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1.
BMC Psychiatry ; 24(1): 660, 2024 Oct 08.
Article in English | MEDLINE | ID: mdl-39379853

ABSTRACT

AIMS: The treatment of diabetes distress plays an important role in diabetes care; however, no meta-analysis has been performed to synthesize the short- and long-term effects of psychological interventions tailored for diabetes distress in people with type 2 diabetes. We aim to evaluate the evidence on tailored psychological interventions for diabetes distress as the primary outcome, focusing on individuals with type 2 diabetes. METHODS: Two reviewers independently searched eight databases from their inception to September 2024. EndNote X9 was used to screen records. The Revised Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. The GRADE system was used to assess the overall certainty of the evidence. A random effect model was used to determine the mean difference or standardized mean difference with 95% CIs. Subgroup analyses based on several intervention characteristics and sensitivity analyses were also conducted. RESULTS: Totally, 22,279 records were yielded, and we finally included 18 studies in our systematic review. The meta-analysis included data from 16 studies representing 1639 participants. Interventions types included mindfulness-based and cognitive behavioral therapy, among others. Duration of interventions ranged from 4 weeks to 6 months. We found that psychological interventions that measured diabetes distress significantly reduced diabetes distress in the short-term in people with type 2 diabetes (SMD= -0.56; 95% CI= -0.90, -0.22; p = 0.001). Subgroup analysis indicated that this effect could be enhanced when delivered in a group format, by psychologist, using a technology component, or including participants having elevated baseline diabetes distress. However, the short- and long-term effects on HbA1c were non-significant, with results showing (MD = 0.02; 95% CI = -0.23 to 0.26; p = 0.89) and (MD = -0.27; 95% CI = -0.64 to 0.10; p = 0.15), respectively. The long-term effect on diabetes distress was also non-significant (SMD = -0.45; 95% CI = -0.93 to 0.03; p = 0.07). CONCLUSIONS: Psychological interventions tailored for diabetes distress in people with type 2 diabetes are effective in reducing the level of diabetes distress immediately after the intervention. More trials are still needed to further enrich the evidence in this area.


Subject(s)
Diabetes Mellitus, Type 2 , Psychological Distress , Psychosocial Intervention , Humans , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapy , Psychosocial Intervention/methods , Stress, Psychological/therapy , Stress, Psychological/psychology , Cognitive Behavioral Therapy/methods , Blood Glucose , Mindfulness/methods , Adult
2.
Cureus ; 16(9): e68911, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39381469

ABSTRACT

Selection bias in clinical trials is a form of systematic error and may be detected using the I² test with a 0/>0% threshold (bias: I² > 0%, no bias: I² = 0%). The test operates on the premise that effective randomisation eliminates in-between study heterogeneity beyond the play of chance in a baseline variable meta-analysis of all the trial's baseline variables. Since the I² statistic was originally designed to measure in-between study heterogeneity in meta-analyses, the test requires the generation of at least two simulated comparator trials (SCTs). During this process, three parameters are set: SCT sample size (NSCT), the minimum-maximum range of random values (RSCT), and the number of generated SCTs to be used (SCTN). Each of these parameters influences the 0/>0% threshold of the resulting I² point estimate, thereby affecting the test's sensitivity in indicating a positive result. The purpose of this technical report is to highlight the effect that SCT parameters have on the test's accuracy and to recommend appropriate parameter settings.

