scholarly journals Swimming as Treatment for Osteoporosis: A Systematic Review and Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yanlin Su ◽  
Zhe Chen ◽  
Wei Xie
Keyword(s):  
Meta Analysis ◽  
Relevant Literature ◽  
Premenopausal Women ◽  
Current Evidence ◽  
Spine Density ◽  
Mineral Density ◽  
Randomized Controlled ◽  
Premenopausal Osteoporosis

Osteoporosis is a chronic disease that seriously affects human health and quality of life. This study is aimed at determining whether swimming had an effect on the bone mineral density (BMD) of the spine and femoral neck in postmenopausal and premenopausal osteoporosis patients. We retrieved relevant literature and analyzed data from randomized controlled trials to assess the effect of swimming on BMD in postmenopausal and premenopausal women. Relevant studies, with no language restrictions, from inception to September 2019, were retrieved from the PubMed, Cochrane, EMBASE, and EBSCO databases independently by two investigators. The keywords used for the literature search were “osteoporosis” and “swimming.” The main results included BMD and T-score. We searched 256 relevant articles and finally screened five articles, including 263 participants. Lumbar spine density was mentioned in three articles. Although the heterogeneity of lumbar vertebral density is moderate, the analysis of swimmers to nonswimmers shows that the lumbar vertebral density in swimmers is improved [heterogeneity: chi2=5.16, df=2 (P=0.08); I2=61%]. We analyzed the following heterogeneous subgroups: subgroup 1 (3–6 hours) and subgroup 2 (<3 hours). The BMD in subgroup 1 was significantly higher than that in the placebo, while no effect on BMD was found in subgroup 2 [heterogeneity: chi2=0.15, df=3 (P=0.70); I2=0%]. According to the current evidence, swimming may improve the BMD of postmenopausal women participants, if the swimming time is between 3 and 6 hours, especially in long-term swimmers. However, the effectiveness of swimming does require further investigation.

Systematic Review and Meta-Analysis of Randomized Controlled Trials of Erythropoietin in Multiple Myeloma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 232-232
Author(s):  
Heloisa P. Soares ◽  
Ambuj Kumar ◽  
Franco Silvestris ◽  
Benjamin Djulbegovic
Keyword(s):  
Systematic Review ◽  
Multiple Myeloma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Epoetin Alpha

Abstract Background: The current approach for treating anemia in multiple myeloma (MM) patients entails prescribing recombinant erythropoetin (EPO) only if chemotherapy fails initially to raise hemoglobin (Hb) levels. However, this practice is not based on synthesis of the totality of evidence obtained from data of all trials testing EPO exclusively in myeloma patients. Objective: To conduct a systematic review/ meta-analysis (SR/MA) regarding the use of EPO in MM patients. Methods: We conducted a SR of all randomized controlled trials (RCTs) that studied the effect of EPO exclusively in MM patients. We searched all major electronic databases (MEDLINE, LILACS, EMBASE and the Cochrane Controlled Trials Register) as well as performing hand searches of relevant meeting proceedings (ASH, ASCO, EHA), and ongoing NCI trials. We included RCTs that had at least 10 patients in each arm and had compared the use of EPO against a control group. We also identified trials that compared different doses of EPO. We excluded trials that enrolled patients treated with high-dose myeloablative chemotherapy followed by stem cell transplantation or hemodialysis. Results: We identified more than 500 relevant studies; 6 trials met our eligibility criteria and were included in the analysis. Five trials (4 published as full text manuscripts and 1 as the abstract) compared epoetin alpha against a control [placebo (2 trials) or no therapy with or without specification of red cells transfusion trigger level (3 trials)] in anemic MM patients. One trial compared 2 different schedules of epoetin alpha. No trial tested the effect of darbopoeitin. All 5 trials that studied EPO against controls used initial doses of 150 IU 3x/week SC with the possibility of increasing to 300 IU if necessary. In the majority of trials the patients had been receiving chemotherapy at the time EPO was administered. The number of patients included in each trial ranged from 24 to 145. All trials concluded that EPO was superior to a placebo or no treatment in terms of Hb increase. Two trials also concluded that EPO improves quality of life. Our meta-analysis showed that hematological response was favored in the group receiving EPO [relative risk (RR) 7.75; 95% CI 4.19 to 14.35, 4 trials, n = 272]. Mean Hb level improvement with EPO was also significant [weighted mean difference (WMD) 2.29; 95% CI2.00 to -2.58, 3 trials, n = 235]. In terms of adverse events, hypertension was more often found in the EPO arm [RR 5.80; 95% CI 1.30-25.90, 4 trials, n = 290]. Survival and data related to tumor response were not available in all trials. Critical appraisal indicated that available evidence was modest in quantity (5 trials, n= 385 total patients enrolled) and poorly reported in all important methodological domains. Conclusion: Available body of evidence suggests that EPO improves hematological outcomes in patients with myeloma. However, the quality of current evidence is insufficient, data on most important patients’ outcomes are lacking (e.g. survival etc.), thus preventing us from making definitive recommendations regarding the role of EPO in managing anemia in the myeloma setting. A definitive RCT to resolve the role of EPO in myeloma is indicated.

