scholarly journals Effects of Acute Heat and Cold Exposures at Rest or during Exercise on Subsequent Energy Intake: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3424
Author(s):  
Juliette Millet ◽  
Julien Siracusa ◽  
Pierre-Emmanuel Tardo-Dino ◽  
David Thivel ◽  
Nathalie Koulmann ◽  
...  
Keyword(s):  
Energy Intake ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Small Decrease ◽  
Eligibility Criteria ◽  
Randomized Controlled ◽  
Ovid Medline ◽  
Study Selection ◽  
Ad Libitum ◽  
Rest And Exercise

The objective of this meta-analysis was to assess the effect of acute heat/cold exposure on subsequent energy intake (EI) in adults. We searched the following sources for publications on this topic: PubMed, Ovid Medline, Science Direct and SPORTDiscus. The eligibility criteria for study selection were: randomized controlled trials performed in adults (169 men and 30 women; 20–52 years old) comparing EI at one or more meals taken ad libitum, during and/or after exposure to heat/cold and thermoneutral conditions. One of several exercise sessions could be realized before or during thermal exposures. Two of the thirteen studies included examined the effect of heat (one during exercise and one during exercise and at rest), eight investigated the effect of cold (six during exercise and two at rest), and three the effect of both heat and cold (two during exercise and one at rest). The meta-analysis revealed a small increase in EI in cold conditions (g = 0.44; p = 0.019) and a small decrease in hot conditions (g = −0.39, p = 0.022) for exposure during both rest and exercise. Exposures to heat and cold altered EI in opposite ways, with heat decreasing EI and cold increasing it. The effect of exercise remains unclear.

scholarly journals The Effect of Acupuncture in Breast Cancer–Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis

2019 ◽  
Vol 18 ◽  
pp. 153473541986691 ◽  
Author(s):  
Tsai-Ju Chien ◽  
Chia-Yu Liu ◽  
Ching-Ju Fang
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Lymphatic Drainage ◽  
Controlled Trials ◽  
Breast Cancer Patients ◽  
Eligibility Criteria ◽  
Randomized Controlled

Background: Breast cancer–related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (−1.90; 95% confidence interval = −5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.

Is intramedullary nailing better than the use of volar locking plates for fractures of the distal radius? A meta-analysis of randomized controlled trials

2016 ◽  
Vol 41 (5) ◽  
pp. 543-552 ◽  
Author(s):  
J. Wang ◽  
L. Zhang ◽  
J. Ma ◽  
Y. Yang ◽  
H. Jia ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Intramedullary Nailing ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Controlled Trials ◽  
Locking Plates ◽  
Distal Radial Fractures ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Randomized Controlled

We conducted a meta-analysis of randomized controlled trials that compared the use of intramedullary nails and volar locking plates in distal radial fractures. PubMed, EMBASE and the Cochrane Collaboration Central database were used to find randomized controlled trials that met the eligibility criteria. Two reviewers screened the studies, extracted the data, evaluated the methodological quality and analysed the data with RevMan 5.1 software. No statistically significant differences were detected in the disability of the arm, shoulder and hand and the Gartland and Werley scores, radiographic parameters, wrist range of motion, grip strength, total complication rate and incidence of tendon rupture between the two groups. However, carpal tunnel syndrome occurred less often after intramedullary nailing. The two fixation methods achieved equal clinical, functional and radiological outcomes for primary fixation of the indicated types of distal radial fractures. Level of evidence: Therapeutic/LevelI

scholarly journals Systematic Review and Meta-Analysis of Randomized Controlled Trials of Xingnaojing Treatment for Stroke

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Weijun Peng ◽  
Jingjing Yang ◽  
Yang Wang ◽  
Weihao Wang ◽  
Jianxia Xu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Conventional Treatment ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Study Selection ◽  
Mild Impairment

Objective. Xingnaojing injection (XNJ) is a well-known traditional Chinese patent medicine (TCPM) for stroke. The aim of this study is to assess the efficacy of XNJ for stroke including ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH).Methods. An extensive search was performed within using eight databases up to November 2013. Randomized controlled trials (RCTs) on XNJ for treatment of stroke were collected. Study selection, data extraction, quality assessment, and meta-analysis were conducted according to the Cochrane standards, and RevMan5.0 was used for meta-analysis.Results. This review included 13 RCTs and a total of 1,514 subjects. The overall methodological quality was poor. The meta-analysis showed that XNJ combined with conventional treatment was more effective for total efficacy, neurological deficit improvement, and reduction of TNF-αlevels compared with those of conventional treatment alone. Three trials reported adverse events, of these one trial reported mild impairment of kidney and liver function, whereas the other two studies failed to report specific adverse events.Conclusion. Despite the limitations of this review, we suggest that XNJ in combination with conventional medicines might be beneficial for the treatment of stroke. Currently there are various methodological problems in the studies. Therefore, high-quality, large-scale RCTs are urgently needed.

