Effect of acupuncture on menopausal hot flushes and serum hormone levels: a systematic review and meta-analysis

2021 ◽  
pp. 096452842110566
Author(s):  
Chang Liu ◽  
Zhijie Wang ◽  
Ting Guo ◽  
Lixing Zhuang ◽  
Xiao Gao
Keyword(s):  
Meta Analysis ◽  
Serum Levels ◽  
Sham Acupuncture ◽  
Hot Flushes ◽  
Hormone Levels ◽  
Hot Flush ◽  
Menopausal Women ◽  
Serum Hormone ◽  
Meta Analyses ◽  
Review Manager

Objective: To evaluate the efficacy/effectiveness and safety of acupuncture for the treatment of hot flushes and its impact on serum hormone levels in menopausal women. Methods: A total of 10 databases were searched from their inception to August 2018. Reference lists of reviews and included articles were also hand-searched. Randomized controlled trials (RCTs) comparing the effect of acupuncture versus sham acupuncture, or acupuncture versus hormone therapy (HT), as treatment for menopausal hot flushes were included. Outcomes included hot flush frequency, hot flush severity and serum hormone levels of estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Meta-analyses were performed using Review Manager 5.3 software. Results: Thirteen RCTs including 1784 patients were selected, seven of which were available for meta-analysis. Compared with sham acupuncture, acupuncture significantly decreased hot flush frequency (mean difference (MD) −0.84, 95% confidence interval (CI) [−1.64, −0.05], I2 = 54%) from baseline to the end of study, but did not impact end scores of hot flush frequency (MD 0.19, 95% CI [−0.61, 0.99], I2 = 0%) or severity (MD 0.02, 95% CI [−0.13, 0.17], I2 = 0%). No differences were found between acupuncture and HT in serum levels of E2 (MD 6.56, 95% CI [−3.77, 16.89], I2 = 76%), FSH (MD 1.06, 95% CI [−1.44, 3.56], I2 = 0%) or LH (MD −3.36, 95% CI [−13.37, 6.65], I2 = 89%). Conclusion: Acupuncture may not decrease hot flush frequency, but yet appears to have similar effects on serum hormone levels as HT, that is, increased E2 and decreased FSH and LH. Considering that no firm conclusions could be drawn due to the low quality and limited number of included trials included, further high-quality RCTs need to be conducted.

scholarly journals “Smoking paradox” is not true in patients with ischemic stroke: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Bo Li ◽  
Dan Li ◽  
Jing-Feng Liu ◽  
Lin Wang ◽  
Bao-Zhu Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Protective Factor ◽  
Meta Analysis ◽  
Vascular Diseases ◽  
Cochrane Library ◽  
Inverse Variance ◽  
First Onset ◽  
Prognostic Outcome ◽  
Meta Analyses ◽  
Review Manager

Abstract Background Ischemic stroke (IS) is a common cause of death from vascular diseases. Studies have found that smoking increases the risk of ischemic stroke, but the association of smoking with the outcome of IS remains unclear. This meta-analysis aims to investigate the effect of smoking on the prognosis of IS. Methods We searched four electronic databases including PubMed, EMBASE, Cochrane library and Web of science for papers, published before January 2019. In this meta-analysis, Review Manager 5.3 software was used to calculate for the pooled estimate effect, as well as the inverse-variance method for pooled mean difference (MD) and odds ratio (OR) of incidence in two groups of population. Results A total of 14,789 citations were identified during the literature search, 21 studies were included in the meta-analyses after screening. The full-adjusted OR of poor prognostic outcome in smoking and nonsmoking patients with stroke was pooled as 0.96 (95% CI 0.77–1.21), suggested that smoking or not has no impact on prognosis of IS. The pooled MD of onset age between smoking and nonsmoking IS patients was − 10.05 (− 12.91, − 7.19), indicated that smoking causes first onset of IS to occur 10 years earlier. Conclusions This meta-analysis showed that smoking was not a protective factor for poor prognosis of IS. Smoking patients with IS are 10 years younger than nonsmoking patients at time of the first onset of stroke.

