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Author(s):  
Hsin-Yu Mao ◽  
Meng-Tzu Hu ◽  
Yea-Yin Yen ◽  
Shou-Jen Lan ◽  
Shin-Da Lee

This study investigated the effects of kinesio taping (KT) or KT plus conventional therapy on pain, muscle strength, funrefction, and range of motion in patients with knee osteoarthritis (OA). Data sources: Databases included PubMed, Ovid Medline, CINAHL, Airiti Library, EMBASE, and WOS search engines. Search terms related to KT and knee OA were combined and searched. Articles that met the inclusion criteria and were graded with a Jadad score ≥3 were included in a meta-analysis to calculate the total effect. The exclusion criteria were non-English-language articles, non-original articles, non-full-text articles, no description of the intervention, or articles with a Jadad score ≤2. Eleven articles were included in the meta-analysis. KT treatment had a significant small total effect on pain reduction (p < 0.001; n = 1509; standardized mean difference (SMD) = −0.42; 95% CI = −0.65 to −0.18) and a significant moderate total effect on isokinetic muscle strength improvement (p = 0.001; n = 447; SMD = 0.72; 95% CI = 0.28 to 1.16). No significant total effects of KT on isometric muscle strength, time to complete functional tasks, or ROM improvement were found. KT or KT plus conventional therapy has a significant effect on pain relief and isokinetic but not isometric muscle strength improvement in patients with knee OA. KT can be an effective tool for treating knee OA pain and is especially valuable for aiding in isokinetic muscle strength. (PROSPERO register ID: CRD42021252313)


2021 ◽  
Vol 8 ◽  
Author(s):  
Bo Liang ◽  
Ning Gu

Traditional Chinese medicine has a history of more than 2,000 years and has been widely used in clinical practice. However, due to the lack of a reliable scientific basis, the role of traditional Chinese medicine in the prevention and treatment of coronary artery disease is not clear. At present, the existing randomized controlled trials about traditional Chinese medicine for coronary artery disease have defects, small sample sizes, and different results, so it is difficult to make a clear conclusion on the actual advantages and disadvantages of traditional Chinese medicine. In this review, the efficacy and safety of traditional Chinese medicine in the prevention and treatment of coronary artery disease were systematically evaluated through randomized controlled trials, most of which were double-blind trials. We reviewed 17 randomized controlled trials that included a total of 11,726 coronary artery disease patients. The methodological quality of the trials was generally high, with nine (52.94%) having a modified Jadad score of 7 and only three (17.65%) having a modified Jadad score of &lt;3. There are 16 trials (94.12%) reporting safety; the safety of traditional Chinese medicine seems not to be inferior to that of mimetic, placebo, or western medications. Moreover, the results from 17 randomized controlled trials (100.00%) showed that traditional Chinese medicine can be applied as a complementary and alternative method to the primary and secondary prevention of coronary artery disease, and only six trials (35.29%) described adverse cardiovascular events specifically. However, it is necessary to assess the safety and efficacy of traditional Chinese medicine in treating coronary artery disease with long-term hard endpoints.


2020 ◽  
Vol 54 (12) ◽  
pp. 1232-1242
Author(s):  
Melissa Lipari ◽  
Pramodini B. Kale-Pradhan ◽  
Sheila M. Wilhelm

Background: Chronic obstructive pulmonary disease (COPD) guidelines recommend both long-acting and dual bronchodilator therapy. It is unclear if there are differences in efficacy and safety. Objective: This meta-analysis evaluates the efficacy of dual therapy with long-acting β-agonist (LABA) + long acting muscarinic antagonist (LAMA) compared with monotherapy with LAMA for COPD. Methods: We searched PubMed, CINAHL, and Web of Science databases from inception through March 2020 to identify English-language, prospective randomized controlled trials (RCTs) that compared dual therapy with monotherapy in adult patients with COPD. Risk of bias was assessed using the Jadad score. Overall analysis was performed using Review Manager 5.3. Treatment effect was determined with the random-effects model using the Mantel-Haenszel method and was reported as mean difference (MD) with 95% CI. Results: A total of 18 RCTs were included (n = 6086; median Jadad score 5/5) that compared LAMA + LABA with LAMA. There was a greater improvement in forced expiratory volume at 1 s (FEV1) with dual therapy compared with LAMA: MD = 0.08; 95% CI = [0.05, 0.11]. There was no difference in St George Respiratory Questionnaire (SGRQ) scores between groups: OR = −0.85; 95% CI = [−1.83, 0.13]. There were no differences in overall adverse events (OR = 1.00; 95% CI = 0.92, 1.09), serious adverse events (OR = 1.01; 95% CI = 0.86, 1.18), or cardiovascular events (OR = 0.88; 95% CI = 0.58, 1.34). Conclusion and Relevance: Dual therapy improves FEV1 and is as safe as LAMA. Dual therapy does not improve SGRQ scores more than LAMA.


Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 293 ◽  
Author(s):  
Erola Astó ◽  
Iago Méndez ◽  
Sergi Audivert ◽  
Andreu Farran-Codina ◽  
Jordi Espadaler

Studies of probiotics, fructan-type prebiotics, and synbiotics in patients with ulcerative colitis (UC) show significant heterogeneity in methodology and results. Here, we study the efficacy of such interventions and the reasons for the heterogeneity of their results. Eligible random controlled trials were collected from the PUBMED and SCOPUS databases. A total of 18 placebo-controlled and active treatment-controlled (i.e., mesalazine) studies were selected with a Jadad score ≥ 3, including 1491 patients with UC. Data for prebiotics and synbiotics were sparse and consequently these studies were excluded from the meta-analysis. The UC remission efficacy of probiotics was measured in terms of relative risk (RR) and odds ratio (OR). Significant effects were observed in patients with active UC whenever probiotics containing bifidobacteria were used, or when adopting the US Food and Drug Administration (FDA)-recommended scales (UC Disease Activity Index and Disease Activity Index). By the FDA recommended scales, the RR was 1.55 (CI95%: 1.13–2.15, p-value = 0.007, I2 = 29%); for bifidobacteria-containing probiotics, the RR was 1.73 (CI95%: 1.23–2.43, p-value = 0.002, I2 = 35%). No significant effects were observed on the maintenance of remission for placebo-controlled or mesalazine-controlled studies. We conclude that a validated scale is necessary to determine the state of patients with UC. However, probiotics containing bifidobacteria are promising for the treatment of active UC.


2018 ◽  
Vol 36 (5) ◽  
pp. 284-293 ◽  
Author(s):  
Xue-bin Li ◽  
Jie Wang ◽  
An-ding Xu ◽  
Jian-min Huang ◽  
Lan-Qing Meng ◽  
...  

Objective The aim of this systematic review was to assess the efficacy/effectiveness and safety of electroacupuncture (EA) in the treatment of post-stroke depression (PSD). Methods A comprehensive literature search in the Pubmed, Embase, CENTRAL, ISI Web of Science, CNKI and Wanfang databases was conducted, and all relevant randomised controlled trials (RCTs) were screened for eligibility by two independent reviewers. The Cochrane Collaboration's tool and Jadad score were used to assess the risk of bias of included studies, and only RCTs scoring ≥3 were included in a meta-analysis. Results 18 RCTs involving a total of 813 participants (mean age 61.6 years) in the EA groups and 723 participants (mean age 61.9 years) in the control groups were included. The included studies had an average 3 point Jadad score. PSD was diagnosed according to the Chinese Classification of Cerebrovascular Disease (CCCD) and the Chinese Classification of Mental Disease (CCMD) criteria. There was no significant difference between EA and antidepressants (fluoxetine 10–40 mg/day, citalopram 20 mg/day, sertraline 50 mg/day) in terms of the Hamilton Depression Rating Scale (HAMD) scores at week 4 after treatment (standardised mean difference (SMD) −0.11, 95% CI −0.31 to 0.10), at week 6 after treatment (SMD 0.04, 95% CI −0.43 to 0.51) or at week 8 after treatment (SMD −0.01, 95% CI −0.23 to 0.22). However, the combined incidence of adverse events in the EA groups was significantly lower than in the antidepressant groups (RR 0.21, 95% CI 0.14 to 0.33). Conclusion There was no significant difference between EA and antidepressants in the severity of depression, however EA caused fewer adverse events than antidepressants. Additional larger scale RCTs with rigorous study design are required.