scholarly journals Effect of Intermittent Fasting Strategies on Cardiometabolic Risk Factors: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1091-1091
Author(s):  
Zhila Semnani-Azad ◽  
Tauseef Khan ◽  
Stefan Kabisch ◽  
Hana Kahleova ◽  
Cyril Kendall ◽  
...  
Keyword(s):  
Body Weight ◽  
Randomized Controlled Trials ◽  
Ldl Cholesterol ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Current Evidence ◽  
Intermittent Fasting ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Ad Libitum

Abstract Objectives Intermittent fasting (IF) is a popular trending diet, yet there is limited evidence-based support considering its clinical impact on cardiometabolic outcomes. In an effort to inform the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a network meta-analysis of randomized controlled trials (RCTs) comparing IF strategies and continuous energy restriction (CER) on cardiometabolic outcomes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Methods MEDLINE, EMBASE, and Cochrane databases were searched through Nov 2020. We included RCTs assessing the effect of IF strategies (alternate-day fasting (ADF), whole-day periodic fasting (WDF), time-restricted feeding (TRF)), CER, and ad libitum diet. Outcomes included body weight, fasting glucose and LDL-cholesterol. Two independent researchers extracted data and assessed risk of bias. A network meta-analysis was performed and data were expressed as mean differences (MD) with 95% confidence intervals (CI). The certainty of the evidence was assessed using GRADE. Results We identified 19 RCTs (n = 590) including adults of varying health backgrounds. ADF and CER both showed a benefit for body weight reduction compared to ad libitum diet (18 trials, n = 520; MD −3.95 kg [95% CI −6.09, −1.81] and MD −2.85 kg [95% CI −4.99, −0.71], respectively). For fasting glucose (17 trials, n = 590), TRF showed a benefit compared to ad libitum diet (MD −0.39 mmol/L [95% CI −0.59, −0.20]), to CER (MD −0.25 mmol/L [95% CI, −0.45 to −0.06]) and to WDF (MD −0.20 mmol/L [95% CI, −0.45, −0.05]). Furthermore, ADF showed a benefit in reducing LDL-cholesterol (17 trials, n = 590) compared to ad libitum diet (MD −0.21 mmol/L [95% CI −0.40, −0.1]), and to CER (MD −0.15 mmol/L [95% CI −0.31, −0.01]). The certainty of the evidence ranged from high to moderate due to variable downgrades for imprecision. Conclusions Current evidence provides a good indication that IF strategies have similar benefits to CER for weight loss but may have additional benefits for fasting glucose and LDL-cholesterol. Long-term high quality RCTs are needed to clarify the effect of different IF strategies on cardiometabolic outcomes. Funding Sources Diabetes and Nutrition Study Group of the EASD, Canadian Institutes of Health Research (CIHR), Diabetes Canada.

scholarly journals Effects of Acetaminophen or Ibuprofen Monotherapy in Febrile Children: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Ning Kuo ◽  
Nien-Yin Su ◽  
Sen-Kuang Hou ◽  
Yi-No Kang
Keyword(s):  
Adverse Event ◽  
Body Temperature ◽  
Randomized Controlled Trials ◽  
Treatment Time ◽  
Meta Analysis ◽  
Interaction Model ◽  
Clinical Encounter ◽  
Controlled Trials ◽  
Eligibility Criteria ◽  
Randomized Controlled

IntroductionWhen a child presents with fever in the clinical encounter, parents are usually concerned about alleviating the fever. However, the indications for selecting an appropriate drug from the most commonly used antipyretic drugs acetaminophen and ibuprofen remain unclear. The purpose of this study was to assess the efficacy and safety of acetaminophen and ibuprofen in febrile children through a systematic review with meta-analysis of randomized controlled trials (RCTs).Material and methodsCochrane, Embase, and PubMed databases were searched for the relevant RCTs. Two authors individually extracted information on trial design, demography, rate of fever resolution, body temperature, and overall adverse event. Data were pooled mainly using random-effects model; however, because of some sparse data, Peto odds ratios (PORs) were used for outcomes of fever resolution and adverse event. 95% confidence intervals (CIs) were also presented.ResultsIn total, 26 RCTs (n=4137) fulfilled eligibility criteria. Pooled estimates demonstrated that acetaminophen led to significantly lower fever resolution rates than ibuprofen did (POR=0.91, 95%CI: 0.84–0.98; I2=0%) in the subgroup of trials with a mean age of <2 years. However, the treatment–time interaction model for body temperature demonstrated that the fever resolution effect was mainly from the time factor based on the available data (effect size=−0.20; 95%CI: −0.30 to −0.11; I2=6.9%). Acetaminophen demonstrated a lower overall adverse event rates than ibuprofen (POR=0.71; 95%CI: 0.58–0.87; I2=0%).ConclusionsThe effects of ibuprofen are similar to acetaminophen even in children mean aged approximately 5 years old. Nevertheless, acetaminophen is safer than ibuprofen, particularly in children approximately 5 years old.

