RESUMO
BACKGROUND: Debate concerning chiropractic management of female infertility occurs largely in the absence of reference to the extant literature. METHODS: A scoping review was conducted of primary (original) data publications on the chiropractic management of female infertility based on searches of the Index to Chiropractic Literature and Pubmed, supplemented by papers from one author's archive. RESULTS: Ten articles, all case studies, met the review's inclusion criteria and documented the experiences of 11 women (mean age 31 years; mean period of infertility 3 years). Pregnancy occurred, on average, after 5 months of treatment with spinal manipulation and adjunctive modalities. No adverse events were reported. DISCUSSION: There are very few original data articles documenting responses of infertile females treated with spinal manipulation. CONCLUSIONS: In the absence of a robust body of primary data literature, the use of spinal manipulation the management of female infertility should be approached with caution.
CONTEXTE: Les controverses au sujet de la prise en charge chiropratique de l'infertilité féminine sont en grande partie liées à l'absence de référence à la littérature existante. MÉTHODOLOGIE: On a effectué une revue exploratoire de publications de données primaires (d'origine) sur la prise en charge chiropratique de l'infertilité féminine en consultant l'Index to Chiropractic Literature, Pubmed et divers documents provenant des archives d'un auteur. RÉSULTATS: Dix articles, qui étaient tous les études de cas, satisfaisaient les critères d'inclusion de la revue. Ils visaient à documenter l'expérience vécue par 11 femmes (âge moyen: 31 ans; durée moyenne de l'infertilité: 3 ans). En moyenne, ces femmes sont devenues enceintes au bout de 5 mois de traitement par manipulations vertébrales et des modalités d'appoint. Aucun effet défavorable n'a été signalé. DISCUSSION: Il existe très peu d'articles documentant les réponses de femmes infertiles traitées par manipulations vertébrales. CONCLUSIONS: En l'absence de corpus robuste de littérature sur des données primaires, il conviendrait de faire preuve de prudence en ayant recours aux manipulations vertébrales dans la prise en charge de l'infertilité féminine.
RESUMO
BACKGROUND: Blood miRNAs are a new promising area of disease research, but variability in miRNA measurements may limit detection of true-positive findings. Here, we measured sources of miRNA variability and determine whether repeated measures can improve power to detect fold-change differences between comparison groups. METHODS: Blood from healthy volunteers (N = 12) was collected at three time points. The miRNAs were extracted by a method predetermined to give the highest miRNA yield. Nine different miRNAs were quantified using different qPCR assays and analyzed using mixed models to identify sources of variability. A larger number of miRNAs from a publicly available blood miRNA microarray dataset with repeated measures were used for a bootstrapping procedure to investigate effects of repeated measures on power to detect fold changes in miRNA expression for a theoretical case-control study. RESULTS: Technical variability in qPCR replicates was identified as a significant source of variability (P < 0.05) for all nine miRNAs tested. Variability was larger in the TaqMan qPCR assays (SD = 0.15-0.61) versus the qScript qPCR assays (SD = 0.08-0.14). Inter- and intraindividual and extraction variability also contributed significantly for two miRNAs. The bootstrapping procedure demonstrated that repeated measures (20%-50% of N) increased detection of a 2-fold change for approximately 10% to 45% more miRNAs. CONCLUSION: Statistical power to detect small fold changes in blood miRNAs can be improved by accounting for sources of variability using repeated measures and choosing appropriate methods to minimize variability in miRNA quantification. IMPACT: This study demonstrates the importance of including repeated measures in experimental designs for blood miRNA research. See all the articles in this CEBP Focus section, "Biomarkers, Biospecimens, and New Technologies in Molecular Epidemiology."
