Effectiveness of cognitive behavioral therapy on mood symptoms in patients with implantable cardioverter defibrillator: A systematic review and meta-analysis

Backgroundand purpose: Cognitive behavioral therapy (CBT) has gained increasing attention in the treatment of psychological disorders, but evidence is required to support practice. This systematic review was conducted to evaluate the current evidence for CBT's effectiveness in relieving symptoms of anxiety and depression experienced by patients with an implantable cardioverter-defibrillator (ICD).MethodsPubMed, Cochrane Library, Web of Science, and Embase databases were systematically searched from inception to March 27, 2020. Both randomized controlled trials and cluster-randomized controlled trials were included in our review. Meta-analysis was conducted using RevMan 5.3 and Stata 15.1 software.ResultsA total of six trials, including 675 participants, were analyzed. The results demonstrated that CBT was superior to standard care in relieving symptoms of depression (standardized mean difference = −0.20; 95% confidence interval (CI): −0.39 to −0.01; P = 0.004). The effectiveness of CBT in relieving symptoms of anxiety experienced by patients with ICDs (standardized mean difference = −0.70; 95% CI: −1.10 to −0.30; P < 0.001) as well as the heterogeneity (I² = 77%) were significant.ConclusionThis meta-analysis indicates that CBT effectively relieves symptoms of anxiety and depression experienced by patients with ICDs. Clinical personnel should pay close attention to the mental health of patients with ICDs and adopt CBT as a management strategy for such patients.     

Effectiveness of Anma massage therapy in alleviating physical symptoms in outpatients with Parkinson's disease: A before-after study

We aimed to confirm the physical effects of a single Anma massage session and continuous Anma massage therapy for outpatients with Parkinson's disease (PD). Twenty-one PD outpatients (mean age, 64.43 ± 8.39 [SD] years; Hoehn and Yahr stage I–IV) received a single 40-min Anma massage session involving upper and lower limb exercises and some subsequently received seven weekly Anma massage sessions. After a single session, visual analogue scale scores were significantly lower for muscle stiffness, movement difficulties, pain, and fatigue; gait speed and pegboard test time were significantly shortened; stride length was significantly lengthened; and shoulder flexion and abduction were significantly improved. No significant changes occurred in controls. After continuous sessions, we found general improvements in the same outcomes. In conclusion, Anma massage might effectively alleviate various physical PD symptoms; furthermore, because it is given through clothing, Anma massage is accessible for PD patients with movement difficulties.     

The effectiveness and safety of Jihwang-eumja (Dihuang Yizi) compared to Western medications in patients with Alzheimer's disease: A systematic review and meta-analysis

Background and purposeJihwang-eumja is reported to be effective in decreasing β-amyloid expression and activating monoamine oxidase and acetylcholinesterase in rat models. This systematic review aims to evaluate the effectiveness of Jihwang-eumja in Alzheimer's disease compared to Western medications.MethodsWe searched Medline, Embase, CENTRAL, CINAHL, CNKI, ScienceON, KISS, and Kmbase. Randomized controlled trials comparing the effectiveness of Jihwang-eumja and Western medications on the cognition and the activities of daily living in Alzheimer's disease were included. The results were synthesized using meta-analysis. The risk of bias was evaluated using the Cochrane risk-of-bias tool, and the evidence level of each outcome was suggested using the GRADE system.ResultsA total of 165 studies were screened, and six were included in the systematic review and meta-analysis. A total of 245 and 240 participants were included in the intervention and comparison groups, respectively. The results showed that Mini-Mental State Examination was 3.19 (95%CI: 1.68–4.70) higher, and the standardized mean difference of activities of daily living was 1.13 (95%CI: 0.89–1.37) higher in the Jihwang-eumja group than in Western medications group. The included studies contained some concerns of the risk of bias, and the certainty of the evidence was considered moderate.ConclusionDespite the small number of studies and high heterogeneity, we could verify the applicability of Jihwang-eumja for Alzheimer's disease.     

