scholarly journals Melodic Intonation Therapy for Post-stroke Non-fluent Aphasia: Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Haro-Martínez ◽  
Carmen M. Pérez-Araujo ◽  
Juan M. Sanchez-Caro ◽  
Blanca Fuentes ◽  
Exuperio Díez-Tejedor
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Expressive Language ◽  
Meta Analysis ◽  
Current Evidence ◽  
Functional Communication ◽  
Post Stroke ◽  
Melodic Intonation Therapy ◽  
Statistical Heterogeneity ◽  
Fluent Aphasia

Introduction: Melodic intonation therapy (MIT) is one of the most studied speech and language therapy (SLT) approaches for patients with non-fluent aphasia, although the methodological quality of the studies has been rated as low in previous reviews. The aim of this study is to update current evidence on the possible efficacy of MIT for the treatment of non-fluent post-stroke aphasia.Methods: A systematic review and meta-analysis. We selected randomized clinical trials (RCT) that included adult patients over 18 years of age with non-fluent post-stroke aphasia, whose intervention was MIT vs. no therapy or other therapy. We excluded non-RCT studies, mixed populations including patients with aphasia of non-stroke etiology, studies with no availability of post-stroke aphasia-specific data, and incomplete studies. Three sections of communicative ability were analyzed as outcomes: functional communication, expressive language (naming and repetition), and comprehension.Results: We identified a total of four eligible RCTs involving 94 patients. Despite the heterogeneity in the psychometric tests employed among the trials, a significant effect of MIT on functional communication (evaluated by the Communication Activity Log) was found (SMD 1.47; 95% CI 0.39–2.56). In addition, a positive effect of MIT on expressive language (repetition) was found (SMD 0.45; 95% CI 0.01–0.90). No significant effects on comprehension measurements were found, despite a lack of significant statistical heterogeneity.Conclusion: This systematic review and meta-analysis shows a significant effect of MIT on improving functional communication and on repetition tasks. Future larger RCT specifically addressing those outcomes should provide the definite evidence on the efficacy of MIT on post-stroke aphasia recovery.Systematic Review Registration:PROSPERO-URL https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020144604.

Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis

2020 ◽  
pp. 238008442092732
Author(s):  
F.S. Al-Hamed ◽  
A. Hijazi ◽  
Q. Gao ◽  
Z. Badran ◽  
F. Tamimi
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mouth Opening ◽  
Case Series ◽  
Platelet Concentrate ◽  
Current Evidence ◽  
Disc Displacement ◽  
Temporomandibular Joint Osteoarthritis ◽  
Vas Scores

Objectives: This systematic review compared platelet concentrates (PCs) versus hyaluronic acid (HA) or saline/Ringer’s solution injections as treatments of temporomandibular osteoarthritis and disc displacement in terms of pain and maximum mouth opening (MMO). Methods: PubMed, Cochrane, and Scopus were searched up to March 6, 2020. Inclusion criteria were randomized clinical trials (RCTs). Exclusion criteria were case series, observational studies, animal studies, and reviews. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess the risk of bias in the included studies. The weighted mean difference was used to compare the results. Results: Nine RCTs were included with a total of 407 patients. The numbers of joints treated were 262, 112, and 112 in the PC, HA, and saline groups, respectively. The quality of studies was rated as strong in 4 studies, moderate in 4 studies, and weak in 1 study. The meta-analysis revealed that PCs decreased pain visual analogue scale (VAS) scores compared to HA by an average of −1.11 (CI, −1.62 to −0.60; P < 0.0001) and −0.57 (CI, −1.55 to 0.41; P = 0.26) at 3 and 12 mo follow-up respectively. Also, the average decrease in pain scores with PC compared to saline was −1.33 (CI, −2.61 to −0.06; P = 0.04), −2.07 (CI, −3.46 to −0.69; P = 0.003), and −2.71 (CI, −4.69 to −0.72; P = 0.008) at 3, 6, and 12 mo, respectively. Regarding MMO measurements, PC was comparable to HA, but it was significantly better than saline after 3 and 6 mo [2.9 mm (CI,1.47 to 4.3; P < 0.0001), and 1.69 mm (CI, 0.13 to 3.25; P = 0.03) respectively]. Conclusion: PC reduces pain VAS scores compared to HA during the first 3 m after treatment, and when compared to saline, it reduces pain and increases MMO for longer durations. However, due to differences between groups regarding PC preparation protocols and study heterogeneity, further standardized RCTs are required. Knowledge Transfer Statement: This study provides researchers and clinicians with quantitative and qualitative analyses of the current evidence regarding the clinical outcomes of platelet concentrate injections in the treatment of temporomandibular joint osteoarthritis and disc displacement in terms of pain control and maximum mouth opening.