scholarly journals Postoperative Complications of Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Gastric Cancer in a Meta-Analysis of High-Quality Case-Controlled Studies

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Mikito Inokuchi ◽  
Sho Otsuki ◽  
Norihito Ogawa ◽  
Toshiro Tanioka ◽  
Keisuke Okuno ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Gastrectomy ◽  
Meta Analysis ◽  
Tumor Stage ◽  
Pulmonary Complications ◽  
Wound Complications ◽  
Anastomotic Complications ◽  
Open Total Gastrectomy ◽  
Meta Analyses ◽  
Review Manager

Background. Some meta-analyses of case-controlled studies (CCSs) have shown that laparoscopic or laparoscopy-assisted total gastrectomy (LTG) had some short-term advantages over open total gastrectomy (OTG). However, postoperative complications differed somewhat among the meta-analyses, and some CCSs included in the meta-analyses had mismatched factors between LTG and OTG. Methods. CCSs comparing postoperative complications between LTG and OTG were identified in PubMed and Embase. Studies matched for patients’ status, tumor stage, and the extents of lymph-node dissection were included. Outcomes of interest, such as anastomotic, other intra-abdominal, wound, and pulmonary complications, were evaluated in a meta-analysis performed using Review Manager version 5.3 software. Result. This meta-analysis included a total of 2,560 patients (LTG, 1,073 patients; OTG, 1,487 patients) from 15 CCSs. Wound complications were significantly less frequent in LTG than in OTG (n = 2,430; odds ratio [OR] 0.30, 95% confidence interval [CI] 0.29–0.85, P=0.01, I2 = 0%, and OR 0.46, 95% CI 0.17–0.52, P<0.0001, I2 = 0%). However, the incidence of anastomotic complications was slightly but not significantly higher in LTG than in OTG (n = 2,560; OR 1.44, 95% CI 0.96–2.16, P=0.08, I2 = 0%). Conclusion. LTG was associated with a lower incidence of wound-related postoperative complications than was OTG in this meta-analysis of CCSs; however, some concern remains about anastomotic problems associated with LTG.

Steroid Hormone Levels in Patients with Advanced Breast Cancer during Therapy with Droloxifene: A Pilot Study

1996 ◽  
Vol 82 (1) ◽  
pp. 45-47
Author(s):  
Jacqueline Dalski ◽  
Max Görlich
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Tumor Progression ◽  
Postmenopausal Women ◽  
Serum Levels ◽  
Dehydroepiandrosterone Sulfate ◽  
Advanced Breast ◽  
Hormone Levels ◽  
Serum Hormone ◽  
Early Indication

Antiestrogens, particularly tamoxifen, are effective in the treatment of pre- and postmenopausal women suffering from all stages of breast cancer. Unfortunately, many patients become resistant to tamoxifen during therapy, which allows the tumor to progress. Thus, a preclinical recognition of tumor progression, i.e. by monitoring serum hormone levels, could be worthwhile. The serum levels of dehydroepiandrosterone sulfate and estradiol of postmenopausal women with advanced breast cancer treated by the new antiestrogen droloxifene were therefore checked. However, only non-significant changes in the hormone levels during droloxifene therapy were observed, and no relation was found between hormone levels and the course of the disease, success or exhaustion of droloxifene application, or development of tumor progression. Our data do not confirm earlier findings reported in the literature that measurement of hormones seems to be suitable for an early indication of tumor progression during an antiestrogen therapy before its clinical manifestation.