Effects of nonpharmacological interventions on depressive symptoms and depression among nursing students: A systematic review and meta-analysis

ObjectivesWe aim to examine whether nonpharmacological interventions could effectively improve depressive symptoms and depression to provide more treatment options for nursing students.MethodsPubMed, the Cochrane Library, EMBase, Web of Science, PsycINFO, and three Chinese electronic databases were comprehensively searched for papers that were published from January 1990 through March 2018. Quality assessment, sensitivity analysis and heterogeneity were performed.ResultsIn our review, 13 controlled trials met the inclusion criteria. The meta-analysis indicated that the depressive symptoms and depression of nursing students in the intervention groups showed significantly moderate improvements compared with the control groups. Three subgroup analyses showed that mindfulness interventions and stress management programs were common and effective, short-term interventions were beneficial to depression, nonpharmacological interventions had great improvements for Asian nursing students and more rigorous researches on methodological quality are recommended.ConclusionNonpharmacological interventions can serve as promising complementary and alternative approaches in reducing the depressive symptoms and depression of nursing students.     

Baduanjin for executive function in patients with mild cognitive impairment: A systematic review and meta-analysis

Background and purposeMild cognitive impairment (MCI) represents age-related cognitive decline and affects various aspects of cognitive function, including memory, attention, executive function (EF), mental processing speed, speech–language skills, and visual–spatial skills. Among these, the EF is the most likely to decline with increasing age. Existing RCTs have shown that Baduanjin can improve the EF in MCI patients. In this study, we aimed to perform a systematic review to assess the efficacy of Baduanjin in improving the EF of patients with MCI.MethodsTen databases [English: Cochrane Library, PubMed, Web of Science, Embase, OVID, and EBSCOhost; Chinese: Wanfang Data, China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP), and SinoMed] were systematically searched in April 2021. We herein included randomized controlled trials (RCTs) written in Chinese or English that assessed the effect of Baduanjin on the EF of patients with MCI. Two researchers used the Cochrane Collaboration's tool and assessed the risks of bias and performed a meta-analysis through the RevMan 5.4 software. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to evaluate the quality of the body of evidence. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines were followed.ResultsSixteen RCTs involving 934 patients with MCI were included. The duration of Baduanjin was 16–24 weeks. The study showed that Baduanjin could significantly improve the EF (P < 0.05) based on the evaluation of the EF of patients with MCI using Montreal Cognitive Assessment, the Clock Drawing Test, the Digit Symbol Coding test, and the Trail Making Test.ConclusionBaduanjin significantly improved the EF of patients with MCI.     

The benefits of yoga for people living with HIV/AIDS: A systematic review and meta-analysis

BackgroundPeople living with HIV/AIDS (PLWHA) often experience psychological stress associated with disease management. This meta-analysis examines the benefits of yoga interventions on psychological distress among PLWHA.MethodsIncluded were studies that (a) evaluated a yoga intervention in PLWHA; (b) provided between-group or within-group changes; and (c) assessed a psychological, physiological, or biomedical outcome.ResultsSeven studies sampling 396 PLWHA (M age = 42 years, SD = 5 years; 40% women) met inclusion criteria. PLWHA who received yoga interventions reported significant improvements in perceived stress (d+ = 0.80, 95% Confidence Interval [CI] = 0.53, 1.07), positive affect (d + = 0.73, 95% CI = 0.49, 0.98), and anxiety (d+ = 0.71, 95% CI = 0.27, 1.14) compared to controls.ConclusionYoga is a promising intervention for stress management. However, the literature is limited by the small number of studies. Randomized controlled trials with objective measures of HIV-related outcomes are needed to further evaluate the benefits of yoga.     

