Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to critically evaluate and summarise all available evidence derived from randomised clinical trials (RCTs) regarding aromatherapy's effects on labour pain and anxiety relief. Literature search was performed in MEDLINE/PubMed, Cochrane library, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus since their respective inception to January 2019. Additionally, Google Scholar was also searched to explore citations of eligible final studies which were subsequently included in the systematic review. The search strategy used was: (pregnancy or pregnant or prenatal or antenatal or perinatal or maternal) AND (aromatherapy or essential oils or aroma therapy). Per inclusion and exclusion criteria established by the current study, nine RCTs were included in the systematic review. Results from the current study suggested that aromatherapy significantly decreased pain and anxiety in the first stage of labour.IMPACT STATEMENTWhat is already known on this subject? Several studies have shown aromatherapy's effectiveness in relieving pain and anxiety for hospitalised patients and on relieving nausea and vomiting for women during pregnancy. Some results have further indicated that aromatherapy was effective in facilitating episiotomy healing and in reducing pain, fatigue and distress. Aromatherapy was also found to play a role in improving maternal moods; reducing post-caesarean pain; and preventing or mitigating stress, anxiety and depression after childbirth. Though most non-pharmaceutical pain management options were considered non-invasive and presumably safe for mothers and their foetuses, their exact efficacies remained unclear due to a lack of high quality evidence.What the results of this study add? This systematic review and meta-analysis summarises all evidence derived from RCTs wherein aromatherapy was performed as a supportive analgesic method during labour. Results of this meta-analysis identified more credible evidence validating that aromatherapy could significantly decrease labour pain both in early active and late active phases.What the implications are of these findings for clinical practice and/or further research? Availability of credible evidence supporting aromatherapy's effectiveness on reducing physiological and psychological stress during pregnancy and childbirth would be useful, both theoretically and practically, for all stakeholders concerned, such as pregnant women, medicine and midwifery students, midwives, nurses, gynaecologists and health policymakers.

Massage therapy for weight gain in preterm neonates: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: Weight gain is the main criterion for hospital discharge. This study measured the effectiveness of treating preterm neonates with massage therapy. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Web of Science, Ovid-Medline, CINAHL, ProQuest, and PubMed (up to July 24, 2018). STUDY SELECTION: Randomized controlled trials involving preterm infants with very-low-birth weight or low-birth-weight that examined the effect of massage therapy, and at least one outcome assessing infants' weight change or weight gain. RESULTS: Pooled effect estimate from 15 trials with 697 participants showed that massage therapy improved daily weight gain by 5.07 g/day (95% CI 2.19-7.94, p = 0.0005). More benefits were observed when preterm neonates received moderate pressure massage (5.60 g/day, 95% CI 2.64-8.56, p = 0.0002) than when receiving light-pressure therapy (1.08 g/day, 95% CI 0.29-1.86, p = 0.007). CONCLUSIONS: Massage therapy is beneficial for preterm infant weight gain.

Horticultural Therapy in Patients With Dementia: A Systematic Review and Meta-Analysis.

BACKGROUND: World Health Organization has communicated that dementia as a public health priority in 2012. Behavioral and psychological symptoms of dementia are the main reason results in hospitalization of dementia patients. Horticulture is one of the favorite activity for many peoples to relax their minds. OBJECTIVES: To investigate psychological health benefits of horticulture intervention in dementia patients. METHODS: The databases including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, and Ovid Medline were searched up to August 2017. RESULTS: Twenty-three articles for systematic review, whereas 8 articles were included in meta-analysis. Meta-analysis verified the beneficial effect of horticultural therapy (HT) on agitation level (standard mean difference: -0.59; P < .00001); increase time spent on activity engagement (mean differences [MD]: 45.10%, P < .00001); decrease time for doing nothing (MD: -29.36%, P = .02). CONCLUSIONS: Patients with dementia benefit from horticultural by alleviating their degrees of agitate behaviors, increasing time of engaging in activities and decrease time of doing nothing.

Epigallocatechin-3-gallate inhibits tumor angiogenesis: involvement of endoglin/Smad1 signaling in human umbilical vein endothelium cells.

