The effect of acupressure on sleep quality of older people: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND OBJECTIVE

The effects of acupressure on sleep quality and insomnia symptoms have been studied in various groups of haemodialysis patients, those undergoing surgery, and those living in elderly care homes. The aim of this study is to determine the effect of acupressure on sleep quality in elderly people.

METHODS

This study was conducted with a systematic review and meta-analysis. In this study, electronic databases of PubMed, Science Direct, National Thesis centre, Google Scholar, Web of Science, EBSCO were systematically scanned between December 2020 and February 2021 using the keywords "older, elderly, sleep quality, acupressure". The study included 11 articles published in English and Turkish languages without any year limitation. This systematic review and meta-analysis were done by following the PRISMA reporting system.

RESULTS

The total sample size of 11 randomized controlled trials included in this systematic review and meta-analysis was 722 (experiment: 363 and control: 359), and the mean duration of acupressure interventions applied was 19.65 ± 11.28 days. The sleep quality of the acupressure group in the elderly was significantly increased compared to the control group (MD: -1.71,%95 CI: -2.31 to -1.11, Z = 5.60, p< 0.00001, I² = 91%). After the subjects received training for acupressure application and applied acupressure themselves, their sleep quality improved compared to the control group (MD: -0.86, 95% CI: -1.39 to -0.32, p <0.001).

CONCLUSIONS

We have utilized meta-analysis to try to reveal statistical significance by pooling small studies with high quality. This meta-analysis provided a potentially effective intervention on the quality of sleep in elderly people.

The effect of COVID-19 pandemic restrictions on neovascular AMD patients treated with treat-and-extend protocol

Purpose

To investigate the adherence rate of neovascular age-related macular degeneration (nAMD) patients in treat-and-extend (TAE) protocol to their anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection (IVI) appointments and to evaluate the functional and anatomical outcomes of the patients who attended and did not attend their IVI appointments during the coronavirus disease 2019 (COVID-19) restriction period (RP).

Methods

The patients with nAMD having IVI appointments between March 16 and June 1, 2020 (RP in Turkey) were included in this retrospective study. For adherence analysis, the patients who attended (Group 1, n = 44) and who did not attend (Group 2, n = 60) their IVI appointment visits during the RP (V_RP) were evaluated according to their last visit before the RP (V₀). For outcome analysis, the patients who attend V_RP and have follow-up (Group 1a, 46 eyes) and who did not attend V_RP but later attended for follow-up (Group 2a, 33 eyes) were evaluated for functional (best-corrected visual acuity, BCVA [logMAR]) and anatomical (optical coherence tomography [OCT] disease activity) outcomes at the first visit after RP (V₁) and last visit within six months after RP (V₂). Patients received a complete ophthalmologic evaluation with anti-VEGF (Aflibercept) IVI administration at all visits.

Results

The adherence rate of the patients to V_RP was 42.3% (44/104). The patients in Group 1 were significantly younger (mean ± SD years, 71.0 ± 8.1 vs. 74.7 ± 8.0, p = 0.024), had better median [IQR] BCVA at their first presentation (0.30 [0.54] vs. 0.61 [1.08], p = 0.023) and V₀ (0.40 [0.48] vs. 0.52 [0.70], p = 0.031), and had less hypertension (36.4% vs. 58.3%, p = 0.044) than Group 2. The mean ± SD delay of planned IVI at V_RP in Group 2a was 13.9 ± 6.2 weeks. Disease activity in OCT was significantly higher in Group 2a than Group 1a at V₁ (60.6% vs. 32.6%, p = 0.025). In Group 2a, the median (IQR) BCVA was significantly worse at V₁ (0.70 [0.58]) and V₂ (0.70 [0.59]) than V₀ (0.52 [0.40], p = 0.047 and p = 0.035, respectively).

Conclusions

More than half of the scheduled nAMD patients in TAE protocol missed their IVI visits during the RP, which resulted in a delay of their treatments. The delay of IVI treatment in those patients resulted in an increase in OCT disease activity and a decrease in BCVA.

Carbonic anhydrase I and II autoantibody levels in primary hypertension: our preliminary results

OBJECTIVE

The pathogenesis of primary hypertension (HT) is still not completely clear, although autoimmunity has been implicated in recent years. Carbonic anhydrase (CA) is an enzyme involved in a number of important metabolic processes. CA I and II autoantibodies have been linked to various autoimmune diseases. However, CA I and II autoantibody levels in primary HT have not been previously investigated. The purpose of this study was, therefore, to investigate levels of CA I and II autoantibodies in primary HT.

PATIENTS AND METHODS

Fifty-six patients newly diagnosed with primary HT and 33 healthy individuals were included in the study. Twenty-four-hour ambulatory blood pressure monitoring was performed following office controls. Blood specimens were collected under appropriate conditions for CA I and II autoantibody level investigation and biochemical tests. Urine sodium and protein excretion were measured after 24 h. Demographic and biochemical parameters and CA I and II autoantibody levels were then compared between the patient and healthy groups.

RESULTS

CA II autoantibody and uric acid levels were significantly higher in the hypertensive group than in the control group (p=0.005, and p<0.001, respectively). CA II autoantibody (exp ß: 79.06 CI: 4.44-1407.02) (p=0.003) and uric acid elevation (exp ß: 2.10 CI: 1.31- 3.34) (p=0.002) were identified as independent predictors of HT development at logistic regression analysis.

CONCLUSIONS

CA II autoantibody levels were higher in hypertensive patients, and this elevation is an independent predictor of HT development.