Evidence-based medicine

2011 ◽  
Author(s):  
Raghbir Khakha ◽  
Adam Hill
Keyword(s):  
Meta Analysis ◽  
Experimental System ◽  
Sham Acupuncture ◽  
Data Sets ◽  
Confounding Factors ◽  
Level Of Evidence ◽  
Or Groups ◽  
Meta Analyses ◽  
Based Medicine

The aim of research is to faithfully observe and describe, predict, determine causation, explain the hitherto unexplained, and conjure further questions. Medical research is concerned with the application of the scientific method to investigating both our population at risk, and our patients. However, it is often impossible to study entire populations. Therefore, many studies are undertaken to analyse representative cohorts before extrapolating the data to the population of interest. Every study is susceptible to bias and error. It is important to determine whether the evidence from an individual or groups of studies is strong or weak. In other words, are these data sets truly representative of the entire population of interest, or are the data distorted due to potential confounding factors? Furthermore, have the investigators presented a measured interpretation of their results in the context of the potential errors within their experimental system? It is these questions that have led to the concept of research evidence, or the hierarchical system in which the strength of the argument within some studies is simply better, or more persuasive, than others. When planning a research study, design is the first consideration. The highest possible level of evidence is a systematic review or meta-analysis of randomized controlled trials (RCTs), or an individual RCT. These are considered the ‘gold standard’ of clinical research. The design of RCTs allows exclusion of confounding factors and bias as much as possible. These studies work very well for certain interventions, such as drug trials. However, where the control and sample groups cannot be blinded, (e.g. ‘sham acupuncture’ or ‘sham manipulation’ as the control), RCTs may be less appropriate. Meta-analyses are considered as type 1 evidence. The more data is pooled, the more valid the results. However, the data may be less relevant to individual patients. Therefore, although potentially the most powerful type of evidence, meta-analyses can have some important limitations. A meta-analysis takes a number of trials from the literature, e.g. 10 trials of 100 patients each.

scholarly journals Sex Hormones Enhance Gingival Inflammation without Affecting IL-1βand TNF-αin Periodontally Healthy Women during Pregnancy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Min Wu ◽  
Shao-Wu Chen ◽  
Wei-Lan Su ◽  
Hong-Ying Zhu ◽  
Shu-Yuan Ouyang ◽  
...  
Keyword(s):  
Gingival Crevicular Fluid ◽  
Interleukin 1 ◽  
Serum Levels ◽  
Hormonal Changes ◽  
Gingival Inflammation ◽  
Pocket Depth ◽  
Hormone Levels ◽  
Probing Pocket Depth ◽  
Inflammatory Status ◽  
Serum Hormone

Hormones (progesterone and estradiol) change greatly during pregnancy; however, the mechanism of hormonal changes on gingival inflammation is still unclear. This study is to evaluate the effects of hormonal changes during pregnancy on gingival inflammation and interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) in gingival crevicular fluid (GCF). 30 periodontally healthy pregnant women were evaluated in the first, second, and third trimesters. 20 periodontally healthy nonpregnant women were evaluated twice (once per subsequent month). Clinical parameters including probing pocket depth (PPD), bleeding index (BI), gingival index (GI), clinical attachment level (CAL), and plaque index (PLI) were recorded. GCF levels of IL-1βand TNF-αand serum levels of progesterone and estradiol were measured. From the data, despite low PLI, BI and GI increased significantly during pregnancy; however, no significant changes in PLI, CAL, IL-1β, or TNF-αGCF levels were observed. Although IL-1β, not TNF-α, was higher in pregnant group than in nonpregnant group, they showed no correlation with serum hormone levels during pregnancy. GI and BI showed significant positive correlation with serum hormone levels during pregnancy. This study suggests that sex hormone increase during pregnancy might have an effect on inflammatory status of gingiva, independent of IL-1βand TNF-αin GCF.

scholarly journals Efficacy Comparison of Different Acupuncture Treatments for Hot Flashes: A Systematic Review with Network Meta-Analysis

2021 ◽  
Vol 38 (2) ◽  
pp. 110-121
Author(s):  
Hyo Rim Jo ◽  
Seong Kyeong Choi ◽  
Won Suk Sung ◽  
Eun Jung Kim ◽  
Su Ji Choi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Hormone Replacement ◽  
Hot Flashes ◽  
Indirect Comparison ◽  
Sham Acupuncture ◽  
Significant Difference ◽  
Review Manager

