Effects of Pilates exercises on cardiorespiratory fitness: A systematic review and meta-analysis

Background and purposeRandomized controlled trials (RCTs) suggest that Pilates improves cardiorespiratory fitness (CRF). However, there is a lack of systematic review studies on this topic. Our aim was to verify the effects of Pilates exercises on CRF in healthy adults.MethodsA systematic literature search was performed in: PubMed, Embase, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS, and PEDro (search on January 12, 2023). Methodological quality was assessed using the PEDro scale. A meta-analysis was performed using the standardized mean difference (SMD). The quality of evidence was rated by the GRADE system.ResultsIn total, 12 RCTs were eligible (569 participants). Only three studies presented high methodological quality. Very low to low quality evidence showed that: a) Pilates was superior to control groups (SMD = 0.96 [CI_95% 0.39 to 1.54] n = 457, studies = 12), even when only high methodological quality studies were included (SMD = 1.14 [CI_95% 0.25 to 2.04] n = 129, studies = 3); b) to be effective, Pilates needed to be performed for ≥1440 min; c) the effects were significant regardless of the form of Pilates application (mat or equipment); d) Pilates was not different from other exercises regarding the effects on CRF.ConclusionPilates had a large effect on CRF, provided that it was administered for at least 1440 min (equivalent to 2x-week for three months or 3x-week for two months). However, due to the low quality of the evidence, these results should be interpreted with caution.     

The effect of slow-stroke back massage on chemotherapy-related fatigue in women with breast cancer: An assessor blinded,parallel group,randomized control trial

ObjectiveThis randomized controlled parallel-group trial was conducted to investigate the effect of slow-stroke back massage (SSBM) on the level of fatigue in women with breast cancer undergoing chemotherapy.MethodsSixty-four women with breast cancer receiving chemotherapy were randomly assigned to SSBMG (n:32), who received SSBM, and CG (n:32), who received routine treatment only. Women with breast cancer in the intervention group received SSBM for a total of 20 min, 10 min before and after each chemotherapy infusion (2nd, 3rd, and 4th cycle). The Brief Fatigue Inventory (BFI) was completed before and after three cycles of chemotherapy (2nd, 3rd, and 4th) to assess the level of fatigue in women with breast cancer.ResultsAfter using SSBM, the BFI score was significantly lower in SSBMG than in CG (p 0.001) at all three-time points (1st, 2nd, and 3rd-time points). While the within-group change (Δ) in SSBMG differed significantly between time points (p = 0.018, η2 = 0.14), in contrast, the within-group change (Δ) in CG was found not to differ between time points.ConclusionThis study has shown that SSBM, one of the non-pharmacological methods, has a positive effect on the level of fatigue in women with breast cancer.     

Effect of auricular acupressure on postpartum blues: A randomized sham controlled trial

AimTo investigate the effect of auricular acupressure on the severity of postpartum blues.MethodsA randomized sham controlled trial was conducted from February to November 2021, with 74 participants who were randomly allocated into two groups of either routine care + auricular acupressure (n = 37), or routine care + sham control (n = 37). Vacaria seeds with special non-latex adhesives were used to perform auricular acupressure on seven ear acupoints. There were two intervention sessions with an interval of five days. In the sham group, special non-latex adhesives without vacaria seeds were attached in the same acupoints as the intervention group. Severity of postpartum blues, fatigue, maternal-infant attachment, and postpartum depression were assessed.ResultsAuricular acupressure was associated with significant effect in reduction of postpartum blues on 10th and 15th days after childbirth (SMD = −2.77 and −2.15 respectively), postpartum depression on the 21st day after childbirth (SMD = −0.74), and maternal fatigue on 10th, 15th and 21st days after childbirth (SMD = −2.07, −1.30 and −1.32, respectively). Also, maternal-infant attachment was increased significantly on the 21st day after childbirth (SMD = 1.95).ConclusionAuricular acupressure was effective in reducing postpartum blues and depression, reducing maternal fatigue, and increasing maternal-infant attachment in the short-term after childbirth.Trial registrationRegistered prospectively in Iranian Registry of Clinical Trials (ID: IRCT20180218038789N2).     

