at the longest duration of follow-up. Results: We screened 1,425 article titles and abstracts. Of the 23 full-text articles reviewed, 5 studies with 462 patients met our eligibility criteria. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for mortality at the longest reported time interval were calculated for each study. Using random effects modeling, the pooled OR (95% CI) for mortality with a PLR-guided resuscitation strategy was 0.82 (0.52 -1.30). The included studies were not blinded and they ranged from having low to high risk of bias using the Cochrane Risk of Bias Tool. Conclusion: Our analysis showed there was no statistically significant difference in mortality among septic shock patients treated with PLR-guided resuscitation vs. those with standard care.

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Effectiveness and safety of herbal medicines for induction of labour: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022499 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022499 ◽

Cited By ~ 8

Author(s):

Collins Zamawe ◽

Carina King ◽

Hannah Maria Jennings ◽

Chrispin Mandiwa ◽

Edward Fottrell

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Experimental Studies ◽

Herbal Medicines ◽

Risk Of Bias ◽

Induction Of Labour ◽

Quality Data ◽

Eligibility Criteria ◽

Significant Difference

ObjectiveThe use of herbal medicines for induction of labour (IOL) is common globally and yet its effects are not well understood. We assessed the efficacy and safety of herbal medicines for IOL.DesignSystematic review and meta-analysis of published literature.Data sourcesWe searched in MEDLINE, AMED and CINAHL in April 2017, updated in June 2018.Eligibility criteriaWe considered experimental and non-experimental studies that compared relevant pregnancy outcomes between users and non-user of herbal medicines for IOL.Data extraction and synthesisData were extracted by two reviewers using a standardised form. A random-effects model was used to synthesise effects sizes and heterogeneity was explored through I2statistic. The risk of bias was assessed using ‘John Hopkins Nursing School Critical Appraisal Tool’ and ‘Cochrane Risk of Bias Tool’.ResultsA total of 1421 papers were identified through the searches, but only 10 were retained after eligibility and risk of bias assessments. The users of herbal medicine for IOL were significantly more likely to give birth within 24 hours than non-users (Risk Ratio (RR) 4.48; 95% CI 1.75 to 11.44). No significant difference in the incidence of caesarean section (RR 1.19; 95% CI 0.76 to 1.86), assisted vaginal delivery (RR 0.73; 95% CI 0.47 to 1.14), haemorrhage (RR 0.84; 95% CI 0.44 to 1.60), meconium-stained liquor (RR 1.20; 95% CI 0.65 to 2.23) and admission to nursery (RR 1.08; 95% CI 0.49 to 2.38) was found between users and non-users of herbal medicines for IOL.ConclusionsThe findings suggest that herbal medicines for IOL are effective, but there is inconclusive evidence of safety due to lack of good quality data. Thus, the use of herbal medicines for IOL should be avoided until safety issues are clarified. More studies are recommended to establish the safety of herbal medicines.

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Preventive Ventricular Tachycardia Ablation in Patients with Ischaemic Cardiomyopathy: Meta-analysis of Randomised Trials

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2019.31.3 ◽

2019 ◽

Vol 8 (3) ◽

pp. 173-179 ◽

Cited By ~ 4

Author(s):

Roland R Tilz ◽

Charlotte Eitel ◽

Evgeny Lyan ◽

Kivanc Yalin ◽

Spyridon Liosis ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Catheter Ablation ◽

Secondary Prevention ◽

Meta Analysis ◽

Randomised Trials ◽

Icd Implantation ◽

Icd Therapy ◽

Number Of Patients ◽

Significant Difference ◽

Vt Ablation

Catheter ablation of ventricular tachycardia (VT) aims to treat the underlying arrhythmia substrate to prevent ICD therapies. The aim of this meta-analysis was to assess the safety and efficacy of VT ablation prior to or at the time of secondary prevention ICD implantation in patients with coronary artery disease, as compared with deferred VT ablation. Based on a systematic literature search, three randomised trials were considered eligible for inclusion in this analysis, and data on the number of patients with appropriate ICD shocks, appropriate ICD therapy, arrhythmic storm, death and major complications were extracted from each study. On pooled analysis, there was a significant reduction of appropriate ICD shocks (OR 2.58; 95% CI [1.54–4.34]; p<0.001) and appropriate ICD therapies (OR 2.04; 95% CI [1.15–3.61]; p=0.015) in patients undergoing VT ablation at the time of ICD implantation without significant differences with respect to complications (OR 1.39; 95% CI [0.43–4.51]; p=0.581). Mortality did not differ between both groups (OR 1.30; 95% CI [0.60–2.45]; p=0.422). Preventive catheter ablation of VT in patients with coronary heart disease at the time of secondary prevention ICD implantation results in a significant reduction of appropriate ICD shocks and any appropriate ICD therapy compared with patients without or with deferred VT ablation. No significant difference with respect to complications or mortality was observed between both treatment strategies.