The efficacy of bloodletting therapy in patients with acute gouty arthritis: A systematic review and meta-analysis

BackgroundBloodletting therapy (BLT) is widely used to relieve acute gouty arthritis (AGA). However, limited evidence-based reports exist on the effectiveness and safety of BLT. This systematic review aims to evaluate the feasibility and safety of BLT in treating AGA.MethodsSeven databases were exhaustively screened from the date of establishment to July 31, 2020, irrespective of the publication source and language. The included articles were evaluated for bias risk by using the Cochrane risk of bias assessment tool. All statistical analyses were done with Review Manager 5.3.ResultsTwelve studies involving 894 participants were included for the final analysis. Our meta-analysis revealed that BLT was highly effective in relieving pain (MD = −1.13, 95% CI [-1.60, −0.66], P < 0.00001), with marked alterations in the total effective (RR = 1.09, 95% [1.05, 1.14], P < 0.0001) and curative rates (RR = 1.37, 95%CI [1.17, 1.59], P < 0.0001). In addition, BLT could dramatically reduce serum C-reactive protein (CRP) level (MD = −3.64, 95%CI [-6.72, −0.55], P = 0.02). Both BLT and Western medicine (WM) produced comparable decreases in uric acid (MD = −18.72, 95%CI [-38.24, 0.81], P = 0.06) and erythrocyte sedimentation rate (ESR) levels (MD = −3.01, 95%CI [-6.89, 0.86], P = 0.13). Lastly, we demonstrated that BLT was safer than WM in treating AGA (RR = 0.36, 95%CI [0.13, 0.97], P = 0.04).ConclusionBLT is effective in alleviating pain and decreasing CRP level in AGA patients with a lower risk of evoking adverse reactions.     

Birth ball use for women in labor: A systematic review and meta-analysis

ObjectiveTo evaluate, with the best level of evidence, the possible benefits of using birth balls during labor in maternal and neonatal outcomes.MethodsThis research was made using MEDLINE/PubMed, LILCAS, CINAHL, CENTRAL, and SCOPUS databases, with no period or language restrictions. The terms "labor" and "birth ball" were used. Clinical trials (randomized and non-randomized) were included when compared a group with parturients using birth ball with control group under usual care. The following primary outcomes were: maternal outcomes: pain intensity; length of first and second stage; perineal trauma and episiotomy. Neonatal outcomes: APGAR score, admission to neonatal intensive care unit and delivery room resuscitation. The quality of evidence was evaluated by the GRADE system. Quantitative analysis through meta-analysis was also applies whenever possible.ResultsSeven studies were included. The pain outcome showed differences in the subgroups of 20/30 min on the birth ball (mean difference) −1,46; 95% Confidence Interval: 2,15 to −0,76, p < 0.0001), 60 min (mean difference −1,95; 95% Confidence Interval: 2,68 to −1,22; p < 0.00001) and 90 min (mean difference −1,72; 95% Confidence Interval: 2,44 to −1,00; p < 0.0001), based in a moderated quality of evidence. Other outcomes did not showed differences between groups after the interventions, with a low and very low level of evidence.ConclusionsUse the birth ball reduced pain after 20–90 min of use and there was no difference in the other outcomes. The low quality of the studies included in this meta-analysis suggests that new trials with better methodology quality are necessary.     

Effects of Baduanjin exercise on quality-of-life and exercise capacity in patients with heart failure: A systematic review and meta-analysis