A pilot randomized controlled clinical trial of dance practice for functionality in autistic children and adolescent with all levels of need support

ObjectiveThis study addressed dance practice intertwining communication, functional independence and social behavior in autistic children and adolescents with all levels of need support.DesignA pilot randomized clinical trial with seventy-two participants between 8 and 15 years old were assessed for eligibility.SettingTheater rehearsal room and mental health clinic.InterventionsDance group (n = 17) or control group (n = 19), 24 sessions, once a week, lasting 40 min.Main outcome measuresThe Autism Behavior Checklist (ABC), Autistic Screening Questionnaire (ASQ), Childhood Autism Rate Scale (CARS), Functional Independence Measure (FIM), and World Health Organization Disability Assessment Schedule (WHODAS, version 2.0, to assess mothers’ functioning) were applied at two time points: baseline and end-point.ResultsDifferences between dance and control groups were significant at post-intervention for communication (mean difference: 1.31; 99.8%CI: 0.29, 2.32, p < 0.001, d = 0.93); social cognition (mean difference: 1.01; 99.8%CI: 0.13, 1.89, p < 0.001, d = 0.82); autistic behavior (mean difference: 11.82; 99.8%CI: 17.33, −6.31, p < 0.001, d = 1.45).ConclusionsIn this preliminary study, the findings provide ways of communication and social interaction through dance practice by autistic children and adolescents with all levels of support needs. Research on neurodiversity is needed to understand its feasibility and the lifestyle appropriation.     

Effects of a structured dance program in Parkinson’s disease. A Greek pilot study

IntroductionDance for Parkinson's Disease® (DfPD®) is a structured dance program that has never been evaluated in Greek PD population. This study assesses for the first time the efficacy, safety and feasibility of DfPD® program in Greek PD patients.Material and methodsA total of 16 early-to-mid-stage PD patients (50% men, aged 56 ± 12) underwent a total of 16 60-min classes of adjusted to Greek music and dance culture DfPD®, twice weekly, over 8 weeks. Assessments were performed at baseline and at the end of the study period and included quality of life (PDQ-8), depressive symptoms (BDI-II), fatigue (PFS-16), cognitive functions (MoCA), balance (BBS) and body mass index (BMI). Safety (possible falls, injuries, muscle soreness or excessive fatigue) and feasibility (technical and financial parameters, willingness for participation and continuation, recruitment rates) were also assessed.ResultsStatistically significant improvements were found in quality of life (29 ± 47%, p = 0,020), depressive symptoms (26 ± 52%, p = 0,046), fatigue (13 ± 20%, p = 0,021), cognitive functions (17 ± 23%, p = 0,010), balance (5 ± 4%, p = 0,003) and BMI (2 ± 2%, p = 0,010). No adverse events, high adherence (93,75%) and low attrition (12,5%) rates were reported.ConclusionA twice weekly 60-min DfPD® class for 8 weeks is a safe and feasible non-pharmacological complementary therapeutic intervention for Greek PD patients and may improve their quality of life, depressive symptoms, fatigue, cognitive functions, balance, and BMI. Further research on this intervention is warranted.     

Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship

BackgroundMindfulness-based interventions (MBIs) are increasingly recognized as an effective strategy for supporting female cancer survivors experiencing sexual health concerns.AimTo examine the feasibility of a sexual health MBI, Mindful After Cancer, which was adapted to meet the needs of breast and gynecologic cancer survivors in a community setting and for delivery via videoconference.MethodsA mixed-methods approach was used to evaluate the acceptability, feasibility, and appropriateness of the 8-week virtual MBI. Weekly sessions were 1.5–2 hours in duration and included guided meditations and group discussion about sexuality after cancer and mindfulness in daily life. Home practice activities related to both mindfulness practice and sexual health. Participants completed online surveys at baseline and 1-month post-intervention. A purposive sample of 10 participants were invited to complete a follow-up interview 2–3 months post-intervention.OutcomesPrimary outcomes included both qualitative and quantitative assessments of acceptability, appropriateness, and feasibility of the Mindful After Cancer intervention for sexual health in cancer survivorship.ResultsTwenty-two women completed the intervention (Mean age 53.2 years, SD = 9.4, Range= 39–73), with time since diagnosis ranging from 1 to 27 years (Mean 6.0 years, SD = 5.9). Participants completed 6.8 sessions on average (Range = 2 – 8) and 77% reported that the time commitment was manageable. Both qualitative and quantitative findings support the feasibility, acceptability, and appropriateness of the intervention.Clinical ImplicationsMany cancer survivors experience sexual dysfunction and related distress after diagnosis and well after treatment ends, yet there are few interventions available. Improved access to effective interventions can improve the delivery of survivorship care and patient outcomes.Strengths & LimitationsThe sample size is small for this pilot study, and a control group was not included. The intervention was offered over two time periods, one prior to COVID-19 pandemic and one during the pandemic, resulting in both limitations associated with potential differences between the experiences of participants and the opportunity to learn more about the feasibility of the intervention during times of crisis.ConclusionResults suggest that virtual delivery of the MBI is feasible, acceptable, and appropriate for breast and gynecologic cancer survivors.Gorman JR, Drizin JH, Smith E, et al. Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship. J Sex Med 2022;19:1131–1146.     

Efficacy of the myofascial approach as a manual therapy technique in patients with clinical anxiety: A randomized controlled clinical trial

BackgroundTo analyze the efficacy of the myofascial approach in patients with clinical anxiety and to study its relationship with associated symptoms.MethodsRandomized placebo-controlled clinical trial. Thirty-six adult patients with clinical anxiety were randomized to receive the myofascial treatment (n = 18) or placebo (n = 18). The patients and the evaluators were blinded to this assignation. The treatment consisted of four myofascial sessions of 40 min each for four weeks. The placebo intervention consisted of four sessions of simulated myofascial intervention of the same duration and frequency as the treatment. Follow-up was at one, three and six months. The primary outcome was clinical anxiety measured using the STAI (State-Trait Anxiety Inventory). Secondary outcomes were central sensitization, general health, somatization, depression, and pain.ResultsThere were significant differences in the behavior of the groups over time for clinical anxiety (STAI Trait-Anxiety) (p < 0.001), central sensitization (p = 0.005) and somatization (p = 0.008) in favor of the myofascial group, with a large effect size for anxiety and a medium effect size for central sensitization and somatization. Regarding clinical anxiety, after the intervention a mean difference was observed with respect to the baseline of 19.98 points in the myofascial group (p < 0.001) and 5.95 in the placebo group (p = 0.22). The intention-to-treat principle was used. There were no adverse events or side effects in either group.ConclusionsThe myofascial approach is effective in improving anxiety levels and associated central sensitization processes in patients with clinical anxiety and this improvement is maintained over time.Clinical Trial RegistrationNCT04826302.     

Yoga and Pilates compared to pelvic floor muscle training for urinary incontinence in elderly women: A randomised controlled pilot trial

Backgroundand purpose: There is limited evidence from randomised controlled trials (RCTs) regarding the use of yoga and Pilates for the management of urinary incontinence (UI) in women. This study aims to investigate the preliminary effects of using Pilates and yoga to manage UI.Materials and methodsAn assessor-blinded, prospective, three-arm parallel-group randomised controlled pilot trial was conducted in three elderly care centres in Hong Kong. Thirty women aged 60 years or above were included in the study. Study centres were randomly assigned to each of the three interventions (yoga, Pilates and pelvic floor muscle training [PFMT; standard care control]). Study interventions were provided once a week for four weeks, followed by unsupervised CD-guided home exercises for eight weeks. Outcomes included the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), 1-h pad test, and feasibility measures such as adherence to the intervention programme, recruitment and retention rates and safety. Outcomes were assessed at baseline, 4 and 12 weeks. Statistical analysis was performed using two-way repeated measures analysis of covariance.ResultsAll three interventions demonstrated a statistically significant effect on ICIQ-SF scores from baseline to weeks 4 and 12. Significant effects in UI were reported for yoga compared with Pilates (mean: −2.93, 95% CI −5.35, −0.51; p = 0.02).ConclusionYoga poses intended to address the pelvic floor and core muscles were found to have superior benefits over Pilates exercises in terms of improved continence measured with the ICIQ-SF.     

