scholarly journals Headache Outcomes After Treatment of Unruptured Intracranial Aneurysm

Stroke ◽  
2019 ◽  
Vol 50 (12) ◽  
pp. 3628-3631 ◽  
Author(s):  
Charlotte Dandurand ◽  
Harman S. Parhar ◽  
Faysal Naji ◽  
Swetha Prakash ◽  
Gary Redekop ◽  
...  

Background and Purpose— While unruptured intracranial aneurysms may be discovered incidentally in the workup of chronic headache, it remains unclear whether their treatment ultimately impacts headache severity. We aim to conduct a systematic review and meta-analysis assessing headache severity after treatment of unruptured intracranial aneurysm. Methods— MEDLINE and EMBASE were systematically reviewed. Results— Data from 7 studies met inclusion criteria (309 nonduplicated patients). The standard mean difference in pre- and post-intervention headache severity was estimated at −0.448 (95% CI, −0.566 to −0.329) under a random effects model. No significant heterogeneity was noted nor was any significant publication bias demonstrated. Conclusions— This is the first systematic review assessing postoperative headache severity following treatment of unruptured intracranial aneurysm. While a significant reduction in headache severity was observed, further investigation into this phenomenon is recommended before it influences clinical practice. Future study should stratify headache outcomes by aneurysm size, location, and treatment modality.

Author(s):  
C Dandurand ◽  
H Parhar ◽  
F Naji ◽  
S Prakash ◽  
PA Gooderham

Background: Headaches are a major cause of disability and healthcare cost worldwide. When investigating headaches etiology, incidental unruptured intracranial aneurysms are often considered unrelated. We conducted a systematic review and meta-analysis to assess headaches outcomes (severity) after treatment of unruptured intracranial aneurysm. Methods: MEDLINE and EMBASE were systematically reviewed. Results: The data from eligible studies (n=7) was extracted and analyzed. 309 nonduplicated patients provided patient-level data for analysis. All studies used the 10-point numeric rating scale (NRS). 88% of patients were treated with endovascular technique. Overall, the observed effect estimate under a random effects model was found to be a standard mean difference in pre- and post-intervention headache severity of -0.448 (95% CI: -0.566 to -0.329). No significant heterogeneity was noted. No significant publication bias was demonstrated. Conclusions: This is the first and largest systematic review assessing postoperative headache outcomes after treatment of unruptured intracranial aneurysm. A significant reduction in headache intensity after treatment is observed in the current published literature. This study highlights an interesting clinical phenomenon that still warrants scientific effort before it can influence clinical practice. We encourage future study to stratify headache outcomes by aneurysm size, location and treatment modality.


2020 ◽  
Vol 27 (1) ◽  
pp. 81-94
Author(s):  
Hayoung Park ◽  
Jinyoung Choi ◽  
Sang Hui Chu

Purpose: The purpose of this study was to comprehensively explore factors affecting quality of life in patients with unruptured intracranial aneurysm (UIA).Methods: This study was conducted base on the National Evidence-based Healthcare Collaborating Agency (NECA) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To search studies related to quality of life in patients with UIA. KoreaMed, Kmbase, Kiss, Pubmed, EMBASE, Cochrane Central and CINAHL were used. Key words were 'unruptured intracranial aneurysm', 'quality of life' and 'well-being'. A total of 136 studies were identified. After confirming duplication and abstracts, 15 studies were selected for analysis.Results: As a result, factors affecting the quality of life in patients with UIA were categorized into individual factors, disease related factors, symptom related factors, and functional related factors. The Short form-36 was one of the most frequently used measurements.Conclusion: To improve the quality of life of patients with UIA, researchers need to explore the multiple factors affecting quality of life in patients with UIA, and consider application of tools that can reflect the disease specific quality of life in patients with UIA.


