Modulation of offset analgesia in patients with chronic pain and healthy subjects – a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Dennis Boye Larsen ◽  
Xenia Jørgensen Uth ◽  
Lars Arendt-Nielsen ◽  
Kristian Kjær Petersen
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Subgroup Analysis ◽  
Healthy Subjects ◽  
Meta Analysis ◽  
Pain Modulation ◽  
Cochrane Library ◽  
Conditioned Pain Modulation ◽  
Qualitative Synthesis ◽  
Current Systematic Review

Abstract Objectives Offset analgesia (OA) induces a brief pain inhibition and studies suggest OA impairment in patients with chronic pain when compared to healthy subjects. Conditioned pain modulation remains the most studied descending pain inhibitory control mechanism and is modulated by centrally-acting analgesics. Since OA may be mediated by similar neural substrates as conditioned pain modulation, understanding if OA is a peripheral or central proxy of pain modulation is important. The modulatory effect of centrally-acting drugs on OA in healthy and chronic pain populations has not yet been systematically reviewed and meta-analyzed, and this systematic review and meta-analysis aimed to identify studies employing interventions for modulating OA magnitude. Methods A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library yielded 146 records of which 11 (172 healthy pain-free subjects, 106 chronic pain patients) were eligible for qualitative synthesis, and 10 for meta-analysis on overall modulatory effect of interventions on OA, and subgroup analysis of patients and healthy pain-free subjects. Results Risk of bias was evident for study participation and study confounding in the included studies. Several different methods for assessing and calculating OA magnitude were identified, which may affect interpretability of findings and warrants standardization. The meta-analysis showed no modulatory effects on OA overall (standardized mean difference (SMD) [95%CI]: 0.04 [−0.22, 0.30], Z=0.29, p=0.77), or in the subgroup analysis for patients (SMD [95%CI]: −0.04 [−0.63, 0.71], Z=0.13, p=0.90) or healthy pain-free subjects (SMD [95%CI]: 0.01 [−0.21, 0.24], Z=0.11, p=0.91). Moderate to substantial heterogeneity was found for the overall analysis (I2=47%, p=0.03) and patient subgroup analysis (I2=75%, p=0.003). Conclusions The current systematic review and meta-analysis conclude that centrally-acting drugs and exercise do not influence OA. Evidence on the peripheral contribution to OA response requires further investigations. Preclinical models of OA should be established to identify the neurophysiology and -biology behind OA.

scholarly journals Effects of Quran Recitation on the Reduction of Preoperative Anxiety in Elective Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Vahideh Zarea Gavgani ◽  
Mortaza Ghojazadeh ◽  
Fatemeh Sadeghi-Ghyassi ◽  
Tahmineh Khodapanah
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Subgroup Analysis ◽  
Randomized Clinical Trials ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Preoperative Anxiety ◽  
Cochrane Library ◽  
Qualitative Synthesis ◽  
Inconsistency Index

Abstract Background: Anxiety is a common reaction among patients undergoing surgery. This study aim to assess effectiveness of Quran recitation on reducing the preoperative anxiety.Methods: A systematic review of the citations in the Medline, EMBASE, Cochrane Library, PsycInfo, Arab World Research Source and other relevant databases was performed to collect the data. Randomized clinical trials about the effect of Quran recitation on the reduction of preoperative anxiety in elective surgery were included without any Language and date restriction. Interventions with self-reading/self-recitation were excluded. The Cochran’s Q statistic and the (I2) with 50 percent threshold was used for calculation of the heterogeneity and inconsistency index. Subgroup analysis was conducted based on the type of surgery. The funnel plot has been used to evaluate the possibility of the publication bias.Results:Twelve studies were included in the qualitative synthesis and nine studies included in the quantitative synthesis. Our meta-analysis showed a significant reduction in the anxiety level with Quran recitation. The heterogeneity of the included studies was statistically significant (Q=23.05, I2=65.29, P=0.003). The pooled effect size of the anxiety was d=−8.893; 95% CI=[−10.763 to −7.022] (P < 0.001). The subgroup analysis showed that Quran recitation has a beneficial effect on reducing anxiety in both major and minor surgeries.There was no publication bias (t=0.907, P=0.39) in the studies.Conclusion: Quran recitation can be considered as a non-invasive and peaceful intervention to reduce preoperative anxiety in elective surgery.

