RESUMEN
BACKGROUND: Myocardial ischemia-reperfusion (I/R) injury significantly impacts recovery in both cardiac and non-cardiac surgeries, potentially leading to severe cardiac dysfunction. Sevoflurane, a volatile anesthetic, is reputed for its protective effects against myocardial I/R injury, although evidence remains inconclusive. This systematic review and meta-analysis aim to clarify the cardioprotective efficacy of sevoflurane. METHODS: The systematic search of databases including Medline, Embase, Scopus, and Web of Science, was supplemented with a manual search to retrieve studies using rat or mouse models of myocardial I/R injury, comparing sevoflurane pretreatment (≥ 24 hours before I/R), preconditioning (within 24 hours before I/R), or post-conditioning (after I/R) against non-treated controls. The outcomes were cardiac function, myocardial infarct size, apoptosis, inflammation, oxidative stress, and cardiac biomarkers. Using the random effects model, standardized mean differences (SMD) were pooled to perform meta-analyses. RESULTS: Fifty-one studies, encompassing 8189 subjects, were included in the meta-analysis. Pretreatment with Sevoflurane significantly reduced infarct size. Sevoflurane preconditioning exhibited positive effects on left ventricular parameters and ejection fraction, and reduced infarct size, apoptosis, and oxidative stress. Post-conditioning with Sevoflurane demonstrated improvements in cardiac function, including enhanced left ventricular parameters and reduced infarct size, apoptosis, inflammation, oxidative stress, and cardiac biomarkers. CONCLUSION: Sevoflurane demonstrates a significant protective effect against myocardial I/R injury in animal models. These findings support the potential clinical utility of sevoflurane as an anesthetic choice in preventing and managing myocardial I/R injury during surgeries.
RESUMEN
BACKGROUND: Prompt identification of large vessel occlusion (LVO) in acute ischemic stroke (AIS) is crucial for expedited endovascular therapy (EVT) and improved patient outcomes. Prehospital stroke scales, such as the 3-Item Stroke Scale (3I-SS), could be beneficial in detecting LVO in suspected patients. This meta-analysis evaluates the diagnostic accuracy of 3I-SS for LVO detection in AIS. METHODS: A systematic search was conducted in Medline, Embase, Scopus, and Web of Science databases until February 2024 with no time and language restrictions. Prehospital and in-hospital studies reporting diagnostic accuracy were included. Review articles, studies without reported 3I-SS cut-offs, and studies lacking the required data were excluded. Pooled effect sizes, including area under the curve (AUC), sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR) with 95% confidence intervals (CI) were calculated. RESULTS: Twenty-two studies were included in the present meta-analysis. A 3I-SS score of 2 or higher demonstrated sensitivity of 76% (95% CI: 52%-90%) and specificity of 74% (95% CI: 57%-86%) as the optimal cut-off, with an AUC of 0.81 (95% CI: 0.78-0.84). DOR, PLR, and NLR, were 9 (95% CI: 5-15), 2.9 (95% CI: 2.0-4.3) and 0.32 (95% CI: 0.17-0.61), respectively. Sensitivity analysis confirmed the analyses' robustness in suspected to stroke patients, anterior circulation LVO, assessment by paramedics, and pre-hospital settings. Meta-regression analyses pinpointed LVO definition (anterior circulation, posterior circulation) and patient setting (suspected stroke, confirmed stroke) as potential sources of heterogeneity. CONCLUSION: 3I-SS demonstrates good diagnostic accuracy in identifying LVO stroke and may be valuable in the prompt identification of patients for direct transfer to comprehensive stroke centers.
