scholarly journals Effect of Acupuncture Intervention and Manipulation Types on Poststroke Dysarthria: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Young-Jae Park ◽  
Jin-Moo Lee
Keyword(s):  
Clinical Efficacy ◽  
Meta Analysis ◽  
Manual Acupuncture ◽  
Language Therapy ◽  
Pubmed Central ◽  
General Management ◽  
Randomized Controlled ◽  
Acupuncture Intervention ◽  
Mean Differences ◽  
Distribution Intensity

This study aimed to evaluate the effect of acupuncture intervention and manipulation types on poststroke dysarthria. Electronic database, including PubMed, CENTRAL, Scopus, RISS, and CNKI, were searched for randomized controlled trials (RCT), treating dysarthria using acupuncture, speech-language therapy (SLT), and general management (GM), published before April 2019. The number, distribution, intensity, depth, and repetition of acupuncture and bleeding therapy on the sublingual veins were considered as manipulation types. Risk of bias of the included trials was evaluated, and their efficacy was assessed using risk ratio (RR) and the standard mean differences in the Frenchay Dysarthria Assessment and Speech Function Grading, with 95% confidence intervals (CIs).Fifteen RCT trials involving 1453 patients were isolated. Electroacupuncture plus SLT and manual acupuncture plus SLT were more effective than SLT only, respectively (RR = 1.520, 95% CI [1.183–1.952], RR = 1.380, 95% CI [1.281–1.488]). The clinical efficacy of acupuncture plus GM was higher than that of GM alone (RR = 1.165, 95% CI [1.050–1.293]). Meta-ANOVA showed that none of the manipulation types increased the clinical efficacy of acupuncture on dysarthria. The methodological quality was low. In conclusion, our study suggests that the effect of acupuncture on poststroke dysarthria may be maximized when manual acupuncture or electroacupuncture is combined with SLT, irrespective of manipulation types.

scholarly journals Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials

PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0119948 ◽  
Author(s):  
Jung Soo Kim ◽  
Jinkyeong Park ◽  
Seong Yong Lim ◽  
Yeon-Mok Oh ◽  
Kwang Ha Yoo ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Clinical Efficacy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled

scholarly journals Disease stability and extended dosing under anti-VEGF treatment of exudative age-related macular degeneration (AMD) — a meta-analysis

2021 ◽  
Author(s):  
Justus G. Garweg ◽  
Christin Gerhardt
Keyword(s):  
Macular Degeneration ◽  
Meta Analysis ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Pubmed Central ◽  
Age Related ◽  
Interval Extension ◽  
Second Year ◽  
Mean Differences

Abstract Purpose To assess disease stability (absence of intra- and/or subretinal fluid) and the portion of eyes being capable to extend their treatment interval to ≥ 12 weeks in exudative age-related macular degeneration (AMD). Methods A systematic literature search was performed in NCBI, PubMed, CENTRAL, and ClinicalTrials.gov to identify clinical studies reporting treatment outcomes for ranibizumab, aflibercept, and brolucizumab in exudative AMD under a treat-and-extend protocol and a follow-up of ≥ 12 months. Weighted mean differences and subgroup comparisons were used to integrate the different studies. Results This meta-analysis refers to 29 published series, including 27 independent samples and 5629 patients. In the pooled group, disease stability was reported in 62.9% and 56.0%, respectively, after 12 and 24 months of treatment, whereas treatment intervals were extended to ≥ 12 weeks in 37.7% and 42.6%, respectively. Ranibizumab, aflibercept, and brolucizumab differed regarding their potential to achieve disease stability (56.3%, 64.5%, and 71.5% after 12, and 50.0%, 52.7% and 75.7% after 24 months; p = < 0.001) and to allow an interval extension to ≥ 12 weeks (28.6%, 34.2%, and 53.3% after 12, and 34.2%, 47.7%, and 41.7% after 24 months; p = < 0.001). Conclusion The portion of eyes achieving disease stability regressed in the second year, whereas the portion of eyes under a ≥ 12-week interval increased. This discrepancy may reflect the challenges in balancing between under-treatment and a reduced treatment burden.