Effect of autogenic training on quality of life and symptoms in people living with HIV: A mixed method randomized controlled trial

ObjectiveQuality of life of people living with HIV is strongly affected by sleep problems, fatigue, pain, anxiety, and depression symptoms. This study set out to evaluate the effects of autogenic training (AT) on quality of life and symptoms within this population.MethodsA mixed method randomized controlled trial was conducted. Participants were randomly assigned to either the AT group (n = 32) or the control group (CG) (n = 31). Quality of life and symptoms were measured in both groups three times: prior to intervention (T0), immediately after intervention (T3), and three months after intervention (T6). Fourteen individual interviews were conducted.ResultsResults show a significant improvement in social and mental dimensions of quality of life for the two groups at T6. They also show a significant improvement in sleep for AT participants at T3. Qualitative results are consistent with quantitative ones.ConclusionAT seems to improve sleep quality and could improve some dimensions of quality of life and other symptoms among people living with HIV. Further studies are needed to confirm these results.Trial registration numberNCT01901016.     

Online structured dance/movement therapy reduces bodily detachment in depersonalization-derealization disorder

BackgroundDepersonalization-derealization disorder (DDD) is a dissociative disorder encompassing pronounced disconnections from the self and from external reality. As DDD is inherently tied to a detachment from the body, dance/movement therapy could provide an innovative treatment approach.Materials and methodsWe developed two online dance tasks to reduce detachment either by training body awareness (BA task) or enhancing the salience of bodily signals through dance exercise (DE task). Individuals with DDD (n = 31) and healthy controls (n = 29) performed both tasks individually in a cross-over design. We assessed symptom severity (Cambridge Depersonalization Scale), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness – II), mindfulness (Five Facet Mindfulness Questionnaire), and body vigilance (Body Vigilance Scale) before, during and after the tasks.ResultsAt baseline, individuals with DDD exhibited elevated depersonalization-derealization symptoms alongside lower levels of interoceptive awareness and mindfulness compared to controls. Both tasks reduced symptoms in the DDD group, though dance exercise was perceived as easier. The DE task increased mindfulness in those with DDD more than the BA task, whereas controls showed the opposite pattern. In the DDD group, within-subject correlations showed that lower levels of symptoms were associated with task-specific elevations in interoceptive awareness and mindfulness.ConclusionIndividual and structured dance/movement practice, performed at home without an instructor present, offers an effective tool to reduce symptoms in DDD and can be tailored to address specific cognitive components of a mindful engagement with the body.     

Maternal and Perinatal Outcomes Among Adolescents and Mature Women: A Hospital-Based Study in the North of Mexico

Study ObjectiveTo compare maternal and newborn pregnancy outcomes from adolescents and mature women.Design, Setting, and ParticipantsA cross-sectional study was carried out in a public hospital, including women with singleton pregnancies, who were classified according to their age, as follows: group 1: younger than 16 years old (n = 37), group 2: 16-19 years old (n = 288), and group 3: 20-34 years old (n = 632).Interventions and Main Outcome MeasuresInformation on clinical characteristics, gynecological and obstetric history, pregnancy complications, and perinatal outcomes was obtained through interviews and from clinical records.ResultsThirty-four percent of deliveries were from adolescents. Mature women were more likely to have prepregnancy overweight or obesity than adolescents (odds ratio [OR] = 2.4, 95% confidence interval [CI], 1.7-3.4). The frequency of maternal complications during pregnancy or delivery was not different between groups. Birth asphyxia was more frequent in group 2 (P = .02). Women with inadequate prenatal care had an increased risk of preterm deliveries (OR = 1.64; 95% CI, 1.06-2.54) and of having newborns with low birth weight (OR = 2.02; 95% CI, 1.22-3.35). Weight of newborns from noncomplicated pregnancies was lower in group 1 (P = .02), after adjustment for prepregnancy body mass index, gestational weight gain, preterm delivery, and newborn sex.ConclusionThe frequency of maternal and perinatal complications was similar in adolescents and mature women. Birth weight was decreased in noncomplicated pregnancies of adolescents younger than 16 years of age. Adequate prenatal care might be helpful in prevention of some adverse perinatal outcomes.     

