scholarly journals ADHD Prescription Medications and Their Effect on Athletic Performance: A Systematic Review and Meta-analysis

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Jenny Berezanskaya ◽  
William Cade ◽  
Thomas M. Best ◽  
Kristopher Paultre ◽  
Carolyn Kienstra
Keyword(s):  
Athletic Performance ◽  
Perceived Exertion ◽  
Performance Enhancement ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Final Analysis ◽  
Study Results ◽  
Adhd Treatment ◽  
Stimulant Medications ◽  
Adhd Medications

Abstract Background Stimulant medications used for the treatment of Attention Deficit-Hyperactivity Disorder (ADHD) are believed to provide a physical advantage in athletics, but several of these medications are not regulated by the World Anti-Doping Association. Given the prevalence of ADHD among the athlete population and concern for abuse of ADHD medications, this review and meta-analysis aimed to evaluate effects of ADHD medications on athletic performance, thereby appraising the validity of claims of performance enhancement. Methods A search of MEDLINE, Embase, CINAHL, and Cochrane Review databases was performed for all randomized controlled trials evaluating athletic performance after ingestion of placebo or ADHD treatment medications from August 2020 through November 2020. All RCTs identified from these search criteria were included for screening, with exclusion of any animal studies. Two reviewers (JB, CK) assessed methodological quality and risk of bias using CONSORT 2010 and Cochrane Collaboration tools. Study results were compiled with corresponding p values for each finding. Effect sizes (Cohen’s D) for athletic performance and physiological changes were aggregated for each study. Studies were further screened for homogeneity that would allow for meta-analysis. Heterogeneity was calculated using I2. Results A total of 13,033 abstracts evaluating amphetamine, methamphetamine, methylphenidate, and bupropion were screened. The final analysis included nine studies, six of which found significant improvement in athletic performance with use of stimulant medications (p < 0.05). Methylphenidate and amphetamine were consistently identified to have a performance effect. Secondary effects identified included significant increase in heart rate, core temperature, and elevation of various serum hormone levels (p < 0.05). Effect size evaluation found seven studies demonstrating small to large effects on physical performance, as well as in categories of cardiometabolic, temperature, hormone, and ratings of perceived exertion, to varying degrees. A meta-analysis was performed on two studies, demonstrating conflicting results. Conclusions Dopaminergic/noradrenergic agonist medications appear to have a positive effect on athletic performance, as well as effects on physiological parameters. Further consideration of medications currently not regulated, i.e. bupropion, is warranted given evidence of athletic performance enhancement. PROSPERO trial registration number: CRD42020211062; 10/29/2020 retrospectively registered.

scholarly journals Upper-Body Post-activation Performance Enhancement for Athletic Performance: A Systematic Review with Meta-analysis and Recommendations for Future Research

2021 ◽  
Author(s):  
Mitchell James Finlay ◽  
Craig Alan Bridge ◽  
Matt Greig ◽  
Richard Michael Page
Keyword(s):  
Systematic Review ◽  
Athletic Performance ◽  
Performance Test ◽  
Bench Press ◽  
Performance Enhancement ◽  
Meta Analysis ◽  
Body Movement ◽  
Individual Performance ◽  
Upper Body ◽  
Repetition Maximum

