scholarly journals Chinese Medicinal Herbs in the Treatment of Diabetic Cognitive Impairment: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Bin Yan ◽  
Jingbo Wang ◽  
Zhigang Xue ◽  
Guoqing Tian
Keyword(s):  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Memory Function ◽  
Effective Rate ◽  
Medicinal Herbs ◽  
Controlled Trials ◽  
Chinese Medicinal Herbs ◽  
Randomized Controlled ◽  
Significant Difference

Background. Diabetic cognitive impairment (DCI), a serious complication of diabetes mellitus (DM), is gaining more acceptance and attention. The learning and memory function of diabetics always decreases. Traditional Chinese medicine (TCM) has been demonstrated to be effective in treating the symptoms in China, and thereinto Chinese medicinal herbs (CMH) are the most widely used. The objective of the present study was to review and analyze the existing data about reducing the symptoms in CMH treatment for DCI. Methods. Electronic literature databases (PubMed, EMBASE, CNKI, SinoMed, and Wan fang) were searched for randomized controlled trials conducted in China, comparing CMH with western medicines in the treatment of DCI, up to April 1, 2018. We applied standard meta-analytic techniques to analyze data from papers that reached acceptable criteria. Result. Nine randomized controlled trials (n = 576) on CMH were included. We found moderate evidence that CMH used alone or in combination with western medicines was more effective than western medicines alone in reliving the symptoms for DCI (total effective rate, odds radio (OR) = 4.64 (2.60, 8.29), and 95% confidence interval, P<0.00001). Besides, CMH along or in combination with western medicines showed more beneficial effects on Montreal Cognitive Assessment (MoCA) scale (mean difference (MD) = 1.31(0.75, 1.87), P<0.00001), Mini-Mental State Examination (MMSE) scale (MD = 2.07 (0.86, 3.28), P<0.00001, and TCM symptom score (TCMSS) (MD = -4.89 (-8.44, -1.34), P = 0.007). Most of the included studies showed that there was not a significant difference in the adverse events. Conclusions. These findings demonstrated that CMH used alone or in combination with western medicines were apparently better than western medicines alone in the treatment of DCI. Because of the poor quality of the studies that were available for the present meta-analysis, further researches are still needed to support these early findings.

scholarly journals Auricular Plaster Therapy for Comorbid Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Huimin Zhao ◽  
Dan Li ◽  
Ying Yang ◽  
Yueting Liu ◽  
Jie Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Effective Rate ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Comorbid Insomnia ◽  
Randomized Controlled ◽  
Significant Difference

Background. Although the effectiveness of auricular plaster therapy (APT) on primary insomnia has been systematically reviewed, no systematic review of studies has focused on the effect on comorbid insomnia. Objective. To evaluate the efficacy and safety of APT for comorbid insomnia. Methods. Fifteen databases were searched from inception to July 2018. Randomized controlled trials (RCTs) of APT as an exclusive intervention for comorbid insomnia against Western medications, sham APT or no treatment were identified. Results. Fourteen studies involving 928 participants were identified. The pooled outcomes revealed that APT was superior to control conditions for the global score on PSQI (SMD = -1.13, and 95% CI = -1.48—-0.78) and the effective rate (RR = 1.24, 95% CI = 1.13—1.36, NNT = 5, and 95% CI =4—7). Furthermore, the results of subgroup analyses were similar to the pooled results. Additionally, the pooled results were verified to be stable by sensitivity analyses. Regarding safety, no significant difference was identified between APT and Western medications. Conclusions. APT appears to be an effective and safe treatment for comorbid insomnia. However, the benefits of APT for comorbid insomnia could not be ascertained due to the paucity of the quantity and quality of the included studies. Large-scale studies using proper methodology are needed to yield a firm conclusion.

scholarly journals Comparative Effectiveness of Interventions for Global Cognition in Patients With Mild Cognitive Impairment: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 13 ◽  
Author(s):  
Zijun Xu ◽  
Wen Sun ◽  
Dexing Zhang ◽  
Vincent Chi-Ho Chung ◽  
Regina Wing-Shan Sit ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Exercise ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Global Cognition

Background: There is a lack of study comprehensively comparing the effects of all existing types of interventions on global cognition among patients with mild cognitive impairment (MCI).Aims: To conduct a network meta-analysis to evaluate the effectiveness of different types of interventions in improving global cognition among MCI patients.Methods: Randomized controlled trials (RCTs) assessing the effects of pharmacological or non-pharmacological interventions on the Mini-Mental State Examination (MMSE) in MCI patients were included. Two authors independently screened the studies and extracted the data. Random-effects network meta-analysis was used to synthesize the data. Results were summarized as mean difference (MD) and corresponding 95% CIs of MMSE in forest plots.Results: Fifty RCTs with 5,944 MCI patients met the inclusion criteria and 49 were included in the network meta-analysis. Compared with the control group, cognition-based intervention (MD = 0.80, 95% CI 0.04–1.57), physical exercise (MD = 1.92, 95% CI 1.19–2.64), combined physical exercise and cognition-based intervention (MD = 1.86, 95% CI 0.60–3.12), and antioxidants (MD = 0.94, 95% CI 0.04–1.83) had positive effects on MMSE in participants with MCI. There was no significant difference between all other interventions included and the control group.Conclusions: This study suggested that cognition-based intervention, physical exercise, combined physical exercise and cognition-based intervention, and antioxidants could be among the most effective interventions on global cognition in older adults with MCI. The availability, acceptability, and cost-effectiveness of interventions should also be taken into consideration when selecting interventions.Registration: PROSPERO CRD42020171985.

