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A summary of the evidence and evaluation of the effectiveness of nonpharmacological interventions for mild cognitive impairment

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Frontiers of Nursing 2019年第4期6卷 301-316页

作者： Zi-Meng Li Ying-Hui Jin Yun-Yun Wang Lu Cui Wei-Jie Gao Jin-Hua Si Yan-Hui Liu School of Nursing Tianjin University of Traditional Chinese MedicineTianjin 301617China Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Evidence-Based Medicine and Clinical Epidemiology The Second Clinical College of Wuhan UniversityWuhan 430071China Center for Evidence-Based and Translational Medicine Wuhan UniversityWuhan 430071China Emergency Department Tianjin Taida HospitalTianjin 300457China Library of Tianjin University of Traditional Chinese Medicine Tianjin 301617China

Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and clinical decisions for MCI ***: Scottish Intercollegiate Guideline Network(SIGN), National Institute for Health and Clinical Excellence(NICE), American Academy of Neurology(AAN), Registered Nurses Association of Ontario(RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure(CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation(AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews(AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach was used to evaluate the quality of ***: Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions(including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4(13%), low for 10(32%), and moderate for 17(55%).Conclusions: Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and qual

关键词： nonpharmacological intervention mild cognitive impairment systematic review methodology evidence evaluation evidence synthesis

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Non-pharmacological interventions for diabetic peripheral neuropathy:Are we winning the battle?

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World Journal of Diabetes 2024年第4期15卷 579-585页

作者： Dania Blaibel Cornelius James Fernandez Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine&HealthThe University of ManchesterManchester M139PLUnited Kingdom

Despite the advent of relatively reliable modalities of diagnosing diabetic peripheral neuropathy(DPN),such as nerve conduction studies,there is still a knowledge gap about the pathophysiology,and thus limited available in-terventions for symptom control and curtailing disease *** pharma-cologic aspect of management is mainly centred on pain control,however,there are several important aspects of DPN such as loss of vibration sense,pressure sense,and proprioception which are associated with risks to lower limb health,which pharmacotherapy does not ***,published evidence suggests non-pharmacologic interventions such as glycaemic control through dietary modification and exercise need to be combined with other measures such as psychotherapy,to reach a desired,however modest *** is emerging as an important treatment modality for several chronic medical conditions including neuropathic and other pain *** their study published in the World Journal of Diabetes on the potential of acupuncture to reduce DPN symptoms and enhance nerve conduction parameters,Hoerder et al have been able to demonstrate that acupuncture improves sensory function and that this effect is likely sustained two months after treatment *** previous studies also support these findings,larger multi-center randomized control trials including a sham-controlled arm accounting for a placebo effect are ***,given the satisfactory safety profile and the positive results found in these studies,it is likely that acupuncture may become an important aspect of the repertoire of effective DPN management.

关键词： Diabetic peripheral neuropathy Diabetes mellitus Pharmacotherapy Acupuncture Neuropathic pain nonpharmacological intervention

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