Abstract Background Research on post-activation performance enhancement (PAPE) is dominated by lower-body conditioning activities/performance test complexes. Despite the contribution of the upper body to many sporting actions, no review on upper-body PAPE currently exists. Objectives The aim of this systematic review with meta-analysis was to provide a synthesis of the available research on the inclusion of upper-body PAPE conditioning activities to improve athletic performance. Methods A review of the literature was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, including a literature search of EBSCOhost, SPORTDiscus, PubMed and Google Scholar databases. A total of 127 studies were identified through database searches, and were assessed against the following criteria: (1) randomised controlled trial or pre-and-post study design; (2) studies explored the effects of prior voluntary muscle activity, and not electrically induced contractions, (3) evidence, or lack thereof, of PAPE was quantified by the monitoring of individual performance to commonly applied physical tests or sport-specific tasks; (4) conditioning activities and performance tests were primarily upper-body; (5) detailed description of a standardised warm-up; and (6) full-text versions of studies could be accessed in English language peer-reviewed journals. Studies were quality assessed for methodological quality via the PEDro scale and ranked accordingly. Results Thirty-one studies met the inclusion criteria. Studies were classified into different conditioning activity modes: bench press variations, sport-specific (modified implement throws, swing-specific, cable pulley, elastic resistance, combination) and bodyweight activity. Acute performance enhancement in several movement-specific combinations was found. A meta-analysis revealed that bench press at  ≥ 80% one repetition maximum significantly (p = 0.03; ES = 0.31) improves subsequent power output in the ballistic bench throw at 30–40% one repetition maximum, following 8–12 min recovery. Additionally, sport-specific overweight implement throws improved subsequent throwing distance at competition weight by ~ 1.7–8.5%; ES = 0.14–0.33, following 3 min recovery. Sport-specific lighter weighted bat swings and swing-specific isometrics resulted in improved subsequent competition weight bat swing velocities, ranging from ~ 1.3–3.3%; ES = 0.16–0.57. Conclusions This review presents several upper-body movement-specific conditioning activities that could be considered by coaches and practitioners as part of complex or contrast training, or used in pre-competition warm-ups to acutely enhance performance.

Metoclopramide versus setrons in delayed emesis in moderate emetogenic chemotherapy: A meta-analysis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20538-e20538
Author(s):  
K. Jordan ◽  
F. Mueller ◽  
A. Hinke ◽  
T. Behlendorf ◽  
P. Feyer ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Final Analysis ◽  
Similar Efficacy ◽  
Emetogenic Chemotherapy ◽  
Delayed Response ◽  
Apparent Difference ◽  
Delayed Emesis ◽  
Medline Search ◽  
Study Results ◽  
Antiemetic Guidelines

e20538 Background: In the actual antiemetic ASCO and MASCC guidelines 5-HT3-RAs but not metoclopramide (MCP) are recommended as prophylaxis option for delayed emesis (DE) in moderate emetogenic chemotherapy (MEC). However, MCP was part of the former guidelines in this setting. As there are no clear study results showing a consistent advantage of 5-HT3-RAs over MCP in delayed emesis a metaanalysis would give more conclusive informations. Methods: In a Medline search 15 potential studies comparing a 5-HT3-RA vs. MCP in DE in patients receiving MEC were identified. Efficacy was classified as complete delayed response (no vomiting 24h-120h after chemotherapy). In 4 studies insufficient data for discrimination of acute and delayed emesis were given and in 5 studies additional antiemetics in one arm or MCP/ 5-HT3-RA were administerd only on demand. For each indivudual study odds ratio was calculated. Combined odds ratios were generated according to the methods developed by the Peto group. Results: Six studies (N=700) could be included in the final analysis. The comparison of 5-HT3-RAs and MCP revealed similar efficacy in the prevention of DE in patients receiving MEC (OR fixed 1.01, 95% CI: 0.75, 1.36, OR random 1.26, 95% CI: 0.64, 2.46). A second analysis (N=895) including the study with additional dexamethasone application in the DE phase confirms no advantage of one drug over the another (OR fixed 1.02, 95% CI: 0.79, 1.22, OR random 1.19, 95% CI: 0.70, 2.04). Conclusions: This is the first meta-analysis of all available randomized trials comparing 5-HT3-RAs and MCP in the delayed phase of MEC demonstrating no apparent difference in efficacy. MCP is a less expensive alternative to setrons in this setting. However, the results of this meta-analysis have to be interpreted with cautious due to the potential carry over effect from the acute phase and heterogeneity of the included studies. Despite these limitations, it should be discussed to recommend MCP again for the propyhlaxis of delayed emesis for MEC when preparing the new antiemetic guidelines. No significant financial relationships to disclose.

