Less invasive surfactant administration versus intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome: a systematic review and meta-analyses

Abstract Objectives To compare LISA with INSURE technique for surfactant administration in preterm with gestational age (GA) < 36 weeks with RDS in respect to the incidence of pneumothorax, bronchopulmonary dysplasia (BPD), need for mechanical ventilation (MV), regional cerebral oxygen saturation (rSO2), peri‑intraventricular hemorrhage (PIVH) and mortality. Methods A systematic search in PubMed, Embase, Lilacs, CINAHL, SciELO databases, Brazilian Registry of Randomized Clinical Trials (ReBEC), Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. RCTs evaluating the effects of the LISA technique versus INSURE in preterm infants with gestational age < 36 weeks and that had as outcomes evaluation of the rates of pneumothorax, BPD, need for MV, rSO2, PIVH, and mortality were included in the meta-analysis. Random effects and hazard ratio models were used to combine all study results. Inter-study heterogeneity was assessed using Cochrane Q statistics and Higgin's I2 statistics. Results Sixteen RCTs published between 2012 and 2020 met the inclusion criteria, a total of 1,944 preterms. Eleven studies showed a shorter duration of MV and CPAP in the LISA group than in INSURE group. Two studies evaluated rSO2 and suggested that LISA and INSURE transiently affect brain autoregulation during surfactant administration. INSURE group had a higher risk for MV in the first 72 h of life, pneumothorax, PIVH and mortality in comparison to the LISA group. Conclusion This systematic review and meta-analyses provided evidence for the benefits of the LISA technique in the treatment of RDS, decreasing CPAP time, need for MV, BPD, pneumothorax, PIVH, and mortality when compared to INSURE.

Metaanálisis de generalización de la fiabilidad de los mitos de violación / Meta-analysis of reliability generalization of the rape myths

Resumen Los mitos de violación son actitudes y creencias generalmente falsas, amplias y persistentes, acerca de la violación, la víctima y el agresor, que son utilizadas para negar o justificar la agresión sexual hacia las mujeres. En las últimas dos décadas, los instrumentos más utilizados para medir este constructo corresponden a la escala de aceptación de mitos de violación de Illinois (IRMAS), que utiliza expresiones directas y explícitas mediante un lenguaje clásico, y la escala de aceptación de mitos modernos de agresión sexual (AMMSA) que usa un lenguaje sutil, indirecto y moderno. Se realizó un metaanálisis de generalización de la fiabilidad de 69 estudios empíricos que utilizaron alguna de las dos escalas de mitos de violación. El objetivo fue estimar la fiabilidad media de las puntuaciones combinadas de las escalas IRMAS y AMMSA para obtener un valor aproximado de su fiabilidad general y evaluar el posible efecto moderador de algunas variables de interés. El promedio de la fiabilidad por consistencia interna de las puntuaciones de las escalas para las 98 muestras estudiadas fue de .85, IC95 % [.84, .86]. Se observó una alta heterogeneidad (I. = 96 %), y el número de ítems es la única variable moderadora que explica significativamente la variabilidad de la fiabilidad observada. Estos resultados muestran que ambas escalas presentan índices de consistencia interna aceptables en sus diversas aplicaciones. Por lo tanto, las medidas de aceptación de mitos de violación cumplen con los criterios de fiabilidad adecuados para ser utilizadas en investigaciones empíricas en distintos contextos.