Asunto(s)
Accidente Cerebrovascular Isquémico , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico , Sensibilidad y Especificidad , Accidente Cerebrovascular/diagnóstico , Servicios Médicos de Urgencia/métodosRESUMEN
BACKGROUND AND IMPORTANCE: Multiple decision-aiding models are available to help physicians identify acute coronary syndrome (ACS) and accelerate the decision-making process in emergency departments (EDs). OBJECTIVE: This study evaluates the diagnostic performance of the Manchester Acute Coronary Syndrome (MACS) rule and its derivations, enhancing the evidence for their clinical use. DESIGN: Systematic review and meta-analysis. SETTINGS AND PARTICIPANTS: Medline, Embase, Scopus, and Web of Science were searched from inception until October 2023 for studies including adult ED patients with suspected cardiac chest pain and inconclusive findings requiring ACS risk-stratification. OUTCOME MEASURES AND ANALYSIS: The predictive value of MACS, Troponin-only MACS (T-MACS), or History and Electrocardiogram-only MACS (HE-MACS) decision aids for diagnosing acute myocardial infarction (AMI) and 30-day major adverse cardiac outcomes (MACEs) among patients admitted to ED with chest pain suspected of ACS. Overall sensitivity and specificity were synthesized using the 'Diagma' package in STATA statistical software. Applicability and risk of bias assessment were performed using the QUADAS-2 tool. MAIN RESULTS: For AMI detection, MACS has a sensitivity of 99% [confidence interval (CI): 97-100], specificity of 19% (CI: 10-32), and AUC of 0.816 (CI: 0.720-0.885). T-MACS shows a sensitivity of 98% (CI: 98-99), specificity of 35% (CI: 29-42), and AUC of 0.859 (CI: 0.824-0.887). HE-MACS exhibits a sensitivity of 99% (CI: 98-100), specificity of 9% (CI: 3-21), and AUC of 0.787 (CI: 0.647-0.882). For MACE detection, MACS demonstrates a sensitivity of 98% (CI: 94-100), specificity of 22% (CI: 10-42), and AUC of 0.804 (CI: 0.659-0.897). T-MACS displays a sensitivity of 96% (CI: 94-98), specificity of 36% (CI: 30-43), and AUC of 0.792 (CI: 0.748-0.830). HE-MACS maintains a sensitivity of 99% (CI: 97-99), specificity of 10% (CI 6-16), and AUC of 0.713 (CI: 0.625-0.787). CONCLUSION: Of all the MACS models, T-MACS displayed the highest overall accuracy due to its high sensitivity and significantly superior specificity. T-MACS exhibits very good diagnostic performance in predicting both AMI and MACE. This makes it a highly promising tool for managing patients with acute chest pain.
RESUMEN
Sexual hyperactivity, often linked with substantial psychological and social disturbances, remains under-researched, particularly in contexts like Iran where cultural and social norms may influence the reporting and treatment of such conditions. This study explores the therapeutic potential of cognitive rehabilitation (CR) and binaural beats (BB) in addressing this issue. The primary objective was to compare the effectiveness of CR and BB in reducing symptoms of sexual hyperactivity and associated comorbid conditions, with a focus on fluctuations in sexual desire and overall mental health. Utilizing a quasi-experimental design, the study involved pretest, posttest, and follow-up assessments to evaluate the interventions' impacts. Recruitment through social media yielded 45 participants from a larger pool, who were then assigned to either the CR group, the BB group, or a control group. The CR and BB interventions were administered over a period of 10 sessions, each lasting 20 min, 3 times a week. Significant improvements were observed in both intervention groups compared to the control group. The CR group showed a marked reduction in Sexual Addiction Screening Test (SAST) scores from an initial average of 24.87 to 6.80 at follow-up, indicating a reduction in symptoms of sexual hyperactivity. The BB group also showed improvement, with SAST scores decreasing from 19.93 to 9.57. In terms of mental health comorbidities, the Depression, Anxiety, and Stress Scale (DASS-21) scores decreased notably in the CR group from a baseline of 8.53 to 3.07 post-intervention, and in the BB group from 10.33 to 5.80. Both interventions showed similar effectiveness in reducing anxiety and stress, with no statistically significant differences between the groups for most of the outcomes studied, affirming their potential for clinical application.
RESUMEN
The utilization of Cold Plasma (CP) technology for decontamination and disinfection has garnered considerable attention across diverse industries. This study aims to investigate the interaction between pH and electrical conductivity (EC) (µS/cm) in Cold Plasma-Activated Water (CPAW) enriched with metal cations and its potential as an antifungal agent against two Penicillium (P.) mold strains. The investigation focuses on elucidating the augmented chemical interactions induced by plasma between radicals, charged particles, and microorganisms' cell membranes within an aqueous environment. Our findings demonstrate a positive correlation between the inactivation potential of CPAW (operating at 10 kV voltage, 2.5 kHz high frequency, and 500 mA current intensity) and pH and EC(µS/cm) values. Notably, the relative chemical reactivity and solubility of calcium oxide emerge as significant factors, highlighting the pronounced link between P. Italicum and Plasma-Activated Water containing Copper cations (CPAW + Cu2+) (p < 0.05). Our study distinctly emphasizes (1) the substantial impact of both activated water type and mold species on CFU/mL values (p < 0.05); (2) the mold-specific effect of activated water on CFU/mL; and (3) the noteworthy EC(µS/cm) enhancement and pH decrease with prolonged activation time, attaining statistical significance (p < 0.01).
