scholarly journals Variable evidence on metformin efficiency as weight-reducing and antiblastomogenic agent: causes and consequences

2012 ◽  
Vol 9 (2) ◽  
pp. 11-16
Author(s):  
L M Berstein
Keyword(s):  
Randomized Trials ◽  
Reference Points ◽  
Clinical Effects ◽  
Control Groups ◽  
Obesity Epidemic ◽  
Cancer Morbidity ◽  
Antidiabetic Biguanides ◽  
Insufficient Number

The growing interest to metformin in areas beyond the limits of diabetology serves as a stimulus for further evaluation of its effectiveness as a potential modulator of cancer morbidity and obesity epidemic. Gradually detectable differences in the intensity of these effects of the drug can be explained by an insufficient number of randomized trials, differences in the control groups (reference points), gender, age, pharmacogenetic and other factors, the study of which collectively promised to increase the likelihood of more favorable clinical effects of metformin and other antidiabetic biguanides in discussed areas.

Interventions for Adolescents With ADHD to Improve Peer Social Functioning: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 108705472090651 ◽  
Author(s):  
Sarah Morris ◽  
Jade Sheen ◽  
Mathew Ling ◽  
Denise Foley ◽  
Emma Sciberras
Keyword(s):  
Social Functioning ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Parent Report ◽  
Self Report ◽  
Age Group ◽  
Control Groups ◽  
Social Interventions ◽  
Meta Analyses ◽  
And Control

Objective: Peer social functioning difficulties characteristic of ADHD persist into adolescence, but the efficacy of interventions for this age group remains unclear. Method: A systematic search of nonpharmacological interventions for adolescents with ADHD (10–18 years) identified 11 trials addressing social functioning, of which eight were included in meta-analyses. Results: Random effects meta-analyses of four randomized trials found no differences in social functioning between treatment and control groups by parent- ( g = −0.08 [−0.34, 0.19], k = 4, N = 354) or teacher-report ( g = 0.17 [−0.06, 0.40], k = 3, N = 301). Meta-analyses of nonrandomized studies indicated participants’ social functioning improved from baseline to postintervention by parent-report, but not teacher- or self-report. All trials had a high risk of bias. Conclusion: These results highlight the paucity of research in this age group. There is little evidence that current interventions improve peer social functioning. Clearer conceptualizations of developmentally relevant targets for remediation may yield more efficacious social interventions.

Psychological Aspects of the Stereotactic Treatment of Parkinsonism

1969 ◽  
Vol 115 (522) ◽  
pp. 541-553 ◽  
Author(s):  
Doreen Asso ◽  
Sidney Crown ◽  
John A. Russell ◽  
Valentine Logue
Keyword(s):  
Concept Formation ◽  
Psychological Aspects ◽  
Clinical Effects ◽  
Control Groups ◽  
Personality Changes ◽  
Lack Of Control ◽  
Human Figure Drawing ◽  
Ventrolateral Nucleus ◽  
Human Figure ◽  
Figure Drawing

The beneficial clinical effects of stereotactic lesions in the ventrolateral nucleus of the thalamus in the treatment of Parkinsonism are well established. Studies of the cognitive and personality changes, however, have given contradictory results. This may be due to the great variety of tests used, to lack of control groups and to the fact that some investigators have studied only unilateral operations, whereas others have included some patients operated on bilaterally. Changes, presumably permanent, have been reported in intelligence (Jurko and Andy, 1961; Lenshoek and Manem, 1960; Niehbuhr, 1962; Jurko and Andy, 1964); concept formation (Jurko and Andy, 1961); extraversion (Fortin, 1960; Jurko and Andy, 1961); and anxiety (Niehbuhr, 1962). Transient changes have been reported in intelligence (Riklan, 1961; Levita et al., 1964); human figure drawing (Riklan et al., 1962); integrity of personality (Fortin et al., 1961; Fortin, 1960; Riklan, 1961); and somatosensory status (Proctor et al., 1963). In other studies no change was found following the operation (Bravo and Cooper, 1959; Gillingham et al., 1960; Gillingham et al., 1964; Levita and Riklan, 1965; Muller and Yasargil, 1959; Riklan, 1962).

scholarly journals Adjuvant therapy efficacy of Chinese drugs pharmaceutics for COPD patients with respiratory failure: a meta-analysis