Dance intervention for negative symptoms in individuals with autism spectrum disorder: A systematic review and meta-analysis

BackgroundAutism spectrum disorder (ASD) is a neurodevelopment disorder, marked by deficits in social communication and social interaction as well as by a restricted, repetitive patterns of behaviors, interests and activities. There is an increasing interest in the use of dance as part of rehabilitation for individuals with ASD. However, it is not clear how dance can influence on ASD symptoms. And few studies have measured and compared the outcomes of multiple studies. This study was aimed to provide a more comprehensive perspective of the efficacy of dance practice on ASD symptoms by conducting a systematic review with meta-analysis.MethodsThe electronic databases PubMed, EBSCO, MEDLINE, Cochrane and PsycINFO were searched for relevant studies reporting on the effects of dance on ASD symptoms. Only randomized controlled trials (RCTs) and non-randomized controlled studies were included in this review. Two review authors independently performed literature search, data extraction, and study quality assessment. Effect sizes for ASD symptoms were expressed as standardized mean differences (SMD) with 95% confidence intervals.ResultsSeven eligible studies were included for meta-analysis. Dance interventions varied in frequency (1–2 sessions/week), time (40 − 90 min), duration (7 − 17 weeks) and type. As compared to control groups, dance practice showed significant alleviation of overall symptoms of ASD (−1.48 points, CI −2.55 to − 0.42 points, p = 0.006, I² = 75%) and improvement in social interaction (0.88, CI 0.46 to 1.30, p < 0.0001, I² = 0%), but no significant effect on empathy (0.09, CI − 0.25 to 0.42, p = 0.61, I² = 2%).ConclusionsDance probably alleviate the negative symptoms and social deficits of individuals with ASD. However, little difference is found in empathy. Further research and studies are needed to determine the optimal dose and if dance results in greater benefits than other types of physical activity.     

Latin dance and Qigong/Tai Chi effects on physical activity and body composition in breast cancer survivors: A pilot study

BackgroundBreast cancer survivors (BCS), particularly Latina BCS, experience weight gain and reduced physical activity (PA) post-treatment increasing the risk for recurrence. There is a lack of evidence on the intensity and type of PA needed to engage cultural subgroups and improve clinical outcomes. This study developed and piloted two non-traditional PA interventions among a diverse sample of BCS.MethodsTwenty BCS (65% Latina; age 25–75) participated in a 2-arm parallel group-randomized pilot study to test the effects of an 8-week Latin dance and Qigong/Tai Chi intervention on PA and body composition. A seven-day pedometer protocol was used to measure steps/week and a bioelectric impedence scale was used to assess BMI and %body fat. T-tests were used to examine preliminary outcomes across both interventions and within intervention arms.ResultsThere were no significant changes in steps/week, BMI, or %body fat across or in each separate intervention. A small effect size for increase in steps/day was found among participants in the Qigong/Tai Chi arm (0.10) and low-to-moderate effect sizes for reductions in % body fat overall (0.36), and separately for participants in Latin dance (0.26) and Qigong/Tai Chi (0.46).ConclusionLatin dance and Qigong/Tai Chi are engaging and acceptable PA modalities that are promising for improving PA and body fat among diverse, high-risk BCS. Our findings highlight the need to continue to reach and engage high-risk BCS, including Latina survivors, using novel, culturally-sensitive PA interventions. Future studies should extend and more rigorously test these novel approaches to improving outcomes associated with recurrence.     

