scholarly journals The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Mei Ji ◽  
Xiaoxia Wang ◽  
Meijuan Chen ◽  
Yan Shen ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Pain Intensity ◽  
Fixed Effects ◽  
Pain Threshold ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Treatment Method ◽  
Threshold Effect ◽  
Effect Sizes

Background. Sciatica is one of the most frequently reported complaints; it affects quality of life and reduces social and economic efficacy. Clinical studies on the efficacy of acupuncture therapy in sciatica are increasing, while systematic reviews assessing the efficacy of acupuncture therapy are still lacking.Objective. This study aims to assess the effectiveness of acupuncture therapy for sciatica.Methods. Comprehensive searches of 8 databases were conducted up until April 2015. Outcomes included effectiveness (proportion of patients who improved totally or partly in clinical symptoms), pain intensity, and pain threshold. Effect sizes were presented as risk ratio (RR) and mean difference (MD). Pooled effect sizes were calculated by fixed effects or random effects model.Results. A total of 12 studies (involving 1842 participants) were included. Results showed that acupuncture was more effective than conventional Western medicine (CWM) in outcomes effectiveness (RR 1.21, 95% CI: 1.16–1.25), pain intensity (MD −1.25, 95% CI: −1.63 to −0.86), and pain threshold (MD: 1.08, 95% CI: 0.98–1.17). Subgroup and sensitivity analysis found that the results did not change in different treatment method and drug categories substantially. The reported adverse effects were acceptable.Conclusions. Acupuncture may be effective in treating the pain associated with sciatica.

A meta-analysis on pain sensitivity in self-injury

2016 ◽  
Vol 46 (8) ◽  
pp. 1597-1612 ◽  
Author(s):  
J. Koenig ◽  
J. F. Thayer ◽  
M. Kaess
Keyword(s):  
Pain Intensity ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Meta Analysis ◽  
Pain Tolerance ◽  
Effect Sizes ◽  
Current Evidence ◽  
Healthy Controls ◽  
Hand Search ◽  
Self Injury

Individuals engaging in self-injurious behavior (SIB) frequently report absence of pain during acts of SIB. While altered pain sensitivity is discussed as a risk factor for the engagement in SIB, results have been mixed with considerable variance across reported effect sizes, in particular with respect to the effect of co-morbid psychopathology. The present meta-analysis aimed to summarize the current evidence on pain sensitivity in individuals engaging in SIB and to identify covariates of altered pain processing. Three databases were searched without restrictions. Additionally a hand search was performed and reference lists of included studies were checked for potential studies eligible for inclusion. Thirty-two studies were identified after screening 720 abstracts by two independent reviewers. Studies were included if they reported (i) an empirical investigation, in (ii) humans, including a sample of individuals engaging in (iii) SIB and a group of (iv) healthy controls, (v) receiving painful stimulation. Random-effects meta-analysis was performed on three pain-related outcomes (pain threshold, pain tolerance, pain intensity) and several population- and study-level covariates (i.e. age, sex, clinical etiology) were subjected to meta-regression. Meta-analysis revealed significant main effects associated with medium to large effect sizes for all included outcomes. Individuals engaging in SIB show greater pain threshold and tolerance and report less pain intensity compared to healthy controls. Clinical etiology and age are significant covariates of pain sensitivity in individuals engaging in SIB, such that pain threshold is further increased in borderline personality disorder compared to non-suicidal self-injury. Mechanisms underlying altered pain sensitivity are discussed.

scholarly journals Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): a meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yanli Liu ◽  
Yilong Pan ◽  
Yuyao Yin ◽  
Wenhao Chen ◽  
Xiaodong Li
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Risk Of Death ◽  
Potential Association ◽  
Increased Risk ◽  
Language Restriction ◽  
Newcastle Ottawa Scale

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.