PurposeExercise training is an efficient non-pharmacological intervention for patients with heart failure (HF). This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life (QOL) and exercise capacity in patients with HF.MethodsPubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data were searched from the date of their inception until 30 September 2022. All randomised controlled trials (RCTs) evaluating the effects of Baduanjin exercise on QOL and exercise capacity in patients with HF were selected. The primary outcomes were QOL, assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and exercise capacity, evaluated using the 6-min walking test (6-MWT). A meta-analysis was performed by comparing the MLHFQ domain scores. Review Manager 5.3 and Stata 14.0, were used for the data analysis.ResultsBaduanjin exercise showed a favourable improvement of the overall QOL (mean difference = −8.25; 95% confidence interval: −13.62 to −2.89; P = 0.003) and exercise capacity (mean difference = 118.49; 95% confidence interval: 52.57 to 184.41; P = 0.0004). Meta-analyses of the MLHFQ domain score indicated that Baduanjin exercise significantly improved the patients’ physical (mean difference = −2.83; 95% confidence interval: −3.76, −1.90; P < 0.00001), emotional (mean difference = −2.52; 95% confidence interval: −3.67 to −1.37; P < 0.0001), and general QOL (mean difference = −2.61; 95% confidence interval: −5.17 to −0.06; P = 0.05), based on the decrease in the MLHFQ domain score. Marked statistical heterogeneity (I2> 70%) was observed for all the QOL and exercise capacity outcomes.ConclusionsBaduanjin exercise is a safe, feasible, and acceptable intervention that can improve the QOL and exercise capacity in patients with HF. However, more RCTs with rigorous research designs are needed to assist in the rehabilitation of such patients.     

Weekly fluconazole therapy for recurrent vulvovaginal candidiasis: a systematic review and meta-analysis

Objective

To investigate the efficacy, compared to placebo, of fluconazole 150 mg weekly, given for six months as prophylaxis against recurrent vulvovaginal candidiasis (RVVC).

Study design

A quantitative systematic review was performed, and randomized controlled trials were included. We conducted searches at Medline, EMBASE, Lilacs, Cochrane Library and ICI Web of Science from 1980 to March 2012. We used the odds ratio (OR) with confidence intervals (CI) of 95% using a random effects model of Mantel-Haenszel. The software used was Review Manager version 5.0.

Results

Through the search strategies we identified 249 articles, of which only two were part of the meta-analysis. Fluconazole was more effective than placebo in reducing symptomatic episodes of VVC, immediately after treatment (OR 0.10, 95% CI 0.03–0.34), 3 months after treatment (OR 0.23, 95% CI 0.07–0.74) and 6 months after treatment (OR 0.39, 95% CI 0.24–0.64).

Conclusion

Weekly treatment with fluconazole (150 mg) for six months is effective against RVVC.     

Acupuncture therapy improves health-related quality of life in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

BackgroundChronic obstructive pulmonary disease (COPD) is highly prevalent around the world and has a large impact on its patients, leading to a poor health-related quality of life (HRQL) and exercise capacity. Even under optimal medications, there are still many patients with poor HRQL. Body acupuncture therapy (BAT) is a non-invasive and a popular therapy. Therefore, we aimed to comprehensively analyze the effects of BAT in COPD.Materials and methodsEight electronic databases were searched. We included randomized controlled trials (RCTs) that evaluated the effect of BAT, medication (M), and pulmonary rehabilitation (PR). The primary outcome was HRQL evaluated by St. George's respiratory questionnaire (SGRQ) or COPD assessment test (CAT).ResultsOf the 922 articles, 12 studies were included with attesting a total of 798 participants. The result obtained indicated a significant improvement that favored the BAT + M group over the M group in CAT scores (MD: −4.77; 95% CI: −6.53 to −3.01; p < 0.00001).ConclusionsBAT is an effective adjunctive non-pharmacological treatment to improve HRQL in patients under medical treatment for COPD. We suggested that BAT should be considered as one of the methods of management in patients with COPD.     