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Corticosteroid as an Adjunct in the Treatment of Endobronchial Tuberculosis: A Systematic Review & Meta-analysis

Current Pediatric Reviews ◽

10.2174/1573396315666191016100615 ◽

2020 ◽

Vol 16 (1) ◽

pp. 53-60

Author(s):

Nihar R. Mishra ◽

Manoj K. Panigrahi ◽

Girish C. Bhatt ◽

Rashmi R. Das

Keyword(s):

Adverse Events ◽

Meta Analysis ◽

Intervention Group ◽

Oral Prednisolone ◽

Oral Steroid ◽

Control Group ◽

Eligibility Criteria ◽

Steroid Group ◽

Significant Difference ◽

Endobronchial Tuberculosis

Background: Corticosteroid exerts anti-inflammatory action and can prevent tissue damage resulting from various causes. Studies have shown that corticosteroids may prevent the damaging effect of tuberculosis (TB) in various organs, but there is no published meta-analysis specifically looking for the effect of corticosteroid in endobronchial TB. Objective: To synthesize the evidence regarding the usefulness of corticosteroid in endo-bronchial TB. Methods: A comprehensive search was performed of the major electronic databases till 30th November 2018. Randomized trials comparing treatment with corticosteroid as an adjunct to antitubercular drugs (ATT) versus placebo/no treatment in endobronchial TB were included. Three authors independently applied eligibility criteria, assessed the studies for methodological quality, and extracted data. The review is registered at PROSPERO database [CRD42016047063]. Results: Out of 525 search results, 4 trials including 205 patients (151 children) were eligible for inclusion. Oral prednisolone was used in various dose schedules. Rifampicin containing ATT regimen was used in 3 trials. The bronchoscopy findings showed no significant improvement at 1 month (effect size could not be calculated due to 0 event in the intervention group, p = 0.05), 2 months (RR 1.26, 95% CI 0.89 to 1.8), and at completion of ATT (RR 0.63, 95% CI 0.1 to 4.14) in steroid-treated group compared to the control group. The need for repeat bronchoscopy was significantly decreased in the steroid group (RR 0.13, 95% CI 0.02 to 0.9). Among the adverse events, the infection rate was significantly lesser in the steroid group (RR 0.53, 95% CI 0.29 to 0.97); but other adverse events (mortality, hypertension, and abdominal distension) showed no significant difference between the two groups. The GRADE evidence generated was of very low quality. Conclusions: The present meta-analysis showed that oral steroid does not help patients with endobronchial tuberculosis. However, the quality of evidence was very low. Future trials with robust design and a larger sample size would be required to provide any firm recommendation regarding the use of oral prednisolone in endobronchial tuberculosis.

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Efficacy, immunogenicity and safety of a recombinant tetravalent dengue vaccine (CYD-TDV) in children aged 2–17 years: systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-019368 ◽

2019 ◽

Vol 9 (3) ◽

pp. e019368 ◽

Cited By ~ 3

Author(s):

Bruno Rodrigues Rosa ◽

Antonio José Ledo Alves da Cunha ◽

Roberto de Andrade Medronho

Keyword(s):