RESUMEN
Introduction: A comprehensive analysis of the epidemiological features of aortic dissections in Azerbaijan Province, Iran, and their influence on patient survival remains unexplored. This study aimed to determine the incidence of aortic dissection and identify the associated factors of mortality in these patients. Methods: A retrospective longitudinal study was conducted using hospital records of patients diagnosed with aortic dissection in Tabriz, Iran, between 2017 and 2021. The 3-month mortality was followed up via telephone calls using the contact numbers provided in the patients' records. Then, independently associated factors of mortality were identified using a multivariate stepwise logistic regression analysis. Results: Among the 150 cases of aortic dissection identified, 74% (n = 111) were classified as type A, and 26% (n = 39) were classified as type B. The overall incidence proportion of aortic dissections was 2.35 per 100000 population. In type A dissections, 64% (71 out of 111) of patients received surgical treatment, while 21.6% (24 out of 111) received medical treatment. Among type B dissections, only 23.1% (9 out of 39) underwent surgery. The all-cause mortality rate at 3 months was 52.5% (73 out of 139 patients with complete follow-up), 47 male (54%) and 26 female (50%). Multivariate analysis showed that higher age was independently associated with increased mortality (odds ratio [OR] = 1.03; 95% confidence interval [CI]: 1.00-1.06, p = 0.027). In contrast, patients with DeBakey Type III classification (OR = 0.29; 95% CI: 0.01-0.87, p = 0.027), hypothyroidism (OR = 0.12; 95% CI: 0.01-0.99, p = 0.049), and those who received either surgical treatment (OR = 0.19; 95% CI: 0.05-0.76, p = 0.019) or medical treatment (OR = 0.18; 95% CI: 0.04-0.80, p = 0.024) had a lower chance of mortality. Gender was not found to be associated with the outcome. Conclusion: The study revealed an annual incidence rate of aortic dissection as 2.35 per 100000 population. Aortic dissection, regardless of type, remains a highly fatal condition, with over half of patients dying within 3 months of the initial event. To reduce the high mortality rates associated with aortic dissections, it is crucial to implement specific measures for the early identification of patients and ensure prompt and appropriate care.
RESUMEN
Introduction: Large vessel occlusion (LVO) strokes are associated with worse functional outcomes and higher mortality rates. In the present systematic review and meta-analysis, we evaluated the diagnostic yield of the Cincinnati Prehospital Stroke Scale (CPSS) in detecting LVO. Methods: We performed an extensive systematic search among online databases including Medline, Embase, Web of Science, and Scopus, until July 31st, 2023. We also conducted a manual search on Google and Google scholar, along with citation tracking to supplement the systematic search in retrieving all studies that evaluated the diagnostic accuracy of the CPSS in detecting LVO among patients suspected to stroke. Results: Fourteen studies were included in the present meta-analysis. CPSS showed the sensitivity of 97% (95% CI: 87%-99%) and the specificity of 17% (95% CI: 4%-54%) at the cut-off point of ≥1. The optimal threshold was determined to be ≥2, with a sensitivity of 82% (95% CI: 74%-88%) and specificity of 62% (95% CI: 48%-74%) in detecting LVO. At the highest cut-off point of ≥3, the CPSS had the lowest sensitivity of 60% (95% CI: 51%-69%) and the highest specificity of 81% (95% CI: 71%-88%). Sensitivity analyses showed the robustness of the results regardless of study population, inclusion of hemorrhagic stroke patients, pre-hospital or in-hospital settings, and the definition of LVO. Conclusion: A very low level of evidence demonstrated that CPSS, with a threshold set at ≥2, is a useful tool for identifying LVO stroke and directing patients to CSCs, both in prehospital and in-hospital settings.