Dissociation of vasospasm-related morbidity and outcomes in patients with aneurysmal subarachnoid hemorrhage treated with clazosentan: a meta-analysis of randomized controlled trials

2013 ◽  
Vol 119 (1) ◽  
pp. 180-189 ◽  
Author(s):  
Jian Shen ◽  
Jian-Wei Pan ◽  
Zuo-Xu Fan ◽  
Xiao-Xing Xiong ◽  
Ren-Ya Zhan
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Randomized Controlled Trials ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Pulmonary Complications ◽  
Neurological Deficits ◽  
Controlled Trials ◽  
Eligibility Criteria ◽  
Randomized Controlled

Object Clazosentan therapy after aneurysmal subarachnoid hemorrhage (SAH) has been found to be effective in reducing the incidence of vasospasm in randomized controlled trials. However, while vasospasm-related morbidity, including delayed ischemic neurological deficits (DINDs) and delayed cerebral infarctions, was consistently decreased, statistical significance was not demonstrated and outcomes were not affected by clazosentan treatment. The objective of this meta-analysis was to determine whether clazosentan treatment after aneurysmal SAH significantly reduced the incidence of DINDs and delayed cerebral infarctions and improved outcomes. Methods All randomized controlled trials investigating the effect of clazosentan were retrieved via searches with sensitive and specific terms. Six variables were abstracted after the assessment of the methodological quality of the trials. Analyses were performed following the method guidelines of the Cochrane Back Review Group. Results Four randomized, placebo-controlled trials met eligibility criteria, enrolling a total of 2181 patients. The meta-analysis demonstrated a significant decrease in the incidence of DINDs (relative risk [RR] 0.76 [95% CI 0.62–0.92]) and delayed cerebral infarction (RR 0.79 [95% CI 0.63–1.00]) in patients treated with clazosentan after aneurysmal SAH. However, this treatment regimen was not shown to outcomes including functional outcomes measured by Glasgow Outcome Scale-Extended (RR 1.12 [95% CI 0.96–1.30]) or mortality (RR 1.02 [95%CI 0.70–1.49]). Adverse events, including pulmonary complications, anemia, and hypotension, were all significantly increased in patients who received clazosentan therapy. Conclusions The results of the present meta-analysis show that treatment with clazosentan after aneurysmal SAH significantly reduced the incidence of the vasospasm-related DINDs and delayed cerebral infarctions, but did not improve poor neurological outcomes in patients with aneurysmal SAH. Further study is required to elucidate the dissociation between vasospasm-related morbidity and outcomes.

scholarly journals The Efficacy of Guanxinning Injection in Treating Angina Pectoris: Systematic Review and Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Yongliang Jia ◽  
Siu-wai Leung ◽  
Ming-Yuen Lee ◽  
Guozhen Cui ◽  
Xiaohui Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity Analysis ◽  
Angina Pectoris ◽  
Randomized Controlled Trials ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Eligibility Criteria ◽  
Randomized Controlled ◽  
Study Characteristics

Objective. The randomized controlled trials (RCTs) on Guanxinning injection (GXN) in treating angina pectoris were published only in Chinese and have not been systematically reviewed. This study aims to provide a PRISMA-compliant and internationally accessible systematic review to evaluate the efficacy of GXN in treating angina pectoris.Methods. The RCTs were included according to prespecified eligibility criteria. Meta-analysis was performed to evaluate the symptomatic (SYMPTOMS) and electrocardiographic (ECG) improvements after treatment. Odds ratios (ORs) were used to measure effect sizes. Subgroup analysis, sensitivity analysis, and metaregression were conducted to evaluate the robustness of the results.Results. Sixty-five RCTs published between 2002 and 2012 with 6064 participants were included. Overall ORs comparing GXN with other drugs were 3.32 (95% CI: [2.72, 4.04]) in SYMPTOMS and 2.59 (95% CI: [2.14, 3.15]) in ECG. Subgroup analysis, sensitivity analysis, and metaregression found no statistically significant dependence of overall ORs upon specific study characteristics.Conclusion. This meta-analysis of eligible RCTs provides evidence that GXN is effective in treating angina pectoris. This evidence warrants further RCTs of higher quality, longer follow-up periods, larger sample sizes, and multicentres/multicountries for more extensive subgroup, sensitivity, and metaregression analyses.