scholarly journals Dengue Virus Infection in Sub-Saharan Africa Between 2010 and 2020: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Khalid Eltom ◽  
Khalid Enan ◽  
Abdel Rahim M. El Hussein ◽  
Isam M. Elkhidir
Keyword(s):  
Systematic Review ◽  
Dengue Virus ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Denv Infection ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
The Past ◽  
Sub Saharan ◽  
Infection Markers

Dengue virus (DENV) infection has garnered a global interest in the past few decades. Nevertheless, its epidemiology in certain developing and low-income regions remains poorly understood, due to the absence of comprehensive surveillance and reporting systems. This systematic review and meta-analysis aimed to determine the prevalence of DENV infection in the population of Sub-Saharan Africa using DENV infection markers, and to track any changes in its prevalence during the past ten years. It was conducted in accordance with the PRISMA guidelines, targeting the literature available at MEDLINE/PubMed, ScienceDirect, Cochrane library and Google Scholar. All articles published in English language between January 2010 and June 2020 were screened for eligibility. Random effects model was used to calculate the pooled prevalence of all infection markers. The Inconsistency Index (I2) was used to assess the level of heterogeneity between studies. Subgroup analysis according to country and time-frame of studies was conducted to provide possible explanations to substantial heterogeneity. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies. A total of 84 articles, covering 21 countries, were included in this review. Quantitative meta-analysis estimated a pooled IgG prevalence of 25% (95% CI: 21-29%, I2 = 99%), a pooled IgM prevalence of 10% (95% CI: 9-11%, I2 = 98%) and a pooled DENV RNA prevalence of 14% (95% CI: 12-16%, I2 = 99%). Evidence for possible publication bias was also found in all three meta-analyses. Subgroup analysis according to the time of sample collection was performed to closely track the changing prevalence of DENV infection markers between 2010 and 2019. This meta-analysis estimates a high prevalence of DENV infection in Sub-Saharan Africa. More cost-efficient vector control strategies should be designed and implemented in order to adapt to the low-resource nature of this region.

Effectiveness of Physiotherapy to Promote Motor Recovery in Individuals with Stroke: A Systematic Review Protocol

2022 ◽  
Author(s):  
Shehong Zhang ◽  
Hongyu Xie ◽  
Chuanjie Wang ◽  
Fengfeng Wu ◽  
Xin Wang
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Systematic Reviews ◽  
Evaluation System ◽  
Meta Analysis ◽  
Primary Data ◽  
Cochrane Library ◽  
Systematic Review Protocol ◽  
Qualitative Synthesis ◽  
Review Protocol

Abstract Introduction: Motor function is essential in our daily lives, one of the most common impairments caused by stroke is loss of functional movement. Over 70% of stroke survivors have motor or other neurological functional disabilities. However, rehabilitation of motor function suffered from a stroke can be rather difficult due to the complexity of organs and systems related to motor function, as well as the neural system that supported motor function. In particularly, previous evidence for the effectiveness of physiotherapy, a commonly prescribed intervention method for people with stroke, that recover motor function in people following a stroke is varied and limited in the chronic rehabilitation phase and therefore has never been reviewed systematically. With the progress of study in neurology and the development of novel tools for rehabilitation, results from more and more clinical trials are now available, thus here justifying conducting a systematic review. Methods and analysis: This systematic review protocol is developed in accordance with the methodology recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, as well as the Cochrane handbook for systematic reviews of interventions. Relevant studies will be identified by searching the databases. We will perform searches for relevant studies in databases, including PubMed, Embase, CINAHL, and Web of Science, Physiotherapy Evidence Database and Cochrane Library databases. The reference lists of included articles and reviews will be searched manually. The date range parameters used in searching all databases will be restricted between January 2001 and January 2021. Randomized controlled trials (RCTs) published will be included. The language used in the articles included was restricted to English. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation system from the Cochrane Handbook for Systematic Reviews of Interventions) approach will be used to systematically appraise the quality of methodology. We will assess the risk of bias of the RCTs included using the Cochrane Collaboration’s tool and provide a qualitative synthesis. After that, we will consider conducting a meta-analysis if the final data across outcomes shows sufficient homogeneity. Ethics and dissemination: No ethical approval is needed as the proposed study does not involve the collection of primary data, and the results of this review will be disseminated via peer-reviewed publications and conference presentations. Trial registration number: CRD42021267069.