Role of Electro Acupuncture Therapy on Temporomandibular Joint Pain With Orofacial Myalgia Following Post Healed Unilateral Cervicofacial Burn

2021 ◽  
Vol 46 (2) ◽  
pp. 123-134
Author(s):  
Gopal Nambi ◽  
Walid Kamal Abdelbasset ◽  
Shereen H. Elsayed ◽  
Anju Verma ◽  
Shimaa Abd El-Hamid Abase ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Temporomandibular Joint ◽  
Joint Pain ◽  
Pain Threshold ◽  
Mouth Opening ◽  
Temporomandibular Joint Pain ◽  
Pain Frequency ◽  
Disability Level

Background: Temporomandibular Joint (TJ) pain and orofacial myalgia (OM) are the most significant problems in physiotherapy context to treat in Cervicofacial burn (CB). However, there is a lack of clinical studies in investigating the effects of electro acupuncture therapy on TJ pain with OM following post healed CB patients.<br/> Objective: To investigate the effects of clinical and functional efficacy of electro acupuncture therapy on temporomandibular joint pain with orofacial myalgia following post healed cervicofacial burn patients.<br/> Methods: Through two block random sampling method, the eligible participants were randomized and allocated into active EAT (Active-EAT; n = 15) and placebo EAT (Placebo-EAT; n = 15) groups. The Active-EAT group received electro acupuncture therapy and the Placebo-EAT group received placebo effect with regular physiotherapy care for 4 times in a week for 4 weeks. Primary (pain intensity, pain threshold, pain frequency) and secondary (mouth opening, disability level and quality of life) measures were measured at baseline, after the 4th week, 8th week and 6 month follow up.<br/> Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After 4 weeks of treatment, and at the end of 6 months follow up, the pain intensity, 3.0 (CI 95% 2.83 to 3.16), pain threshold 18.6 (CI 95% -35.0 to -2.1), pain frequency 2.9 (CI 95% 2.54 to 3.25), mouth opening, -13.4 (CI 95% -15.1 to -11.6), disability level 12.4 (CI 95% 12.16 to 12.63), and quality of life -25.8 (CI 95% -31.0 to -20.5) showed more improvement (p < 0.001) in Active-EAT group than Placebo-EAT group.<br/> Conclusion: The reports of this study proved that, 4 weeks active electro acupuncture therapy with regular physiotherapy care has an ideal treatment protocol for temporomandibular joint pain with orofacial myalgia following post healed cervicofacial burn. This study also provided a new knowledge for physiotherapists in the field of TJ rehabilitation.

scholarly journals Minor Physical Anomalies in Bipolar Disorder—A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Eszter Varga ◽  
András Hajnal ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
Dóra Kovács ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Bipolar Disorders ◽  
Effect Sizes ◽  
Inclusion Criteria ◽  
Weighted Mean ◽  
Quality Of Evidence ◽  
Minor Physical Anomalies ◽  
The Brain

Introduction: Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial.Objectives: The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC).Methods: Four studies, involving 155 patients with BPD, and 187 HC, were involved in the analysis after searching the literature. For the investigation of MPAs in the peripheral (MPA-P) and in the head and facial regions (MPA-CF), two studies involving 121 BPD patients, and 133 HC passed the inclusion criteria.Results: The number of the MPAs in the BPD group was significantly higher compared to HC. Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of the HC. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects. It is important to note that there was a low number of eligible publications included, which caused higher heterogeneity.Conclusions: Low quality of evidence suggests that MPAs are more common in patients with BPD than in HC and the higher rate of MPAs is found predominantly in the head and facial regions.

scholarly journals Clinical Features of Coexisting Anti-NMDAR and MOG Antibody-Associated Encephalitis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiayue Ding ◽  
Xiangyu Li ◽  
Zhiyan Tian
Keyword(s):  
Optic Neuritis ◽  
Clinical Features ◽  
Antibody Titer ◽  
Fixed Effects ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Involuntary Movement ◽  
Meta Analysis ◽  
Abnormal Behavior ◽  
Fixed Effects Model