2021 ◽  
Vol 27 (6) ◽  
pp. 646-654
Author(s):  
Roberto Lohn Nahon ◽  
Jaqueline Santos Silva Lopes ◽  
Anibal Monteiro de Magalhães Neto ◽  
Aloa de Souza Machado ◽  
Luiz Claudio Cameron

ABSTRACT Objective: To investigate the effectiveness of pharmacological interventions in the treatment of delayed onset muscle soreness (DOMS). Design: A systematic review and meta-analysis of randomized controlled clinical trials (RCTs). Data sources: The PubMed/MEDLINE, EMBASE, SPORTDiscus, Scielo and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs published prior to August 3, 2020. Eligibility criteria for selecting studies: Studies that 1) used an RCT design; 2) evaluated the effectiveness of steroidal or nonsteroidal anti-inflammatory drugs (NSAIDs) in treating DOMS; and 3) therapeutically used drugs after exercise were included. Results: In total, 26 studies (patients = 934) were eligible for inclusion in the qualitative analysis on the treatment of DOMS. The results of the meta-analysis showed no superiority between the use and non-use of NSAIDs in the improvement of late muscle pain, as no statistically significant differences were verified (21 studies, n= 955; standard mean difference (SMD)= 0.02; 95% confidence interval (CI) −0.58, 0.63; p=0.94; I2=93%). The quality of the synthesized evidence was very low according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and there was significant heterogeneity among the included studies. Conclusion: The results demonstrate that NSAIDs are not superior to controls/placebos in treating DOMS. The inclusion of both studies with dose-response protocols and those with exercise protocols may have influenced the results. In addition, the high risk of bias identified reveals that limitations need to be considered when interpreting the results. Level of evidence I; ystematic review of RCT (Randomized and Controlled Clinical Trials).


2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aongart Mahittikorn ◽  
Frederick Ramirez Masangkay ◽  
Kwuntida Uthaisar Kotepui ◽  
Giovanni De Jesus Milanez ◽  
Manas Kotepui

Abstract Background Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat Plasmodium-mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of Plasmodium-mixed infection. The results of the study may provide benefits in the management of Plasmodium-mixed infection in co-endemic regions. Methods This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with Plasmodium-mixed infection. The primary outcome was the pooled prevalence of Plasmodium parasitemia after initiating antimalarial treatment for Plasmodium-mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in Plasmodium-mixed infection compared with those in Plasmodium falciparum and Plasmodium vivax mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of Plasmodium parasitemia was compared in subgroup analysis. Results Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of Plasmodium-mixed parasitemia was 30% (95% confidence interval (CI) 16–43; I2: 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of Plasmodium-mixed parasitemia compared with the treatment of P. falciparum was 1.22 (p: 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93; I2: 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of P. falciparum (p: 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05; I2: 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity (p: 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834; I2: 0%). Conclusions The present findings showed a high prevalence of malarial recurrence after the initial treatment of Plasmodium-mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs. Graphic Abstract


Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 377
Author(s):  
Domingo Jesús Ramos-Campo ◽  
Luis Andreu Caravaca ◽  
Alejandro Martínez-Rodríguez ◽  
Jacobo Ángel Rubio-Arias

We assessed the effects of resistance circuit-based training (CT) on strength, cardiorespiratory fitness, and body composition. A systematic review with meta-analysis was conducted in three databases, ending on March, 2020. Meta-analysis and subgroup analysis were used to analyze the effects of pre–post-intervention CT and differences from control groups (CG). Of the 830 studies found, 45 were included in the meta-analysis (58 experimental groups (n = 897) and 34 CG (n = 474)). The CT interventions led to increases in muscle mass (1.9%; p < 0.001) and decreases in fat mass (4.3%; p < 0.001). With regard to cardiorespiratory fitness, CT had a favorable effect on VO2max (6.3%; p < 0.001), maximum aerobic speed or power (0.3%; p = 0.04), and aerobic performance (2.6%; p = 0.006) after training. Concerning strength outcome, the CT increased the strength of the upper and lower extremities. Only the magnitude of strength performance appears to be influenced by the training (number of sessions and frequency) and the training status. Moreover, low and moderate intensities and short rest time between exercise increase the magnitude of change in fat mass loss. Therefore, CT has been shown to be an effective method for improving body composition, cardiorespiratory fitness, and strength of the lower and upper limbs.


Author(s):  
Liselotte De Wit ◽  
Vitoria Piai ◽  
Pilar Thangwaritorn ◽  
Brynn Johnson ◽  
Deirdre O’Shea ◽  
...  

AbstractThe literature on repetition priming in Alzheimer’s disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing.


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