2019 ◽  
Vol 39 (4) ◽  
Author(s):  
Chunqiu Liu ◽  
Yin Li ◽  
Xinqiu Wang ◽  
Tong Lu ◽  
Xuejing Wang
Keyword(s):  
Respiratory Failure ◽  
Western Medicine ◽  
Meta Analysis ◽  
Test Group ◽  
Cochrane Library ◽  
Control Group ◽  
Chronic Obstructive ◽  
Clinical Effects ◽  
Control Groups ◽  
Chinese Drugs

Abstract We performed a meta-analysis to evaluate the efficacy and safety of Western medicine combined with Tanreqing for patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. We comprehensively searched several online databases from the times of their inception to November 2018. The trial quality was assessed using the bias risk tool recommended by the Cochrane library. Relative risks (RRs) and their 95% confidence intervals (CIs) for binary outcomes and weighted mean differences (MDs) with 95% CIs for continuous data were calculated. A fixed effect model indicated that integrated Tanreqing group experienced higher overall treatment effectiveness (RR = 1.23, 95% CI: 1.17–1.30, P=0.000). Pooled results from random effects models indicated the oxygen partial pressure of the test group was significantly higher than that of the control groups (MD = 9.55, 95% CI: 4.57–14.52, P<0.000). The carbon dioxide pressure of the test group was significantly lower than that of the control groups (MD = –6.06, 95% CI: –8.19 to –3.93, P=0.000). The lung function score of the test group was significantly higher than that of the control group (MD = 7.87, 95% CI: 4.45–11.29). Sensitivity analysis indicated that the data were statistically robust. Clinical effects of Western medicine combined with Tanreqing used to treat combined COPD/respiratory failure were better than those afforded by Western medicine; no serious adverse reactions were noted. However, publication bias was evident, and further trials with larger sample sizes are required.

scholarly journals Safety and Efficacy of Ginkgo-Damole and Nitroglycerin or Sodium Nitroprusside on Hypertensive Cerebropathies: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Li Peng ◽  
Wei-kun Zhao ◽  
Tong-tong Xu ◽  
Qi Wu ◽  
Pan Lu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sodium Nitroprusside ◽  
Meta Analysis ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Control Groups ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
And Control

Objective. To systematically evaluate the safety and efficacy of ginko-damole combined with nitroglycerin or unitary sodium nitroprusside on hypertensive cerebropathy. Methods. Four Chinese databases (VIP, CBM, Wanfang database, and CNKI database) and three English databases (Cochrane, PubMed, and EMBASE) were used to screen randomised controlled trials (RCTs) on treatments of hypertensive cerebropathy using both ginko-damole and nitroglycerin or unitary sodium nitroprusside. Outcomes included clinical effect, blood pressure after treatment, and adverse effects. These indicators were then analysed statistically using the RevMan 5.3 and Stata 12.0 software. Results. Altogether, 16 RCTs including 1507 patients with hypertensive cerebropathy were included in the present meta-analysis, of which, 755 patients treated with combined ginko-damole and nitroglycerin were included in the observation group and 752 patients treated with sodium nitroprusside were included in the control group. The curative effect of the observation group was significantly better than that of the control group (RR: 1.115 [1.077, 1.155], p<0.05). DBPs of the observation and control groups were both lower after treatment, and no significant difference was observed between the observation and control groups (MD: −1.072 [−2.578, 0.434], p>0.05). SBPs in the observation group were significantly lower than those in the control group (MD: −2.842 [−5.222, −0.462], p<0.05). The probability of adverse response in both groups did not differ significantly (RR: 0.752 [0.412, 1.374], p>0.05). Conclusion. Compared with sodium nitroprusside, the combined ginkgo-damole and nitroglycerin could better control blood pressure in patients with hypertensive cerebropathy and showed enhanced clinical effects and improved safety. However, due to poor quality of the included studies, results of the present meta-analysis should be confirmed by more stringent RCTs.

scholarly journals Outcome of patients with pregnancy during or after breast cancer: a review of the recent literature