Abstract 15656: Manual vs Remote Magnetic Navigation for Ventricular Tachycardia Ablation: A Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ghulam Murtaza ◽  
Mohit K Turagam ◽  
Jalaj Garg ◽  
Krishna Akella ◽  
Donita Atkins ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Final Analysis ◽  
Magnetic Navigation ◽  
Continuous Variables ◽  
Remote Magnetic Navigation ◽  
Ventricular Tachycardia Ablation ◽  
Vt Ablation ◽  
Mean Differences

Introduction: The role of remote magnetic navigation (RMN) for ventricular tachycardia (VT) ablation is not well established. In this meta- analysis, we aim to evaluate the safety and efficacy of RMN vs manual navigation (MAN) for VT ablation. Methods: A comprehensive literature search in PubMed, Google Scholar and Cochrane Review from inception till November 9th, 2019 was performed. Studies reporting clinical outcomes comparing MAN vs RMN were included. Two investigators independently extracted the data and individual quality assessment was performed. Results were expressed as odds ratio (OR) for dichotomous outcomes and mean differences (MD) for continuous variables with 95% confidence intervals (CI). Results: Eight studies including a total of 861 patients (475 in RMN arm and 386 in MAN arm) were included in the final analysis. VT recurrence was significantly lower with RMN compared with MAN (OR 0.65, 95% CI 0.48-0.88, p= 0.005). Acute procedural success was significantly higher with RMN (OR 2.21, 95% CI 1.51-3.23, p < 0.0001). Total procedure time [MD -8.83, 95% CI -17.72- 0.05, p=0.05], fluoroscopy time [MD -10.24, 95% CI -12.28- -8.19, p= 0.00001), and complications [OR 0.36, 95% CI 0.18- 0.72, p= 0.003] were significantly lower in RMN compared to MAN. Conclusion: Results of our meta-analysis indicate that RMN is safer and more effective than MAN in patients with VT undergoing ablation. Further, randomized studies are needed to validate these findings.

scholarly journals Dyslipidaemia and mortality in COVID-19 patients - a meta-analysis

QJM ◽  
2021 ◽  
Author(s):  
Marco Zuin ◽  
Gianluca Rigatelli ◽  
Claudio Bilato ◽  
Carlo Cervellati ◽  
Giovanni Zuliani ◽  
...  
Keyword(s):  
Random Effects ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Random Effect ◽  
Final Analysis ◽  
Short Term ◽  
Random Effects Models ◽  
Pooled Prevalence ◽  
Statistical Heterogeneity ◽  
Trim And Fill

Abstract Objective The prevalence and prognostic implications of pre-existing dyslipidaemia in patients infected by the SARS-CoV-2 remain unclear. To perform a systematic review and meta-analysis of prevalence and mortality risk in COVID-19 patients with pre-existing dyslipidaemia. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to January 31, 2021, reporting data on dyslipidaemia among COVID-19 survivors and non-survivors. The pooled prevalence of dyslipidaemia was calculated using a random effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. Results Eighteen studies, enrolling 74.132 COVID-19 patients [mean age 70.6 years], met the inclusion criteria and were included in the final analysis. The pooled prevalence of dyslipidaemia was 17.5% of cases (95% CI: 12.3-24.3%, p &lt; 0.0001), with high heterogeneity (I2=98.7%). Pre-existing dyslipidaemia was significantly associated with higher risk of short-term death (OR: 1.69, 95% CI: 1.19-2.41, p = 0.003), with high heterogeneity (I2=88.7%). Due to publication bias, according to the Trim-and-Fill method, the corrected random-effect ORs resulted 1.61, 95% CI 1.13-2.28, p &lt; 0.0001 (one studies trimmed). Conclusions Dyslipidaemia represents a major comorbidity in about 18% of COVID-19 patients but it is associated with a 60% increase of short-term mortality risk.

scholarly journals Fibroblast Growth Factor 20 Gene Polymorphism in Parkinson’s Disease in Asian Population: A Meta-Analysis

Genes ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 674
Author(s):  
Han-Lin Chiang ◽  
Yih-Ru Wu ◽  
Yi-Chun Chen ◽  
Hon-Chung Fung ◽  
Chiung-Mei Chen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Lewy Bodies ◽  
Asian Population ◽  
Protective Role ◽  
Lewy Neurites ◽  
Chinese Populations ◽  
Study Results