2018 ◽  
Vol 43 (8) ◽  
pp. 801-807 ◽  
Author(s):  
Chao Long ◽  
Heather E. desJardins-Park ◽  
Rita Popat ◽  
Paige M. Fox

We assessed the quantity, quality and trends of randomized controlled trials comparing hand surgical interventions. Study characteristics were collected for 125 randomized controlled trials comparing hand surgical interventions. The Jadad scale (0–5), which assesses methodological quality of trials, was calculated. Logistic regressions were conducted to determine associations with the Jadad score. The studies were published between 1981 and 2015, with an increase over time, most often in Journal of Hand Surgery (European). Mean study size was 68 patients. Mean Jadad score was 2.1, without improvement over time. Thirty percent conducted a power analysis and 8% an intention-to-treat analysis. Studies conducted in the United Kingdom and with smaller sample sizes, power analysis and intention-to-treat analysis were associated with a higher Jadad score. The quantity of trials has increased over time while methodological quality has remained low, indicating a need to improve quality of trials in hand surgery literature.


2018 ◽  
Vol 154 (6) ◽  
pp. S-1339
Author(s):  
Vikram Kate ◽  
Subair Mohsina ◽  
Niranjan Ravichandran ◽  
Souraja Datta ◽  
Gubbi S. Sreenath ◽  
...  

2018 ◽  
Vol 156 (04) ◽  
pp. 436-442 ◽  
Author(s):  
Milena Ploeger ◽  
Norbert Müller ◽  
Dieter Wirtz ◽  
Hendrik Kohlhof

Zusammenfassung Hintergrund Über die letzten Jahre zeigt sich ein deutlicher Trend hin zum Übergewicht innerhalb der deutschen Bevölkerung. Folglich wurde auch eine deutliche Zunahme der Anzahl adipöser Patienten in der Primärendoprothetik beschrieben. Als Folge der hohen Anzahl von primärendoprothetischen Gelenkersätzen steigt aktuell auch die Zahl der revisionsendoprothetischen Eingriffe, sodass auch hier mit einer Zunahme der Anzahl übergewichtiger Patienten zu rechnen ist. Trotz dieser Tatsachen beschreiben viele Prothesenhersteller Adipositas als eine relative, teilweise sogar absolute Kontraindikation, und auch die Datenlage in der Revisionsendoprothetik bez. Adipositas und deren Auswirkungen ist gering. Ziel dieses systematischen Reviews ist es daher, Fragen bez. der Re-Revisionsoperation, der Infektionsrate, des postoperativen Outcomes, der Implantatüberlebensrate und der rechtlichen Konsequenzen bei adipösen Patienten in der Revisionsendoprothetik des Kniegelenks zu erörtern. Patienten/Material und Methoden Basierend auf einem systematischen Review der Datenbank PubMed identifizierten wir Studien, die sich mit der Thematik Adipositas und Übergewicht in der Wechselendoprothetik des Kniegelenks befassten. Die Bewertung der Studienqualität erfolgte anhand des Evidenzgrades sowie des modifizierten Jadad-Scores. Zusätzlich wurden die Studien nach Fallzahl, Alter, Größe, Gewicht, Geschlecht und Follow-up-Zeit analysiert. Zusätzlich erfolgte eine Analyse des aktuellen rechtlichen Aspekts. Ergebnisse und Schlussfolgerung Insgesamt wurden aus n = 118 Suchergebnissen 5 Studien eingeschlossen. Der durchschnittliche Jadad-Score lag bei 1, das durchschnittliche Level of Evidence bei 3. Bezüglich der Infektionsrate und Revisionsoperationsrate zeigten 2 Studien deutlich schlechtere Werte für adipöse Patienten in der Wechselendoprothetik. Patienten mit einer morbiden Adipositas hatten in der Literatur ein deutlich erhöhtes Risiko für Wundheilungsstörungen und periprothetische Gelenkinfekte. Drei Studien gaben schlechtere Werte für adipöse Patienten an bez. des postoperativen Outcomes bei Funktion und Schmerz. Der rechtliche Aspekt wurde in keiner der 5 Studien genauer erörtert. Insgesamt ist die Datenlage bez. der Fragestellung gering und sehr heterogen, sodass die Gruppenbildung der 5 Studien nur bedingt vergleichbar ist. Insgesamt weisen jedoch die Ergebnisse des Reviews darauf hin, dass Adipositas auch in der Revisionsendoprothetik des Kniegelenks eine prognostisch ungünstige Einflussgröße ist. Rechtlich gesehen muss der Faktor Adipositas/Übergewicht in der Aufklärung der Wechselendoprothetik zwingend berücksichtigt werden, da sonst die Möglichkeit besteht, dass die Aufklärung nicht dem zu fordernden Fachstandard entsprechend erfolgt.