Comparison of dry needling and self-stretching in muscle extensibility,pain, stiffness,and physical function in hip osteoarthritis: A randomized controlled trial

Background and purposePatients with hip osteoarthritis (OA) present myofascial trigger points in the hip muscles that may reduce muscle extensibility, provoke pain and stiffness, and decrease physical function. The purpose of the study was to compare the effects of dry needling (DN) intervention with a self-stretching protocol on muscle extensibility, pain, stiffness, and physical function in patients with hip OA.Materials and methodsA single-blinded randomised controlled trial was designed. Thirty-eight participants with hip OA were randomly assigned to the DN group (n = 19) or the stretching group (n = 19). The DN group received three sessions of DN, and the stretching group followed a 3-week protocol. Hip muscle extensibility was the primary outcome and was measured using the Ely test, the modified Ober test, and the Active Knee Extension test. Pain, stiffness, and physical function were the secondary outcomes measured with the WOMAC questionnaire. The variables were assessed before and after treatment by blinded examiners.ResultsDN was more effective than self-stretching for improving hip flexor and abductor muscles extensibility (p < 0.05). DN and self-stretching techniques improved hip extensor muscles extensibility, pain, stiffness, and physical function in patients with hip OA (<0.05). The DN group showed large effect sizes in all the variables (d > 0.8).ConclusionThree sessions of DN were more effective than three weeks of self-stretching to improve hip muscle extensibility in patients with hip OA. DN and self-stretching techniques decreased pain and stiffness and improved physical function in patients with hip OA.     

Long-Term Follow-Up After Penile Prosthesis Implantation—Survival and Quality of Life Outcomes

IntroductionHydraulic penile prostheses have shown an overall good mechanical reliability up to 10 years after surgery; however, few data have been published on very long-term follow-up.AimWe looked at long-term (≥15 years) complications, including functional and quality of life (QoL) outcomes, after 3-piece inflatable penile prosthesis (IPP) implantation in patients with erectile dysfunction (ED).MethodsData regarding 149 patients submitting to IPP placement before 2001 were analyzed. All patients were implanted with AMS CX and Ultrex Plus 3-piece prostheses.Main Outcome MeasurePatients were reassessed to evaluate rates of complications and functional outcomes. The validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) was used to assess patient QoL. Kaplan-Meier analysis estimated the probability of prosthesis survival (defined as working device/not-explanted).ResultsMedian follow-up of 51 patients was 206 months (interquartile range [IQR], 145–257). The etiology of ED was vasculogenic (n = 20; 39%), Peyronie’s disease (n = 15; 29%), pelvic surgery (n = 4; 7.8%), organic other than vasculogenic (n = 3; 5.9%), or other (n = 9; 18%). Throughout the follow-up, 24 patients (49%) experienced complications: mechanical failure (n = 19; 79%), pain (n = 3; 12%), orgasmic dysfunctions (n = 1; 4.5%), or device infection (n = 1; 4.5%). The estimated IPP survival was 53% (95% CI, 36–67) at 20-year follow-up. Baseline characteristics (age, Charlson comorbidity index, body mass index, and erectile dysfunction etiology) were not significantly associated with the risk of IPP failure over time by Cox regression analysis. At 20-year follow-up, 41% (95% CI, 19–49) of the patients were still using the device. Among them, QoLSPP median domain scores were high: functional 22/25 (IQR, 20–23), relational 17/20 (IQR, 15–18), personal 14/15 (IQR, 12–15), and social 14/15 (IQR, 11–15).Clinical ImplicationsThe longevity of the device and long-term satisfaction rates should be comprehensively discussed during patient consultation for IPP surgery.Strengths & LimitationsTo our knowledge, this is the first study reporting long-term QoL outcomes using a dedicated questionnaire for penile prostheses. The low response rate for the telephone interviews, the retrospective design of the study, and the relatively small number of patients are the main limitations.ConclusionLong-term follow-up data after IPP placement showed that almost half of the devices still worked properly 20 years after the original penile implant, as 60% of patients were still using the device with high satisfaction and adequate QoL outcomes. Both patients and physicians should be aware of the expected life and outcomes of IPP implants.Chierigo F, Capogrosso P, Dehò, et al. Long-Term Follow-Up After Penile Prosthesis Implantation—Survival and Quality of Life Outcomes. J Sex Med 2019;16:1827–1833.     