3.
Cureus ; 16(9): e68602, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39371740

ABSTRACT

Acute coronary syndrome (ACS) remains a leading cause of morbidity and mortality worldwide. Statins, particularly atorvastatin, and rosuvastatin, are crucial in managing cholesterol levels and reducing cardiovascular risk in ACS patients. However, direct comparative studies between these two statins are limited. This meta-analysis aimed to compare the efficacy of atorvastatin and rosuvastatin in reducing major adverse cardiovascular events (MACE) and all-cause mortality in patients with ACS. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, and Scopus for studies published up to July 2024. Randomized controlled trials and observational studies directly comparing atorvastatin and rosuvastatin in ACS patients were included. The primary outcomes were the incidence of MACE and all-cause mortality. Six studies involving 4195 patients were included in the meta-analysis. Pooled analysis showed no statistically significant difference between atorvastatin and rosuvastatin in reducing MACE [risk ratio (RR): 0.91, 95% confidence interval (CI): 0.68 to 1.22, p-value: 0.54] or all-cause mortality (RR: 0.94, 95% CI: 0.52 to 1.70, p-value: 0.83). No significant heterogeneity was observed among the studies (I-square: 0% for both outcomes). This meta-analysis suggests that atorvastatin and rosuvastatin have comparable efficacy in reducing MACE and all-cause mortality in ACS patients. These findings provide clinicians with flexibility in choosing between these statins based on individual patient factors. However, further large-scale randomized controlled trials are needed to confirm these results and explore potential differences in specific patient subgroups.

4.
Clin Exp Nephrol ; 2024 Oct 04.
Article in English | MEDLINE | ID: mdl-39365526

ABSTRACT

BACKGROUND: Muscle wasting, a prevalent issue in hemodialysis patients, is effectively assessed by measuring quadriceps muscle thickness, a crucial health indicator. This meta-analysis integrates findings from various studies on the application of ultrasonography (US) for measuring the thickness of quadriceps muscles in patients undergoing maintenance hemodialysis. DESIGN AND METHODS: We conducted a thorough literature search across PubMed, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science up to April 2023. The R software's Meta package was used for mean difference analysis of quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) between hemodialysis patients and healthy controls. All of the patients entered the meta-analysis are Caucasians. Sub-group analyses based on measurement sites and pre- and post-dialysis comparisons were performed. RESULTS: Among 15 studies with 1584 patients, a significant decrease in QRFT and QVIT was observed in hemodialysis patients compared to healthy controls (mean difference = 0.40 cm, 95% CI: -0.49 to -0.31 and 0.46 cm, respectively). Right and left QRFT were notably thinner in hemodialysis patients (RT: mean difference = 0.39 cm; LT: mean difference = 0.42 cm). Similarly, right and left QVIT were notably thinner in hemodialysis patients (RT: mean difference = 0.45 cm; LT: mean difference = 0.47 cm). No significant pre- and post-dialysis QRFT differences were found. CONCLUSION: Ultrasonography is a reliable, accessible tool for assessing quadriceps muscle thickness in hemodialysis patients, revealing consistent muscle thickness reduction. These findings emphasize the need for routine muscle health monitoring in this population and support ultrasound use for regular assessments.

5.
J Affect Disord ; 2024 Oct 08.
Article in English | MEDLINE | ID: mdl-39389122

ABSTRACT

BACKGROUND: This meta-epidemiological study seeks to further investigate the reciprocal relationship between allergic rhinitis (AR) and attention-deficit/hyperactivity disorder (ADHD). METHODS: A comprehensive search of the databases was conducted up to March 3, 2024. We performed a synthesis and meta-analysis of odds ratios and their corresponding 95 % confidence intervals using Stata 14.0. Funnel plot analysis and Egger's regression test were utilized to assess potential publication bias. RESULTS: Eighteen articles involving 4,289,444 participants were included. AR patients had an increased risk of developing ADHD (OR: 1.83; 95 % CI: 1.37-2.43), while ADHD patients were also more likely to have AR (OR: 1.38; 95 % CI: 1.11-1.72). Subgroup analysis indicated a predisposition of AR patients to autism spectrum disorder (OR: 1.34; 95 % CI: 0.86-1.0) and a higher risk of ADHD in cohort studies (OR: 1.90; 95 % CI: 1.26-2.88). Female AR patients were more likely to develop ADHD than males (OR: 1.86; 95 % CI: 1.43-2.43), and children aged ≤8 years with AR were at greater risk for ADHD compared to older children (OR: 1.75; 95 % CI: 1.14-2.69). CONCLUSIONS: This meta-analysis confirms a bidirectional association between AR and ADHD, indicating that they are mutually independent risk factors.

