Background and Purpose. Mild cognitive impairment (MCI) is a common condition, which threatens the quality of life of older adults. Tai Chi (TC) is growing in popularity among patients with MCI. This study is aimed at evaluating the effectiveness and safety of TC in older adults with MCI. Design. Randomized controlled trials (RCTs) from multiple databases from inception to December 2020 published in English were searched. Two researchers independently performed eligible study screening and data extraction. The methodological quality was assessed with the Jadad score. Meta-analysis of RCTs on TC in the treatment of MCI was performed with RevMan Version 5.4.1. Results. Seven RCTs with 1265 participants were included. For most RCTs, the overall reporting of methodological quality was high. Results of the meta-analysis indicate that TC improved MCI patients’ cognitive function significantly, including overall cognitive function ( MD = − 2.24 , 95% CI -3.51 to -0.97, P = 0.0005 ), memory and learning ( SMD = 0.83 , 95% CI 0.22 to 1.45, P = 0.008 ), visuospatial ability ( MD = 3.15 , 95% CI 0.74 to 5.56, P = 0.01 ), executive functions ( MD = 0.32 , 95% CI 0.03 to 0.61, P = 0.03 ), and physical activity ( MD = 18.78 , 95% CI 10.80 to 26.76, P < 0.00001 ). However, no significant benefit was found for TC on psychological activity ( MD = 0.17 , 95% CI -0.62 to 0.96, P = 0.36 ) and biomarker improvement. Conclusion. The meta-analysis confirmed the clinical therapeutic effect of TC for MCI. More rigorous and long-term follow-up RCTs should be conducted in the future.
Background The world is currently struggling with the Coronavirus disease 2019 (COVID-19) pandemic. Dietary supplements (DSs) and herbal medicine provide a potentially convenient and accessible method for its recovery, but direct evidence is limited. Objective This study aims to investigate the effectiveness of DSs and herbs in patients with COVID-19. Methods A systematic literature search was conducted in multiple electronic English and Chinese databases. Randomized controlled trials (RCTs) involving DSs or herbal medicine interventions on patients with COVID-19 from November 2019 to February 2021 were included. Data was extracted, summarized and critically examined. Results Out of 9402 records identified in the initial search, twelve RCTs were included in this review. Risk of bias of these RCTs was deemed high. Most of the trials were of low methodologic quality. Nine studies showed herbal supplements were beneficial to the recovery of COVID-19 patients; zinc sulfate could shorten the duration of loss of smell but not total recovery from COVID-19. No severe adverse events were reported. Conclusion Herbal supplements may help patients with COVID-19, zinc sulfate is likely to shorten the duration of olfactory dysfunction. DS therapy and herbal medicine appear to be safe and effective adjuvant therapies for patients with COVID-19. These results must be interpreted with caution due to the overall low quality of the included trials. More well-designed RCTs are needed in the future.
To assess the hypothesis that breast, genitourinary (GU), and rectal examinations are performed more frequently when the physician and patient are of the same gender, the authors reviewed the records of 529 patients in a housestaff medical clinic. They found no significant difference between gender-congruent and gender-incongruent patient encounters in the rates of these examinations. However, higher rates of performance by primary care housestaff compared with those of internal medicine housestaff were noted in all categories. The authors conclude that performances of breast, GU, and rectal examinations were not related to gender congruence but may have been associated with the houseofficers' training program.
Background Upper limb and hand motor dysfunction is one of the challenges in rehabilitation after cerebral ischemic stroke (CIS), and the clinical efficacy of rehabilitation needs to be improved. This study aims to combine Jin’s three-needle acupuncture (JTN) therapy with mirror therapy (MT) for hemiplegia after CIS, objectively evaluate the clinical effects and safety of JTN to treat upper limb dysfunction, and use functional magnetic resonance imaging (fMRI) of the brain to investigate the central mechanisms of the effects, which would provide a powerful evidence-based medical basis for further supporting the application of JTN combined with MT. Methods/design This trial will be a single-blind, randomized controlled study. Patients who meet the study criteria will be recruited and randomly assigned to either the combined treatment group (JTN+MT) or the JTN group. Both interventions will be conducted for 6 days per week and last for 4 weeks. The primary outcome will be the effective rate based on the Fugl–Meyer Assessment for Upper Extremity (FMA-UE). Other outcome measures will include scores on the motor assessment scale (MAS), action research arm test (ARAT), activities of daily living (ADL) scale, and fMRI analyses. For safety evaluation, adverse events will be observed and recorded. Discussion This study may help to identify the efficacy and safety of acupuncture combined with MT for upper limb dysfunction after CIS and explore the central mechanisms with brain fMRI. Trial registration Chinese Clinical Trial Registry ChiCTR-IOR-17012174. Registered on 5 April 2017.
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