Coexisting anti-NMDAR and MOG antibody (anti-NMDAR-IgG+/MOG-IgG+)-associated encephalitis have garnered great attention. This study aimed to perform a secondary analysis to determine the clinical features of this disease. We searched several databases for related publications published prior to April 2021. A pooled analysis was conducted with the fixed-effects model using the Mante-Haenszel method (I2 ≤ 50%), or the random-effects model computed by the DerSimonian–Laird method (I2 &gt; 50%). Stata software (version 15.0 SE) was used for the analyses. Nine observational studies and 16 case reports (58 cases with anti-NMDAR-IgG+/MOG-IgG+, 21.0 [8.5, 29.0] years, male 58.6%) were included. The incidences (95%CI) of anti-NMDAR-IgG+/MOG-IgG+ in the patients with serum MOG-IgG+ and CSF anti-NMDAR-IgG+ were 0.09 (0.02–0.19) and 0.07 (0.01–0.19), respectively. The median [IQR] of CSF anti-NMDAR antibody titer was 32 [10, 100], and the serum anti-MOG antibody titer was 100 [32, 320]. The prominent clinical symptoms were encephalitic manifestations, including seizures (56.9%) and abnormal behavior (51.7%), rather than demyelinating manifestations, such as speech disorder (34.5%) and optic neuritis (27.6%). Relapse occurred in 63.4% of anti-NMDAR-IgG+/MOG-IgG+ patients, in whom 50.0% of cases relapsed with encephalitic manifestations, and 53.8% relapsed with demyelinating manifestations. The common MRI changes were in the cortex or subcortex (70.7%) and brainstem (31.0%). 31.3% of patients presented with unilateral cerebral cortical encephalitis with epilepsy and 12.5% displayed bilateral frontal cerebral cortex encephalitis. Anti-NMDAR-IgG+/MOG-IgG+ patients showed more frequent mental behavior (OR, 95%CI, 68.38, 1.36–3,434.37), involuntary movement (57.86, 2.53–1,325.11), sleep disorders (195.00, 7.07–5,380.15), and leptomeninge lesions (7.32, 1.81–29.58), and less frequent optic neuritis (0.27, 0.09–0.83) compared to anti-NMDAR-IgG−/MOG-IgG+ patients and presented more common relapse (5.63, 1.75–18.09), preceding infection (2.69, 1.03–7.02), subcortical lesions (116.60, 4.89–2,782.09), basal ganglia lesions (68.14, 2.99–1,554.27), brainstem lesions (24.09, 1.01–574.81), and spinal cord lesions (24.09, 1.01–574.81) compared to anti-NMDAR-IgG+/MOG-IgG−. In conclusion, anti-NMDAR-IgG+/MOG-IgG+ was rarely observed, but the incidence rate of relapse was very high. The overall symptoms seemed to be similar to those of NMDAR encephalitis.

scholarly journals The Distinction of Hot Herbal Compress, Hot Compress, and Topical Diclofenac as Myofascial Pain Syndrome Treatment

2018 ◽  
Vol 23 ◽  
pp. 215658721775345 ◽  
Author(s):  
Jurairat Boonruab ◽  
Netraya Nimpitakpong ◽  
Watchara Damjuti
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Topical Diclofenac ◽  
Hot Compress

This randomized controlled trial aimed to investigate the distinctness after treatment among hot herbal compress, hot compress, and topical diclofenac. The registrants were equally divided into groups and received the different treatments including hot herbal compress, hot compress, and topical diclofenac group, which served as the control group. After treatment courses, Visual Analog Scale and 36-Item Short Form Health survey were, respectively, used to establish the level of pain intensity and quality of life. In addition, cervical range of motion and pressure pain threshold were also examined to identify the motional effects. All treatments showed significantly decreased level of pain intensity and increased cervical range of motion, while the intervention groups exhibited extraordinary capability compared with the topical diclofenac group in pressure pain threshold and quality of life. In summary, hot herbal compress holds promise to be an efficacious treatment parallel to hot compress and topical diclofenac.

scholarly journals Comparative clinical trials in psychotherapy: Have large effects been replicated?

2020 ◽  
Vol 29 ◽  
Author(s):  
Nickolas D. Frost ◽  
Thomas W. Baskin ◽  
Bruce E. Wampold
Keyword(s):  
Clinical Trials ◽  
Treatment Efficacy ◽  
Literature Search ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Depression And Anxiety ◽  
Inclusion Criteria ◽  
Average Quality ◽  
Meta Analyses