2017 ◽  
Vol 54 (2) ◽  
pp. 142-152 ◽  
Author(s):  
Joseph Hardwicke ◽  
Mohammad Nassimizadeh ◽  
Bruce Richard

Objectives Reviews of the quality of reporting of randomized controlled trials (RCTs) have recently been conducted in different surgical specialties. In this review of RCTs relating to cleft lip, cleft palate, and cleft lip and palate (CL/P), we investigate the quality of reporting against the Consolidated Standards of Reporting Trials (CONSORT) checklist. Design A systematic review of CL/P RCTs published from 2004 to 2013, with the included articles scored against the CONSORT checklist. Patients, Participants The literature search identified 174 articles. Studies were selected for participants with CL/P who were involved in an RCT with prospective data collection and reported in a full journal article. A total of 6352 participants were included from 65 CUP RCTs during the study period. Main Outcome Measures The methodological quality of RCTs was assessed using the CONSORT checklist and Jadad scale. Results The mean CONSORT score was 15.8, and the mean Jadad score was 3.3. There was a significant positive correlation between the CONSORT and Jadad score ( P < .0001, ρ = .47). The only significant correlation showed that with an increasing number of authors, both the CONSORT and the Jadad score increased. Conclusion This analysis has shown that that there are deficiencies in the transparent reporting of factors such as randomization implementation, blinding, and participant flow. Interventions, outcomes, and the interpretation of results are well presented. We would recommend that RCTs are conceived and undertaken using the CONSORT checklist and reported in a clear and reproducible manner.


2017 ◽  
Vol 24 (3) ◽  
pp. 164-171
Author(s):  
Esther Granitzer ◽  
Beat Meier ◽  
Heinz Drexel ◽  
Christoph H. Saely

Ziel dieser Literaturübersicht war es, den klinischen Stellenwert von Flohsamen (Psyllium) und deren Auswirkungen auf Parameter des Glukosestoffwechsels zu bewerten. Hierzu wurde in den Datenbanken CAMbase, CAM-QUEST, Cochrane Library, EMBASE und PubMed die Literatur zur glukosesenkenden Wirkung von Flohsamen herangezogen und letztmalig am 16. September 2015 systematisch erfasst. Von ursprünglich 107 als potenziell relevant identifizierten Veröffentlichungen erwiesen sich 11 als randomisierte, kontrollierte klinische Studien, in denen 417 Testpersonen Psyllium eingenommen hatten. Das Phytotherapeutikum zeigte in 2 Studien signifikante Senkungen der Nüchternglukose. In 1 Studie konnte durch die Einnahme von Flohsamen der Hämoglobin-A1c (HbA1c)-Wert signifikant um 1,6% gesenkt werden. Signifikant Auswirkungen von Psyllium auf den postprandialen Glukosewert konnten in 4 Studien gemessen werden. Ebenfalls reduzierte Psyllium in 4 Studien den Insulinspiegel nach Nahrungsaufnahme signifikant. Der Jadad-Score für die ausgewerteten Publikationen lag im Durchschnitt bei 3 Punkten, das Minimum bei 1 Punkt, das Maximum bei 5 Punkten. Gegenwärtig ist die Evidenz aus publizierten, randomisierten Studien für eine glukosesenkende Wirkung von Flohsamen für eine behördliche Empfehlung oder eine Aufnahme in therapeutische Richtlinien ungenügend. Da aber in einigen, teilweise kleineren Studien positive Auswirkungen des pflanzlichen Arzneimittels auf Parameter des Glukosestoffwechsels beobachtet wurden, erscheint die Prüfung der glukosesenkenden Wirkung von Flohsamen in größeren, methodisch einwandfreien Studien sinnvoll.


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