Strategies targeting endoglin are currently being investigated in clinical trials as an anti-angiogenic therapy. The redundancy between endoglin and vascular endothelial growth factor (VEGF) signaling in angiogenesis was verified. Increased endoglin signaling after an anti-VEGF treatment was observed in patients. Treatment with an endoglin-neutralizing antibody increased VEGF signaling in endothelial cells. Therefore, strategies targeting both the endoglin and VEGF pathways were applied to determine whether the anti-angiogenic effects were increased in vitro. Five possible hits for endoglin were identified from 2000 compounds in the Traditional Chinese Medicine Database using Discovery Studio 4.5 Epigallocatechin-3-gallate (EGCG) attenuates angiogenesis by downregulating VEGF; however, researchers have not determined whether its anti-angiogenic effects are mediated by endoglin/Smad1 signaling. A major contribution of this study is that EGCG significantly inhibited the upregulation of endoglin in semaxanib-treated human umbilical vein endothelial cell. Thus, a combination treatment with EGCG and a VEGF tyrosine kinase inhibitor would be appropriate to reverse drug resistance. EGCG alone significantly decreased endoglin/pSmad1 levels in HUVECs. In the angiogenesis assay, the migration, invasion, and tube formation of HUVECs were markedly suppressed by higher concentrations of EGCG. A combination treatment with EGCG and semaxanib further produced increased anti-angiogenic effects. The main contribution of the study indicated that EGCG significantly decreased the semaxanib-induced overexpression of endoglin. Therefore, a combination treatment including EGCG will probably solve the drug resistance to anti-VEGF treatments.

Inhibitory effects of pu-erh tea on alpha glucosidase and alpha amylase: a systemic review.

OBJECTIVE: Pu-erh tea was presumed to have anti-hyperglycemic effects via inhibition on alpha-amylase and alpha-glucosidase. However, no integerated literatures were published to substantiate such presumption. METHODS: Current study adopted systemic review method to validate inhibitory effects on alpha amylase and alpha-glucosidase. Five English databases (PubMed, EBSCO, SCOPUS, Cochrane Library, Web of Science) and three Chinese ones (Airti Library, CNKI Library, and Google Scholar) were searched up to 22 March 2018 for eligible literatures, using keywords of Pu-erh, Pu'er, alpha-amylase or alpha-glucosidase. RESULTS: Six studies exploring inhibitory effects on alpha-glucosidase and seven on alpha-amylase were included for systemic review. Though results showed pu-erh tea has significant inhibitory effects on alpha-amylase and alpha-glucosidase, high heterogeneity was detected among studies included. CONCLUSIONS: High heterogeneity may be due to complex alterations of chemicals under different degrees of fermentation. More future studies are required to further identify principal bioactive component(s) at work.

Tragic result of traditional Chinese medicine manipulation: an unusual case report of bilateral anterior shoulder dislocations.

BACKGROUND: In Taiwan, there is a good universal healthcare system to the patients; however, the majority of Taiwanese seek the complementary and alternative medicine when they are injured or ill. The traditional Chinese medicine, which is a branch of complementary alternative medicine, is prevalent in Taiwan. Without proper sequence of maneuvers, either traditional Chinese medicine or conventional medicine might cause unexpected complications. We report a case of 76-year-old woman who was manipulated by a bonesetter, leading to bilateral anterior shoulder dislocations. To the authors' best knowledge, this injury mechanism of bilateral shoulder dislocations has not been reported in the literature. Since the traditional Chinese medicine is popular in Taiwan, proper training with better skills for the practitioners should be emphasized. We highlight the integration and collaboration of traditional Chinese medicine with western medicine to achieve a better health care for the patients. CASE PRESENTATION: A 76-year-old Taiwanese woman has been suffering from soreness and stiffness of bilateral shoulders for 6 months. She went to a bonesetter for mobilization for her shoulders. After manipulations for bilateral shoulders, the woman experienced locked both shoulders with sharp pain. She came to our institute, where the radiographs confirmed bilateral anterior shoulder dislocations. Closed reduction for the dislocations was done by the physician. The patient returned to good range of motion of bilateral shoulders after subsequent rehabilitation without any neurologic deficits. CONCLUSIONS: To the authors' best knowledge, this unusual injury of bilateral anterior shoulder dislocations had not been reported. The possible mechanism of this injury and the health belief of traditional Chinese medicine in Taiwan are discussed. Improper shoulder manipulations would lead to unexpected complication in any medical practices. We suggest that both traditional Chinese medicine and conventional medicine should follow specific sequences of manipulations; Collaboration and integration with each other could achieve a better healthcare for the patients.