2014 ◽  
Vol 22 ◽  
pp. 8 ◽  
Author(s):  
J. Raphael ◽  
M.E. Trudeau ◽  
K. Chan
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Randomized Trials ◽  
Recent Literature ◽  
Stage At Diagnosis ◽  
Control Groups ◽  
Level Of Evidence ◽  
Web Based ◽  
High Level ◽  
Meta Analyses

BackgroundAn increasing number of young women are delaying childbearing; hence, more are diagnosed with breast cancer (bca) before having a family. No clear recommendations are currently available for counselling such a population on the safety of carrying a pregnancy during bca or becoming pregnant after treatment for bca.MethodsUsing a Web-based search of PubMed we reviewed the recent literature about bca and pregnancy. Our objective was to report outcomes for patients diagnosed with bca during pregnancy, comparing them with outcomes for non-pregnant women, and to evaluate prognosis in women diagnosed with and treated for bca who subsequently became pregnant.Results“Pregnancy and bca” should be divided into two entities. Pregnancy-associated bca tends to be more aggressive and advanced in stage at diagnosis than bca in control groups; hence, it has a poorer prognosis. With respect to pregnancy after bca, there is, despite the bias in reported studies and meta-analyses, no clear evidence for a different or worse disease outcome in bca patients who become pregnant after treatment compared with those who do not.ConclusionsPregnancy-associated bca should be treated as aggressively as and according to the standards applicable in nonpregnant women; pregnancy after bca does not jeopardize outcome. The guidelines addressing risks connected to pregnancy and bca lack a high level of evidence for better counselling young women about pregnancy considerations and preventing unnecessary abortions. Ideally, evidence from large prospective randomized trials would set better guidelines, and yet the complexity of such studies limits their feasibility.

Effect of 10-day forced treadmill training on neurotrophic factors in experimental autoimmune encephalomyelitis

2013 ◽  
Vol 38 (2) ◽  
pp. 194-199 ◽  
Author(s):  
Darpan I. Patel ◽  
Lesley J. White
Keyword(s):  
Experimental Autoimmune Encephalomyelitis ◽  
Disease Progression ◽  
Wheel Running ◽  
Treadmill Running ◽  
Clinical Effects ◽  
Control Groups ◽  
Autoimmune Encephalomyelitis ◽  
Tnf Α ◽  
The Impact ◽  
Experimental Autoimmune

The impact of exercise on disease progression in multiple sclerosis (MS) is unclear. In the present study, we evaluated the clinical effects of forced wheel running on rats induced with experimental autoimmune encephalomyelitis (EAE), a model of MS. Female Lewis rats (n = 40) were randomly assigned to 1 of 4 groups prior to inoculation: EAE exercise (EAE-Ex), EAE sedentary (EAE-Sed), control exercise (Con-Ex), or control sedentary (Con-Sed). Exercise training was composed of forced treadmill running at increasing intensity across 10 consecutive days. No significant differences in clinical disability were observed in the EAE groups at the conclusion of this study. Furthermore, no significant differences in brain mass were observed across groups. Analysis of brain tissue proteins revealed that tumour necrosis factor-α (TNF-α) concentrations were higher in both EAE groups compared with the control groups (p < 0.05); however, no significant differences were seen between the EAE-Ex and EAE-Sed groups. The Con-Ex group had lower whole-brain TNF-α compared with the Con-Sed group (p < 0.05). Nerve growth factor concentrations were greater in the EAE-Ex animals compared with both control groups (p < 0.05 for both). No differences were seen in brain-derived neurotrophic factor. Our results indicate that aerobic exercise can modulate the proteins associated with disability in EAE; however, further research is required to understand the total impact of exercise on EAE disability and disease progression.

scholarly journals Enhanced recovery after surgery protocols in total knee arthroplasty via midvastus approach: a randomized controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Bo Wei ◽  
Cheng Tang ◽  
Xuxiang Li ◽  
Rongcai Lin ◽  
Liu Han ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Control Group ◽  
Clinical Effects ◽  
Control Groups ◽  
Midvastus Approach ◽  
Vas Scores ◽  
Total Knee ◽  
And Control ◽  
Walking Time

