scholarly journals Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Lara Sharpe ◽  
Justin Sinclair ◽  
Andrew Kramer ◽  
Michael de Manincor ◽  
Jerome Sarris
Keyword(s):  
Animal Studies ◽  
Anxiolytic Effect ◽  
Epidemiological Studies ◽  
Current Data ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Anxiogenic Effect ◽  
Central Register ◽  
Cannabis Consumption ◽  
Higher Doses

Abstract Background Cannabis has been documented for use in alleviating anxiety. However, certain research has also shown that it can produce feelings of anxiety, panic, paranoia and psychosis. In humans, Δ9-tetrahydrocannabinol (THC) has been associated with an anxiogenic response, while anxiolytic activity has been attributed mainly to cannabidiol (CBD). In animal studies, the effects of THC are highly dose-dependent, and biphasic effects of cannabinoids on anxiety-related responses have been extensively documented. A more precise assessment is required of both the anxiolytic and anxiogenic potentials of phytocannabinoids, with an aim towards the development of the ‘holy grail’ in cannabis research, a medicinally-active formulation which may assist in the treatment of anxiety or mood disorders without eliciting any anxiogenic effects. Objectives To systematically review studies assessing cannabinoid interventions (e.g. THC or CBD or whole cannabis interventions) both in animals and humans, as well as recent epidemiological studies reporting on anxiolytic or anxiogenic effects from cannabis consumption. Method The articles selected for this review were identified up to January 2020 through searches in the electronic databases OVID MEDLINE, Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. Results Acute doses of CBD were found to reduce anxiety both in animals and humans, without having an anxiogenic effect at higher doses. Epidemiological studies tend to support an anxiolytic effect from the consumption of either  CBD or THC, as well as whole plant cannabis. Conversely, the available human clinical studies demonstrate a common anxiogenic response to THC (especially at higher doses). Conclusion Based on current data, cannabinoid therapies (containing primarily CBD) may provide a more suitable treatment for people with pre-existing anxiety or as a potential adjunctive role in managing anxiety or stress-related disorders. However, further research is needed to explore other cannabinoids and phytochemical constituents present in cannabis (e.g. terpenes) as anxiolytic interventions. Future clinical trials involving patients with anxiety disorders are warranted due to the small number of available human studies.

scholarly journals Metabolomics Studies in Psoriatic Disease: A Review

Metabolites ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 375
Author(s):  
John Koussiouris ◽  
Nikita Looby ◽  
Melanie Anderson ◽  
Vathany Kulasingam ◽  
Vinod Chandran
Keyword(s):  
Psoriatic Arthritis ◽  
Small Molecules ◽  
Web Of Science ◽  
Citation Index ◽  
Cochrane Central Register ◽  
Psoriatic Disease ◽  
Ovid Medline ◽  
Standardized Protocol ◽  
Central Register ◽  
Endogenous Metabolites

Metabolomics investigates a broad range of small molecules, allowing researchers to understand disease-related changes downstream of the genome and proteome in response to external environmental stimuli. It is an emerging technology that holds promise in identifying biomarkers and informing the practice of precision medicine. In this review, we summarize the studies that have examined endogenous metabolites in patients with psoriasis and/or psoriatic arthritis using nuclear magnetic resonance (NMR) or mass spectrometry (MS) and were published through 26 January 2021. A standardized protocol was used for extracting data from full-text articles identified by searching OVID Medline ALL, OVID Embase, OVID Cochrane Central Register of Controlled Trials and BIOSIS Citation Index in Web of Science. Thirty-two studies were identified, investigating various sample matrices and employing a wide variety of methods for each step of the metabolomics workflow. The vast majority of studies identified metabolites, mostly amino acids and lipids that may be associated with psoriasis diagnosis and activity. Further exploration is needed to identify and validate metabolomic biomarkers that can accurately and reliably predict which psoriasis patients will develop psoriatic arthritis, differentiate psoriatic arthritis patients from patients with other inflammatory arthritides and measure psoriatic arthritis activity.

Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta-analysis

2022 ◽  
pp. 019459982110677
Author(s):  
Firas Sbeih ◽  
Malek H. Bouzaher ◽  
Swathi Appachi ◽  
Seth Schwartz ◽  
Michael S. Cohen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Central Register ◽  
Data Source ◽  
Anesthetic Complications ◽  
Full Text Screening

Objective To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger. Data Source Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021. Review Methods Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias. Results The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies. Conclusion The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.