scholarly journals Use of convalescent plasma in patients with coronavirus disease (Covid-19): Systematic review and meta-analysis

2021 ◽  
Author(s):  
Fernando Tortosa ◽  
Gabriela Carrasco ◽  
Martin Ragusa ◽  
Pedro Haluska ◽  
Ariel Izcovich
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Standard Of Care ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Assessment Development ◽  
Treatment Standard ◽  
Study Selection

AbstractObjetivesTo assess the effects of convalescent plasma treatment in patients with coronavirus disease (COVID-19).Study designSystematic review and Meta-analysisData sourcesA systematic search was carried out on the L · OVE (Living OVerview of Evidence) platform for COVID-19 until October 31, 2020Study selectionRandomized clinical trials in which people with probable or confirmed COVID-19 were randomized to drug treatment, standard care, or placebo. Pairs of reviewers independently screened potentially eligible articles.MethodsThe PRISMA guidelines were followed for conducting a systematic review and meta-analysis. The risk of bias of the included studies was assessed using the Cochrane risk of bias tool 2.0, and the certainty of the evidence using the recommendation assessment, development and evaluation (GRADE) approach. For each outcome, the interventions were classified into groups, from most to least beneficial or harmful.ResultsWe identified 10 RCTs (randomized controlled trials) involving 11854 patients in which convalescent plasma was compared with standard of care or other treatments. The results of five RCTs that evaluated the use of convalescent plasma in patients with COVID-19 did not show significant differences in the effect on mortality and the need for invasive mechanical ventilation.ConclusionsCurrent evidence is insufficient to recommend the use of convalescent plasma in the treatment of moderate or severe COVID-19.Contribution of the authors

scholarly journals The Effect of L-Arginine Supplementation on Obesity-Related Indices: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Seyed Mohammad Mousavi ◽  
Alireza Milajerdi ◽  
Somaye Fatahi ◽  
Jamal Rahmani ◽  
Meysam Zarezadeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Body Weight ◽  
Waist Circumference ◽  
Randomized Clinical Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Statistical Heterogeneity ◽  
Mean Differences ◽  
Arginine Supplementation

Abstract. The clinical studies regarding the effect of L-arginine in human anthropometry have not been fully consistent, therefore, we carried out a systematic review and meta-analysis of randomized clinical trials in order to precisely evaluate and quantify the efficacy of L-arginine on weight, waist circumference, and BMI. We searched online databases including PubMed, SCOPUS, and Google Scholar for relevant articles up to September 2017. Eligible articles were reviewed by two independent investigators. Mean differences of the outcomes were used for calculation of weighted mean difference (WMD) derived from the random-effects model. Statistical heterogeneity between studies was examined using Cochran’s Q-test and I 2 index. Funnel plot and Egger’s tests were performed to assess the publication bias. In our initial search, we found 1598 publications, of which 8 RCTs (9 treatment arms) were included. The results of the meta-analysis displayed a significant reduction in WC following L-arginine supplementation (WMD: −2.97 cm; 95% CI: −4.75 to −1.18, P = 0.001). However, L-arginine intervention had not elicited a significant effect on BMI (WMD: −0.51 kg/m2; 95% CI: −1.11 to .08, P = 0.09) and body weight (WMD: −0.57 kg; 95% CI: −1.77 to 0.61, P = 0.34). Subgroup analyses displayed that longer-term interventions (≥8 weeks) had a positive effect on body weight and using < 8 g/day L-arginine with longer duration (≥8 weeks) could significantly decrease BMI. In conclusion, this meta-analysis result suggested L-arginine supplementation could reduce waist circumference without any significant effect on body weight and body mass index.

scholarly journals Impact of mental disorders on active TB treatment outcomes: a systematic review and meta-analysis

2020 ◽  
Vol 24 (12) ◽  
pp. 1279-1284
Author(s):  
G. Lee ◽  
J. Scuffell ◽  
J. T. Galea ◽  
S. S. Shin ◽  
E. Magill ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Disorders ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Patient Characteristics ◽  
Current Evidence ◽  
Random Effects Models ◽  
Loss To Follow Up ◽  
Tb Treatment ◽  
Statistical Heterogeneity