scholarly journals Melatonin and Cardioprotection in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Alberto Domínguez-Rodríguez ◽  
Pedro Abreu-González ◽  
Néstor Báez-Ferrer ◽  
Russel J. Reiter ◽  
Pablo Avanzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Left Ventricular Ejection ◽  
Favorable Effect ◽  
Controlled Trials ◽  
Weighted Mean ◽  
Randomized Controlled ◽  
Mean Differences

Myocardial ischemia/reperfusion (IR) injury represents a critical problem associated with interventional approaches for coronary reperfusion. Pharmacological cardioprotective interventions are advocated to ameliorate IR injury. Melatonin is an anti-inflammatory and antioxidant agent with a wide range of therapeutic properties that may contribute to its cardioprotective effects. No systematic review or meta-analysis has compared melatonin vs. placebo as a cardioprotective agent in humans. The present study, based on a systematic review and meta-analysis, was carried out to assess melatonin's efficacy as a cardioprotective treatment. We performed a systematic review of the available literature. Randomized controlled trials (RCTs) were identified and information was extracted using predefined data extraction forms. The primary outcomes were (a) left ventricular ejection fraction (LVEF) and (b) blood troponin levels in patients who underwent myocardial revascularization and were randomized to melatonin or placebo. The inverse-variance random-effects method was used to pool the estimates. Heterogeneity and publication bias were assessed. Weighted mean differences or standardized mean differences were calculated. A total of 283 records were screened and seven RCTs met all the inclusion criteria. After the pooled analysis, the results on LVEF were consistent across all studies, and a significant heterogeneity was found in the results on troponin levels. The melatonin-treated patients had on average higher LVEF than the placebo-treated individuals with a weighted mean difference = 3.1% (95% CI 0.6–5.5, p = 0.01). Five works compared the levels of troponin after melatonin or placebo treatment. The melatonin-treated patients had lower levels of troponin with a standardized mean difference = −1.76 (95% CI −2.85 to −0.67, p = 0.002). The findings of this meta-analysis revealed that melatonin administration in humans as a cardioprotective agent attenuated heart dysfunction with a favorable effect on the LVEF.

scholarly journals The risks and benefits of yoga for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

2019 ◽  
Vol 33 (12) ◽  
pp. 1847-1862 ◽  
Author(s):  
Holger Cramer ◽  
Heidemarie Haller ◽  
Petra Klose ◽  
Lesley Ward ◽  
Vincent CH Chung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Function ◽  
Exercise Capacity ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Controlled Trials ◽  
Obstructive Pulmonary Disease ◽  
Randomized Controlled ◽  
Mean Differences

Objectives: To determine the effectiveness and safety of yoga interventions on disease symptoms, quality of life and function in patients diagnosed with chronic obstructive pulmonary disease (COPD). Data sources: Medline/PubMed, Scopus, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched through 6 June 2019. Review methods: Randomized controlled trials assessing the effects of yoga on quality of life, dyspnea, exercise capacity, and pulmonary function (FEV1) in patients with COPD were included. Safety was defined as secondary outcome. Mean differences (MD) and standardized mean differences (SMD) with 95% confidence intervals (CIs) were computed. Risk of bias was assessed using the Cochrane tool. Results: Eleven randomized controlled trials with a total of 586 patients were included. Meta-analysis revealed evidence for effects of yoga compared to no treatment on quality of life on the COPD Assessment Test (MD = 3.81; 95% CI = 0.97 to 6.65; P = 0.009, I2 = 70%), exercise capacity assessed by the 6-minute walk test (MD = 25.53 m; 95% CI = 12.16 m to 38.90 m; P = 0.001, I2 = 0%), and pulmonary function assessed by FEV1 predicted (MD  = 3.95%; 95% CI = 2.74% to 5.17%; P < 0.001, I2 = 0%). Only the effects on exercise capacity and pulmonary function were robust against methodological bias. Effects were only present in breathing-focused yoga interventions but not in interventions including yoga postures. Adverse events were reported infrequently. Conclusion: This meta-analysis found robust effects of yoga on exercise capacity and pulmonary function in patients with COPD. Yoga, specifically yoga breathing techniques, can be an effective adjunct intervention for patients with COPD. Yoga’s safety needs to be assessed in more depth in future studies.