scholarly journals Association between quantitative sensory testing and pain or disability in paediatric chronic pain: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031861 ◽  
Author(s):  
Daniel Eric Schoth ◽  
Markus Blankenburg ◽  
Julia Wager ◽  
Philippa Broadbent ◽  
Jin Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Quantitative Sensory Testing ◽  
Ethical Issues ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Anatomical Site ◽  
Thermal Stimulus ◽  
Sensory Testing ◽  
Pain Mechanisms

IntroductionThis protocol describes the objective and methods of a systematic review of the association between quantitative sensory testing (QST) measures and pain intensity or disability in paediatric chronic pain (PCP). The review will also assess whether the relationship strength is moderated by variables related to the QST method and pain condition; the use of QST in PCP (modalities, outcome measures and anatomical test sites as well as differentiating between pain mechanisms (eg, neuropathic vs nociceptive) and in selecting analgesics); the reliability of QST across the paediatric age range; the ability of QST to differentiate patients with chronic pain from healthy controls; and differences between anatomical test sites.Methods and analysisMedline, PsycINFO, CINHAL, Web of Science, Scopus, Cochrane Library and OpenGrey will be searched. English language studies will be eligible if they recruit a sample aged 6–24 (inclusive) with chronic pain, including primary and secondary pain; apply at least one of the following QST modalities: chemical, electrical, mechanical (subgroups include pressure, punctate/brush and vibratory) or thermal stimulus to measure perception of noxious or innocuous stimuli applied to skin, muscle or joint; use a testing protocol to control for stimulus properties: modality, anatomical site, intensity, duration and sequence. Following title and abstract screening, the full texts of relevant records will be independently assessed by two reviewers. For eligible studies, one reviewer will extract study characteristics and data, and another will check for accuracy. Both will undertake independent quality assessments using the Appraisal Tool for Cross-Sectional Studies. A qualitative synthesis will be presented with discussion centred around different QST modalities. Where eligible data permit, meta-analyses will be performed separately for different QST modalities using comprehensive meta-analysis.Ethics and disseminationReview findings will be reported in a peer-reviewed journal and presented at conferences. The study raises no ethical issues.PROSPERO registration numberCRD42019134069.

scholarly journals A Systematic Review and Meta-analysis to Determine the Effect of Oral Anticoagulants on Incidence of Dementia in Patients with Atrial Fibrillation

2021 ◽  
Author(s):  
Mingjie Lin ◽  
Wenqiang Han ◽  
Jingquan Zhong ◽  
Lin Wu
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Publication Bias ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Significant Risk ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Adjusted Risk ◽  
Incidence Of Dementia