BACKGROUND: Comorbid mental disorders in patients with TB may exacerbate TB treatment outcomes. We systematically reviewed current evidence on the association between mental disorders and TB outcomes.METHODS: We searched eight databases for studies published from 1990 to 2018 that compared TB treatment outcomes among patients with and without mental disorders. We excluded studies that did not systematically assess mental disorders and studies limited to substance use. We extracted study and patient characteristics and effect measures and performed a meta-analysis using random-effects models to calculate summary odds ratios (ORs) with 95% confidence intervals (CIs).RESULTS: Of 7687 studies identified, 10 were included in the systematic review and nine in the meta-analysis. Measurement of mental disorders and TB outcomes were heterogeneous across studies. The pooled association between mental disorders and any poor outcome, loss to follow-up, and non-adherence were OR 2.13 (95%CI 0.85–5.37), 1.90 (95%CI 0.33–10.91), and 1.60 (95%CI 0.81–3.02), respectively. High statistical heterogeneity was present.CONCLUSION: Our review suggests that mental disorders in TB patients increase the risk of poor TB outcomes, but pooled estimates were imprecise due to small number of eligible studies. Integration of psychological and TB services might improve TB outcomes and progress towards TB elimination.

scholarly journals Association of l-Arginine Supplementation with Markers of Endothelial Function in Patients with Cardiovascular or Metabolic Disorders: A Systematic Review and Meta-Analysis

Nutrients ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 15 ◽  
Author(s):  
Josianne Rodrigues-Krause ◽  
Mauricio Krause ◽  
Ilanna Rocha ◽  
Daniel Umpierre ◽  
Ana Fayh
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Metabolic Diseases ◽  
Data Extraction ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Inconsistency Index ◽  
Statistical Heterogeneity ◽  
Nitrite Nitrate ◽  
Arginine Supplementation

l-Arginine supplementation is a potential therapy for treating cardiovascular and metabolic diseases. However, the use of distinct l-arginine sources, intervened populations, and treatment regimens may have yielded confusion about their efficacy. This research constitutes a systematic review and meta-analysis summarizing the effects of l-arginine supplementation compared to placebo in individuals with cardiovascular disease (CVD), obesity, or diabetes. Eligibility criteria included randomized clinical trials and interventions based on oral supplementation of l-arginine with a minimum duration of three days; comparison groups consisted of individuals with the same disease condition receiving an oral placebo substance. The primary outcome was flow-mediated dilation, and secondary outcomes were nitrite/nitrate (NOx) rate and asymmetric dimethylarginine (ADMA). Statistical heterogeneity among studies included in the meta-analyses was assessed using the inconsistency index (I2). Fifty-four full-text articles from 3761 retrieved references were assessed for eligibility. After exclusions, 13 studies were included for data extraction. There was no difference in blood flow after post-ischemic hyperemia between the supplementation of l-arginine and placebo groups before and after the intervention period (standardized mean difference (SMD) = 0.30; 95% confidence intervals (CIs) = −0.85 to 1.46; I2 = 96%). Sensitivity analysis showed decreased heterogeneity when the studies that most favor arginine and placebo were removed, and positive results in favor of arginine supplementation were found (SMD = 0.59; 95% CIs = 0.10 to 1.08; I2 = 75%). No difference was found in meta-analytical estimates of NOx and ADMA responses between arginine or placebo treatments. Overall, the results indicated that oral l-arginine supplementation was not associated with improvements on selected variables in these patients (PROSPERO Registration: CRD42017077289).

Abstract TP164: Statins for the Prevention of Post-Stroke Seizure and Epilepsy Development: A Systematic Review and Meta-Analysis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Emily K Acton ◽  
Ossama Khazaal ◽  
Allison W Willis ◽  
Sean Hennessy ◽  
Michael A Gelfand ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
English Language ◽  
Meta Analysis ◽  
Lipid Lowering ◽  
Current Evidence ◽  
Preventive Strategy ◽  
Post Stroke ◽  
Reduced Risk ◽  
Statin Use