Cochrane corner: water for wound cleansing

2012 ◽  
Vol 37 (4) ◽  
pp. 375-376 ◽  
Author(s):  
J. Henton ◽  
A. Jain
Keyword(s):  
Tap Water ◽  
Data Extraction ◽  
Healing Process ◽  
Cost Effective ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Central Register ◽  
The Cochrane Library

Background: Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and does not interfere with the normal healing process. Tap water is commonly used in the community for cleansing wounds because it is easily accessible, efficient and cost effective; however, there is an unresolved debate about its use. Objectives: The objective of this review was to assess the effects of water compared with other solutions for wound cleansing. Search strategy: For this update we searched the Cochrane Wounds Group Specialised Register (Searched 22 February 2010); The Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library, 2010 Issue 1); Ovid MEDLINE – 2007 to February Week 2 2010; Ovid MEDLINE – In-Process & Other Non-Indexed Citations (Searched19 February 2010); Ovid EMBASE – 2007 to 2010 Week 06; EBSCO CINAHL – 2007 to 22 February 2010. Selection criteria: Randomized and quasi-randomized controlled trials that compared the use of water with other solutions for wound cleansing were eligible for inclusion. Additional criteria were outcomes that included objective or subjective measures of wound infection or healing. Data collection and analysis: Two review authors independently carried out trial selection, data extraction and quality assessment. We settled differences in opinion by discussion. We pooled some data using a random-effects model.

Urine Leukotriene E4: Implications as a Biomarker in Chronic Rhinosinusitis

2021 ◽  
pp. 019459982110110
Author(s):  
Garret Choby ◽  
Christopher M. Low ◽  
Joshua M. Levy ◽  
Janalee K. Stokken ◽  
Carlos Pinheiro-Neto ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Disease Severity ◽  
State Of The Art ◽  
Cochrane Central Register ◽  
Diagnostic Biomarker ◽  
Ovid Medline ◽  
Potential Marker ◽  
Cochrane Database ◽  
Central Register

Objective To provide a comprehensive state-of-the-art review of the emerging role of urine leukotriene E4 (uLTE4) as a biomarker in the diagnosis of chronic rhinosinusitis (CRS), aspirin-exacerbated respiratory disease (AERD), and asthma. Data Sources Ovid MEDLINE(R), Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Review Methods A state-of-the-art review was performed investigating the role of uLTE4 as a diagnostic biomarker, predictor of disease severity, and potential marker of selected therapeutic efficacy. Conclusions uLTE4 has been shown to be a reliable and clinically relevant biomarker for CRS, AERD, and asthma. uLTE4 is helpful in ongoing efforts to better endotype patients with CRS and to predict disease severity. Implications for Practice Aside from being a diagnostic biomarker, uLTE4 is also able to differentiate aspirin-tolerant patients from patients with AERD and has been associated with objective disease severity in patients with CRS with nasal polyposis. uLTE4 levels have also been shown to predict response to medical therapy, particularly leukotriene-modifying agents.

scholarly journals Effectiveness of Interventions for Dysphagia in Parkinson Disease: A Systematic Review

2021 ◽  
pp. 1-23
Author(s):  
Pooja Gandhi ◽  
Catriona M. Steele
Keyword(s):  
Parkinson Disease ◽  
Outcome Measures ◽  
Signal Acquisition ◽  
Cochrane Central Register ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Lee Silverman Voice Treatment ◽  
Voice Treatment ◽  
Ovid Medline ◽  
Central Register

Purpose: Dysphagia is a common sequela of Parkinson disease (PD) and is associated with malnutrition, aspiration pneumonia, and mortality. This review article synthesized evidence regarding the effectiveness of interventions for dysphagia in PD. Method: Electronic searches were conducted in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and speechBITE. Of the 2,015 articles identified, 26 met eligibility criteria: interventional or observational studies with at least five or more participants evaluating dysphagia interventions in adults with PD-related dysphagia, with outcomes measured using videofluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), or electromyography (EMG). Risk of bias (RoB) was evaluated using the Evidence Project tool and predetermined criteria regarding the rigor of swallowing outcome measures. Results: Interventions were classified as follows: pharmacological ( n = 11), neurostimulation ( n = 8), and behavioral ( n = 7). Primary outcome measures varied across studies, including swallowing timing, safety, and efficiency, and were measured using VFSS ( n = 17), FEES ( n = 6), and EMG ( n = 4). Critical appraisal of study findings for RoB, methodological rigor, and transparency showed the majority of studies failed to adequately describe contrast media used, signal acquisition settings, and rater blinding to time point. Low certainty evidence generally suggested improved swallow timing with exercises with biofeedback and deep brain stimulation (DBS), improved safety with DBS and expiratory muscle strength training, and improved efficiency with the Lee Silverman Voice Treatment and levodopa. Conclusions: Studies with lower RoB and greater experimental rigor showed potential benefit in improving swallowing efficiency but not safety. Further research investigating discrete changes in swallowing pathophysiology post-intervention is warranted to guide dysphagia management in PD. Supplemental Material https://doi.org/10.23641/asha.17132162

scholarly journals The impact of equol-producing status in modifying the effect of soya isoflavones on risk factors for CHD: a systematic review of randomised controlled trials