Abstract Rape myths are widespread and persistent attitudes, beliefs, and stereotypes, usually false, about rape, the victim, and the perpetrator. Their function is to deny and justify sexual assaults against women, affecting the victim's attributions of responsibility and the perpetrator's attributions of guilt in rape cases. These myths exert a bias in the processing of information, directing attention and perception toward stimuli that justify the victim's responsibility for sexual aggression. These beliefs can be grouped into several types of myths: Myths that hold the victim responsible by arguing that women should be careful and not expose themselves to avoid sexual aggression, myths that justify and reduce the responsibility of the aggressor by stating that the man could not contain his sexual desire and those myths that deny or normalize sexual aggression, which propose that rape occurs only in very specific contexts. In the last two decades, the instruments most commonly used to measure these beliefs are The Illinois Rape Myth Acceptance Scale (IRMAS), which uses direct and explicit expressions through classic language, and the Modern Sexual Assault Myth Acceptance Scale (AMMSA), where its expressions are modern, subtle and indirect. Considering the wide use of these instruments, it is justified to provide empirical evidence showing information on the psychometric properties of these scales. One of the procedures for synthesizing empirical results is meta-analyses (MA). This methodology can synthesize studies of specific variables and analyze the psychometric properties of the measurement instruments, providing relevant information on the quality of a given scale. Within this last type of RM are reliability generalizations (RG), those that study the reliability coefficients obtained in different applications of a scale, providing evidence on the properties of the measures used in measuring a construct. A meta-analysis of the RGs of 69 empirical studies that used any of the rape myth scales was performed. The objective was to estimate the mean reliability of the combined scores of the IRMAS and AMMSA scales to obtain an approximate value of their overall reliability and to assess the possible moderating effect of some variables of interest (e.g., research design, culture, sample type, etc.). The mean internal consistency reliability of the scale scores for the 98 samples studied was .85, 95 % C.I. [.84, .86] and the mean coefficient for each of the IRMAS and AMMSA scales was .84 and .85 respectively. All these values are above .80, a value established as satisfactory reliability of the instrument for general research. The Cronbach's alpha coefficients reported by the studies ranged from .71 to .98, with values considered moderate to excellent. These results show that both scales present acceptable internal consistency indices in various applications. There is high heterogeneity (I. = 96 %), with the number of items being the only moderating variable significantly explaining the observed reliability variability. This result was to be expected, given that the effect of test length on the estimation of reliability indices has a long tradition and is widely known in the psychometric literature.

Re-evaluation of systematic reviews of acupuncture and moxibustion for childhood autism / 中国针灸

OBJECTIVE@#To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment.@*METHODS@#The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence.@*RESULTS@#A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias.@*CONCLUSION@#Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.

The effect of rapid maxillary expansion in children: a meta-analysis / Efeito da expansão rápida da maxila em crianças: uma metanálise

Abstract Introduction: Craniofacial growth is modified by chronic mouth breathing. Rapid maxillary expansion leads to separation of the mid-palatal suture, improving the occlusion and the upper airway size. Aim: Systematically evaluate scientific articles on the effects of rapid maxillary expansion on airway dimensions and classify the quality of the evidence of the information. Methods: Searches on PUBMED, LILACS, EMBASE, SCOPUS, WEB OF SCIENCE and COCHRANE, as well as in the grey literature were performed. The articles found were selected and evaluated both for the risk of bias (ROBINS-I) and for the quality of evidence (GRADE). Results: Of the 309 works found, 26 papers were selected for full reading, of which 22 were excluded. Data compilation and analysis were performed in four papers, two being controlled non-randomized clinical trials and two non-randomized and uncontrolled clinical trials. No randomized clinical trial was found. Conclusions: The meta-analysis found an increase in the internasal and inter-zygomatic distances and oropharyngeal volume after rapid maxillary expansion, which, together with clinical findings, makes the recommendation favorable to the intervention. The quality of the evidence for each outcome was considered very low.

Resumo Introdução: O crescimento craniofacial é modificado pela respiração oral crônica. A expansão rápida da maxila promove a separação da sutura palatino mediana, melhora a oclusão e a dimensão da via aérea superior. Objetivo: Avaliar de forma sistematizada os artigos científicos dos efeitos da expansão rápida da maxila sob as dimensões das vias aéreas e classificar a qualidade da evidência das informações. Método: Foi feita a busca nas plataformas Pubmed, Lilacs, Embase, Scopus, Web of Science e Cochrane, bem como a literatura cinzenta. Os artigos foram selecionados e avaliados quanto aos riscos de viés (ROBINS-I), e feita a avaliação da qualidade da evidência (GRADE). Resultados: De 309 estudos encontrados, 26 artigos foram selecionados para leitura completa, dos quais 22 excluídos, restaram 4 artigos para a análise e compilamento de dados, dois ensaios clínicos não randomizados controlados e dois ensaios clínicos não randomizados e não controlados. Nenhum ensaio clínico randomizado foi encontrado. Conclusões: As metanálises mostraram aumento de distância internasal, interzigomática e volume orofaríngeo após a expansão rápida da maxila, o que, juntamente aos achados clínicos, torna a recomendação favorável à intervenção. A qualidade da evidência de cada desfecho foi considerada muito baixa.