RESUMEN
Introduction: Traumataic brain injury (TBI) represents a significant global health burden. This systematic review delves into the comparison of S100B and Neuron-Specific Enolase (NSE) regarding their diagnostic and prognostic accuracy in TBI within the adult population. Methods: Conducted on October 21, 2023, the search identified 24 studies encompassing 6454 adult patients. QUADAS-2 and QUAPAS tools were employed to assess the risk of bias. The analyses aimed to evaluate the diagnostic and prognostic performance of S100B and NSE based on sensitivity, specificity, and area under the curve (AUC). The outcomes were detecting intracranial injury, mortality, and unfavorable outcome. Results: Pooled data analysis tended towards favoring S100B for diagnostic and prognostic purposes. S100B exhibited a diagnostic AUC of 0.74 (95% confidence interval (CI): 0.70-0.78), sensitivity of 80% (95% CI: 63%-90%), and specificity of 59% (95% CI: 45%-72%), outperforming NSE with an AUC of 0.66 (95% CI: 0.61-0.70), sensitivity of 74% (95% CI: 53%-88%), and specificity of 46% (95% CI: 24%-69%). Notably, both biomarkers demonstrated enhanced diagnostic value when blood samples were collected within 12 hours post-injury. The analyses also revealed the excellent diagnostic ability of S100B with a sensitivity of 99% (95% CI: 4%-100%) and a specificity of 76% (95% CI: 51%-91%) in mild TBI patients (AUC = 0.89 [0.86-0.91]). In predicting mortality, S100B showed a sensitivity of 90% (95% CI: 65%-98%) and specificity of 61% (95% CI: 39%-79%), slightly surpassing NSE's performance with a sensitivity of 88% (95% CI: 76%-95%) and specificity of 56% (95% CI: 47%-65%). For predicting unfavorable outcomes, S100B exhibited a sensitivity of 83% (95% CI: 74%-90%) and specificity of 51% (95% CI: 30%-72%), while NSE had a sensitivity of 80% (95% CI: 64%-90%) and specificity of 59% (95% CI: 46%-71%). Conclusion: Although neither biomarker has shown promising diagnostic performance in detecting abnormal computed tomography (CT) findings, they have displayed acceptable outcome prediction capabilities, particularly with regard to mortality.
RESUMEN
INTRODUCTION AND PURPOSE: According to the prevalence of balance disorders among children with hearing loss (HL), researchers used exercise programs to improve balance in children with HL. So, the present systematic review and meta-analysis briefly summarize findings regarding the impacts of exercise training programs on balance in children with HL. METHODS: Science Direct, MEDLINE/PubMed, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar were searched from inception until November 11th, 2023. Two independent researchers analyzed and extracted the data from potential papers whose eligibility was confirmed. Then, the PEDro scale was used to obtain quality assessment scores. The total PEDro score is 11 and incorporates the presentation of statistical analysis and evaluation criteria of internal validity. Studies that scored 7-11 were considered methodologically "high", 5 to 6 were "fair", and ≤4 were considered "poor". RESULTS: 10 studies involving a total of 304 participations were included in the systematic review. Our results demonstrate that exercise training programs positively impact static balance (p = 0.001) with level 1a evidence, the postural sway (p = 0.001) with level 1a evidence, and dynamic balance (p = 0.001) with level 1a evidence in children with HL. CONCLUSION: The findings of this systematic review and meta-analysis related to studies with excellent methodological quality revealed that the intended training programs significantly impact postural sway along with static and dynamic balance in children with HL. It is recommended that future exercise training programs be paired with rehabilitation programs for children with HL.