scholarly journals Exercise and Bone Mineral Density in Premenopausal Women: A Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
George A. Kelley ◽  
Kristi S. Kelley ◽  
Wendy M. Kohrt
Keyword(s):  
Bone Mineral Density ◽  
Randomized Controlled Trials ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Premenopausal Women ◽  
The United States ◽  
Controlled Trials ◽  
Number Needed To Treat ◽  
Mineral Density ◽  
Randomized Controlled

Objective. Examine the effects of exercise on femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD) in premenopausal women.Methods. Meta-analysis of randomized controlled exercise trials ≥24 weeks in premenopausal women. Standardized effect sizes (g) were calculated for each result and pooled using random-effects models,Zscore alpha values, 95% confidence intervals (CIs), and number needed to treat (NNT). Heterogeneity was examined usingQandI2. Moderator and predictor analyses using mixed-effects ANOVA and simple metaregression were conducted. Statistical significance was set atP≤0.05.Results. Statistically significant improvements were found for both FN (7g's, 466 participants,g=0.342, 95%  CI=0.132, 0.553,P=0.001,Q=10.8,P=0.22,I2=25.7%,NNT=5) and LS (6g's, 402 participants,g=0.201, 95%  CI=0.009, 0.394,P=0.04,Q=3.3,P=0.65,I2=0%,NNT=9) BMD. A trend for greater benefits in FN BMD was observed for studies published in countries other than the United States and for those who participated in home versus facility-based exercise. Statistically significant, or a trend for statistically significant, associations were observed for 7 different moderators and predictors, 6 for FN BMD and 1 for LS BMD.Conclusions. Exercise benefits FN and LS BMD in premenopausal women. The observed moderators and predictors deserve further investigation in well-designed randomized controlled trials.

scholarly journals Combination of Excimer Laser and Topical Treatment for Psoriasis: A Systematic Review and Meta-analysis

2019 ◽  
Vol 53 (2) ◽  
Author(s):  
Marie Len A. Camaclang ◽  
Leah Antoinette M. Caro-Chang ◽  
Ma. Lorna F. Frez
Keyword(s):  
Excimer Laser ◽  
Topical Treatment ◽  
Meta Analysis ◽  
Current Evidence ◽  
Combination Group ◽  
Inclusion Criteria ◽  
Plaque Type ◽  
Pasi Score

Objectives. To assess the efficacy and safety of excimer laser in combination with topical standard therapies for treatment of plaque-type psoriasis in comparison to excimer laser alone, standard topical treatment alone, or placebo. Methods. A literature search using Medline, Cochrane and HERDIN was conducted. Data were analyzed using mean difference at 95% confidence interval, with heterogeneity determined by I2 test. Results. Three articles with total of 130 patients fulfilled the inclusion criteria. Topical treatments studied were vitamin analog (calcipotriol), anthralin (dithranol), and steroid (flumethasone pivalate). A subgroup analysis comparing combination therapy and excimer laser alone showed a greater reduction in pooled PASI score reduction (-2.52; 95% CI: -4.28, -0.77) in the combination group after five to six weeks. There was also a significantly greater reduction in cumulative UVB dose (-3.29; 95% CI: -4.29, -2.30) needed for clearing in the combination group. Pigmentation was the commonly observed adverse event in both groups. Conclusions. Excimer laser, in combination with topical treatment, is more effective than excimer laser alone, with significantly lower cumulative UVB dose, but the quality of current evidence is low. Long-term controlled trials are warranted to increase our confidence in the estimates of these outcomes.

scholarly journals Acupuncture for adenomyosis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Shike Lin ◽  
◽  
Bing Tan ◽  
Suren Rao Sooranna ◽  
Tlaye Kenean Getaneh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Current Evidence ◽  
Randomized Controlled ◽  
Clinical Presentations ◽  
Review Question ◽  
Pelvic Imaging ◽  
Gynecological Disorder

Review question / Objective: Can patients with adenomyosis benefit from acupuncture treatments? Evaluation of current evidence with respect to the efficacy and safety of acupuncture for adenomyosis by conducting a systematic review and meta-analysis of the available randomized controlled trial. Condition being studied: Adenomyosis is a gynecological disorder defined as the presence of the endometrial gland and stroma cells within the myometrium. This condition mainly occurs in women who are multiparous and over the age of 30. Among women undergoing hysterectomy, the frequency of adenomyosis is reported to range from 8.8% to 61.5%. Adenomyosis is also observed in 20. 9% to 34% of women who have been referred for pelvic imaging. The incidence of adenomyosis in the general population remains uncertain. Adenomyosis can significantly decrease the patient’s quality of life, with the clinical presentations of menorrhagia, dysmenorrhea, metrorrhagia, chronic pelvic pain and dyspareunia.