Priorização de projetos de recursos hídricos sob a perspectiva de modelos de apoio à decisão multicritério: uma revisão sistemática / Prioritization of water resources projects from the perspective of multicriteria decision aid models: a systematic review

Resumo Este estudo apresenta a análise da literatura científica quanto à aplicação de modelos de apoio à decisão multicritério na priorização de projetos de recursos hídricos, por meio de uma revisão sistemática. Metodologicamente, a pesquisa caracteriza-se como diagnóstico-descritiva. Para a realização da revisão sistemática, seguiu-se o protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses. No que tange à análise dos dados, após o levantamento do portfólio bibliográfico, realizou-se uma bibliometria com o auxílio dos softwares VOSviewer e UCINET 6 em conjunto com o NetDraw, e posteriormente se procedeu à metassíntese. Como principais resultados, percebeu-se: (i) uma carência na produção científica sobre o tema investigado (23 artigos); (ii) a recorrente aplicação de métodos de apoio à decisão multicritério na priorização de projetos de recursos hídricos; (iii) o destaque para o governo e companhias de saneamento com setores de maior interesse em projetos de recursos hídricos; (iv) a falta de informação sobre os atores envolvidos na priorização dos projetos e as técnicas que apoiam o consenso da decisão; e (v) além da preocupação econômica, a importância que vem sendo dada às dimensões social e ambiental. A contribuição prática deste estudo é dada pelo conhecimento gerado para as companhias e instituições que desejem realizar a priorização de projetos de recursos hídricos, uma vez que são exibidas metodologias, técnicas, dimensões e critérios que vêm sendo considerados cientificamente na priorização de projetos no setor de recursos hídricos. Já a contribuição teórica é realizada por meio da apresentação de um panorama atual do tema objeto de estudo, de forma a permitir a identificação de lacunas e apontando áreas em desenvolvimento para pesquisas futuras.

Abstract This study presents the analysis of the scientific literature on the application of multicriteria decision aid models in the prioritization of water resources projects through a systematic review. Methodologically, the research is characterized as descriptive diagnosis. For the systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was followed. Regarding data analysis, after surveying a bibliographic portfolio, a bibliometry was carried out with the aid of VOSviewer and UCINET 6 software, in addition to NetDraw software; subsequently, a metasynthesis was performed. As main results, the following aspects were observed: (i) lack of scientific production on the investigated topic (23 articles); (ii) recurring application of multicriteria decision aid methods in prioritizing water resource projects; (iii) emphasis on the government and sanitation companies with sectors of greatest interest in water resources projects; (iv) lack of information about the actors involved in the prioritization of projects and the techniques that support the decision consensus; and (v) in addition to the economic concern, the importance that has been given to social and environmental dimensions. The practical contribution of this study consists in the knowledge generated for companies and institutions that intend to prioritize water resource projects, as this study presents the methodologies, techniques, dimensions, and criteria that have been scientifically considered in the prioritization of projects in the water resources sector. The theoretical contribution consists in the presentation of a current overview of the topic under study, in such a way to allow the identification of gaps and indicating areas under development for future research.

Effects of dance training on cognitive functioning and the emotional state of people with Parkinson′s disease: A meta-analysis / 中华物理医学与康复杂志

Objective:To assess systematically the effect of dance training on the cognitive functioning and emotional state of people with Parkinson′s disease.Methods:Randomized controlled trials (RCTs) of the effect of dance training on the cognition and emotional state of people with Parkinson′s disease were retrieved from the Pubmed, Embase, Cochrane Library, Web of Science, Science Direct, Ovid, CNKI, Wan fang and VIP databases. The period was from January 1995 to January 10, 2019. The literature was screened, collected and evaluated by two reviewers independently. The meta-analysis was conducted using version 5.3 of the Revman software.Results:Seven RCTs involving 167 patients were discovered. According to the meta-analysis, dance training significantly relieved depression [SMD=-0.75, 95%CI: -1.41 to -0.10]. It improved the average score on the Montreal Cognitive Assessment Scale [WMD=2.05, 95%CI: 0.87 to 3.23] and on the Frontal Assessment Battery [WMD=1.41, 95%CI: 0.49 to 2.33]. However, dance training could not effectively improve apathy.Conclusions:Current evidence shows that dance training can relieve depression and promote better cognitive functioning for people with Parkinson′s disease.