Asunto(s)
Pérdida Auditiva , Niño , Humanos , Ejercicio Físico , Terapia por Ejercicio , Proyectos de Investigación , InvestigadoresRESUMEN
BACKGROUND: When mother`s own milk (MOM) is unavailable or insufficient, donor milk (DM) from a human milk bank serves as an alternative feeding option. Our study sought to investigate and compare the outcomes and complications of very low birth weight (VLBW) preterm infants who receive MOM versus DM. METHODS: In this retrospective cohort study conducted between 2018 and 2022, we compared 70 VLBW preterm infants exclusively fed with DM to 70 randomly selected counterparts fed with MOM. Both groups began enteral feeding within 72 hours of birth. Various clinical outcomes were investigated during a three-month follow-up. The clinical outcomes were compared via independent t-tests, Mann-Whitney U, and Fisher`s exact test. RESULTS: The mean gestational age of the infants who were included was 29.6 ± 1.6 weeks, 84 (60%) were males, and the average birth weight was 1217 ± 151 grams. Both groups had similar baseline characteristics. The results of the study demonstrated no statistically significant differences between the groups in terms of hospital length of stay (37±16.3 days in MOM vs 40.3±16.9 days in DM group, P= 0.17), growth rate (13±4 gram/day in MOM vs 13±4 gram/day in DM group, P=0.51), growth velocity (9.8±3.0g/kg/d in MOM vs 9.5±3.2 g/kg/d in DM group), infants with in-hospital vomiting (51 cases in MOM vs 59 cases in DM group, P=0.15),vomiting frequency (1.3±1.1 times in MOM vs 1.5±1.0 times in DM group), incidence of retinopathy of prematurity (ROP) (4 cases in MOM vs 5 cases in DM group, P > 0.999) and incidence of bronchopulmonary dysplasia (BPD) (7 cases in MOM vs 6 cases in DM group, P > 0.999). CONCLUSION: Our study findings indicate that the utilization of DM didn`t have a substantial negative impact on infants` outcomes nor any complications in comparison with MOM.
Asunto(s)
Recien Nacido Prematuro , Retinopatía de la Prematuridad , Femenino , Humanos , Recién Nacido , Masculino , Lactancia Materna , Recién Nacido de muy Bajo Peso , Leche Humana , Madres , Estudios Retrospectivos , VómitosRESUMEN
PURPOSE: Motor skills are involved in many physical activities and are prerequisites for the performance of sport skills. The purpose of this systematic review was to examine the effects of exercise training programs (ETP) on the motor skills of individuals with intellectual disabilities (IwID). METHODS: Primary sources were obtained from four databases including PubMed, SCOPUS, CENTRAL, and Web of Science. The search period covered years from inception to October 26th, 2023. Inclusion criteria were as follows: Population: IwID; Intervention: ETP; Comparator: motor skills vs. nontraining control; Outcomes: motor skills outcomes. Standardized mean differences, weighted mean differences, and 95% confidence intervals (CI) were calculated using both random and fixed-effect models for outcomes. RESULTS: A total of 14 studies involving 586 participants were included in the systematic review. The results of the present meta-analysis showed that ETP improved composite motor skills (1.28 95% CI: [0.86, 1.70], p = 0.001), gross motor skills (0.91, 95% CI: [0.62,1.19], p = 0.001), fine motor skills (0.74, 95% CI: [0.21,1.27], p = 0.01) and fine-gross motor skills (0.64, 95% CI: [0.29, 1.00], p = 0.001). CONCLUSION: The results meta-analysis demonstrated that ETP improves the motor skills of IwID. Therefore, it is recommended to apply ETP to improve the motor skills of the IwID.
Exercise training programs is a rehabilitation program to enhance motor skills in individuals with intellectual disabilities.It is recommended for rehabilitation professionals to apply exercise training programs to improve the motor skills of the individuals with intellectual disabilities.The positive outcomes underscore the importance of incorporating tailored exercise training programs interventions into the improves the motor skills for individuals with intellectual disabilities.
RESUMEN
The importance of feeding as a vital physiological function, on the one hand, and the spread of complications induced by its disorder in humans and animals, on the other hand, have led to extensive research on its regulatory factors. Unfortunately, despite many studies focused on appetite, only limited experiments have been conducted on avian, and our knowledge of this species is scant. Considering this, the purpose of this review article is to examine the role of central neurotransmitters in regulating food consumption in broilers and layers and highlight the similarities and differences between these two strains. The methodology of this review study includes a comprehensive search of relevant literature on the topic using appropriate keywords in reliable electronic databases. Based on the findings, the central effect of most neurotransmitters on the feeding of broilers and laying chickens was similar, but in some cases, such as dopamine, ghrelin, nitric oxide, and agouti-related peptide, differences were observed. Also, the lack of conducting a study on the role of some neurotransmitters in one of the bird strains made it impossible to make an exact comparison. Finally, it seems that although there are general similarities in appetite regulatory mechanisms in meat and egg-type chickens, the long-term genetic selection appropriate to breeding goals (meat or egg production) has caused differences in the effect of some neurotransmitters. Undoubtedly, conducting future studies while completing the missing links can lead to a comprehensive understanding of this process and its manipulation according to the breeding purposes of chickens.