scholarly journals The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Xiaojin Feng ◽  
Jialing Hu ◽  
Fuzhou Hua ◽  
Jing Zhang ◽  
Lieliang Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Intraoperative Hypotension ◽  
Significant Difference ◽  
Postoperative Cognitive Impairment

Abstract Background There is no consensus on whether intraoperative hypotension is associated with postoperative cognitive impairment. Hence, we performed a meta-analysis to evaluate the correlation of intraoperative hypotension and the incidence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD).Methods We searched PubMed, Embase, and Cochrane library databases to find randomized controlled trials (RCTs) in which reported the relationship of intraoperative hypotension and POD or POCD. The retrieval time is up to January 2020, without language restrictions. Quality assessment of the eligible studies was conducted by two researchers independently using the Cochrane evaluation system.Results Five RCTs were included. For the incidence of POD, there are two studies with 99 participants in the low-blood pressure (LP) group and 94 participants in the high-blood pressure (HP) group. For the incidence of POCD, there are four studies with 360 participants in the LP group and 341 participants in the HP group, with a study contains both POD and POCD. No significant difference between the LP and the HP group was observed in the incidence of POD (RR = 3.30, 95% CI 0.80 to 13.54, P = 0.10), or POCD (RR = 1.26, 95% CI 0.76 to 2.08, P = 0.37). Furthermore, it also demonstrated that intraoperative hypotension prolonged the length of ICU stay, but did not increased the mortality, the length of hospital stay, and mechanical ventilation (MV) time.Conclusions There is no significant correlation between intraoperative hypotension and the incidence of POD or POCD.

Early Versus Routine Stoma Closure in Patients With Colorectal Resection: A Meta-Analysis of 7 Randomized Controlled Trials

2020 ◽  
Vol 27 (3) ◽  
pp. 291-298
Author(s):  
Yinyin Guo ◽  
Yanxin Luo ◽  
Hui Zhao ◽  
Liangliang Bai ◽  
Juan Li ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Randomized Controlled Trials ◽  
Bowel Obstruction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Wound Complications ◽  
Controlled Trials ◽  
Stoma Closure ◽  
Randomized Controlled ◽  
Significant Difference

Background. A substantial proportion of patients undergoing colorectal surgery receive a temporary stoma, and the timing for stoma closure remains unclear. The aim of this study was to evaluate the safety and feasibility of early stoma closure (ESC) compared with routine stoma closure (RSC) after colorectal surgery. Methods. We comprehensively searched PubMed, Embase, and the Cochrane Library for randomized controlled trials that compared ESC and RSC after colorectal surgery. Results. A total of 7 randomized controlled trials with 814 enrolled patients were identified for this meta-analysis. There were no significant differences between the ESC and RSC groups regarding the complications of stoma closure (26.8% and 16.6%, respectively; odds ratio [OR]: 1.30; 95% confidence interval [CI]: 0.89-1.90; P = .17). A subgroup analysis was conducted by Clavien-Dindo grade of complication, and no significant difference was observed in any subgroup ( P > .05). However, the ESC group had a significantly higher risk of wound complications than the RSC group (17.6% and 7.8%, respectively; OR: 2.61; 95% CI: 1.43-4.76; P = .002), and the RSC group had more cases of small bowel obstruction than the ESC group (3.1% and 8.4%, respectively; OR: 0.37; 95% CI: 0.15-0.87; P = .02). Conclusions. ESC is a safe and effective therapeutic approach in patients who have undergone colorectal surgery; it is associated with a reduced risk of bowel obstruction but a higher risk of wound complications.

scholarly journals The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 9 (10) ◽  
pp. 3151
Author(s):  
Chang-Hoon Koo ◽  
Jin-Woo Park ◽  
Jung-Hee Ryu ◽  
Sung-Hee Han
Keyword(s):  
Virtual Reality ◽  
Randomized Controlled Trials ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

