Acupuncture for Relieving Abdominal Pain and Distension in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Background: Clinical evidence suggests that acupuncture is effective for relieving abdominal pain and distension in acute pancreatitis (AP). However, there is a lack of systematic reviews and meta-analyses that provide high-quality evidence of the efficacy and safety of acupuncture in this context.Aim: To assess the efficacy and safety of acupuncture for relieving abdominal pain and distension in AP.Methods: We searched the PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP, and China Biomedical Literature databases. Randomized controlled trials of acupuncture plus routine treatment (RT) vs. RT alone or RT plus sham/placebo acupuncture were included. Primary outcomes included total effectiveness rate, VAS scores for abdominal pain and distension, and time until relief of abdominal pain and distension. Secondary outcomes included time until recovery of bowel sound, time until first defecation, length of hospital stay, and APACHE II score.Results: Nineteen eligible original studies (n = 1,503) were included. The results showed that acupuncture in combination with RT had a significant advantage in terms of increasing the total effectiveness rate [risk ratio: 1.15; 95% confidence interval (CI): 1.06–1.24; P = 0.001]. Acupuncture also reduced the VAS score for abdominal pain [weighted mean difference (WMD): −1.45; 95% CI: −1.71 to −1.19; P < 0.0001] and the VAS score for abdominal distension (WMD: −0.71; 95% CI: −1.04 to −0.37; P < 0.0001) in patients with AP. Other results also showed the efficacy of acupuncture. One study reported adverse events after acupuncture.Conclusion: Acupuncture in combination with RT has a better effect than RT alone for relieving abdominal pain and distension in AP. More rigorous studies are needed to confirm this result.Systematic Review Registration: PROSPERO CRD42019147503 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=147503).

Efficacy and Safety of TCMI in Patients With Combined Coronary Heart Disease and Heart Failure: A Systematic Review and Network Meta-Analysis

Objective: To compare the efficacy and safety of conventional treatments (CTs) to those that included traditional Chinese medicine injections (TCMIs) in patients with combined coronary heart disease and heart failure (CHD-HF).Methods: Eight electronic literature databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, Wanfang Database, Chinese Biomedical Database) were searched from their inceptions to May 18, 2021, to identify relevant randomised controlled trials (RCTs). The primary outcomes analyzed included the total effectiveness rate and adverse events (ADRs). The secondary outcomes analyzed included the left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP), brain natriuretic peptide (BNP), and 6-min walk test (6MWT). Cochrane risk-of-bias tool was used to assess quality of the analyzed RCTs. Stata and OpenBUGS software were used to prior to the systematic review and network meta-analysis.Results: Sixty-one eligible trials involved 5,567 patients and one of the following 15 TCMIs: Shuxuetong, Shenmai, Shenfu, Shengmai, Danshenduofenyansuan, Danhong, Dazhuhongjingtian, Xinmailong, Dengzhanxixin, Gualoupi, Shuxuening, Xuesaitong, Yiqi Fumai, Shenqi Fuzheng, Huangqi. Network meta-analysis revealed that Shuxuetong injection + CT group was superior to CT only in improving the total effectiveness rate [odds ratio (OR): 7.8, 95% confidence interval (CI): 1.17–27.41]. Shenmai injection + CT was superior to CT only for LVEF (OR: 8.97, CI: 4.67–13.18), Xinmailong injection + CT was superior to CT only for NT-proBNP (OR: −317.70, CI: −331.10–303.10), Shenqi Fuzheng injection + CT was superior to CT only for BNP (OR: −257.30, CI: −308.40–242.80); and Danhong injection + CT was superior to CT only for 6MWT (OR: 84.40, CI: 62.62−106.20). Different TCMIs had different toxicity spectrums.Conclusion: TCMIs combined with CT are better than CT alone in treating CHD-HF. Different TCMIs improve different outcomes. Additional properly designed RCTs are needed to conduce a more refined comparison of various TCMIs.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021258263].

Effectiveness of goalball athletes throwing in the Chilean National League

Goalball is a collective Paralympic sport with oppositional characteristics but without invasion by the athletes that, despite requiring great physical condition in offensive and defensive actions, is also identified as a tactical sport, where the administration of technique in the various game situations determines success in competition. The objective of the study was to analyze the effectiveness of the attack of the Chilean National Goalball League, according to type of shot and trajectory. Four Goalball matches of the final phase of a national tournament were filmed. For this, a digital camera was used behind an arch located in height. The matches were analyzed following the diagrams proposed by Morato et al. (2016) and Morato (2012). The front throw (FRO) was used the most (88.9%) with an effectiveness rate of 6.2%. Longer trajectories were made in short diagonals (SD) and parallel (PA) (31.3% and 23.2%, respectively). The FRO throw was directed in SD (34.5%) and PA (22.4%), while on the other hand, the spinning throws (SP) were directed preferably in PA (30.4%) and SD (29.1%). The FRO throw was more effective in PA (10.6%), whereas the SP throw was more effective in the middle diagonal (MD) (12.5%). The lateral positions execute throws, preferably FRO, but in defense the central positions are protagonists. Throws are most effective when they are directed in PA and SD.

BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting: A Note

In their important and innovative study, Dagan et al. (2021) were the first to provide evidence on the effectiveness of BNT162b2 mRNA Covid-19 vaccine on a large scale population. The authors used a matched pair Israeli sample of 596,618 individuals belonging to the vaccinated group and 596,618 individuals with similar characteristics belonging to the unvaccinated group. Based on the information obtained in Figure 2 of Dagan et al. (2021) on cumulative events 14, 21 and 28 days after the first dose, the authors of this Note found inconsistencies between the calculated effectiveness of the dose from Figure 2, and the reported effectiveness rates in Table 2. Compared to the effectiveness rate reported by Dagan et al. (2021), and referring to the criteria of: documented SARS-CoV-2 infection, symptomatic Covid-19 and severe Covid-19, 14-20 days after the first dose, according to the CDC formula, our calculations suggest an elevated effectiveness of the vaccine ranging between 1.75%-4.67%. Referring to the criteria of Covid-19 hospitalization and death, 14-20 days after the first dose, our calculations suggest a reduced effectiveness of the vaccine ranging between minus 2.77% and minus 2%. Given the widespread public vaccination resistance, transparency and accuracy in vaccination effectiveness might prove to be especially important. As of October 31, 2021, the official accumulated Covid-19 cases are 247,376,970 and deaths worldwide are approx. 5 million persons. Consequently, the implication of a 2% gap after 21 days is 4.947 million cases and 100,000 deaths.

Effects of Uremic Clearance Granules in Uremic Pruritus: A Meta-Analysis

Uremic pruritus is common among patients with advanced or end-stage renal disease, with an incidence of >40% among patients on dialysis. Uremic clearance granules (UCGs) are effective in managing uremic pruritus and delay the progression of chronic kidney disease. We conducted a systematic review and a meta-analysis to evaluate the efficacy of UCG in patients with uremic pruritus. Several electronic databases were searched systematically from their inceptions until 19 July 2021. Randomized control trials evaluating the efficacy of UCG in patients with uremic pruritus were selected. Eleven trials including 894 participants were published between 2011 and 2021. Patients administered UCGs had a significantly decreased visual analog scale score (mean difference [MD], −2.02; 95% confidence interval [CI], −2.17 to −1.88), serum levels of hsCRP (MD, −2.07 mg/dL; 95% CI, −2.89 to −1.25; p < 0.00001), TNF-α (MD, −15.23 mg/L; 95% CI, −20.00 to −10.47; p < 0.00001]), β2-MG (MD, −10.18 mg/L; 95% CI, −15.43 to −4.93; p < 0.00001), and IL-6 (MD, −6.13 mg/L; 95% CI, −7.42 to −4.84; p < 0.00001). In addition, UCGs significantly reduced serum levels of creatinine, BUN, PTH, iPTH, phosphorus, and the overall effectiveness rate. UCGs could be an attractive complementary therapy for patients with uremic pruritus.

An Analysis of the Effectiveness and Contribution of Regional Original Revenue for Regional Expenditures in Magelang Regency 2015-2019

The purpose of this research is to observe in detail related to how the level of effectiveness and contribution of Regional Original Income (PAD) to Regional Expenditures in Magelang Regency in 2015 - 2019. The data used by researchers in conducting this research is secondary data. which comes from a review of the financial information of the Regional Government of Magelang Regency in the 2015-2019 period. This study uses descriptive methods or rules. This study produces several findings which state that the Magelang Regency Government in realizing Regional Original Income in the 2015-2019 period has been considered very effective with the calculation results of an average effectiveness rate of 109.56%. While the PAD contribution to Regional Expenditures remains low because, on average, the rate of contribution (contribution) is only 15.05%.