6.
Clin Neurol Neurosurg ; 246: 108560, 2024 Sep 19.
Article in English | MEDLINE | ID: mdl-39326281

ABSTRACT

BACKGROUND: Heparin may be administered during mechanical thrombectomy (MT) for acute ischemic stroke due to large vessel occlusions (AIS-LVO), with the aim of enhancing reperfusion and improving patient outcomes. The uncertain balance between risks and benefits of administering heparin during MT prompted us to perform this systematic review and meta-analysis. METHODS: A comprehensive search was conducted in PubMed, Embase, and Scopus to find studies that report the safety or efficacy of administering heparin during MT for AIS-LVO. Meta-analysis was performed using the random effects model. In case of significant heterogeneity a subgroup analysis was performed. RESULTS: From 2398 screened records, we included 15 studies. Rate of favorable functional outcome (90 day modified Rankin Scale 0-2 (mRS 0-2)) was lower among patients who received heparin (OR, 0.88 [95 %CI 0.79-0.98]; p=.023). Risk of distal embolization was higher in patients who received heparin (OR, 1.25 [95 %CI 1.01-1.55]; p=.04). The subgroup analysis showed that patients who received intravenous thrombolysis (IVT) had higher risk of Symptomatic intracranial hemorrhage (sICH) (OR, 2.94 [95 %CI 1.30-6.63]; p=.009) and lower rate of mRS 0-2 (OR, 0.66 [95 %CI 0.50-0.87]; p=.004). Heparin use didn't affect successful reperfusion rate (Thrombolysis in cerebral infarction ≥2B), mortality or any ICH risk. CONCLUSION: Overall, our analysis indicates that administering heparin during MT for AIS-LVO correlates with worse clinical outcomes and increased distal embolization rates. Moreover, it is linked to a higher risk of sICH in patients who receive IVT. Consequently, the routine utilization of heparin during MT should be reconsidered.

7.
World J Emerg Surg ; 19(1): 30, 2024 Sep 10.
Article in English | MEDLINE | ID: mdl-39256790

ABSTRACT

BACKGROUND: Recent studies suggest that low-molecular-weight heparin (LMWH) may play a role in mitigating the severity of acute pancreatitis (AP). This systematic review and meta-analysis aims to synthesise existing evidence on the effectiveness and safety of LMWH in the treatment of moderately-severe and severe AP. METHODS: This systematic review and meta-analysis was conducted in accordance with the 2020 update of the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The systematic search was conducted in MEDLINE, the Cochrane Central Register of Controlled Trials, Scopus, and EMBASE, covering studies published up to February 2024. Randomised controlled trials (RCTs) and observational studies (n-RCTs) that reported the differences in the outcomes of AP for patients receiving LMWH in addition to the standard treatment (Intervention), compared to patients managed by standard treatment without LMWH (Control) were eligible. A random-effects model was used to calculate the pooled relative risk (RR) and mean differences (MD) with the corresponding 95% CI. RESULTS: Thirteen studies were included in the meta-analysis, all published between 2004 and 2022. Eight studies were RCTs, and five were n-RCTs. Data from 13,709 patients (6.971 Interventions and 6.738 Controls) were analysed. The comparison of Intervention and Control groups showed the superiority of LMWH to standard treatments in terms of overall mortality (RR = 0.44, 95% CI = 0.31; 0.64, P < 0.0001, I2 = 51%), acute necrotic collections (RR = 0.24, 95% CI = 0.09; 0.62, P = 0.003, I2 = 0%), and organ failure (RR = 0.67, 95% CI = 0.48; 0.93, P = 0.02, I2 = 78%). The Intervention group showed superior outcomes compared with the Control group for gastrointestinal bleeding (RR = 0.64, 95% CI = 0.44; 0.94, P = 0.02, I2 = 0%), length of hospital stay (MD= - 6.08, 95% CI = - 10.08; - 2.07, P = 0.003, I2 = 98%), need for operative interventions (RR = 0.50, 95% CI = 0.29; 0.87, P = 0.01, I2 = 61%), and vascular thrombosis (RR = 0.43, 95% CI = 0.31; 0.61, P < 0.00001, I2 = 0%). CONCLUSIONS: Moderate to high-quality evidence suggests that early intervention with LMWH could improve the prognosis of non-mild AP in terms of mortality, organ failure, and decreased incidence of vascular thrombosis. In light of our findings, integrating LMWH into the treatment regimen for moderate-severe to severe AP is advocated.