Virtual reality (VR), a technology that provides a stimulated sensory experience, has recently been implemented in various fields of medicine. Several studies have investigated the efficacy of VR on preoperative anxiety. The purpose of this meta-analysis was to validate whether VR could relieve preoperative anxiety in patients undergoing surgery. Electronic databases were searched to identify all randomized controlled trials (RCTs) investigating the effect of VR on preoperative anxiety. The primary outcome was defined as the preoperative anxiety scores. We estimated the effect size using the standard mean difference (SMD) with a 95% confidence interval (CI) using a random effect model. Ultimately, 10 RCTs, with a total of 813 patients, were included in the final analysis. Preoperative anxiety was significantly lower in the VR group than in the control group (SMD −0.64, 95% CI −1.08 to −0.20, p = 0.004). In a subgroup analysis, the preoperative anxiety scores were lower in the VR group than in the control group in pediatric patients (SMD −0.71, 95% CI −1.14 to −0.27, p = 0.002), whereas a significant difference was not observed between the two groups in adult patients (p = 0.226). The results of this meta-analysis indicated that VR could decrease preoperative anxiety, especially in pediatric patients.

scholarly journals Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 7 (8) ◽  
pp. 208 ◽  
Author(s):  
I-Ling Cheng ◽  
Yu-Hung Chen ◽  
Chih-Cheng Lai ◽  
Hung-Jen Tang
Keyword(s):  
Combination Therapy ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Randomized Controlled ◽  
Carbapenem Resistant ◽  
Significant Difference ◽  
All Cause Mortality

This meta-analysis aims to compare intravenous colistin monotherapy and colistin-based combination therapy against carbapenem-resistant gram-negative bacteria (GNB) infections. PubMed, Embase, and Cochrane databases were searched up to July 2018. Only randomized controlled trials (RCTs) evaluating colistin alone and colistin-based combination therapy in the treatment of carbapenem-resistant GNB infections were included. The primary outcome was all-cause mortality. Five RCTs including 791 patients were included. Overall, colistin monotherapy was associated with a risk ratio (RR) of 1.03 (95% confidence interval (CI), 0.89–1.20, I2 = 0%) for all-cause mortality compared with colistin-based combination therapy. The non-significant difference was also detected in infection-related mortality (RR, 1.23, 95% CI, 0.91–1.67, I2 = 0%) and microbiologic response (RR, 0.86, 95% CI, 0.72–1.04, I2 = 62%). In addition, no significant difference was observed in the subgroup analysis—high or low dose, with or without a loading dose, carbapenem-resistant Acinetobacter baumannii infections, and in combination with rifampicin. Finally, colistin monotherapy was not associated with lower nephrotoxicity than colistin combination therapy (RR, 0.98; 95% CI, 0.84–1.21, I2 = 0%). Based on the analysis of the five RCTs, no differences were found between colistin monotherapy and colistin-based combination therapy against carbapenem-resistant GNB infections, especially for A. baumannii infections.

Protective Effects of Vitamin E on Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Huikai Miao ◽  
Rongzhen Li ◽  
Dongni Chen ◽  
Jia Hu ◽  
Youfang Chen ◽  
...  
Keyword(s):  
Vitamin E ◽  
Peripheral Neuropathy ◽  
Randomized Controlled Trials ◽  
Lower Incidence ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Modest Improvement ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Vitamin E Supplementation

Abstract Background Chemotherapy often causes chemotherapy-induced peripheral neuropathy (CIPN), but effective prevention measures are still lacking. Whether vitamin E can prevent peripheral neurotoxicity caused by chemotherapy is inconclusive. Therefore, we collected related randomized controlled trials (RCTs) and conducted a meta-analysis to examine whether vitamin E could prevent CIPN. Methods We searched PubMed, EMBASE and the Cochrane databases in November 2019 for eligible trials. Two reviewers conducted the analysis independently when studies were homogeneous enough. Results Eight RCTs, involving 555 patients, were identified. Upon pooling these RCTs, patients who received vitamin E supplementation of 600 mg/day had a significantly lower incidence of peripheral neuropathy (RR 0.31; 95% CI 0.14 to 0.65; P = 0.002) induced by chemotherapy compared with the placebo group. Vitamin E played a key role in decreasing the incidence of peripheral neuropathy in the cisplatin chemotherapy group (RR 0.28; 95% CI 0.14 to 0.54; P = 0.0001). With regard to improvements in sural amplitude, vitamin E supplementation significantly decreased patients’ sural amplitude after three rounds of chemotherapy (RR -2.66; 95% CI -5.09 to -0.24; P =0.03) in contrast with that of placebo supplementation, while no significant difference was observed when patients were treated with vitamin E after six rounds of chemotherapy. In addition, the vitamin E group had better improvement in the neurotoxicity score (RR -2.65; 95% CI -4.01to -1.29; P = 0.0001) and a lower incidence of reflexes and distal paraesthesias (RR 0.50; 95% CI 0.29 to 0.87; P = 0.01) compared to the control group. Conclusion Available data included in this meta-analysis showed that vitamin E supplementation can confer modest improvement in the prevention of CIPN. However, large-scale, well-designed RCTs are needed to confirm the exact role of vitamin E supplementation in the prevention of CIPN.

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