Introduction: Cerebrovascular disease is the leading cause of seizures and incident epilepsy of known etiology in older adults. As prophylactic use of antiepileptic drugs remains controversial, statins have garnered attention as an alternate preventive strategy due to pleiotropic effects, beyond lipid-lowering, which may include neuroprotective and anti-epileptogenic properties. Our objective was to assess the current evidence on statin use for prevention of post-stroke seizure and post-stroke epilepsy (PSE). Methods: We conducted a systematic review following PRISMA guidelines. Pubmed and Embase were searched from database inception to May 2019 for English-language, full-text experimental, observational analytic, or systematic reviews/meta-analytic studies examining the association between statin use in adults and development of early-onset seizures (ES; seizures ≤7 days after stroke) or PSE. Pooled analyses were based on random-effects models using the inverse-variance method. Results: Of 157 citations, 154 were excluded due to duplication or ineligibility, yielding 3 cohort studies from East Asia. Two studies reported on outcomes of ischemic stroke and 1 on hemorrhagic stroke. Only 1 study reported on ES, finding a significantly reduced risk following post-stroke statin use (OR 0.35, CI 0.20-0.60). Two studies reported on pre-stroke statin use, with findings demonstrating a lack of association with PSE (pooled OR 1.17, CI 0.93-1.48; Figure 1.1). However, post-stroke statin use was associated with less PSE (pooled OR 0.61, CI 0.50-0.74), without evidence of heterogeneity (Figure 1.2). Conclusions: Systematic review and meta-analysis of 3 high-quality cohort studies suggests post-stroke, but not pre-stroke, statin use may be associated with reduced risk of PSE. Further research is warranted to verify if these findings are replicable in other populations, as well as to explore the influence of timing and duration of statin use on outcomes.

Is It Better to Routinely Use Tourniquet for Knee Arthroscopic Surgery: A Systematic Review and Meta-analysis

2019 ◽  
Vol 33 (09) ◽  
pp. 866-874 ◽  
Author(s):  
Jinyou Wang ◽  
Wennan Xu ◽  
Jiayin Lv
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Arthroscopic Surgery ◽  
Operation Time ◽  
Current Evidence ◽  
Postoperative Blood Loss ◽  
Cochrane Library ◽  
Significant Difference

AbstractThe use of tourniquet in knee arthroscopic surgery is a routine technique and provides convenience for the operation. However, the adverse effects caused by tourniquet during the operation are noticed by more and more researchers. The purpose of our study was to perform a systematic review and meta-analysis to assess the effects of tourniquet use in knee arthroscopy. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched databases like PubMed, Cochrane library, EMBASE, and Web of Science from inception of the database up to November 20, 2018, using the keywords “ anterior cruciate ligament,” “meniscectomy,” “arthrocopy,” etc. to identify randomized clinical trials. A total of 16 randomized controlled trials involving 1,132 participants fulfilled the inclusion criteria with 582 patients in tourniquet group and 550 patients in nontourniquet group. Compared with tourniquet group, nontourniquet group had less postoperative blood loss and less consumption of analgesic. There was no significant difference between the two groups in intraoperatively arthroscopic visualization, postoperative pain score, postoperative quadriceps muscle strength, and operation time. Our study suggested that compared with tourniquet use, arthroscopic surgery of the knee without tourniquet did not appear to have any disadvantage, and the current evidence was more inclined not to use tourniquet as a routine procedure during the knee arthroscopic surgery.

scholarly journals Impact of mental disorders on active tuberculosis treatment outcomes: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Ga Eun Lee ◽  
James Scuffell ◽  
Jerome T. Galea ◽  
Sanghyuk S. Shin ◽  
Elizabeth Magill ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Disorders ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Patient Characteristics ◽  
Current Evidence ◽  
Random Effects Models ◽  
Loss To Follow Up ◽  
Tb Treatment ◽  
Statistical Heterogeneity

ABSTRACTBackgroundComorbid mental disorders in patients with tuberculosis (TB) may exacerbate TB treatment outcomes. We systematically reviewed current evidence on the association between mental disorders and TB outcomes.MethodsWe searched eight databases for studies published from 1990-2018 that compared TB treatment outcomes among patients with and without mental disorders. We excluded studies that did not systematically assess mental disorders and studies limited to substance use. We extracted study and patient characteristics and effect measures and performed a meta-analysis using random-effects models to calculate summary odds ratios (OR) with 95% confidence intervals (CI).FindingsOf 7,687 studies identified, ten were included in the systematic review and nine in the meta-analysis. Measurement of mental disorders and TB outcomes were heterogeneous across studies. The pooled association between mental disorders and any poor outcome, loss to follow-up, and non-adherence were OR 2.13 (95% CI: 0.85-5.37), 1.90 (0.33-10.91), and 1.60 (0.81-3.02), respectively. High statistical heterogeneity was present.InterpretationOur review suggests that mental disorders in TB patients increase the risk of poor TB outcomes, but pooled estimates were imprecise due to small number of eligible studies. Integration of psychological and TB services might improve TB outcomes and progress towards TB elimination.

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