Subject(s)
Heparin, Low-Molecular-Weight , Pancreatitis , Humans , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Heparin, Low-Molecular-Weight/administration & dosage , Heparin, Low-Molecular-Weight/adverse effects , Pancreatitis/drug therapy
8.
Cureus ; 16(8): e68116, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39347368

ABSTRACT

The purpose of this study was to examine the effect of follow-up time on revision rates of in situ decompression and ulnar nerve transposition for the surgical treatment of cubital tunnel syndrome. A comprehensive literature search was performed to identify prospective and retrospective primary comparison studies assessing the revision rates of in situ decompression and ulnar nerve transposition for the treatment of cubital tunnel syndrome. Meta-regression analyses were used to assess the effect of average study follow-up on the revision rates of both cubital tunnel syndrome treatments. Modeling results were then used to estimate revision rates between decompression and transposition at increasing follow-up times. Sixteen studies including 2,225 patients were included. Average study follow-up time was a statistically significant moderator of revision rates. Model predictions show that in situ decompression operations had an increased risk for revision as compared to ulnar transposition after 48 months of follow-up. In studies with follow-up time ≥48 months, revision rates for in situ decompression (11.9%) were significantly greater than in ulnar transposition (3.2%). In situ decompression for cubital tunnel syndrome is associated with an increased risk of revision surgery as compared to ulnar nerve transposition, particularly when assessed at longer follow-up intervals. The effect of follow-up duration on revision rates demonstrates the need for additional studies to compare outcomes of these operative approaches at follow-up times ≥48 months. This study provides evidence that ulnar nerve transposition may ultimately lead to lower revision rates and demonstrates the need for prospective, randomized trials to corroborate this effect.

9.
Cureus ; 16(8): e67917, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39328702

ABSTRACT

Endotracheal intubation carries risks, including arytenoid dislocation (AD), a rare but severe complication. Due to small sample sizes, the incidence of AD varies considerably among studies. Proposed risk factors for AD include difficult intubation, prolonged intubation, certain surgeries, patient positioning, female sex, and BMI. This review aims to investigate the incidence of AD and explore the various predisposing risk factors. We retrieved relevant studies up to April 2024 from PubMed, Scopus, Web of Science, and the Cochrane Library. Using OpenMeta v5.26.14 software (Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, Boston, USA), we pooled AD incidence rates from individual studies. Other outcomes, reported in fewer studies and thus not suitable for meta-analysis, were synthesized manually. Study selection yielded 16 eligible articles. A random-effects model analysis of nine studies found a significant AD incidence rate of 0.093% (confidence interval (CI): 0.045% to 0.14%), but the results were highly heterogeneous (I2 = 91%). Older age was associated with prolonged hoarseness, while younger age and female sex increased the risk of AD. Additionally, AD risk factors included taller stature, higher BMI, specific surgeries, esophageal instrumentation, prolonged procedure durations, head-neck movement, and inexperienced intubators. However, intubation with a stylet reduced the AD risk. AD post-endotracheal intubation is rare (incidence: 0.09%), with potential underdiagnosis in larger datasets. Many risk factors may contribute to the condition, but the small number of studies per risk factor limits the ability to draw robust conclusions. Subjective diagnoses and retrospective studies further restrict comprehensive understanding. Further research is needed to explore AD risk factors effectively.