Parkinson’s disease (PD) is a neurodegenerative disease with the pathological hallmark of Lewy bodies and Lewy neurites composed of α-synuclein. The SNP rs591323 is one of the risk loci located near the FGF20 gene that has been implicated in PD. The variation of FGF20 in the 3′ untranslated region was shown to increase α-synuclein expression. We examined the association of rs591323 with the risk of PD in a Taiwanese population and conducted a meta-analysis, including our study and two other studies from China, to further confirm the role of this SNP in Taiwanese/Chinese populations. A total of 586 patients with PD and 586 health controls (HCs) were included in our study. We found that the minor allele (A) and the AA + GA genotype under the dominant model are significantly less frequent in PD than in controls. The meta-analysis consisted of 1950 patients with PD and 2073 healthy controls from three studies. There was significant association between rs591323 and the risk of PD in the additive (Z = −3.96; p < 0.0001) and the dominant models (Z = −4.01; p < 0.0001). Our study results and the meta-analysis support the possible protective role of the rs591323 A allele in PD in Taiwanese/Chinese populations.

scholarly journals MGMT promoter methylation testing to predict overall survival in people with glioblastoma treated with temozolomide: a comprehensive meta-analysis based on a Cochrane Review

2021 ◽  
Author(s):  
Sebastian Brandner ◽  
Alexandra McAleenan ◽  
Claire Kelly ◽  
Francesca Spiga ◽  
Hung-Yuan Cheng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Dna Methyltransferase ◽  
Meta Analysis ◽  
Alkylating Agents ◽  
Cochrane Review ◽  
Predictive Biomarker ◽  
Test Method ◽  
Sufficient Information ◽  
Cpg Sites ◽  
Hazard Ratios

Abstract BACKGROUND The DNA repair protein O6 methylguanine-DNA methyltransferase (MGMT) causes resistance of tumour cells to alkylating agents. It is a predictive biomarker in high grade gliomas treated with temozolomide, however there is no consensus on which test method, methylation sites, and cut-off values to use. METHODS We performed a Cochrane Review to examine studies using different techniques to measure MGMT and predict survival in glioblastoma patients treated with temozolomide. Eligible longitudinal studies included adults with glioblastoma treated with temozolomide with or without radiotherapy, or surgery; where MGMT status was determined in tumour tissue, and assessed by one or more technique; and where overall survival was an outcome parameter, with sufficient information to estimate hazard ratios. Two or more methods were compared in 32 independent cohorts with 3474 patients. RESULTS Methylation-specific PCR (MSP) and pyrosequencing (PSQ) techniques were more prognostic than immunohistochemistry for MGMT protein, and PSQ is a slightly better predictor than MSP. CONCLUSIONS We cannot draw strong conclusions about use of frozen tissue versus formalin-fixed paraffin embedded in MSP and PSQ. Also, our meta-analysis does not provide strong evidence about the best CpG sites or threshold. MSP has been studied mainly for CpG sites 76-80 and 84-87 and Pyrosequencing at CpG sites ranging from 72 to 95. A cut-off threshold of 9% for CpG sites 74-78 performed better than higher thresholds of 28% or 29% in two of three good-quality studies. 190 studies were identified presenting hazard ratios from survival analysis in patients in which MGMT methylation was measured by one technique only.

A Meta-Analysis of Extracorporeal Anticoagulants in Pediatric Continuous Kidney Replacement Therapy

2021 ◽  
pp. 088506662199275
Author(s):  
Rupesh Raina ◽  
Nirav Agrawal ◽  
Kirsten Kusumi ◽  
Avisha Pandey ◽  
Abhishek Tibrewal ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Electrolyte Imbalance ◽  
Therapeutic Modality ◽  
Regional Citrate Anticoagulation ◽  
Increased Risk ◽  
Study Results ◽  
Significant Difference ◽  
Kidney Replacement Therapy