Treating post-stroke dysphagia with biofeedback: A meta-analysis / 中华物理医学与康复杂志

Objective To evaluate the effect of treating post-stroke dysphagia with biofeedback.Methods PubMed,the Cochrane library,EMbase,the Web of Science,the Chinese biomedical database,the Wanfang database,the China national knowledge infrastructure and the VIP database were searched for reports of randomized and controlled trials (RCTs) of biofeedback for treating post-stroke dysphagia.The search covered the period from each database's inception to December 31,2018.Version 5.3 of the RevMan software was used to analyze the data.Results A total of 17 studies were included,covering 1306 patients.The meta-analysis showed that the intervention group was significantly better than the control group in terms of the total effectiveness rate,the average Functional Oral Intake Scale score,and scores on the Standardized Swallowing Assessment and on the Swallowing Quality-of-Life Questionnaire.The incidence of aspiration pneumonia was also significantly lower in the biofeedback treatment group.Conclusion Biofeedback can be applied to improve swallowing,the level of ingestion and the quality of life of stroke survivors.It can also reduce the incidence of pneumonia.More high-quality RCTs with large samples are needed to further verify these conclusions.

Efficacy of miltefosine compared with glucantime for the treatment of cutaneous leishmaniasis: a systematic review and meta-analysis / 한국역학회지

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I² index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.

Infratemporal fossa approach: the modified zygomatico-transmandibular approach / 대한악안면성형재건외과학회지

BACKGROUND: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. METHODS: A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors’ diverse clinical experiences. RESULTS: We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail. CONCLUSIONS: An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.

Efficacy of miltefosine compared with glucantime for the treatment of cutaneous leishmaniasis: a systematic review and meta-analysis / 한국역학회지

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I² index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.

Efficacy of calcitonin gene-related peptide antagonists in the treatment of acute migraine: A systematic review and meta-analysis

Objective@#This study determined the efficacy of calcitonin gene-related peptide (CGRP) antagonists in the treatment of acute migraine.

The effectiveness of virtual reality therapy in relieving upper limb hemiparesis after stroke:A meta-analysis of randomized and controlled trials / 中华物理医学与康复杂志

Objective To analyze the clinical efficacy of using virtual reality ( VR) to improve the upper limb function of hemiplegic persons. Methods A search was conducted in the PubMed, Cochrane Library, EM-BASE, CNKI and Wanfang Data as well as VIP for reports of randomized and controlled studies of using VR in train-ing upper limb function after stroke. A meta-analysis was then performed using version 5. 3 of the Review Manager software. Results Ninety studies involving 879 patients were found and analyzed. The data showed that VR was sig-nificantly more effective than conventional training in improving Fugl-Meyer assessment scores. It was not superior, however, in improving average Functional Independence Measure scores or performance in the box and blocks test. Conclusion VR is superior to conventional training in promoting the recovery of upper limb function after a stroke.

Effects of mirror therapy on lower extremity motor function and activities of daily living after stroke: A me-ta-analysis / 中华物理医学与康复杂志

Objective To meta-analyze the effect of mirror therapy on the lower limb motor function and ac-tivities of daily living of stroke survivors so as to evaluate its clinical efficacy. Methods Medline, PubMed, OT seeker, the Cochrane library, the Wanfang database, the VIP database and the CNKI were searched for reports of randomized and controlled trials (RCTs) of the effect of mirror therapy on the lower limb motor function and activities of daily living of stroke survivors published between December 2008 and December 2018. Strict inclusion and exclu-sion criteria were applied, and the quality of the documents was comprehensively assessed according to version 5.1.0 of the Cochrane manual. The results were analyzed using version 5.2 of the RevMan software suite. Results Four-teen trials were included. Meta-analysis showed that mirror therapy had been shown to improve the patients'scores of Fugl-Meyer assessment ( FMA ), functional ambulance category ( FAC ) and modified Barthel index ( MBI ). Conclusion Mirror therapy can improve the motor function of the affected lower extremities of stroke survivors and their ability in the activities of daily living.