scholarly journals The Derivative of Tripterygium wilfordii Hook F—Kunxian Capsule, Attenuated Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Ya-Fei Liu ◽  
Zhe Zhang ◽  
Jun-Jun Zhang ◽  
Zhe Chen ◽  
Sheng-Hao Tu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Meta Analysis ◽  
Tender Joint ◽  
Tripterygium Wilfordii Hook F ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Tripterygium Wilfordii Hook ◽  
Mean Differences ◽  
Review Manager

The study aimed to explore the efficacy and safety of Kunxian Capsule (KXC) in the treatment of rheumatoid arthritis (RA). The randomized controlled trials (RCTs) comparing the effects of KXC in patients with RA were included in this study. Weighted mean differences (MDs) were calculated for net changes by employing Review Manager meta-analysis software. Nine RCTs were included in the systematic review with a total of 747 patients. The overall effects showed that KXC alone or combined with disease-modifying antirheumatic and drugs decreased tender joint counts (P=0.02, MD = −1.07, 95% CI: −1.95 to −0.18), shortened duration of morning stiffness (P<0.0001, MD = −9.01, 95% CI: −13.08 to −4.93), lowered erythrocyte sedimentation rate (P<0.00001, MD = −5.27, 95% CI: −6.78 to −3.77), and reduced C-reactive protein (P<0.0001, MD = −5.04, 95% CI: −7.28 to −2.80). The most common adverse events were gastrointestinal disturbances and abnormal liver function. These results suggest that KXC is likely to be a more effective and safe candidate for treating RA compared with conventional therapies.

scholarly journals The clinical efficacy of continuous renal replacement in the treatment of acute pancreatitis: a meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
sijia Ma ◽  
mingming Zhao ◽  
zhiyu Pan ◽  
jiao Fan ◽  
xuexue Zhang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Randomized Controlled Trials ◽  
Clinical Efficacy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Review Author ◽  
Inclusion Criteria ◽  
Randomized Controlled

Abstract：Objective: The purpose of this study was to investigate the effect of continuous renal replacement therapy(CRRT) on patients with acute pancreatitis(AP). Methods: A comprehensive search of seven databases without language restrictions includes PubMed, Cochrane Library, Scopus, Embase, Web of Science, China National Knowledge Infrastructure(CNKI) and Wan fang database. Randomized controlled trials (RCTs) for the treatment of acute pancreatitis with CRRT were searched. All the included literatures were published before December 2020. Two review authors independently selected the study and extracted the data according to the inclusion criteria. A third review author will and discuss with the first two review authors and resolve the differences. Weighted mean difference(WMD), risk ratio (RR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of AP in CRRT and control treatment. Results: Fifty-three RCTs met the inclusion criteria and were used in the meta-analysis, with a total of 3,382 effective samples. A comprehensive review of the system shows that the mortality rate of the CRRT group was significantly lower than that of the control group, and the difference was statistically significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78, 95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6 clearance effect. According to liver function, the patients using CRRT had lower ALT and AST levels. In the same way, according to renal function, the patients using CRRT had lower SCr (WMD=-94.28, 95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003). Moreover, Results shown no statistical difference in Serum potassium level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two groups. Conclusions: Our findings suggest that treatment with CRRT for acute pancreatitis may be more beneficial than conventional treatment. However, high-quality studies with a larger sample size are still needed to confirm our results.

scholarly journals Clinical Efficacy and Safety of Human Mesenchymal Stem Cell Therapy for Degenerative Disc Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Baocheng Xie ◽  
Shichun Chen ◽  
Yongxiang Xu ◽  
Weichao Han ◽  
Runkai Hu ◽  
...  
Keyword(s):  
Stem Cell ◽  
Back Pain ◽  
Clinical Efficacy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Efficacy And Safety ◽  
Disc Disease ◽  
Randomized Controlled ◽  
Vas Scores