Aims: To assess the effect of oral anticoagulant (OAC) administration on incidence of dementia in patients with atrial fibrillation (AF) with Systematic review and meta-analysis in according with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. Methods: We systematically searched the electronic databases including Pubmed, Embase, Cochrane library, and ClinicalTrails.gov for relevant articles. The primary outcome was the incidence of dementia. The adjusted risk ratio (RR), odds ratio, or hazard ratio were extracted and pooled by the random-effects models. Subgroup analysis was performed according to the setting observational window. Risk of bias was assessed using the Newcastle-Ottawa Scale, while publication bias was assessed by the Begg’s and Egger’s tests. Results: Nine studies included in this review (2 prospective and 7 retrospective observational studies, including 613,920 patients). The results presented the significant association between OAC therapy and the reduced risk of dementia compared with no treatment (RR [95%CI] =0.72 [0.60, 0.86], I2=97.2%; P =0.000). In the subgroup analysis, the pooled RR became statistically non-significant (including four studies, RR [95%CI] =0.75 [0.51, 1.10], I2=98.8%; P =0.000). There is no significant risk of bias and publication bias. Conclusions: This study indicated the protective effect of OAC therapy for dementia in patients with AF. However, the results are limited because of high heterogeneity, inconsistent direction of effect in subgroup analysis. Further prospective well-designed study is needed with longer follow-up duration in younger patients.

scholarly journals Fluoroquinolones and the Risk of Aortic Aneurysm or Aortic Dissection: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 17 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Prashanth Rawla ◽  
Marie Line El Helou ◽  
Anantha R. Vellipuram
Keyword(s):  
Systematic Review ◽  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Response Analysis ◽  
Adjusted Relative Risk ◽  
Risk Increase ◽  
Increased Risk

Objective: We performed a systematic review and meta-analysis to explore the risk of an aortic aneurysm or aortic dissection following fluoroquinolone administration. Methods: PubMed, Cochrane library, ClinicalTrials.gov, Embase and Google Scholar were systematically reviewed for controlled studies including adult patients exposed to fluoroquinolones with a primary outcome of aortic aneurysm or aortic dissection. Results: The meta-analysis was conducted by pooling the effect estimates of four controlled observational studies (one case-control, one case-crossover and two cohort studies). Fluoroquinolone administration more than doubled the risk to develop aortic aneurysm or aortic dissection within 60 days following fluoroquinolone exposure (adjusted Relative Risk [RR] (95% confidence interval [CI]) = 2.14 (1.93 - 2.36); I2 = 15.8%). The quality of the finding was rated as moderate. : The risk increase for aortic aneurysm alone was found to be significant (adjusted RR (95% CI) = 2.23 (2.01 - 2.45); I2 = 0%) while the risk increase for aortic dissection alone was not found to be significant (adjusted RR = 1.88 (0.11 - 3.65); I2 = 74%). : In subgroup analysis, the risk increase for aortic aneurysm or aortic dissection appeared to be higher in females compared to males (RR = 1.87 (1.24 - 2.51); I2 = 0% versus RR = 1.58 (1.25 - 1.92); I2 = 0%, respectively) and higher in older patients compared to younger patients (RR = 1.72 (1.37 - 2.07); I2 = 0% versus RR = 1.47 (0.91 - 2.04); I2 = 0%, respectively). : Subgroup analysis of two studies which measured the duration-response analysis found that as the duration of fluoroquinolone therapy increased from 3 to 14 days to greater than 14 days, there was an increased risk of aortic aneurysm or dissection. Conclusion: The findings of this meta-analysis confirm the positive association between fluoroquinolones and the development of aortic aneurysm or dissection. The data tend to show that this association may be majorly driven by aortic aneurysm. Additionally, some risk factors appear to prevail including prolonged fluoroquinolone treatment and older age.

scholarly journals Burden of tinea capitis among children in Africa: protocol for a systematic review and meta-analysis of observational studies, 1990–2020

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e041230
Author(s):  
Felix Bongomin ◽  
Ronald Olum ◽  
Lauryn Nsenga ◽  
Joseph Baruch Baluku
Keyword(s):  
Systematic Review ◽  
Tinea Capitis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trend Test ◽  
Qualitative Synthesis ◽  
Institutional Review ◽  
Ethical Approval ◽  
Study Characteristics ◽  
The Impact