Effect of manual soft tissue therapy on the pain in patients with chronic neck pain: A systematic review and meta-analysis

ObjectiveTo systematically evaluate the impact of manual soft tissue therapy (MSTT) on the degree of pain in patients with chronic neck pain (CNP).MethodsTrials included in the meta-analysis were identified by searching 5 English databases, including the PubMed, Embase, Cochrane Library, Web of Science and U.S. Clinical Trial Registry databases. The search was conducted with the subject terms neck pain, soft tissue treatment, massage, and myofascial release. We assessed the included trials using the Cochrane risk-of-bias tool. STATA statistical software version 16.0 was used for statistical analysis. Additionally, subgroup analysis and sensitivity analysis were performed to analyze the sources of heterogeneity and assess the stability of the research results. Begg's funnel plot and Egger's publication bias plot were used to assess potential publication bias.ResultsThis systematic review included a total of 12 randomized controlled trials (566 patients in total). The participants were between 18 and 85 years old. Most of the included studies were of medium quality. This meta-analysis validated the effectiveness of MSTT in alleviating pain symptoms in patients with CNP (ES: 0.83; 95% CI: 1.15 to −0.51; P = 0.001). Egger's publication bias plot and Begg's funnel plot indicated that there may be potential publication bias.ConclusionThis meta-analysis found that MSTT has a significant effect on alleviating the pain of patients with CNP. In addition, the use of different pain measurement tools may influence effect of the intervention, but more clinical studies are needed in the future to determine the specific effect.     

Effects of cinnamon supplementation on lipid profiles among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis

Background and purposeStudies in animals and humans have reported numerous beneficial effects of cinnamon. However, its hypolipidemic efficacy in patients with metabolic syndrome (MetS) and related disorders is still controversial. This meta-analysis aimed to evaluate the lipid-regulating effects and safety of cinnamon in a population with MetS and related disorders.MethodsStudies that met the inclusion criteria were retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Randomized placebo-controlled trials of cinnamon or its extracts in the treatment of MetS and related metabolic diseases were the main eligibility criteria. The Cochrane Handbook was used to guide the study selection, quality assessment, and data analysis. All statistical analyses were performed using Stata 15.0.ResultsTwelve studies involving 773 subjects were included in the meta-analysis. The overall results showed that cinnamon could significantly reduce total cholesterol (weighted mean difference [WMD]: −0.19 mmol/L [−7.34 mg/dL]; 95% confidence interval [CI]: −0.24, −0.14 [−9.27, −5.41]), triglyceride (WMD: −0.10 mmol/L [−8.85 mg/dL]; 95% CI: −0.16, −0.04 [−14.16, −3.54]), and low-density lipoprotein cholesterol (WMD: −0.16 mmol/L [−6.18 mg/dL]; 95% CI: −0.20, −0.11 [−7.72, −4.25]). In the subgroup analysis, cinnamon did not exhibit a significant effect on lipid profiles in European and American patients. Larger doses of cinnamon tended to exhibit better regulation of lipid profiles and high-dose cinnamon (≥1.5 g/d) significantly increased high-density lipoprotein cholesterol (WMD: 0.07 mmol/L [2.70 mg/dL]; 95% CI: 0.03, 0.11 [1.16, 4.25]).ConclusionThe current evidence shows that cinnamon can regulate lipid profiles in patients with metabolic disorders.     

Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis

ObjectiveCupping therapy is widely used in East Asia, the Middle East, or Central and North Europe to manage the symptom of knee osteoarthritis (KOA). The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of cupping therapy for treating patients with KOA.MethodsThe following databases were searched from their inception until January 2017: PubMed, Embase, the Cochrane Central Register of Controlled Trials and four Chinese databases [WanFang Med Database, Chinese BioMedical Database, Chinese WeiPu Database, and China National Knowledge Infrastructure (CNKI)]. Only the RCTs related to the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials.ResultsSeven RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the dry cupping therapy plus the Western medicine therapy group showed significantly greater improvements in the pain [MD = −1.01, 95%CI (−1.61, −0.41), p < 0.01], stiffness [MD = −0.81, 95%CI (−1.14, −0.48), p < 0.01] and physical function [MD = −5.53, 95%CI (−8.58, −2.47), p < 0.01] domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group, with low heterogeneity (Chi² = 0.00 p = 1.00, I² = 0% in pain; Chi² = 0.45 p = 0.50, I² = 0% in stiffness; Chi² = 1.09 p = 0.30, I² = 9% in physical function). However, it failed to do so on a Visual Analog Scale (VAS) [MD = −0.32, 95%CI (−0.70, 0.05), p = 0.09]. In addition, when compared with Western medicine therapy alone, meta-analysis of four RCTs suggested favorable statistically significant effects of wet cupping therapy plus western medicine on response rate [MD = 1.06, 95%CI (1.01, 1.12), p = 0.03; heterogeneity: Chi² = 1.13, p = 0.77, I² = 0%] and Lequesne Algofunctional Index (LAI) [MD = −2.74, 95%CI (−3.41, −2.07), p < 0.01; heterogeneity: Chi² = 2.03, p = 0.57, I² = 0% ].ConclusionOnly weak evidence can support the hypothesis that cupping therapy can effectively improve the treatment efficacy and physical function in patients with KOA.     