Efficacy of calcitonin gene-related peptide antagonists in the treatment of acute migraine: A systematic review and meta-analysis

Objective: This study determined the efficacy of calcitonin gene-related peptide (CGRP) antagonists in the treatment of acute migraine.Methods: Seven randomized, controlled trials were included. Outcome measures used were pain freedom and pain relief two hours after treatment.Results: The difference in pain freedom 2 hours post-dose significantly favored gepants 140/150 mg (OR=2.39, 95% CI=1.93-2.96, PConclusion: With regard to pain freedom and pain relief two hours post-dose, CGRP antagonists are more efficacious than placebo in the treatment of acute migraine but there is insufficient evidence to demonstrate superior efficacy of CGRP antagonists over triptans.

The efficacy of different modes of analgesia in postoperative pain management and early mobilization in postoperative cardiac surgical patients: A systematic review

Cardiac surgery induces severe postoperative pain and impairment of pulmonary function, increases the length of stay (LOS) in hospital, and increases mortality and morbidity; therefore, evaluation of the evidence is needed to assess the comparative benefits of different techniques of pain management, to guide clinical practice, and to identify areas of further research. A systematic search of the Cochrane Central Register of Controlled Trials, DARE database, Joanna Briggs Institute, Google scholar, PUBMED, MEDLINE, EMBASE, Academic OneFile, SCOPUS, and Academic search premier was conducted retrieving 1875 articles. This was for pain management postcardiac surgery in intensive care. Four hundred and seventy-one article titles and 266 abstracts screened, 52 full text articles retrieved for critical appraisal, and ten studies were included including 511 patients. Postoperative pain (patient reported), complications, and LOS in intensive care and the hospital were evaluated. Anesthetic infiltrations and intercostal or parasternal blocks are recommended the immediate postoperative period (4–6 h), and patient-controlled analgesia (PCA) and local subcutaneous anesthetic infusions are recommended immediate postoperative and 24–72 h postcardiac surgery. However, the use of mixed techniques, that is, PCA with opioids and local anesthetic subcutaneous infusions might be the way to go in pain management postcardiac surgery to avoid oversedation and severe nausea and vomiting from the narcotics. Adequate studies in the use of ketamine for pain management postcardiac surgery need to be done and it should be used cautiously.

Mirror therapy improves the upper limb function of hemiparetic stroke survivors: A meta-analysis / 中华物理医学与康复杂志

Objective To evaluate systematically the efficacy of mirror therapy for improving the upper limb function, daily life and pain of stroke survivors. Methods The PubMed, EBSCO, Web of Science, Ovid, Co-chrane Library, Open Gray, China Biological Medicine, China National Knowledge Infrastructure, GoogleScholar, VIP and Wan Fang Data databases were searched for reports of randomized and controlled trials ( RCTs) of mirror therapy for improving the upper limb function of stroke survivors. Only papers published before December 2015 were surveyed. The relevant references of the primary studies were also searched. The literature screening, data extraction and assessments were conducted by two reviewers independently. The meta-analysis was performed using version 5.2 of the RevMan software. Results A total of 22 RCTs involving 823 patients were discovered, some not dealing with mirror therapy. Comparing the studies with and without visual feedback, there were significant differences in upper limb motor function as measured by the Fugl-Meyer, ARAT and Brunnstrom instruments. The average Barthel indexes and visual analogue scale were also significantly different. Conclusion Mirror therapy can improve upper limb function and ability in the activities of daily living, and also relieve pain among stroke survivors to some degree, though its long-term efficacy is still unclear. Large-sample, multi-center, high-quality RCTs are required to verify these conclusions.

The effectiveness of acupuncture and moxibustion in treating acute cerebral infarction: A meta-analysis / 中华物理医学与康复杂志

Objective To analyze the clinical efficacy of acupuncture and moxibustion in treating acute cerebral infarction.Methods A thorough literature search of randomized and controlled tests of acupuncture and moxibustion in treating the acute cerebral infarction was conducted.A meta-analysis was performed using version 5.3 of the ReviewManager software.Results Thirty-nine reports covering 3792 cases were found and analyzed.The neurologic impairment analysis found that in the experimental group mean difference (MD) was-1.86,with the 95％ credibility interval (CI) of between-2.06 and-1.66 showing significant differences compared with the control group.The average clinical effectiveness rate of the experimental groups was 3.95,with a 95％ CI of between-3.02 and 5.16,significantly higher than the control groups'.The experimental groups' markedly effective rate was 1.54,with a 95％ CI of 1.40 to 1.70,showing significant differences compared with the control groups.Conclusion Acupuncture and moxibustion are effective in treating acute cerebral infarction.They are worth popularizing in clinical practice.