Repellent Effectiveness of Permot Leaf Ethanol Extract (Passiflora Foetida Linn.) against Aedes Aegypti Adult Mosquitoes

Indonesia is one of the largest tropical countries in the world and various diseases can arise in the tropics which are caused by animals as vectors. An example of a vector that can carry diseases is a mosquito. Mosquitoes are insects that live side by side with humans buy act as vectors of disease. Mosquito Aedes aegypti is a type of mosquito that can carry the virus that causes Dengue Hemorrhagic Fever. This research was conducted to determine the effectiveness of Permot leaf ethanol extract (Passiflora foetida L.) as an alternative repellent against adult mosquitoes Aedes aegypti. This research was conducted from October to December 2020 and used Permot leaf ethanol extract consisting of 3 cream concentrations, namely 2.5%, 5%, 7.5%, negative control using cream without permot leaf ethanol extract and positive control using mosquito cream. The data of this study were tested using one way ANOVA to find the effectiveness rate and comparations of the each Permot leaf repellent extract. This study proven that the permot leaf ethanol extract is effective as a repellent for Aedes aegypti mosquitoes.

Which features of an outpatient treatment for COVID-19 would be most important for pandemic control? A modelling study

The global pandemic of coronavirus disease 2019 (COVID-19) has challenged healthcare systems worldwide. Lockdown, social distancing, and screening are thought to be the best means of stopping the virus from spreading and thus of preventing hospital capacity from being overloaded. However, it has also been suggested that effective outpatient treatment can control pandemics. We adapted a mathematical model of the beneficial effect of lockdown on viral transmission and used it to determine which characteristics of outpatient treatment would stop an epidemic. The data on confirmed cases, recovered cases, and deaths were collected from Santé Publique France. After defining components of the epidemic flow, we used a Morris global sensitivity analysis with a 10-level grid and 1000 trajectories to determine which of the treatment parameters had the largest effect. Treatment effectiveness was defined as a reduction in the patients' contagiousness. Early treatment initiation was associated with better disease control—as long as the treatment was highly effective. However, initiation of a treatment with a moderate effectiveness rate (5%) after the peak of the epidemic was still better than poor distancing (i.e. when compliance with social distancing rules was below 60%). Even though most of today's COVID-19 research is focused on inpatient treatment and vaccines, our results emphasize the potentially beneficial impact of even a moderately effective outpatient treatment on the current pandemic.

Effects of Dingchuan Decoction on Lung Function and Clinical Effectiveness Rate in Children with Asthma: A Systematic Review and Meta-Analysis

Dingchuan decoction (DCD) is a traditional Chinese prescription for asthma that remains popular today. To systematically evaluate the effect of DCD on lung function, clinical effectiveness rate, and safety in children with asthma, significant databases were searched for randomized controlled trials from their inception to September 9, 2019. Randomized controlled trials assessing the effect of DCD on lung function and clinical effectiveness rate in children with asthma were included in this meta-analysis. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool. RevMan 5.3 was used for data analysis. Fourteen studies with 1,384 children were reviewed. FEV₁ improvement rate (mean difference [MD] 12.50, 95% confidence interval [CI] 8.72–16.29), PEF improvement rate (MD 14.28, 95% CI 11.08–17.49), and clinical effectiveness rate (relative risk 1.19, 95% CI 1.14–1.25) significantly increased in the DCD group when compared to simple conventional medication. Four trials suggest that DCD is safe for children. In conclusion, the use of DCD combined with conventional medication improves lung function and clinical effectiveness rate better than simple conventional medication. However, the selected trials lack blinding and large-scale studies. Therefore, to better manage DCD in clinical practice, more randomized controlled trials and large-scale studies are required for further evaluation.

A retrospective cohort study on a pharmaceutical consultation mode of multidisciplinary individualized medication recommendations

Aims: To develop a pharmaceutical consultation mode of multidisciplinary individualized medication recommendations, to improve the quantity and quality of clinical pharmacists’ consultations Methods: A retrospective study of 542 clinical pharmacists-led consultations was conducted. In the pre-intervention group, medication advice was given based on the purpose of the consultation. In the post-intervention group, a consultation mode of multidisciplinary individualized medication recommendation was implemented, in which clinical pharmacists with specialties of anticoagulation, gastroenterology and nutrition were asked to give individualized medication recommendations and a set of evaluation criteria for rational drug use was formulated. Outcomes, including the patterns and number of consultations, individualized medication recommendations, acceptance rate and effectiveness rate, were compared between the two periods. Results: A total of 651 cases were reviewed, and 542 cases of which meeting the predesigned inclusion and exclusion criteria were included, with 94 and 448 patients in the pre-intervention and post-intervention groups, respectively. The total number of consultations increased year by year, so did the number of general consultations, multidisciplinary difficult consultations, departments applying for general consultations, departments applying for multidisciplinary difficult consultations, anti-infection consultations and non-anti-infection consultations in details. The effectiveness rate of consultations in the post-intervention group was 81.7% vs 70.2% in the pre-intervention group (P < 0.05). No difference was shown between two groups in acceptance rate (96.9% vs 95.7%, p=0.578).