10.
BMC Infect Dis ; 24(1): 1030, 2024 Sep 27.
Article in English | MEDLINE | ID: mdl-39333960

ABSTRACT

OBJECTIVE: In order to synthesize available results regarding human immunodeficiency virus (HIV) infection and inflammatory bowel disease (IBD), we conducted a systematic review and meta-analysis to provide quantitative estimates of associated risk. METHODS: A systematic search of four scientific databases, PubMed, the Cochrane Library, EMBASE, and Scopus, was performed. The overall odds ratio (OR) with the corresponding 95% CI was calculated via a random effects model. Sensitivity analyses and tests for publication bias were then performed. RESULTS: Of the 3046 articles retrieved, seven studies with a cumulative sample size greater than 57,000,000 were included in our analysis. A subsequent meta-analysis based on a random effects model (heterogeneity test, I2 = 99.9) revealed an association between HIV infection and IBD: OR = 2.68 (95% CI: 1.17, 6.13). The funnel plot of this meta-analysis was asymmetric (Egger's test: P = 0.01), and significant publication bias was found. Sensitivity analysis of the 3 dimensions revealed that the results of this meta-analysis were relatively stable. CONCLUSIONS: A significant correlation may exist between HIV infection and intestinal disease, and more large-scale studies are needed to draw firm conclusions. It is recommended that HIV patients be screened for intestinal diseases.


Subject(s)
HIV Infections , Inflammatory Bowel Diseases , Humans , HIV Infections/complications , Inflammatory Bowel Diseases/complications , Risk Factors , Odds Ratio
11.
BMC Geriatr ; 24(1): 789, 2024 Sep 28.
Article in English | MEDLINE | ID: mdl-39342118

ABSTRACT

BACKGROUND: China has the largest number of dementia patients worldwide. The prolonged course of dementia has a serious negative impact on the economy and quality of life of patients and their families. OBJECTIVE: The purpose of this study was to conduct a systematic review and meta-analysis of the existing literature about economic burden and quality of life of people with dementia in China. METHODS: Six databases were systematically searched for observational studies of the economic burden or quality of life of dementia that were published before June 30, 2024. This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS: A total of 36,411 papers were identified, and 21 studies met the inclusion criteria. The annual economic burden of dementia was 20,893 RMB (3,104 USD). The total costs associated with mild, moderate, and severe dementia were 16,619 RMB (2,469 USD), 22,283 RMB (3,311 USD), and 34,611 RMB (5,143 USD), respectively, indicating that the cost increased significantly with increasing dementia severity. In terms of the quality of life, the combined total score for the Quality of Life-Alzheimer's Disease scale was 30.11, with lower scores for the Housekeeping, Recreation, and Memory items. CONCLUSIONS: Dementia imposes a significant economic and quality of life burden on Chinese patients. The government should pay more attention to dementia and develop a comprehensive prevention and treatment system to reduce the heavy burden of dementia. TRIAL REGISTRATION: This systematic review has the registration number CRD42022374470 on PROSPERO.


Subject(s)
Cost of Illness , Dementia , Quality of Life , Humans , Quality of Life/psychology , Dementia/economics , Dementia/psychology , Dementia/epidemiology , China/epidemiology
12.
Sci Rep ; 14(1): 21932, 2024 09 20.
Article in English | MEDLINE | ID: mdl-39304728

ABSTRACT

The association between vitamin D concentrations and the occurrence of diabetic foot ulcers (DFUs) remains a topic of ongoing debate. In order to provide a comprehensive and updated review, we conducted this meta-analysis to further investigate the relationship between vitamin D concentrations and DFUs occurrence. The following databases, including Cochrane Library, EMBASE, Web of Science, PubMed, CBM, CNKI, WANFANG DATA and VIP Database, were systematically searched for studies published up to Dec. 20th, 2023. The combined estimation was calculated using both fixed-effects and random-effects models. The overall effect size was reported as a weighted mean difference (WMD) with a corresponding 95% confidence interval (95%CI). Data analysis was performed utilizing Review Manager 5.4 and Stata 14. The Protocol has been registered in PROSPERO CRD42024503468. This updated meta-analysis, incorporating thirty-six studies encompassing 11,298 individuals with or without DFUs, demonstrated a significant association between vitamin D deficiency/insufficiency and an elevated risk of DFUs occurrence (< 25 nmol/L, OR 3.28, P < 0.00001; < 50 nmol/L, OR 2.25, P < 0.00001; < 75 nmol/L, OR 1.67, P = 0.0003). Vitamin D concentrations were significantly lower in individuals with DFUs compared to those without DFUs (P < 0.00001). Subgroup analyses consistently demonstrated this trend among the older population (> 50 years, P < 0.00001), individuals with long duration of diabetes (> 10 years, P < 0.00001), and those with poor glycemic control (mean HbA1c 8%-9% and > 9%, P < 0.00001).