Fetal arrhythmias case series: Experiences from a fetal screening center in Taiwan

ObjectiveFetal arrhythmias are common and in rare cases can be associated with severe mortality and morbidity. Most existing articles are focused on classification of fetal arrhythmias in referral centers. Our main objective was to analyze types, clinical characteristics, and outcomes for arrhythmia cases in general practice.Case reportWe retrospectively reviewed a case series of fetal arrhythmias in a fetal medicine clinic between September 2017 and August 2021.Fetal arrhythmias in our sample presented byEctopies (86%, n = 57), bradyarrhythmias (11%, n = 7), and tachyarrhythmias (3%, n = 2). One tachyarrhythmia case was associated with Ebstein's anomaly. Two cases of second-degree AV block received transplacental fluorinated steroid therapy with recovery of fetal cardiac rhythm in later gestation. One case of complete AV block developed hydrops fetalis.ConclusionDetection and careful stratification of fetal arrhythmias in obstetric screening is crucial. While most arrhythmias are benign and self-limited, some require prompt referral and timely intervention.     

Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer – A Systematic Review

BackgroundEmerging evidence suggests that exercise interventions may improve sexual dysfunction, one of the most common and distressing long-term adverse effects of cancer treatment.AimThe aim of this systematic review is to provide an overview of the effects of exercise on sexual dysfunction in prostate cancer patients.MethodsA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The systematic literature search was performed on 13th July 2021 using CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing sexual function in prostate cancer patients conducting an exercise intervention alone or in combination with other supportive interventions. The methodological quality was assessed using the Physiotherapy Education Database Score and Jadad scale. Outcomes were reported as between-group differences. Intragroup differences were also reported if significant.OutcomesPositive intervention effects on sexual function were primarily observed in patients following prostatectomy and undergoing anti-hormone treatment and for pelvic floor muscle exercises as well as aerobic and resistance exercise.Results22 RCTs (n = 1.752 patients) met the eligibility criteria, conducting either an exercise-only intervention (n = 10), a multimodal (exercise plus other supportive therapy) intervention (n = 4), or pelvic floor muscle exercises (n = 8). 6 RCTs assessed sexual dysfunction as a primary endpoint and 8 RCTs used dedicated assessment methods. 9 of the 22 RCTs found significant between-group differences in favor of the intervention group.Clinical ImplicationsThe multifaceted etiology of sexual dysfunction provides a strong rationale to further investigate the effects of exercise on sexual dysfunction in prostate cancer patients and also to consider a multidisciplinary approach.Strengths and LimitationsA strength is the comprehensive literature search to identify RCTs involving different exercise interventions and a wide range of sexual function assessments. Further, this is the first systematic review on this topic. The main limitations include the difficulty to compare studies due to the heterogeneity of exercise interventions and low questionnaire completion rates in some studies.ConclusionPreliminary data from a small number of studies suggest that certain exercise interventions may improve sexual dysfunction in prostate cancer patients, however further trials involving sexual dyfunction as a primary outcome and more comprehensive assessment tools are needed to confirm the rehabilitative and preventive effects of exercise on sexual dysfunction in prostate cancer patients.Nadine Reimer, Eva Maria Zopf, Rebecca Böwe, et al. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer – A Systematic Review. J Sex Med 2021;18:1899–1914.     