Abstract Aims The purpose of this review is to examine the replication attempts of psychotherapy clinical trials for depression and anxiety. We focus specifically on replications of trials that exhibit large differences between psychotherapies. The replicability of these trials is especially important for meta-analysis, where the inclusion of false-positive trials can lead to erroneous conclusions about treatment efficacy. Methods Standard replication criteria were developed to distinguish direct from conceptual replication methodologies. Next, an exhaustive literature search was conducted for published meta-analyses of psychotherapy comparisons. Trials that exhibited large effects (d > 0.8) were culled from these meta-analyses. For each trial, a cited replication was conducted to determine if the trial had been subsequently replicated by either ‘direct’ or ‘conceptual’ methods. Finally, a broader search was conducted to examine the extent of replication efforts in the psychotherapy literature overall. Results In the meta-analytic search, a total of N = 10 meta-analyses met the inclusion criteria. From these meta-analyses, N = 12 distinct trials exhibited large effect sizes. The meta-analyses containing more than two large effect trials reported evidence for treatment superiority. A cited replication search yielded no direct replication attempts (N = 0) for the trials with large effects, and N = 4 conceptual replication attempts of average or above average quality. However, of these four attempts, only two partially corroborated the results from their original trial. Conclusion Meta-analytic reviews are influenced by trials with large effects, and it is not uncommon for these reviews to contain several such trials. Since we find no evidence that trials with such large effects are directly replicable, treatment superiority conclusions from these reviews are highly questionable. To enhance the quality of clinical science, the development of authoritative replication criteria for clinical trials is needed. Moreover, quality benchmarks should be considered before trials are included in a meta-analysis, or replications are attempted.

Problem solving therapies for depression: A meta-analysis

2007 ◽  
Vol 22 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Pim Cuijpers ◽  
Annemieke van Straten ◽  
Lisanne Warmerdam
Keyword(s):  
Problem Solving ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Problem Solving Therapy ◽  
Intention To Treat ◽  
Positive Effects ◽  
Randomized Controlled Studies ◽  
Subgroup Analyses

AbstractPurposeIn the past decades, the effects of problem-solving therapy (PST) for depression have been examined in several randomized controlled studies. However, until now no meta-analysis has tried to integrate the results of these studies.MethodsWe conducted a systematic literature search and identified 13 randomized studies examining the effects of PST, with a total of 1133 subjects. The quality of studies varied.ResultsThe mean standardized effect size was 0.34 in the fixed effects model and 0.83 in the random effects model, with very high heterogeneity. Subgroup analyses indicated significantly lower effects for individual interventions in studies with subjects who met criteria for major depression, studies in which intention-to-treat analyses were conducted instead of completers-only analyses, and studies with pill placebo and care-as-usual control groups. Heterogeneity was high, and the subgroup analyses did not result in clear indications of what caused this high heterogeneity. This indicates that PST has varying effects on depression, and that it is not known to date what determines whether PST has larger of smaller effects.ConclusionAlthough there is no doubt that PST can be an effective treatment for depression, more research is needed to ascertain the conditions and subjects in which these positive effects are realized.

scholarly journals Music Therapy in Pain and Anxiety Management during Labor: A Systematic Review and Meta-Analysis

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 526
Author(s):  
Rocio Santiváñez-Acosta ◽  
Elena de las Nieves Tapia-López ◽  
Marilina Santero
Keyword(s):  
Music Therapy ◽  
Pain Intensity ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Final Analysis ◽  
Beneficial Effects ◽  
Quasi Experimental ◽  
Vas Scores ◽  
Mean Differences

Background and Objective: The study of music therapy in labor is unknown. The main objective of this research was to evaluate the effectiveness of music therapy to manage pain and anxiety during labor. Materials and Methods: A search strategy was used with PubMed/MEDLINE, LILACS, Cochrane, TRIPDATABASE, and Google Scholar. The selection criteria were based on randomized clinical trials; quasi-experimental research on pain intensity and anxiety during labor was evaluated. The primary outcomes were measured by the Visual Analogue Scale (VAS). A meta-analysis of the fixed effects was performed using mean differences (MD). Twelve studies were included for the final analysis, six (778 women) of which were meta-analyzed. Results: Decreased VAS scores for pain intensity associated with music therapy were found in the latent (MD: −0.73; 95% CI −0.99; −0.48) and active (MD: −0.68; 95% CI −0.92; –0.44) phases of labor. VAS scores for anxiety decreased both in the latent (MD: −0.74; 95% CI −1.00; −0.48) and active (MD: −0.76; 95% CI −0.88; −0.64) phases. Conclusion: Music therapy seems to have beneficial effects on pain intensity and anxiety during labor, especially for women giving birth for the first time. However, the evidence is qualified as low.

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