The objective of this study was to conduct a systematic review and network meta-analysis to evaluate and compare the effectiveness of various types of acupuncture for menopausal hot flashes (HF). Randomized controlled trials (RCTs) were retrieved from 8 electronic databases, and the risk of bias was evaluated for the included studies. Pairwise meta-analysis and network meta-analysis were performed using Review Manager and R software for indirect comparison and ranking, respectively. In total, 23 RCTs (2,302 patients) were eligible for systematic review, of which 10 were included in network meta-analysis. Network meta-analysis showed manual acupuncture (MA) had the highest probability of reducing HF frequency and severity, followed by sham acupuncture (SA), electroacupuncture, usual care, or no treatment; furthermore, warm acupuncture significantly improved menopause-specific quality of life compared with MA or electroacupuncture. Compared with hormone replacement therapy, acupuncture had less efficacy in reducing HF frequency but enhanced menopause-specific quality of life. There was no significant difference between MA and SA in mitigating HF. The existing evidence showed that MA could be used for alleviating menopausal HF. However, it is recommended that more high-quality RCTs should be performed.

scholarly journals Efficacy Comparison of Different Acupuncture Treatments for Functional Dyspepsia: A Systematic Review with Network Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-18
Author(s):  
Jinhuan Zhang ◽  
Yongfeng Liu ◽  
Xingxian Huang ◽  
Yirong Chen ◽  
Liyu Hu ◽  
...  
Keyword(s):  
Functional Dyspepsia ◽  
Short Form ◽  
Meta Analysis ◽  
Life Quality ◽  
Sham Acupuncture ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Manual Acupuncture ◽  
China National Knowledge Infrastructure ◽  
Meta Analyses

Background. Acupuncture has been found to be an effective treatment for functional dyspepsia (FD). Currently, several types of acupuncture have been developed but it is not clear which type is suitable for FD. Currently, doctors often rely on experience to decide which form of acupuncture to apply. Herein, we employed network meta-analysis (NMA) to compare the effectiveness of various methods of acupuncture in the treatment of functional dyspepsia. Methods. We searched for randomized controlled trials (RCTs) of acupuncture treatments for functional dyspepsia in seven databases; PubMed, the Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure (CNKI) database, Chinese Science and Technique Journals (CQVIP), and Chinese Biomedical Database (CBM) from the date of database inception to October 10, 2019. Cochrane risk of bias tool was used to analyze the risk of bias of the included RCTs. Pairwise meta-analyses were performed with RevMan 5.3 and the network meta-analysis of the included RCTs was performed using the frequentist framework. Results. A total of 35 studies involving 3301 patients and 10 interventions were eligible for this study. NMA results showed that five types of acupuncture (manual acupuncture, acupoint application, moxibustion, acupoint catgut embedding, and warm acupuncture alone) all were superior to prokinetics (itopride, mosapride, and domperidone) and sham acupuncture in terms of improving the symptoms of functional dyspepsia. Specifically, manual acupuncture and electroacupuncture were more effective in improving the MOS 36 Item Short-Form Health Survey (SF-36) compared to itopride and sham acupuncture, and electroacupuncture was the best among the three acupuncture therapies (acupuncture, electroacupuncture, and acupoint catgut embedding). Moxibustion and manual acupuncture were more effective in improving Nepean Dyspepsia Life Quality Index (NDLQI) compared to itopride, domperidone, and sham acupuncture; moxibustion ranks first among the three acupuncture therapies (acupuncture, electroacupuncture, moxibustion). Conclusions. These results showed that manual acupuncture alone was the most effective therapy for FD. It should, therefore, be considered as an alternative treatment for FD patients who are unresponsive to prokinetics or intolerant to the adverse effects of prokinetics. We recommend further multiple centers and high-quality RCT studies to confirm the present findings.