Abstract Background Enhanced recovery after surgery (ERAS) protocols were rapidly adopted in many surgeries such as fast-track arthroplasty. The study aimed to investigate the impact of ERAS protocols on the clinical effect of total knee arthroplasty (TKA) via the midvastus approach. Methods A total of 69 patients who underwent primary unilateral TKA via the midvastus approach from October 2018 to June 2019 were enrolled and randomly divided into two groups: ERAS group and Control group. The ERAS protocols were adopted for the ERAS group and consisted of pure juice drinking 2 h before the surgery, optimization of the preoperative anesthesia plan, phased use of tourniquets, and the use of tranexamic acid as well as a drug cocktail. The operative time, first postoperative walking time, first straight leg elevation time, postoperative hospitalization time, visual analogue scale score (VAS score), Hospital for Special Surgery score (HSS score), conventional Knee Society score (KSS), and knee range of motion (ROM) were used to assess the clinical effects in the two groups. All the included patients were followed up for 12 months. Results There were no significant differences in the basic demographic information and operation time between the ERAS and Control groups (P > 0.05). The first postoperative walking time (2.11 ± 0.11 h) and first postoperative straight leg elevation time (6.14 ± 1.73 h) in the ERAS group were significantly earlier than those in the Control group (P < 0.001) and the postoperative hospitalization time was significantly shorter (3.11 ± 0.32 days). The postoperative mean VAS scores in both groups were significantly reduced compared with those before surgery (P < 0.001). The VAS scores for the ERAS group were significantly lower than those for the Control group at 1, 2, and 7 days after surgery (P < 0.001). The mean HSS scores, KSS, and knee ROM were significantly increased in both the ERAS and Control groups at 1, 3, 6, and 12 months after surgery (P < 0.001). In addition, the HSS scores, KSS, and knee ROM in the ERAS group were significantly higher than those in the Control group at 1 month after surgery (P < 0.001). Conclusions ERAS protocols improved the clinical effects of TKA via the midvastus approach, facilitating early out-of-bed activity and comfortable postoperative rehabilitation exercise, and further increasing patient satisfaction. Trial registration ClinicalTrials.gov Identifier: NCT04873544.

P4415Long obstructive sleep apneas as a biomarker of atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Allam ◽  
P Reddy ◽  
E Valladares ◽  
T Hammond ◽  
V Grbach ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Randomized Trials ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Control Groups ◽  
Obstructive Sleep ◽  
Patients At Risk ◽  
History Of ◽  
And Control ◽  
Obstructive Sleep Apneas

Abstract Background Even though obstructive sleep apnea (OSA) is strongly associated with atrial fibrillation (AF), the use of traditional OSA scoring by apnea hypopnea index (AHI) did not result in improved arrhythmia outcomes in recent randomized trials. Longer OSA episodes lead to stronger pro-arrhythmic changes, and whether very long OSA episodes are more prevalent in AF patients remains unknown. Purpose We hypothesized that AF patients with mild-moderate OSA manifest greater percentage of long (>20s), very long (>30s), and extremely long (>40s) OSA episodes, compared to control OSA patients matched to AHI, age and sex. Methods From patients studied with diagnostic polysomnography in our laboratory between 2016 and 2018, we selected 22 patients with mild-moderate untreated OSA of which 11 patients had history of paroxysmal AF and 11 patients did not have any cardiac history. The length, oxygen desaturation, and relationship to neighboring events was manually re-measured in all recorded apnea and hypopnea events. Results In the 22 included patients (age 62.5±9.1 years, AHI 12.8±6.1, 40% female) we recorded 1021 apneas: 508 in the AF group and 513 in the control group. AF patients had longer apneas compared to the patients without AF history (mean length 28.7±11.7s vs. 23.3±9.9s; p<0.0001). The proportion of apneas that were long (>20s), very long (>30s), and extremely long (>40s) was greater in the AF group as compared to the control (p=0.0039, p=0.0215, p=0.0104, respectively; see figure). The acute oxygen saturation drops (>2%) during apneas were comparable between the AF group and control groups (p=0.13), but the long (>20s) apneas were prone to greater oxygen desaturations. Length of Apneas Conclusions While traditional scoring of OSA focuses on episodes lasting >10s, our data newly show that longer durations of OSA events are particularly prevalent in AF patients. These results, combined with recent mechanistic studies showing that longer apneas exert greater pro-arrhythmic effect on atrial conduction, suggest that novel scoring of OSA placing more weight on longer apneas should be explored, especially when screening and titrating OSA therapy in patients at risk of AF.

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