2016 ◽  
Vol 5 ◽  
Author(s):  
Rahel L. Birru ◽  
Vasudha Ahuja ◽  
Abhishek Vishnu ◽  
Rhobert W. Evans ◽  
Yoshihiro Miyamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomised Controlled Trials ◽  
Statistical Power ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Central Register ◽  
Bacterial Action ◽  
Randomised Controlled ◽  
The Impact

AbstractRecent studies suggest that the ability to produce equol, a metabolite of the soya isoflavone daidzein, is beneficial to coronary health. Equol, generated by bacterial action on isoflavones in the human gut, is biologically more potent than dietary sources of isoflavones. Not all humans are equol producers. We investigated whether equol-producing status is favourably associated with risk factors for CHD following an intervention by dietary soya isoflavones. We systematically reviewed randomised controlled trials (RCT) that evaluated the effect of soya isoflavones on risk factors for CHD and that reported equol-producing status. We searched PubMed, EMBASE, Ovid Medline and the Cochrane Central Register for Controlled Trials published up to April 2015 and hand-searched bibliographies to identify the RCT. Characteristics of participants and outcomes measurements were extracted and qualitatively analysed. From a total of 1671 studies, we identified forty-two articles that satisfied our search criteria. The effects of equol on risk factors for CHD were mainly based on secondary analyses in these studies, thus with inadequate statistical power. Although fourteen out of the forty-two studies found that equol production after a soya isoflavone intervention significantly improved a range of risk factors including cholesterol and other lipids, inflammation and blood pressure variables, these results need further verification by sufficiently powered studies. The other twenty-eight studies primarily reported null results. RCT of equol, which has recently become available as a dietary supplement, on CHD and its risk factors are awaited.

scholarly journals Cuidado ao paciente em ecmo (extracorporeal membrane oxygenation): um desafio para a enfermagem neonatal

2022 ◽  
Vol 24 (283) ◽  
pp. 6923-6934
Author(s):  
Tamara Soares ◽  
Ana Cristina Nunes Salvado ◽  
Cristiane Raupp Nunes ◽  
Maitê Larini Rimolo ◽  
Raquel Cristina Concatto
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Membrane Oxygenation ◽  
Ovid Medline ◽  
Central Register

Objetivo: avaliar as evidências científicas disponíveis sobre as intervenções de enfermagem no atendimento aorecém-nascido submetido à terapia de oxigenação por membrana extracorpórea. Método: Pesquisa bibliográfica utilizandocomo fonte de pesquisa plataformas online como Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials ePubmed, SCOPUS, Scielo nos últimos 15 anos, realizada no período de junho de 2019 à outubro de 2020. Resultado: a utilizaçãoda membrana de oxigenação extracorpórea é uma terapia de alta complexidade, cabendo ao enfermeiro, privativamente, aresponsabilidade pela assistência direta ao paciente submetido a esta intervenção. É primordial que o enfermeiro possua amploconhecimento técnico-científico sobre o procedimento a fim de garantir a qualidade da assistência de enfermagem e a segurançado paciente em uso da tecnologia em estudo. Conclusão: O conhecimento científico e a capacitação profissional são vistos comofatores determinantes para o êxito na implantação e manutenção da oxigenação por membrana extracorpórea.

scholarly journals The Role of Orthodontics in the Management of Obstructive Sleep Apnea OSA in Children: Systematic Review

2019 ◽  
Author(s):  
Norah Alotaibi ◽  
Amani alkhamees ◽  
Rabia Bilal
Keyword(s):  
Meta Analysis ◽  
Oral Appliance ◽  
Included Study ◽  
Cochrane Central Register ◽  
Oral Appliances ◽  
Ovid Medline ◽  
Study Selection ◽  
Central Register ◽  
Obstructive Sleep ◽  
Reported Data