scholarly journals Variants in SULT2A1 Affect the DHEA Sulphate to DHEA Ratio in Patients With Polycystic Ovary Syndrome But Not the Hyperandrogenic Phenotype

2013 ◽  
Vol 98 (9) ◽  
pp. 3848-3855 ◽  
Author(s):  
Yvonne V. Louwers ◽  
Frank H. de Jong ◽  
Nathalie A. A. van Herwaarden ◽  
Lisette Stolk ◽  
Bart C. J. M. Fauser ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Genetic Variants ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Significant Snps ◽  
Serum Levels ◽  
Dehydroepiandrosterone Sulfate ◽  
Nucleotide Polymorphisms ◽  
Ovary Syndrome ◽  
Hormone Levels

Context: Because of the elevated dehydroepiandrosterone sulfate (DHEAS) levels in polycystic ovary syndrome (PCOS) and the heritability of DHEAS serum levels, genes encoding the enzymes that control the sulfation of dehydroepiandrosterone (DHEA) to DHEAS and vice versa are obvious candidate genes to explain part of the heritability of PCOS. Objective: The objective of the study was to determine the role of genetic variants in sulfotransferase (SULT2A1), 3-phosphoadenosine 5-phosphosulfate synthase isoform 2 (PAPSS2), and steroid sulfatase (STS) in PCOS and in hormone levels related to the hyperandrogenic phenotype of PCOS. Design: This was a candidate-gene study. Patients: The discovery set consisted of 582 patients and 2017 controls. Main Outcome Measures: A pruned subset of 28 single-nucleotide polymorphisms (SNPs) in SULT2A1, PAPSS2, and STS was generated based on pairwise genotypic correlation. Association with PCOS was tested, and we studied whether the SNPs modulate DHEAS levels, DHEA levels, and their ratio in PCOS. Significant SNPs were replicated in an independent sample of patients. Results: None of the SNPs in SULT2A1, PAPSS2, and STS constituted risk alleles for PCOS. SNP rs2910397 in SULT2A1 decreased the DHEAS to DHEA ratio in PCOS by 5% in the discovery sample. Meta-analysis of discovery and replication sample resulted in a combined effect of −0.095 (P = .027). However, carrying the minor T allele did not contribute to differences in the hyperandrogenic phenotype, including the levels of T and androstenedione, of PCOS patients. Conclusions: Genetic variants in SULT2A1, PAPSS2, and STS do not predispose to PCOS. Although a variant in SULT2A1 decreased the DHEAS to DHEA ratio, no changes in other androgenic hormone levels were observed.

scholarly journals Antiphospholipid Antibody and Recurrent Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3728-3732
Author(s):  
Yerim Kim ◽  
Soo Young Kim
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Young Patients ◽  
Cochrane Library ◽  
Computer Assisted ◽  
Antiphospholipid Antibody ◽  
Prospective Trials ◽  
Meta Analyses ◽  
Review Manager

Background and Purpose: Although aPLs (antiphospholipid antibodies) are associated with thrombotic events, especially in young patients, the role of aPLs in recurrent ischemic strokes (RIS) is unclear. This systematic review and meta-analysis evaluated the association between aPLs and RIS. Methods: The systematic review was conducted by a computer-assisted search of literature in PubMed, EMBASE, and Cochrane library published in English or Korean from 1990, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Review Manager 5.3 software was used for statistical analyses. Results: Of the 2272 identified articles, 8 studies were included (2510 subjects; 844 aPL positive). The meta-analysis revealed a relative risk of aPLs for RIS of 1.41 (95% CI, 0.91–2.17; I 2 =54%). In the subgroup analysis, age <50 years, ethnicity, and type of aPL did not increase the risk of RIS. Conclusions: We found that aPLs are not an independent predictor for RIS in adults. However, considering the nonstandardized disease criteria, further well-designed prospective trials should be considered to confirm these findings.

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