Stability and volatile oxidation compounds of grape seed, flax seed and black cumin seed cold-pressed oils as affected by thermal oxidation

The old-pressed oils (CPO) from grape seeds (GSO), flax seeds (FSO) and black cumin seeds (BSO) were analyzed for their fatty acid profiles, tocopherols, total phenolics, bioactives and phenolic compositions. The stability of CPO under thermal oxidation conditions was evaluated. The main fatty acid in FSO was linolenic acid (56.5% of total fatty acids); while GSO and BSO were rich in linoleic acid, which accounted for 66.8 and 56.8%, respectively. GSO was rich in ?-tocopherol (123.0 mg/kg), while ?-tocopherol was a prevalent isomer in FSO and BSO (137.9 and 128.9 mg/kg, respectively). The total phenolic contents in the oils ranged from 554 mg GAE/kg oil (FSO) to 1140 mg GAE/kg oil (BSO). Luteolin, dihydroquercetin and benzoic acids were the dominant bioactives and phenolics in FSO, GSO and BSO, respectively. Based on the oxidative stability index (OSI) value, BSO showed the highest value (6.14 h) among the other oils. The oxidative stability of FSO and BSO were higher than GSO according to peroxide value (PV) and conjugated diene (CD) values of the oils during storage at 60 °C. Hexanal, 2,4-heptadienal and (E,E)-2,4-heptadienal were the major volatile oxidation compounds (VOC) in FSO. Hexanal and (E)-2-heptanal were the main identified VOC in the GSO and BSO under the same oxidation conditions.

Evaluation of the factors associated with sublingual varices: a descriptive clinical study

BACKGROUND

Age is considered as an important factor for the development of sublingual varices (SV). It has been suggested that some other conditions such as gender, systemic diseases, smoking, denture wearing may play a role in aetiology. However, there are a limited number of studies investigating these associations. This study was perform to evaluate association between SV and the conditions which are described as possible risk factors previously.

MATERIALS AND METHODS

A total of 691 patients (470 females, 221 males) who attended for comprehensive clinical examination were included in the study. Age, gender, systemic health, venous varix of the lower extremities, smoking status, denture wearing were recorded during the history taking. SV were classified into two categories: stage 0 (few or none visible) and stage 1 (moderate or severe). Tongue photographs were taken from a group of these patients. For the evalu- ation of intra-observer reliability, 60 photographs of tongue were re-evaluated by the same observer. Intra-observer reliability was evaluated using Kappa statistics. Pearson c2 test and Fisher's exact test were used to assess SV in relation to each variable, and variables showing associations with p < 0.05 were selected for the multivariable analysis, then logistic regression analysis was applied.

RESULTS

Kappa value of intra-observer reliability was 0.91. SV were significantly associated with age (odds ratio [OR] = 1.08, p = 0.000), hypertension (OR = 2.3, p = 0.007) and denture wearing (OR = 2.17, p = 0.02).

CONCLUSIONS

The presence of SV is associated with hypertension and denture wearing as well as aging. More detailed studies are needed to prove causative relations between SV and systemic diseases.

Note: Inhibition of Pathogenic Bacteria by Essential Oils at Different Concentrations

The antimicrobial effect of 11 selected Turkish spice essential oils was investigated against seventeen pathogenic bacteria. The antimicrobial activity of the essential oils of six spices (cumin, fennel, laurel, mint, marjoram, oregano, pickling herb, sage, savory, thyme (black) and thyme) was tested at four concentrations (0.2, 0.4, 1 and 2%) on various microorganisms ( E. aerogenes, E. coli, E. coli O157:H7, K. pneumoniae, P. vulgaris, S. enteritidis, S. gallinarum, S. typhimurium, S. aureus, Y. enterocolitica, A. hydrophila, C. xerosis, M. luteus, M. smegmatis, E. feacalis, P. aeruginosa and P. fluorescens). All preparations showed antibacterial activity against at least one or more bacteria. The inhibitory effect of the essential oils was evaluated through paper disc diffusion method. In general, the essential oils at 1 and 2% levels were effective. The most active essential oils were marjoram, thyme and oregano. According to the results, the studied essential oils potentially might be used as antibacterial agents to prevent the spoilage of food products, although further research is needed.

New probing and warm-wash-out technique improves early patency rates in arteriovenous fistula surgery

OBJECTIVE

Arteriovenous fistulas (AVFs) are commonly used during hemodialysis. Early failure of AVFs is quite common with incidence of 43% to 63%. In this study we aimed to describe a novel approach to AVF surgery for improving early patency rates.

PATIENTS AND METHODS

Patients were divided into two groups according to use of probing and warm-wash-out technique. Group I consisted of 31 patients with additional probing technique. Group II consisted of 32 patients without additional maneuver. End-to-side anastomosis were used to all patients. Technical success was defined as having palpation of a thrill on fistula. Flow rates of draining vein was measured at 1st hour, 24th hour, 1st week and 3rd week of surgery.

SURGICAL TECHNIQUE

Classical maneuvers were performed until end of the anastomosis. At this time, vein lumen was washed by low-dosed heparinized warm fluid, with assistance of a simple catheter.

RESULTS

Technical success was similar in both groups at 1st hour and 24th hour, while there were significantly differences between groups at 1st week (p = 0.042) and 3rd week (p = 0.05) assessments. Flow rates were also measured significantly higher in Group I at 1st hour (p = 0.011) and 24th hour (p = 0.016). Flow rates were almost similar in two groups at 1st and 3rd weeks but overall success rate was higher in Group I comparing with Group II (96.8% vs. 81.3%, respectively, p = 0.05).

CONCLUSIONS

Probing and warm-wash out technique will simply increase the surgical success and flow rate of draining vein.