The effectiveness of surface neuromuscular electrical stimulation for relieving post-stroke dysphagia: A meta-analysis of randomized and controlled trials / 中华物理医学与康复杂志

Objective To evaluate the effectiveness of swallowing training supplemented with neuromuscular electrical stimulation to provide a reference for clinical treatment and further study.Methods Reports of randomized and controlled trials of surface neuromuscular electrical stimulation in treating post-stroke dysphagia were sought in the Cochrane library,the PubMed and Embase databases,the Cumulative Index to Nursing and Allied Health Literature (CINAHL),and also in the ProQuest,PsycARTICLES,CBMdisc,China National Knowledge Infrastructure (CNKI),CQVIP database and Wanfang databases.All of the literature found was evaluated by 2 researchers according to predefined inclusion and exclusion criteria and the data were extracted and combined.Then meta-analysis was performed using version 5.3 of the RevMan software package.Results Eleven randomized and controlled trials involving 576 patients were included in the meta-analysis.Together,the data showed that swallowing training supplemented by neuromuscular electrical stimulation is significantly more effective than swallowing training alone in improving swallowing function.It reduces the risk of aspiration and improves quality of life.It does not,however,generally shorten the pharyngeal transmit time.Conclusions Swallowing training supplemented with neuromuscular electrical stimulation is a promising approach for treatment of post-stroke dysphagia and warrants further study.

Appropriate indicated use for IVIG in neonatal infections / Uso indicado y apropiado de la inmunoglobulina G intravenosa para el tratamiento de infecciones neonatales

Infection is a leading cause of mortality and morbidity in the newborn and preterm neonates due to immuno-incompetence in these patients. Administration of intravenous immunoglobulin (IVIG) provides immunoglobulin G (IgG) that can protect the body from infection. In theory, morbidity and mortality due to infections in newborns and preterm infants could be reduced by the administration of IVIG. Two meta-analyses were evaluated comparing IVIG to treat various infection versus conventional treatments. The results showed that IVIG is not effective as an adjunctive treatment for suspected or proven infections in neonates.

La infección es la causa principal de la mortalidad y de la morbilidad entre los recién nacidos y los neonatos prematuros debido a la incompetencia inmunológica de estos pacientes. El suministro de inmunoglobulina por vía intravenosa brinda la inmunoglobulina G que protege al cuerpo humano de las infecciones. En términos teóricos, la morbilidad y la mortalidad por infecciones en recién nacidos y en bebés prematuros, podrían reducirse si se administra inmunoglobulina G intravenosa. Se evaluaron dos meta-análisis que comparaban el uso de la inmunoglobulina G intravenosa para tratar diversas infecciones con los tratamientos convencionales. Los resultados demostraron que dicha inmunoglobulina no es eficaz como tratamiento adyuvante para combatir sospechas de infección o infecciones comprobadas en los recién nacidos.

Anodal transcranial direct current stimulation can relieve aphasia among stroke survivors: A meta-analysis of randomized and controlled trials / 中华物理医学与康复杂志

Objective To systematically review the efficacy of anodal transcranial direct current stimulation (A-tDCS) for relieving aphasia among stroke survivors.Methods The Chinese BioMedical Literature database,China National Knowledge Infrastructure,WanFang database,Chinese Scientific Journals full-text database,PubMed,Embase,MEDLINE and the Cochrane Library for clinical randomized and controlled trials were searched for reports about the use of A-tDCS in the treatment of aphasia after stroke.The resulting reports were retrieved manually and evaluated by two independent reviewers according to pre-set inclusion and exclusion criteria.The reports covered the period to November 2016.A meta-analysis was then conducted using RevMan software version 5.3.Results Seven studies covering 101 patients were selected for analysis.Meta-analysis showed that the average aphasia function score improved after A-tDCS significantly more than in the control group.Picture naming ability in stroke survivors with aphasia showed particular improvement.Only 11 patients in the 7 studies presented light adverse effects from AtDCS,always within the patients' tolerance range.Conclusion A-tDCS can significantly improve the speech of patients with aphasia after cerebral infarction.It is safe and easy to administer and is a rehabilitation technology worth popularizing and applying.Considering the limited number of articles,the conclusion remains to be further verified with randomized clinical trials of higher quality and a larger sample.