scholarly journals Effects of Phytoestrogen Supplement on Quality of Life of Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Ching-Ching Peng ◽  
Chia-Yu Liu ◽  
Nai-Rong Kuo ◽  
Tao-Hsin Tung
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Postmenopausal Women ◽  
Meta Analysis ◽  
Mean Difference ◽  
Current Evidence ◽  
Controlled Trials ◽  
Randomized Controlled

Background. The effect of phytoestrogen on postmenopausal quality of life is unclear. This study evaluated the effects of phytoestrogen supplement on quality of life for postmenopausal women. Methods. We conducted a systematic review and meta-analysis of randomized controlled trials on the effects of phytoestrogen supplements on the quality of life of postmenopausal women. We searched PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials on March 31, 2018, for relevant randomized controlled trials. Two authors independently selected studies, assessed risk of bias, and extracted data. Disagreement was resolved through discussion with a third author. Results. We involved 10 articles in the systematic review. 8 studies and a total of 1,129 subjects were included in the meta-analysis. The questionnaires used in the evaluation of quality of life were as follows: SF-36, 4 studies; MENQOL, 4 studies; For Short Form 36 surveys, phytoestrogen groups scored significantly higher for body pain (mean difference = 3.85, 95% confidence interval [CI] = [1.14, 6.57], P < 0.01), mental health (mean difference = 4.01, 95% CI = [1.49, 6.57], P < 0.01), and role limitations caused by emotional problems domains (mean difference = 3.83, 95% CI = [1.81, 5.85], P < 0.01). No statistically significant difference was obtained from Menopause-Specific Quality of Life surveys (vasomotor domain mean difference 0.14, 95% CI = [−0.08, 0.36], P = 0.20; physical domain mean difference 0.20, 95% CI [−0.08, 0.48], P = 0.15; psychological domain mean difference −0.10, 95% CI [−0.26, 0.07], P = 0.27; sexual domain mean difference −0.17, 95% CI [−0.42, 0.09], P = 0.19). Conclusion. Current evidence does not support phytoestrogen supplementation improving postmenopausal quality of life. Further comprehensive trials or long-term follow-up studies are warranted.

Effect of long-term intervention of soy isoflavones on bone mineral density in women: A meta-analysis of randomized controlled trials

Bone ◽  
2009 ◽  
Vol 44 (5) ◽  
pp. 948-953 ◽  
Author(s):  
Jing Liu ◽  
Suzanne C. Ho ◽  
Yi-xiang Su ◽  
Wei-qing Chen ◽  
Cai-xia Zhang ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Randomized Controlled Trials ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Soy Isoflavones ◽  
Controlled Trials ◽  
Mineral Density ◽  
Randomized Controlled

scholarly journals Short- and Long-Term Prognosis of Intravascular Ultrasound-Versus Angiography-Guided Percutaneous Coronary Intervention: A Meta-Analysis Involving 24,783 Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Qun Zhang ◽  
Bailu Wang ◽  
Yu Han ◽  
Shukun Sun ◽  
Ruijuan Lv ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Controlled Trials ◽  
Left Main ◽  
Randomized Controlled ◽  
Percutaneous Coronary ◽  
Short And Long Term

Background. Intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) has potential benefits. This meta-analysis aimed to explore whether IVUS-guided PCI had better short- and long-term prognoses than angiography-guided PCI. Methods. We retrieved studies from PubMed, Embase, and Cochrane Library. Clinical trials including retrospective and randomized controlled trials (RCTs) that compared IVUS-guided PCI with angiography-guided PCI were included. The patients were followed up after operation at 30 days, 1 year, 2 years, and 3 years. The clinical outcomes were target lesion revascularization (TLR), target vessel revascularization (TVR), and MACEs, including stent thrombosis (ST), myocardial infarction (MI), cardiac death, and all-cause death. The study population included patients with MI, coronary bifurcation lesions, short or long lesions, and unprotected left main coronary artery stenosis (ULMCA). The quality of retrospective trials was evaluated using the Newcastle–Ottawa Scale, and the quality of randomized controlled trials was evaluated using the Jadad score. A total of 20 clinical trials met the criteria. Three trials were randomized controlled trials, while 17 were retrospective trials. Results. A total of 24,783 patients were included. In observational trials, the OR of MACEs was 0.49 (95% CI: 0.38–0.62) in 30 days, 0.65 (95% CI: 0.58–0.73) in one year, 0.51 (95% CI: 0.36–0.71) in two years, and 0.45 (95% CI: 0.31–0.65) in three years. In patients with long coronary lesions, the OR of MACEs in 1 year was 0.64 (95% CI: 0.28–1.50). In patients with left main artery disease, the OR of MACEs in 3 years was 0.42 (95% CI: 0.26–0.67). Compared with angiography-guided PCI, IVUS-guided PCI was associated with a lower incidence of MACEs during the same following period. Conclusion. Compared with angiography-guided PCI, IVUS-guided PCI has better performance in reducing the occurrence of MACEs.