Asunto(s)
Pollos , Neurotransmisores , Animales , Pollos/fisiología , Neurotransmisores/metabolismo , Regulación del Apetito/fisiología , Femenino , Apetito/fisiologíaRESUMEN
PURPOSE: The purpose of this study was to examine the balance recovery strategy in children with hearing (HI) and visual impairments (VI) compared with those without these disorders. MATERIALS AND METHODS: This study featured a cross-sectional design with subjects (N = 45) placed within one of three equally stratified purposive groups (HI, VI, and comparison) within the age range of 9-13 years (mean = 11.43, SD = 1.5). Balance recovery strategy was measured in static and after-perturbation conditions by a four-camera Vicon system used to record three-dimensional lower body kinematic data. A repeated-measures analysis of variance (3 × 2, Group × Condition) was utilized to analyze data. Significance was set at p ≤ .05. RESULTS: In the static condition, the results of the study showed that there was no significant difference between the groups in the ankle joint sway (p > .05). In hip joint sway, VI children had greater sway compared with comparison (p = .001) and HI children (p = .02). Also, HI children had greater sways than comparison (p = .02). In the after-perturbation condition, the results showed that VI children had greater sway in the hip and ankle joints than HI children (p = .001) and comparison (p = .001) to restore and maintain balance. CONCLUSION: It seems that comparison as well as higher proportion VI children use a hip strategy to maintain and restore balance. Also, it seems that HI children use a different strategy (ankle strategy) to maintain and restore balance compared with comparison and VI children.
Asunto(s)
Tobillo , Equilibrio Postural , Niño , Humanos , Adolescente , Estudios Transversales , Audición , Trastornos de la VisiónRESUMEN
Comprehensive insights into balance control of individuals with hearing impairment are compared with individuals with hearing. Primary sources were obtained from 7 databases including PubMed, LILACS, SCOPUS, CINAHL, PEDro, CENTRAL, and Web of Science. The search period extended from inception until January 5, 2022. The systematic review included 24 studies and 27 trials, with a total of 2,148 participants. The meta-analysis showed a significant difference in the average balance control between individuals with hearing impairment and individuals with hearing, with individuals with hearing having a favorable advantage (p = 0.001). Additionally, average balance control was found to be in favor of individuals with hearing (p = 0.001) when comparing individuals with hearing impairment who participated in sports. Finally, individuals with hearing impairment who participated in sports demonstrated a significantly higher average difference in balance control (p = 0.001) when compared to sedentary people with hearing impairment. Our meta-analysis results indicate a balance defect in individuals with hearing impairment compared to individuals with hearing. In addition, with increasing age, the balance in individuals with hearing impairment improved. Additionally, the dependence of individuals with hearing impairment on the visual and proprioception systems to maintain balance increased. Finally, there was more dependence on the proprioception than the visual system, while individuals with hearing had stronger average balance control than individuals with hearing impairment who participated in sports, when compared to sedentary people with hearing impairment.
Asunto(s)
Pérdida Auditiva , Equilibrio Postural , HumanosRESUMEN
The current study aimed to explore the effects of proprioception versus core stability training over 8 weeks on the gait parameters of deaf adolescents. A total of 20 deaf adolescents were randomized into two groups: one group receiving proprioception training (PT, n = 10), another group receiving core stability training (CST, n = 10), and eleven typically developing adolescents assigned into the control group (CON; n = 11). Gait was recorded by two digital cameras; then, using the Kinovea software, the parameters of gait included: gait velocity, cadence, stride length, stride time, stance time, and swing time were calculated in terms of percentages of the walking cycle. After 8 weeks of PT, no significant differences were observed for all gait parameters between PT and control groups (p > 0.05). Also, after 8 weeks of CST, no significant differences were observed in gait velocity and cadence between the CST and control groups (p > 0.05). However, after 8 weeks of CST, stride length (p = 0.02) was higher in the control group; Stride time (p = 0.03), stance time (p = 0.04) and swing time (p = 0.04) were higher in the CST group. Moreover, after 8 weeks of PT, values showed significant improvements in all gait parameters (p = 0.001). Also, after 8 weeks of CST, values showed significant improvements in gait velocity and cadence (p = 0.001), but no significant differences were observed in other gait parameters (p > 0.05). The findings of this study indicated that PT improved all gait parameters, whereas CST improved gait velocity and cadence. The results of the present study also demonstrated that PT had a greater effect on gait parameters of deaf adolescents compared with CST. It seems that PT induces more training effects than CTS for enhancing gait parameters of deaf adolescents.Trial registration: Clinical trial registry number: IRCT20170312033029N2. URL: https://en.irct.ir/trial/25584 .