Olaparib as maintenance therapy and salvage therapy in recurrent ovarian cancer: The early experience in Taiwan

ObjectiveThe first Poly (adenosine diphosphate [ADP]-ribose) polymerase inhibitor, olaparib, was approved by Taiwan Food and Drug Administration in June 2018, which was available under a compassionate use program since 2015. This study aims to report the early experience of the effectiveness and adverse effects of olaparib in recurrent ovarian cancer patients in Taiwan.Materials and methodsThis retrospective study enrolled patients with recurrent epithelial ovarian and peritoneal cancer who received olaparib as maintenance therapy or salvage therapy between December, 2015 and October, 2019. We observed response rates in the salvage therapy group, and progression-free interval (PFI) in both groups.ResultsA total of 20 patients (10 in maintenance and 10 in salvage groups) were enrolled. BRCA status was checked in 18 patients by blood or tumor samples, and 83.3% were mutated (n = 15), including pathological/probable pathological variants in BRCA1 (n = 11), BRCA2 (n = 2), or both BRCA1/BRCA2 (n = 2). In the salvage group, there were two partial responses and two stable diseases, adding up to a clinical benefit rate at 40%. In the maintenance group, median PFI was 20.1 months (range, 1.0–33.1). The median PFI of those with chemotherapy-free interval >12 months was not reached, which was significantly better than those ≤12 months, with median PFI 3.1 months (p = 0.022). The most common grade 3/4 adverse effects in patient with olaparib as monotherapy were neutropenia (30.8%) and fatigue (7.7%). Anemia of grade 1/2 was noted in 76.9%.ConclusionThis real-world experience of olaparib for recurrent ovarian cancer in Taiwan showed efficacy and safety similar to the results of previous clinical trial.     

Predictors of positive opinion about Bach Flower Remedies in adults from three Latin-American countries: An exploratory study

The current study aimed to determine if positive opinions about BFR interacts with spirituality in adults from three Latin-American countries using a CHAID algorithm. Participants were 703 adults from Cuba (n = 319), Costa Rica (n = 252) and Chile (n = 132). Predictors: demographic data, received information, received treatment, spirituality, dispositional optimism and willingness to use a placebo intervention were measured and analyzed. A supervised classification which included a training phase (n = 423) and a test phase (n = 280) was employed. Received information about BFR, spirituality and education were selected as significant predictors of the positive opinion about BFR (>90% of correct classifications).     

Effectiveness of cognitive-behavioral therapy (CBT) in improving the quality of life and psychological fatigue in women with polycystic ovarian syndrome: a randomized controlled clinical trial

Introduction: Given the increasing prevalence of complications caused by the polycystic ovarian syndrome (PCOS) such as medical and psychological problems and also the chronicity of this disease, patients with the PCOS tend to experience lower quality of life and greater psychological fatigue similar to other patients with chronic diseases. This study was conducted to determine the effects of cognitive-behavioral therapy (CBT) on the quality of life and psychological fatigue in women with the PCOS.

Methods: This randomized controlled clinical trial study, conducted from 2016 to 2017, enrolled 74 women aged between 18 and 35?years from the Iranian city of Saqqez. The participants were assigned to a CBT group and a control group via block randomization. The intervention group received 8 weekly CBT sessions between 45 and 60?minutes each. The Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ) and the Fatigue Impact Scale (FIS) were completed by the patients before and after the intervention.

Results: No significant differences were observed between the two groups before the intervention in terms of sociodemographic characteristics and the mean scores of quality of life and psychological fatigue. After the intervention, the mean (standard deviation [SD]) of the quality of life score was 60.2 (13.3) in the intervention group and 24.4 (15) in the control group, with the mean score of quality of life being significantly higher in the intervention group than in the control group (adjusted mean difference?=?33.1). The mean (SD) score of psychological fatigue was 28.2 (13.9) in the intervention group and 78.2 (37.1) in the control group, with the mean score of psychological fatigue being significantly lower in the intervention group than in the control group (?54.8).

Conclusions: The results showed that CBT was able to reduce fatigue and improve quality of life in our sample of women with the PCOS and ultimately boost their health.