Subject(s)
Diabetic Foot , Vitamin D Deficiency , Vitamin D , Diabetic Foot/blood , Diabetic Foot/epidemiology , Humans , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/complications , Risk Factors
13.
Article in English | MEDLINE | ID: mdl-39312001

ABSTRACT

PURPOSE: Septic cavernous sinus thrombosis (SCST) is a rare but life-threatening condition with high mortality and morbidity. The role of anticoagulation in the treatment of SCST remains unclear because there is limited evidence to support this treatment. This study aims to explore (1) the association between anticoagulation administration and mortality of cavernous sinus thrombosis from sinusitis, and (2) the types and duration of anticoagulation used. METHODS: This review was undertaken and reported in accordance with PRISMA guidelines. We included the studies that reported individual data of adult patients (≥ 18 years) diagnosed with cavernous sinus thrombosis from sinusitis confirmed by objective methods with documented therapy and outcome. A systematic search carried out in Embase, Medline, Scopus, and CENTRAL by two reviewers up to Dec 2023. The quality was evaluated using tool proposed by Murad et al. The logistic regression analysis was employed to adjust the confounding factors. RESULTS: A total of 72 articles with 110 patients, were eligible for inclusion in our meta-analysis. There was a significant difference less mortality in the group that received anticoagulants (3.3 vs. 18%, p = 0.022). The adjusted odds ratio for mortality in the anticoagulant-given group is 0.067 (0.009, 0.475). Heparin is the most frequently used initial agent and one-third of patients receiving anticoagulants for three months. CONCLUSION: In an adult patient diagnosed with cavernous sinus thrombosis, there was a strong suggestion that anticoagulation could improve mortality. We recommend that patients with hyperglycemia should be carefully considered before receiving an anticoagulant.

14.
Gastroenterol Res Pract ; 2024: 9097892, 2024.
Article in English | MEDLINE | ID: mdl-39220730

ABSTRACT

Purpose of the study: We aim to examine the association between liver function-related indicators and gallstone disease (GSD) risk. Study design: The subjects who participated in the China Multicenter Physical Examination Cohort (CMPEC) were enrolled. Relative odds ratios (ORs) with 95% CIs and standardized mean differences (SMDs) were applied to investigate the effect of liver function-related indicators and GSD risk. Moreover, a systematic review and meta-analysis were conducted until July 2021. Additionally, the results in the CMPEC and the systematic review and meta-analysis were combined by meta-analysis. Finally, the results were validated by a cohort study of the UK Biobank (UKB). Results and conclusions: Totally, 369,931 subjects in CMPEC were included in the study. A total of 28 publications were incorporated into the systematic review and meta-analysis. The pooled analysis suggested that aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total protein (TP), and low albumin (ALB) were positively associated with the risk of GSD. Meanwhile, GSD present to have higher AST, ALT, gamma-glutamyl transferase (GGT), total bilirubin (TBil), globulin (G), and ALP levels and relatively lower TP and ALB levels than the healthy participants. These results were consistent when stratified by the study design, geographic background, and study quality. Only the association between ALP and GSD risk was validated in the UKB cohort. This study suggests liver function indicators were associated with GSD risk. The results may provide the basis for exploring the etiology of GSD and may help clinicians identify high-risk subjects. Trial Registration: PROSPERO (CRD42020179076).