scholarly journals Systematic Review and Meta-analysis of the Effect of Portion Size and Ingestive Frequency on Energy Intake and Body Weight Among Adults in Randomized Controlled Trials (P08-007-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kelly Higgins ◽  
Joshua Hudson ◽  
Richard Mattes ◽  
Nilupa Gunaratna ◽  
Bethany McGowan ◽  
...  
Keyword(s):  
Body Weight ◽  
Randomized Controlled Trials ◽  
Energy Intake ◽  
Energy Content ◽  
Meta Analysis ◽  
Portion Size ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Randomized Controlled ◽  
Over Time

Abstract Objectives Total energy intake is the product of portion size (PS), the energy content of an ingestive event, and ingestive frequency (IF), the number of ingestive events per unit time. An alteration in either portion size or ingestive frequency, that is not compensated by the other, must result in a change in energy intake and, if maintained over time, body weight. The primary objective of this meta-analysis was to assess the independent effects of PS and IF on dietary energy intake and body weight among healthy adults in randomized controlled trials. Methods 8,614 articles (duplicates removed) published through 2018 with no date restriction were identified with PubMed, Web of Science, Cochrane, and CINAHL databases. The articles were divided among ten researchers and each article was screened for eligibility by two to three independent reviewers. Exclusion criteria included: populations <19 y and >65 y, unhealthy, assessment <24 h in duration, and controlled feeding trials. Studies investigating the effect of IF or PS on body weight were at least 4 weeks in duration. Eleven articles (IF = 3, PS = 8) met the inclusion criteria. There were not enough articles to assess the effect of PS on body weight. Results There was significant heterogeneity in the effect sizes among all comparisons (I2 = >50%). Consuming smaller portion sizes was associated with lower 24 h energy intake [–135 kcal (–249, –21), n = 15; WMD (95% CI), n = comparisons]. In contrast, IF was not associated with a difference in 24 h energy intake [–103 kcal (–230, 24), n = 5], but was positively related to body weight in trials ≥6 wk duration [0.40 kg (0.70, 0.11), n = 4]. Conclusions Results from RCTs support that greater PS but not IF is associated with higher daily energy consumption. However, IF is positively associated with increased body weight over time. Funding Sources NA

Acupressure for labor pain management: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 096452842094604
Author(s):  
Yao Chen ◽  
Xiang-Yin Xiang ◽  
Kien Howe Robert Chin ◽  
Jing Gao ◽  
Junmei Wu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Mode Of Delivery ◽  
Labor Pain ◽  
Controlled Trials ◽  
Eligibility Criteria ◽  
Second Stage Of Labor ◽  
Randomized Controlled ◽  
Standard Procedures

Objective: To evaluate the efficacy/effectiveness of acupressure as an adjunct to standard procedures during labor and delivery, compared with standard procedures with/without sham acupressure, in randomized controlled trials (RCTs). Methods: Ten main databases were searched from their inception until 31 January 2018. Two reviewers independently extracted data concerning the effects of acupressure on pain intensity, labor duration, mode of delivery, use of medications and adverse events. A meta-analysis of these measures was performed using RevMan 5.3. Pooled standardized mean differences (SMDs) or odds ratios (ORs) for the above outcomes were estimated with a fixed or random effects model, according to the heterogeneity. Results: A total of 13 RCTs including 1586 enrolled patients met the eligibility criteria. Acupressure plus standard procedures (ASP) for labor management significantly reduced pain sensation, compared with sham acupressure plus standard procedures (SASP) and standard procedures (SP) alone. The analgesic effect of acupressure was immediate and persisted for at least 60 min (all p < 0.01). Compared with the untreated control groups, the acupressure group had a shorter duration of labor, especially the first stage of labor (SMD = −0.76, 95% confidence interval (CI) = −1.10 to −0.43; p < 0.001; I2 = 74%) and second stage of labor (SMD = −0.37, 95% CI = −0.59 to −0.18; p < 0.001; I2 = 0%). Data suggesting that acupressure reduced the Cesarean section rate was inconclusive. The use of pharmacologic agents (oxytocin and analgesics) did not differ between the ASP, SASP and SP groups. No adverse events were reported in this limited number of studies. Conclusion: Moderate evidence indicates that acupressure may have promising effects on labor pain and duration. However, high-quality trials to verify these findings are warranted.

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