Systematic Review ◽

Incomplete Data ◽

Meta Analysis ◽

Randomised Trials ◽

Dengue Vaccine ◽

Eligibility Criteria ◽

Registration Number ◽

Randomised Controlled

BackgroundRandomised controlled trials have evaluated the recombinant tetravalent dengue vaccine (CYD-TDV). However, individual results may have little power to identify differences among the populations studied.ObjectiveTo evaluate efficacy, immunogenicity and safety of CYD-TDV in the prevention of dengue in children aged 2–17 years.DesignSystematic review and meta-analysis.Data sourcesMEDLINE (from 1950 to 5 December 2018), EMBASE (from 1947 to 5 December 2018) and Cochrane (from 1993 to 5 December 2018).Eligibility criteria of studiesRandomised trials comparing efficacy, immunogenicity and safety of CYD-TDV with placebo or other vaccines for preventing dengue cases in children aged 2–17 years.Outcome measuresEfficacy, immunogenicity and safety of CYD-TDV.Study appraisal and methodsCalculations were made of relative risk (RR) and mean difference (MD) for dichotomous and continuous outcomes, respectively. All estimates were calculated considering a 95% CI estimate. A p<0.05 was considered statistically significant.ResultsNine studies involving 34 248 participants were included. The overall efficacy of CYD-TDV was 60% (RR 0.40 (0.30 to 0.54)). Serotype-specific efficacy of the vaccine was 51% for dengue virus type-1 (DENV-1) (RR 0.49 (0.39 to 0.63)); 34% for DENV-2 (RR 0.66 (0.50 to 0.86)); 75% for DENV-3 (RR 0.25 (0.18 to 0.35)) and 77% for DENV-4 (RR 0.23 (0.15 to 0.34)). Overall immunogenicity (MD) of CYD-TDV was 225.13 (190.34 to 259.93). Serotype-specific immunogenicity was: DENV-1: 176.59 (123.36 to 229.83); DENV-2: 294.21 (181.98 to 406.45); DENV-3: 258.78 (146.72 to 370.84) and DENV-4: 189.35 (141.11 to 237.59). The most common adverse events were headache and pain at the injection site.LimitationsThe main limitation of this study was unclear or incomplete data.Conclusions and implications of key findingsCYD-TDV is considered safe and able to partially protect children and adolescents against four serotypes of DENV for a 1-year period. Despite this, research should prioritise improvements in vaccine efficacy, thus proving higher long-term protection against all virus serotypes.PROSPERO registration numberCRD42016043628.

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Quiet Eye and Performance in Sport: A Meta-Analysis

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.2015-0123 ◽

2016 ◽

Vol 38 (5) ◽

pp. 441-457 ◽

Cited By ~ 41

Author(s):

Jean-Charles Lebeau ◽

Sicong Liu ◽

Camilo Sáenz-Moncaleano ◽

Susana Sanduvete-Chaves ◽

Salvador Chacón-Moscoso ◽

...

Keyword(s):

Effect Size ◽

Meta Analysis ◽

Effect Sizes ◽

Subsequent Performance ◽

Quiet Eye ◽

Performance Effects ◽

Moderate Effect Size ◽

Moderate Effect ◽

And Performance ◽

Absolute Duration

Research linking the “quiet eye” (QE) period to subsequent performance has not been systematically synthesized. In this paper we review the literature on the link between the two through nonintervention (Synthesis 1) and intervention (Synthesis 2) studies. In the first synthesis, 27 studies with 38 effect sizes resulted in a large mean effect (d = 1.04) reflecting differences between experts’ and novices’ QE periods, and a moderate effect size (d = 0.58) comparing QE periods for successful and unsuccessful performances within individuals. Studies reporting QE duration as a percentage of the total time revealed a larger mean effect size than studies reporting an absolute duration (in milliseconds). The second synthesis of 9 articles revealed very large effect sizes for both the quiet-eye period (d = 1.53) and performance (d = 0.84). QE also showed some ability to predict performance effects across studies.

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Carbon dioxide versus air insufflation enteroscopy: a systematic review and meta-analysis based on randomized controlled trials

Endoscopy International Open ◽

10.1055/a-0574-2357 ◽

2018 ◽

Vol 06 (06) ◽

pp. E637-E645 ◽

Cited By ~ 3

Author(s):

Julio Aquino ◽

Wanderley Bernardo ◽

Diogo de Moura ◽

Flávio Morita ◽

Rodrigo Rocha ◽

...