16.
Neurosurg Rev ; 47(1): 618, 2024 Sep 16.
Article in English | MEDLINE | ID: mdl-39278993

ABSTRACT

Electrical stimulation is an important adjuvant therapy for spinal surgery, but whether receiving electrical stimulation can improve the fusion rate after spinal surgery is still controversial. The purpose of this study was to analyse and evaluate the effect of electrical stimulation on the fusion rate after spinal surgery. We systematically searched for related articles published in the PubMed, Embase and Cochrane Library databases on or before September 30, 2023. The odds ratio (OR) with 95% confidence interval (CI) and the fusion rates of the experimental group and the control group were calculated by a random-effects meta-analysis model. The analysis showed that receiving electrical stimulation significantly increased the probability of successful spinal fusion (OR 2.66 [95% CI 1.79-3.97]), and the average fusion rate of the electrical stimulation group (86.8%) was significantly greater than that of the control group (73.7%). The fusion rate in the direct current (DC) stimulation group was 2.33 times greater than that in the control group (OR 2.33 [95% CI 1.37-3.96]), and that in the pulsed electromagnetic field (PEMF) group was 2.60 times greater than that in the control group (OR 2.60 [95% CI 1.29-5.27]). Similarly, the fusion rate in the capacitive coupling (CC) electrical stimulation group was 3.44 times greater than that in the control group (OR 3.44 [95% CI 1.75-6.75]), indicating that regardless of the type of electrical stimulation, the fusion rate after spinal surgery improved to a certain extent. Electrical stimulation as an adjuvant therapy seems to improve the fusion rate after spinal surgery to a certain extent, but the specific effectiveness of this therapy needs to be further studied.


Subject(s)
Spinal Fusion , Humans , Spinal Fusion/methods , Electric Stimulation Therapy/methods , Electric Stimulation/methods , Treatment Outcome , Spinal Diseases/surgery
17.
Heliyon ; 10(17): e36776, 2024 Sep 15.
Article in English | MEDLINE | ID: mdl-39296143

ABSTRACT

Introduction: Child maltreatment is any type of abuse or child negligence which results the concrete or prospective hurt for those under age of eighteen. It is a global issue which severely endangered children's physical, emotional, behavioral, developmental and mental well-being for immediate and later in life. Although, its magnitude and devastating burden are difficult to comprehend, much remains to be done to know its prevalence and comprehensive impact. This meta-analysis and comprehensive review will provide important light on the burden, consequences, and contributing factors for child maltreatment. Methods: This meta-analysis and comprehensive review was coded at Prospero number of CRD42024503799. Universal online databanks including PubMed, Cochrane, Google, Google Scholar, SCOPUS, and Web of Science and Global Health were used to search for articles. Microsoft Excel was used for data extraction, and STATA17 was used to analyze this systematic review and meta-analysis. A random effect model exploration was employed when heterogeneity among included studies were evidenced. Results: The pooled prevalence of childhood maltreatment was 57.0 % (95 % CI = 32.00, 83.00). Included studies revealed that childhood maltreatment has multiple child health-related consequences. Being female (AOR = 2.94, 95 % CI: 1.48, 4.41), being young (AOR = 1.22, 95%CI: 1.09, 3.35), paternal illiteracy (AOR = 2.16, 95%CI: 1.012, 3.302) and have an open family discussion about sexual matters (AOR = 0.381 (95%CI: 0.121, 0.884) were considerably associated with child maltreatment. Conclusion: This finding publicized that the burden and multiple consequences of childhood maltreatment need much attention. Childhood maltreatment has both immediate and life time consequences for children later in life. Being female, being young, having illiterate fathers, and open family discussion about sexual matters were associated factors of child maltreatment.