Objective: Continuous kidney replacement therapy (CKRT) is the primary therapeutic modality utilized in hemodynamically unstable patients with severe acute kidney injury. As the circuit is extracorporeal, it poses an increased risk of blood clotting and circuit loss; frequent circuit losses affect the provider’s ability to provide optimal treatment. The objective of this meta-analysis is to evaluate the safety and efficacy of the extracorporeal anticoagulants in the pediatric CKRT population. Data Sources: We conducted a literature search on PubMed/Medline and Embase for relevant citations. Study Selection: Studies were included if they involved patients under the age of 18 years undergoing CKRT, with the use of anticoagulation (heparin, citrate, or prostacyclin) as a part of therapy. Only English articles were included in the study. Data Extraction: Initial search yielded 58 articles and a total of 24 articles were included and reviewed. A meta-analysis was performed focusing on the safety and effectiveness of regional citrate anticoagulation (RCA) vs unfractionated heparin (UFH) anticoagulants in children. Data Synthesis: RCA had statistically significantly longer circuit life of 50.65 hours vs. UFH of 42.10 hours. Two major adverse effects metabolic alkalosis and electrolyte imbalance seen more commonly in RCA compared to UFH. There was not a significant difference in the risk of systemic bleeding when comparing RCA vs. UFH. Conclusion: RCA is the preferred anticoagulant over UFH due to its significantly longer circuit life, although vigilant circuit monitoring is required due to the increased risk of electrolyte disturbances. Prostacyclin was not included in the meta-analysis due to the lack of data in pediatric patients. Additional studies are needed to strengthen the study results further.

scholarly journals Socioeconomic status correlates with measures of Language Environment Analysis (LENA) system: a meta-analysis

2021 ◽  
pp. 1-15
Author(s):  
Leonardo PIOT ◽  
Naomi HAVRON ◽  
Alejandrina CRISTIA
Keyword(s):  
Socioeconomic Status ◽  
Meta Analysis ◽  
Final Analysis ◽  
Publication Type ◽  
Environment Analysis ◽  
System A ◽  
Language Environment Analysis ◽  
Language Environment ◽  
Strength Of Association ◽  
Important Evidence

Abstract Using a meta-analytic approach, we evaluate the association between socioeconomic status (SES) and children's experiences measured with the Language Environment Analysis (LENA) system. Our final analysis included 22 independent samples, representing data from 1583 children. A model controlling for LENATM measures, age and publication type revealed an effect size of r z = .186, indicating a small effect of SES on children's language experiences. The type of LENA metric measured emerged as a significant moderator, indicating stronger effects for adult word counts than child vocalization counts. These results provide important evidence for the strength of association between SES and children's everyday language experiences as measured with an unobtrusive recording analyzed automatically in a standardized fashion.

scholarly journals Epidemiology of Secondary Warm Autoimmune Haemolytic Anaemia—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1244
Author(s):  
Stinne Tranekær ◽  
Dennis Lund Hansen ◽  
Henrik Frederiksen
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Underlying Disease ◽  
Age At Diagnosis ◽  
Autoimmune Haemolytic Anaemia ◽  
Sex Distribution ◽  
Number Of Patients ◽  
Study Results ◽  
Full Text Review

Background: Warm autoimmune haemolytic anaemia (wAIHA) is a haemolytic disorder, most commonly seen among adults and is classified as either primary or secondary to an underlying disease. We describe the age and sex distribution and the proportion of secondary wAIHA. Method: We retrieved 2635 published articles, screened abstracts and titles, and identified 27 articles eligible for full-text review. From these studies, we extracted data regarding number of patients, sex distribution, age at diagnosis, number of patients with secondary wAIHA, and whether the patients were diagnosed through local or referral centres. All data were weighted according to the number of included patients in each study. Results: 27 studies including a total of 4311 patients with wAIHA, of which 66% were females, were included. The median age at diagnosis was 68.7 years, however, wAIHA affected all ages. The mean proportion of secondary wAIHA was 49%, most frequently secondary to systemic lupus erythematosus. The proportions of secondary wAIHA reported from primary vs. referral centres were 35% vs. 59%, respectively. Conclusion: This review consolidates previously reported gender distribution. The higher proportion of secondary wAIHA in referral centres suggests that the most severely affected patients are disproportionally more frequent in such facilities.

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