Degenerative disc disease (DDD) can cause severe low back pain, which will have a serious negative impact on the ability to perform daily tasks or activities. For the past few years, mesenchymal stem cell (MSC) transplantation has emerged as a promising strategy for the treatment of DDD. However, the clinical efficacy of MSC in the treatment of DDD still lacks clinical evidence and is controversial. We conducted a meta-analysis with randomized controlled trials (RCTs) to evaluate the clinical efficacy and safety of MSC transplantation in patients with DDD. We searched major databases using terms from the database’s inception through March 2021. The Cochrane bias risk assessment tool was used to assess quality. The analysis showed that MSC therapy could decrease visual analog scale (VAS) scores ( SMD = − 0.50 , 95 % CI = − 0.68 ~ − 0.33 , P < 0.00001 ) and Oswestry Disability Index (ODI) scores ( SMD = − 0.27 , 95 % CI = − 0.44 ~ − 0.09 , P = 0.003 ). The outcomes with subgroup analysis showed that MSC therapy could decrease VAS scores in 3 months ( P = 0.001 ), 6 months ( P = 0.01 ), 12 months ( P = 0.02 ), and ≥24 months ( P = 0.002 ) and ODI scores in ≥24 months ( P = 0.006 ). Pooled analysis showed that MSC therapy has a higher ratio of patients at most thresholds but particularly at the MIC (minimally important change) ( P = 0.0002 ) and CSC (clinically significant change) ( P = 0.0002 ) in VAS and MIC ( P = 0.0005 ) and CSC ( P = 0.001 ) pain responders in ODI. Adverse events (AE) of treatment-emergent adverse events (TEAE), back pain, arthralgia, and muscle spasms were not statistically significant between the two groups. However, our further statistical analysis showed that MSC therapy may induce AE of TEAE related to study treatment ( OR = 3.05 , 95 % CI = 1.11 ~ 8.40 , P = 0.03 ). In conclusion, this study pooled the main outcomes and showed that MSC therapy could significantly decrease VAS and ODI scores in patients with DDD. Distinctly, the findings of this meta-analysis suggest a novel therapeutic strategy for patients with chronic low back pain (LBP) and lumbar dysfunction by DDD.

scholarly journals Antioxidant Therapy for Pain Relief in Patients with Chronic Pancreatitis: Systematic Review and Meta-analysis

2013 ◽  
Vol 6;16 (6;11) ◽  
pp. E521-E532
Author(s):  
Sheng-Xi Wu
Keyword(s):  
Systematic Review ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Antioxidant Therapy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomized Controlled ◽  
Mean Differences

Background: Currently, there is no specific therapy for chronic pancreatitis (CP). The treatment of micronutrient antioxidant therapy for painful CP has been sporadically used for more than 30 years, however, its efficacy are still poorly understood. Objective: The purpose of this meta-analysis is to investigate the safety and efficacy of antioxidant therapy for pain relief in patients with CP. Setting: University Hospital in China Study Design: Systematic review and meta-analysis Methods: Two authors independently reviewed the search results and extracted data and disagreements were resolved by discussion. Effects were summarized using standardized mean differences (SMDs), weighted mean differences, or odds ratio (OR) according to the suitable effect model. MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from 1980 through December 2012. Randomized controlled trials (RCTs) that studied antioxidant supplementation for pain relief in patients with CP were analyzed. Results: Nine randomized controlled trials (RCTs) involving 390 patients were included. Overall, there was no association of antioxidant therapy with pain reduction in CP patients (SMD, −0.55; 95% CI, −1.22 to 0.12; P = 0.67). However, antioxidant therapy significantly increased blood levels of antioxidants in CP patients versus the placebo group (SMD, 1.08; 95% CI, 0.74 to 1.43; P < 0.00001). Interestingly, combined antioxidant (selenium, β-carotene, vitamin C, vitamin E, methionine) therapy was found to be associated with pain relief (SMD, -0.93; 95% CI, -1.72 to -0.14; P = 0.02), while the trials in which a single antioxidant was used revealed no significant pain relief (SMD, -0.12; 95% CI, -1.23 to 0.99; P = 0.83) in CP patients. Strong evidence was obtained that the antioxidants increased adverse effects (OR, 6.09; 95% CI, 2.29 to 16.17, P < 0.01); nevertheless, none was serious. Limitations: Because of the small sample, a consolidated conclusion cannot be reached based on current RCTs. Large-sample RCTs are needed to clarify the analgesic effect of antioxidants in CP patients. Conclusions: Combined antioxidant therapy seems to be a safe and effective therapy for pain relief in CP patients. Measures of total antioxidant status may not help to monitor the efficacy of antioxidant therapy for patients with CP. Key words: Antioxidant, pain, chronic pancreatitis, meta-analysis

Sign in / Sign up

Export Citation Format

Share Document