18.
Anat Sci Educ ; 2024 Sep 19.
Article in English | MEDLINE | ID: mdl-39300601

ABSTRACT

Anatomy is the cornerstone of medical education. Virtual reality (VR) and augmented reality (AR) technologies are becoming increasingly popular in the development of anatomy education. Various studies have evaluated VR and AR in anatomy education. This meta-analysis aims to evaluate the effectiveness of VR and AR in anatomical education. The protocol was registered in Prospero. Scopus, PubMed, Web of Science, and Cochrane Library databases were searched. From the 4487 articles gathered, 24 randomized controlled trials were finally selected according to inclusion criteria. According to the results of the meta-analysis, VR had a moderate and significant effect on the improvement of knowledge scores in comparison with other methods (standardized mean difference = 0.58; 95% CI = 0.22, 0.95; p < 0.01). Due to the high degree of heterogeneity (I2 = 87.44%), subgroup analyses and meta-regression were performed on eight variables. In enhancing the "attitude," VR was found to be more "useful" than other methods (p = 0.01); however, no significant difference was found for "enjoyable" and "easy to use" statements. Compared with other methods, the effect of AR on knowledge scores was non-significant (SMD = -0.02; 95% CI = -0.39, 0.34; p = 0.90); also, in subgroup analyses and meta-regression, the results were non-significant. The results indicate that, unlike AR, VR could be used as an effective tool for teaching anatomy in medical education. Given the observed heterogeneity across the included studies, further research is warranted to identify those variables that may impact the efficacy of VR and AR in anatomy education.

19.
Health Promot Perspect ; 14(2): 109-120, 2024.
Article in English | MEDLINE | ID: mdl-39291040

ABSTRACT

Background: Quality of life (QoL) of women with gestational diabetes mellitus (GDM) is one of the fundamental issues and public health challenges. This study examines the QoL among pregnant women with GDM through a systematic review and meta-analysis. Methods: A search was conducted in Scopus, PubMed, and the Web of Science databases for articles published until Jan 30, 2024. Manual searches of gray literature, Google Scholar, reference checks, and citation checks were conducted. The JBI's Critical Appraisal Checklist for Analytical Cross-Sectional Studies was utilized to assess the quality of the articles' reporting. The random model implemented in Stata software (version 16; Stata Corp.) was utilized to conduct the meta-analysis. Results: Among the 516 studies obtained from the literature, only 15 were deemed suitable for inclusion. Most studies (73.3%) were conducted in nations with high-income levels. Additionally, general QoL was assessed in most studies (11 studies). The SF-36 and WHOQOLBREF questionnaires were the most often utilized. Based on the SF-36 measure, there was no statistically significant difference in the QoL of patients with GDM compared to the control group in most of dimensions. The WHOQOL-BREF instrument was utilized to estimate the QoL score at 49.69. The EQ-5D-5L tool revealed a difference in QoL scores between the GDM and control groups (MD=-7.40). The research findings were highly heterogeneous. The median evaluation score for the reporting quality of the articles was calculated to be 5, with a mean of 4.8 out of 7. Conclusion: The results of the present study showed that GDM reduces the QoL of pregnant women, especially in terms of mental and social health. Therefore, interventions and support programs should be designed and implemented to improve these women's QoL.

20.
Cureus ; 16(8): e66938, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39280403

ABSTRACT

Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease, but it carries a risk of periprocedural myocardial injury (PMI). This meta-analysis evaluated the efficacy of nicorandil, a hybrid compound with nitrate-like and potassium channel-opening properties, in preventing PMI during PCI. A comprehensive literature search identified 14 studies involving 1,762 patients, with 882 receiving nicorandil and 880 in the control group. The analysis revealed that nicorandil significantly reduced the incidence of PMI (RR: 0.73, 95% CI: 0.61-0.86) and major adverse cardiovascular events (MACE) (RR: 0.76, 95% CI: 0.58-0.99) compared to the control group. Nicorandil's cardioprotective effects are attributed to its ability to improve coronary blood flow, precondition the myocardium, and reduce oxidative stress and inflammation. These findings suggest that nicorandil could be a valuable adjunctive therapy during PCI, potentially improving patient outcomes. However, the study had limitations, including variations in drug administration methods and a lack of individual-level data for subgroup analysis. Future research should focus on optimizing dosing regimens and administration timing and comparing nicorandil's effectiveness with other cardioprotective agents.

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