Keyword(s):

Clinical Trials ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Meta Analysis ◽

Ambient Air ◽

Quality Analysis ◽

Cochrane Library ◽

Eligibility Criteria ◽

Co2 Insufflation ◽

Significant Difference

Abstract Objectives To compare the insufflation of CO2 and ambient air in enteroscopy. Search sources The investigators researched the electronic databases MedLine, Cochrane Library, Central, LILACS, BVS, Scopus and Cinahl. The grey search was conducted in the base of theses of the University of São Paulo, books of digestive endoscopy and references of selected articles and in previous systematic revisions. Study eligibility criteria The evaluation of eligibility was performed independently, in a non-blind manner, by two reviewers, firstly by title and abstract, followed by complete text. Disagreements between the reviewers were resolved by consensus. Data collection and analysis method Through the spreadsheet of data extraction, where one author extracted the data and a second author checked the extraction. Disagreements were resolved by debate between the two reviewers. The quality analysis of the studies was performed using the Jadad score. The software RevMan 5 version 5.3 was used for the meta-analysis. Results Four randomized clinical trials were identified, totaling 473 patients submitted to enteroscopy and comparing insufflation of CO2 and ambient air. There was no statistical difference in the intubation depth between the two groups. When CO2 insufflation was reduced, there was a significant difference in pain levels 1 hour after the procedure (95 % IC, –2.49 [–4.72, –0.26], P: 0.03, I2: 20%) and 3 hours after the procedure (95% IC, –3.05 [–5.92, –0.18], P: 0.04, I2: 0 %). There was a usage of lower propofol dosage in the CO2 insufflation group, with significant difference (95 % IC, –67.68 [–115.53, –19.84], P: 0.006, I2: 0 %). There was no significant difference between the groups in relation to the use of pethidine and to the oxygen saturation. Limitations Restricted number of randomized clinical trials and nonuniformity of data were limitations to the analysis of the outcomes. Conclusion The use of CO2 as insufflation gas in enteroscopy reduces the pain levels 1 hour and 3 hours after the procedure, in addition to the reduction of the sedation (propofol) dosage used.

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Bottom-Up Interventions Effective in Promoting Work Engagement: A Systematic Review and Meta-Analysis

Frontiers in Psychology ◽

10.3389/fpsyg.2021.730421 ◽

2021 ◽

Vol 12 ◽

Author(s):

Janina M. Björk ◽

Pernilla Bolander ◽

Anna K. Forsman

Keyword(s):

Systematic Review ◽

Work Engagement ◽

Meta Analysis ◽

Eligibility Criteria ◽

Bottom Up ◽

Online Databases ◽

Randomized Intervention ◽

Engagement Interventions ◽

And Performance ◽

Underlying Mechanisms

Background: Promoting work engagement is of interest to organizations across sectors due to the associated positive outcomes. This interest warrants research on the evidence of work engagement interventions. Intervention research increasingly advocates a bottom-up approach, highlighting the role of employees themselves. These workplace interventions often encourage employees to identify, develop, and make use of workplace resources. The aim of this systematic review and meta-analysis is to investigate the effectiveness and potential underlying mechanisms of these bottom-up, resource-developing interventions.Method: Systematic searches were conducted in the online databases Web of Science, Academic Search Complete, Business Source Ultimate, PsycInfo, PsycArticles, SCOPUS, and Google Scholar. Publication year range was 2000–2020. Eligibility criteria were defined using PICOS. To be eligible for the systematic review, the intervention study identified had to aim at promoting working individuals’ work engagement by developing workplace resources from bottom-up. Work engagement had to be measured using the Utrecht Work Engagement Scale. The systematic review included one-, two-, or multiple-armed – randomized or non-randomized – intervention studies with various study designs. Further, a meta-analysis was conducted on a sub-set of the studies included in the systematic review. To be eligible for the meta-analysis, the studies had to be two- or multiple-armed and provide the information necessary to compute effect sizes.Results: Thirty-one studies were included in the systematic review. The majority reported that overall work engagement increased as an effect of the intervention. The evidence regarding the sub-components of work engagement was scattered. Potential underlying mechanisms explored were intervention foci, approach, and format. Dimensions of satisfaction and performance were identified as secondary outcomes. Participant experiences were generally described as positive in most of the studies applying mixed methods. The meta-analysis showed a small but promising intervention effect on work engagement (24 studies, SMD: −0.22, 95% CI: −0.34 to −0.11, with I2=53%, indicating moderate inconsistency in the evidence).Conclusion: The synthesized evidence suggests that bottom-up, resource-developing interventions are effective in the promotion of work engagement. The meta-analysis suggests that focusing on strengths use or mobilizing ego resources and adopting a universal approach increase intervention effectiveness.

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