Asunto(s)
Estabilidad Central , Marcha , Humanos , Adolescente , Caminata , PropiocepciónRESUMEN
In this study, we simulate the reductive coupling (Barbier-Grignard-type) reaction of organohalides with aldehydes using a new reusable catalyst. In this regard, bimetallic alloys of NiCo encapsulated in melamine-based dendrimers (MBD) immobilized on magnetic nanoparticles symbolized as γ-Fe2O3-MBD/NiCo were designed and synthesized. The structure and properties of the catalyst were studied by a variety of techniques such as Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), thermogravimetric analysis (TGA), vibrating sample magnetometry (VSM), energy-dispersive spectrometry (EDS) mapping, and inductively coupled plasma (ICP). The presence of NiCo nanoalloys was confirmed by XRD and XPS analysis, TEM images, and EDS mapping. Various secondary alcohols were produced in good to high yields by reductive coupling of different types of aldehydes and organohalides in the presence of HCO2K as a nonmetallic reducing agent in aqueous media catalyzed by γ-Fe2O3-MBD/NiCo. In these reactions, the high catalytic performance of γ-Fe2O3-MBD/NiCo was achieved in comparison to monometallic counterparts due to the synergistic cooperative effect of Co and Ni in the NiCo nanoalloys. Magnetic and hydrophilic properties of the catalyst facilitate the catalyst recyclability for seven runs. The reusability of γ-Fe2O3-MBD/NiCo, use of water as an environmentally friendly solvent, ease of processing, and absence of metal additives make this process an excellent choice for the reductive coupling reaction to produce secondary alcohols from aldehydes. This is the first report on these kinds of reactions using a reusable catalyst.
RESUMEN
OBJECTIVE: The objective of this systematic review and meta-analysis was to assess the efficacy of exercise in neuropathic pain following traumatic spinal cord injuries. METHODS: The search was conducted in MEDLINE, Embase, Scopus, and Web of Science by the end of 2022. Two independent researchers included the articles based on the inclusion and exclusion criteria. A standardized mean difference was calculated for each data and they were pooled to calculate an overall effect size. To assess the heterogeneity between studies, I2 and chi-square tests were utilized. In the case of heterogeneity, meta-regression was performed to identify the potential source. RESULTS: Fifteen preclinical studies were included. Meta-analysis demonstrated that exercise significantly improves mechanical allodynia (standardized mean difference [SMD], -1.59; 95% confidence interval [CI], -2.16 to -1.02; p < 0.001; I2 = 90.37%), thermal hyperalgesia (SMD, 1.95; 95% CI, 0.96-2.94; p < 0.001), and cold allodynia (SMD, -2.92; 95% CI, -4.4 to -1.43; p < 0.001). The improvement in mechanical allodynia is significantly more in animals with a compression model of SCI (meta-regression coefficient, -1.33; 95% CI, -1.84 to -0.57; p < 0.001) and in mild SCI (p < 0.001). Additionally, the improvement was more prominent if the training was started 7 to 8 days postinjury (coefficient, -2.54; 95% CI, -3.85 to -1.23; p < 0.001) and was continued every day (coefficient, -1.99; 95% CI, -3.07 to -0.9; p < 0.001). Likewise, voluntary exercise demonstrated a significantly more effect size (coefficient, -1.45; 95% CI, -2.67 to -0.23; p = 0.02). CONCLUSION: Exercise is effective in the amelioration of neuropathic pain. This effect in mechanical allodynia is more prominent if voluntary, continuous training is initiated in the subacute phase of mild SCI.