Feasibility,acceptability and effects of dance therapy in stroke patients: A systematic review

IntroductionStroke is the leading cause of non-traumatic disability in adults, with balance and gait disturbances representing the main limitations of body functions. Dance therapy (DT) has shown positive effects in older adults and in patients with neurological pathologies. This systematic review aims to examine the feasibility, acceptability and effects of DT in stroke rehabilitation, specifically on functional gains of gait and balance.MethodsA systematic search was carried out for articles published in the MEDLINE, PEDro, Web of Science, Scopus and CINHAL in February 2021 and updated in April 2021. Results: Eight studies were included (2 clinical cases, 5 case series and 1 randomized controlled trial), 7 of them in patients with chronic stroke and only 1 in subacute stroke phase. The most widely used dance modality was tango and ballet, with sessions ranging from 30 to 110 min. DT seems to show positive effects on post-stroke body functions and activities such as gait and balance. Reported dropout rates are inconsistent, no adverse effects were reported, and participant satisfaction was high.ConclusionGiven the heterogeneity and uneven quality of the included studies, strong conclusions cannot be put forward on the effectiveness of DT in post-stroke body function and activities. Nevertheless, DT seems to be safe and acceptable therapy for patients, and no adverse effects have been reported. More studies with a high level of evidence and feasibility are needed to determine the patient profile, the characteristics of the intervention, the participation rate and the role of the rehabilitation professional most likely to generate optimal benefit.     

Prevalence of Human Papillomavirus in endometrial cancer: A systematic review and meta-analysis

Objective

HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer.

Methods

We conducted a systematic review and meta-analysis to investigate the pooled prevalence of HPV DNA in endometrial cancer. Using meta-regression, we further analyzed whether factors such as geographical region, HPV DNA detection method, publication year and tissue type were associated with HPV prevalence. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for studies providing data on HPV prevalence in cases with endometrial cancer and in controls with normal or hyperplastic endometrial tissue.

Results

We identified 28 papers (29 studies) examining the prevalence of HPV DNA in tumor tissue from endometrial cancer comprising altogether 1026 cases of endometrial cancer. The HPV prevalence varied considerably from 0% to 61.1%. From the random effects meta-analysis, the pooled prevalence of HPV DNA in endometrial cancer was 10.0% (95% CI: 5.2–16.2) with large between-study heterogeneity (I² = 88.2%, p < 0.0001). The meta-regression showed that HPV DNA detection method was statistically significantly associated with HPV prevalence (p = 0.0016): the pooled HPV prevalence was 6.0% (95% CI: 1.5–13.0) using general primers, 18.9% (95% CI: 8.6–32.1) using type-specific primers and 1.0% (95% CI: 0.0–3.6) using non-PCR based methods. None of the other a priori defined variables were statistically significantly associated with HPV prevalence. The pooled OR was 1.43 (95% CI: 0.68–3.00) indicating that the odds of HPV was not increased in cases versus controls.

Conclusions

HPV appears to have a limited or no role in the etiology of endometrial cancer.