IntroductionTinea capitis is the most common form of dermatophytosis among children, contributing significantly to the global burden of skin and hair infections. However, an accurate account of its burden in Africa, where most cases are thought to occur, is lacking. We aim to systematically evaluate the burden, aetiology and epidemiological trend of tinea capitis among children over a 30-year period in Africa.Methods and analysisA systematic review will be conducted using Embase, PubMed, African Journals Online, Web of Science and the Cochrane Library of Systematic Review. These resources will be used to identify studies published between 1990 and December 2020, which report the prevalence, aetiology and trend of tinea capitis among children younger than 18 years in Africa. Articles in English and French will be considered. Two independent reviewers will screen the articles for eligibility, and any discrepancies will be resolved by discussion and consensus between the authors. Methodological quality of all studies will be assessed and critically appraised. We will perform a metaregression to assess the impact of study characteristics on heterogeneity and also to correct the meta-analytical estimates for biases. A qualitative synthesis will be performed, and STATA V.16.0 software will be used to estimate the pooled prevalence and aetiology of tinea capitis. The Mann-Kendall trend test will be use to evaluate the trend in the prevalence of tinea capitis over the study period.Ethics and disseminationEthical approval from an institutional review board or research ethics committee is not required for this systematic review and meta-analysis. The results will be published in a peer-reviewed journal and presented in conferences.

Systematic review with meta-analysis: conditioned pain modulation in patients with the irritable bowel syndrome

2018 ◽  
Vol 48 (8) ◽  
pp. 797-806 ◽  
Author(s):  
Ahmed Albusoda ◽  
James K. Ruffle ◽  
Kathrine A. Friis ◽  
Maximilian R. Gysan ◽  
Asbjørn M. Drewes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Meta Analysis ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Irritable Bowel

Acupuncture for post-stroke cognitive impairment: a systematic review and meta-analysis

2021 ◽  
pp. 096452842110095
Author(s):  
Xu Kuang ◽  
Wenjuan Fan ◽  
Jiawei Hu ◽  
Liqun Wu ◽  
Wei Yi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Qualitative Synthesis ◽  
China National Knowledge Infrastructure ◽  
Quality Of Evidence ◽  
Post Stroke ◽  
Assessment Development

Objectives: The aim of this study was to evaluate the effectiveness and safety of acupuncture for the treatment of post-stroke cognitive impairment (PSCI). Methods: The Cochrane Library, Embase, Medline, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical (VIP), Wanfang, and Chinese Biological Medicine (CBM) databases were electronically searched from their inception to 10 April 2019. The Montreal Cognitive Assessment (MoCA) scale and Mini-Mental State Examination (MMSE) scale were used as outcomes to assess effectiveness with respect to cognitive function. Assessment of risk of bias (ROB) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment were performed by two reviewers independently. Data were analyzed using Review Manager (RevMan) 5.3. Results: A total of 28 trials with 2144 participants were included in the qualitative synthesis and meta-analysis. Four of the 28 trials (14%) were assessed as being at overall low ROB, 24 of the 28 trials (86%) were assessed as having overall high ROB. The quality of evidence for both MoCA and MMSE were deemed to be very low by the GRADE criteria. Results indicated that acupuncture groups may be benefiting more than non-acupuncture groups with respect to variation of MoCA scores (merged mean difference (MMD): 2.66, 95% confidence interval (CI): 2.18 to 3.13, p < 0.00001; heterogeneity: χ2 = 35.52, p = 0.0007, I2 = 63%), and the heterogeneity decreased in both subgroup analysis and sensitivity analysis. In addition, acupuncture groups might be benefiting more than non-acupuncture groups in terms of changes in MMSE score (MMD = 2.97, 95% CI = 2.13 to 3.80, p < 0.00001; heterogeneity: χ2 = 269.75; p < 0.00001; I2 = 92%), and the heterogeneity decreased in subgroup analysis. Only one RCT addressed adverse events, and the symptoms were mild and did not affect treatment and evaluation. Conclusion: Acupuncture could be effective and safe for PSCI. Nevertheless, the results should be interpreted cautiously due to the high ROB of included trials and very low quality of evidence for assessed outcomes.

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