RESUMEN
BACKGROUND: Individuals with visual impairment have balance deficits; therefore, this systematic review aimed to provide comprehensive insights into the balance control of individuals with visual impairments when compared with individuals with full vision. METHODS: Primary sources were obtained from eight databases including PubMed, LILACS, Science Direct, SCOPUS, CINAHL, PEDro, CENTRAL, and Web of Science. The search period covered years from inception to January 10, 2022. RESULTS: A total of 20 studies with 29 trials with 1,280 participants were included in the systematic review. The results showed that individuals with sight had better static and dynamic balance than individuals with visual impairment (p = .001). However, individuals with visual impairment had significantly better static balance with visual perturbation and stronger static balance with visual and proprioception perturbation (p = .001). Furthermore, individuals with sight had better balance control than individuals with visual impairment who participated in sports (p = .001). Finally, individuals with visual impairment who participated in sports had better balance control than sedentary people with visual impairment (p = .001). CONCLUSION: Individuals with visual impairment have defects in both dynamic and static balance when compared to individuals with sight. In addition, balance improved with increasing age in individuals with visual impairment while balance control was dependent on the proprioception and vestibular systems. Also, individuals with sight had better balance than individuals with visual impairment who participated in sports and individuals with visual impairment who participated in sports compared with sedentary people with visual impairment.
RESUMEN
Introduction: The Corticosteroid Randomization After Significant Head injury (CRASH) and the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) are two prognostic models frequently used in predicting the outcome of patients with traumatic brain injury. There are ongoing debates about which of the two models has a better prognostic value. This study aims to compare the CRASH and IMPACT in predicting mortality and unfavorable outcome of patients with traumatic brain injury. Method: We performed a literature search using Medline (via PubMed), Embase, Scopus, and Web of Science databases until August 17, 2022. After two independent researchers screened the articles, we included all the original articles comparing the prognostic value of IMPACT and CRASH models in patients with traumatic brain injury. The outcomes evaluated were mortality and unfavorable outcome. The data of the included articles were analyzed using STATA 17.0 statistical program, and we reported an odds ratio (OR) with a 95% confidence interval (95% CI) for comparison. Results: We included the data from 16 studies. The analysis showed that the areas under the curve of the IMPACT core model and CRASH basic model do not differ in predicting the mortality of patients (OR=0.99; p=0.905) and their six-month unfavorable outcome (OR=1.01; p=0.719). Additionally, the CRASH CT model showed no difference from the IMPACT extended (OR=0.98; p=0.507) and IMPACT Lab (OR=1.00; p=0.298) models in predicting the mortality of patients with traumatic brain injury. We also observed similar findings in the six-month unfavorable outcome, showing that the CRASH CT model does not differ from the IMPACT extended (OR=1.00; p=0.990) and IMPACT Lab (OR=1.00; p=0.570) in predicting the unfavorable outcome in head trauma patients. Conclusion: Low to very low level of evidence shows that IMPACT and CRASH models have similar values in predicting mortality and unfavorable outcome in patients with traumatic brain injury. Since the discriminative power of the IMPACT Core and CRASH basic models is not different from the IMPACT extended, IMPACT Lab, and CRASH CT models, it may be possible to only use the core and basic models in examining the prognosis of patients with traumatic injuries to the brain.
RESUMEN
PURPOSE: Children with hearing impairment are unable to speak and may suffer from some physical problems such as weakness in postural performance ability and development. The aim of the current study was to explore the effects of proprioception versus core stability training for an 8-week period followed by a 6-month detraining protocol on the balance performance of deaf students. MATERIALS AND METHODS: This is a randomized controlled trial design of three groups in blinded evaluators. The study was conducted at the school gym. A total of 30 participants, of male deaf students, were randomized into three groups: (1) one group receiving proprioception training (PT, n = 10), (2), one group receiving core stability training (CST, n = 10) for 8 weeks, and (3), and control group (CON, n = 10). The Balance Error Scoring System (BESS) test and Y-balance test assess static and dynamic balance at pre- and post-training following a 6-month detraining. RESULTS: Post 8 weeks of training intervention, PT and CST values showed significant improvements in both static (p = 0.001) and dynamic (p = 0.001) balance. Following the 6-month detraining, only the PT group maintained their improvements in both the static and dynamic balance tests (p = 0.348) and the CST group showed decreases in the balance tests (p = 0.034). CONCLUSIONS: The results indicate that 8 weeks rehabilitation program (PT and CST) is an optimum training modality to enhance balance in deaf students and PT induces more training effects than CST for maintaining training benefits following the detraining. Clinical trial registry number: IRCT20170312033029N2; URL: https://en.irct.ir/trial/25584; Trial Id: 25584; Registration date: 2017-12-08; Study start date; 2017-12-22.