Abstract Objective review the effectiveness of the use of different orthodontic oral appliance as a primary or adjective treatment of OSAS in children. methods: systemic search of online databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), international Registry Platform for ongoing trials and clinical trails.gov, Embase Ovid, Medline complete) for randomized control trail and non-randomized prospective or retrospective clinical studies published in 2000-2019 that uses oral appliances for the treatment of OSA in children. Study selection was done by 2 reviews. Results 9 studies were included in the review. Based on the limited evidence oral appliances improve OSA in children measured by the reduction of AHI. Due to heterogeneity of included study designs and reported data meta-analysis was not possible. Limitation limited number of studies and study populations. High risk of bias. Conclusion oral appliances show a promising improvement in AHI and should be considered as a treatment option for OSA in children

Taxane-induced arthralgia and myalgia: A literature review

2016 ◽  
Vol 23 (1) ◽  
pp. 56-67 ◽  
Author(s):  
Nicholas Chiu ◽  
Leonard Chiu ◽  
Ronald Chow ◽  
Henry Lam ◽  
Sunil Verma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Joint Pain ◽  
Cochrane Central Register ◽  
Comprehensive Understanding ◽  
True Incidence ◽  
Ovid Medline ◽  
Central Register ◽  
Taxane Chemotherapy ◽  
A Prospective Study

Purpose Arthralgia and myalgia following taxane chemotherapy has been documented in the literature. However, these two toxicities associated with taxane treatment have not been closely examined in the literature, and data remain inconsistent in terms of the reported incidences of these toxicities. The purpose of this literature review was to provide a more comprehensive understanding of the incidence of taxane-induced arthralgia and myalgia, as well as to document the risk factors and preventative and therapeutic treatments that have been investigated. Methods A literature search was conducted in Ovid Medline, OldMedline, Embase, Embase Classic, and Cochrane Central Register of Controlled Trials using relevant subject headings and keywords such as: “arthralgia,” “myalgia,” “muscle pain,” “joint pain,” “taxane,” “chemotherapy,” “docetaxel,” “paclitaxel.” Results The reported incidences of arthralgia and myalgia were variable. Taxane chemotherapy was found to be associated with greater incidences of arthralgia and myalgia than non-taxane forms of chemotherapy. Moreover, docetaxel and nab-paclitaxel seem to be associated with lower incidences of arthralgia and myalgia than paclitaxel. Finally, the literature on prevention and therapeutic treatment of taxane-induced arthralgia and myalgia is scarce. Conclusion More studies should be done in order to more conclusively identify optimal therapeutic and preventative treatments as well as different risk factors. We recommend that a prospective study be done in order to better understand the true incidence of arthralgia and myalgia in patients being treated with the paclitaxel, docetaxel, and nab-paclitaxel.

scholarly journals The path toward ectogenesis: looking beyond the technical challenges

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Seppe Segers
Keyword(s):  
Neonatal Intensive Care ◽  
Animal Studies ◽  
Current Data ◽  
Safety Testing ◽  
Future Challenges ◽  
Critical Issues ◽  
Expected Benefits ◽  
Physical Impact ◽  
Biological Parenthood ◽  
Experimental Use

Abstract Background Breakthroughs in animal studies make the topic of human application of ectogenesis for medical and non-medical purposes more relevant than ever before. While current data do not yet demonstrate a reasonable expectation of clinical benefit soon, several groups are investigating the feasibility of artificial uteri for extracorporeal human gestation. Main text This paper offers the first comprehensive and up to date discussion of the most important pros and cons of human ectogenesis in light of clinical application, along with an examination of crucial ethical (and legal) issues that continued research into, and the clinical translation of, ectogenesis gives rise to. The expected benefits include advancing prenatal medicine, improving neonatal intensive care, and providing a novel pathway towards biological parenthood. This comes with important future challenges. Prior to human application, important questions have to be considered concerning translational research, experimental use of human fetuses and appropriate safety testing. Key questions are identified regarding risks to ectogenesis’ subjects, and the physical impact on the pregnant person when transfer from the uterus to the artificial womb is required. Critical issues concerning proportionality have to be considered, also in terms of equity of access, relative to the envisaged application of ectogenesis. The advent of ectogenesis also comes with crucial issues surrounding abortion, extended fetal viability and moral status of the fetus. Conclusions The development of human ectogenesis will have numerous implications for clinical practice. Prior to human testing, close consideration should be given to whether (and how) ectogenesis can be introduced as a continuation of existing neonatal care, with due attention to both safety risks to the fetus and pressures on pregnant persons to undergo experimental and/or invasive procedures. Equally important is the societal debate about the acceptable applications of ectogenesis and how access to these usages should be prioritized. It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy.

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