scholarly journals Network Meta‐Analysis Comparing the Outcomes of Treatments for Intermittent Claudication Tested in Randomized Controlled Trials

2021 ◽  
Vol 10 (9) ◽  
Author(s):  
Shivshankar Thanigaimani ◽  
James Phie ◽  
Chinmay Sharma ◽  
Shannon Wong ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Exercise Therapy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Home Exercise ◽  
Controlled Trials ◽  
Randomized Controlled

Background No network meta‐analysis has considered the relative efficacy of cilostazol, home exercise therapy, supervised exercise therapy (SET), endovascular revascularization (ER), and ER plus SET (ER+SET) in improving maximum walking distance (MWD) over short‐ (<1 year), moderate‐ (1 to <2 years), and long‐term (≥2 years) follow‐up in people with intermittent claudication. Methods and Results A systematic literature search was performed to identify randomized controlled trials testing 1 or more of these 5 treatments according to Preferred Reporting Items for Systematic Review and Meta‐Analysis guidelines. The primary outcome was improvement in MWD assessed by a standardized treadmill test. Secondary outcomes were adverse events and health‐related quality of life. Network meta‐analysis was performed using the gemtc R statistical package. The Cochrane collaborative tool was used to assess risk of bias. Forty‐six trials involving 4256 patients were included. At short‐term follow‐up, home exercise therapy (mean difference [MD], 89.4 m; 95% credible interval [CrI], 20.9–157.7), SET (MD, 186.8 m; 95% CrI, 136.4–237.6), and ER+SET (MD, 326.3 m; 95% CrI, 222.6–430.6), but not ER (MD, 82.5 m; 95% CrI, −2.4 to 168.2) and cilostazol (MD, 71.1 m; 95% CrI, −24.6 to 167.9), significantly improved MWD (in meters) compared with controls. At moderate‐term follow‐up, SET (MD, 201.1; 95% CrI, 89.8–318.3) and ER+SET (MD, 368.5; 95% CrI, 195.3–546.9), but not home exercise therapy (MD, 99.4; 95% CrI, −174.0 to 374.9) or ER (MD, 84.2; 95% CrI, −35.3 to 206.4), significantly improved MWD (in meters) compared to controls. At long‐term follow‐up, none of the tested treatments significantly improved MWD compared to controls. Adverse events and quality of life were reported inconsistently and could not be meta‐analyzed. Risk of bias was low, moderate, and high in 4, 24, and 18 trials respectively. Conclusions This network meta‐analysis suggested that SET and ER+SET are effective at improving MWD over the moderate term (<2 year) but not beyond this. Durable treatments for intermittent claudication are needed.

scholarly journals Corticosteroids Had no Effect on 28-Days Mortality in Adult Patients with sepsis: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Huoyan Liang ◽  
Heng Song ◽  
Gaofei Song ◽  
Hongyi Li ◽  
Xianfei Ding ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Evaluation Methodology ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Assessment Development ◽  
Randomized Controlled ◽  
Long Term Mortality

Abstract Objective: Corticosteroids are a common option used in the treatment of sepsis. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. We performed this review to assess the efficacy and safety of corticosteroids in sepsis patients.Methods: We searched the PubMed, Embase, and Cochrane library databases from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on septic patients were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The data were pooled by using relative risk (RR) and mean difference (MD). The random-effects model were used to to eveluate the pooled MD or RR and 95% CI.Results: Fifty-three RCTs that included 12,310 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate), and long-term mortality (>60 d) (RR, 0.96; 95% CI, 0.88–1.05) in septic patients (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in ICU (RR, 0.89; 95% CI, 0.80–0.98), in-hospital (RR, 0.93; 95% CI, 0.88–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a very small reductions in the length of hospital stay and ICU. Corticosteroids were associated with an higher risk of hypernatremia and hyperglycemia; further, they appear to have no significant effect on superinfection and gastroduodenal bleeding.Conclusions: Corticosteroids had no significant effect on the 28 and long-term mortality; however, they decreased the ICU and hospital mortality. Further, corticosteroids could increase the risk of the hypernatremia and hyperglycemia in sepsis patients.

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