Objective To study the risk factors of urinary incontinence in acute stroke patients and provide scientific evidence for preventing and managing such complication. Methods A computerized literature search was performed on both English and Chinese databases including Embase, Medline, Wanfang Data, VIP, and CNKI from January 1990 to January 2017 based on such search strategies as literature review and manual retrieval. In addition, we tracked down the related reference lists. The RevMan 5.3 software was used for Meta-analysis. Categorical data were calculated by the pooled odds ratio (OR) values and 95% confidence intervals (CI), and numerical data were calculated by pooled mean difference (MD) and 95%CI. Results A total of 17 articles of controlled studies with 2 428 cases and 3 725 controls were included. According to the results of Meta-analysis, factors associated with urinary incontinence following acute stroke were age [MD=2.80, 95%CI (0.29, 5.30),P=0.03], female gender [OR=1.29, 95%CI (1.16, 1.45),P<0.000 01], diabetes [OR=1.40, 95%CI (1.13, 1.73),P=0.002], heart disease [OR=1.65, 95%CI (1.29, 2.13),P<0.000 1), former cerebrovascular disease [OR=1.43, 95%CI (1.21, 1.69),P<0.000 1), speech disorder [OR=4.20, 95%CI (3.45, 5.10),P<0.000 01], smoking [OR=0.68, 95%CI (0.50, 0.92),P=0.01]. Hypertension [OR=1.25, 95%CI (0.99, 1.58),P=0.06], left hemisphere involvement [OR=1.29, 95%CI (0.81, 2.06),P=0.29], and hemorrhagic stroke [OR=1.26, 95%CI (0.79, 2.03),P=0.33] were not correlated with urinary incontinence following acute stroke. Conclusions Older age, female gender, diabetes, heart disease, former cerebrovascular disease and speech disorder are risk factors associated with post-stroke urinary incontinence, while smoking lowers the potential risk. However, hypertension, hemorrhagic stroke and left hemisphere involvement do not significantly increase the risk of urinary incontinence following stroke.
ObjectiveTo systematically review the efficacy of virtual reality technology on cognitive dysfunction in patients with cerebral vascular accident (CVA).MethodsEMbase, Web of Science, PubMed, The Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect the randomized controlled trials (RCTs) on virtual reality technology on cognitive dysfunction in patients with CVA from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 25 RCTs involving 1 113 patients were included. The results of the meta-analysis showed that the scores of MBI (MD=9.24, 95%CI 1.91 to 16.56, P=0.01), MMSE (MD=3.02, 95%CI 1.11 to 4.93, P=0.002) and RBMT-2 (MD=2.74, 95%CI 1.97 to 3.51, P<0.000 01) in VR group were superior to the control group. However, there were no significant differences between the two groups in scores of BI, MOCA, and VCPT.ConclusionsCurrent evidence shows that virtual reality technology may have positively influence on cognitive function and participation in the daily life activities of patients with CVA. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
ObjectiveTo systematically review the efficacy of immunoglobulin for treatment of clinical diagnosed viral encephalitis in China.MethodsCNKI, VIP, WanFang Data, PubMed, ScienceDirect, The Cochrane Library and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) of immunoglobulin for treatment of clinical diagnosed viral encephalitis in China from inception to January 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.4 software.ResultsA total of 57 RCTs involving 4 431 patients were included. The results of meta-analysis showed that in both children and adults of clinically diagnosed viral encephalitis, the combination of immunoglobulin could reduce the mean recovery time of fever, unconsciousness, convulsion, emesis, average hospitalization time, and non-effective rate. Moreover, there was no difference in the incidence of adverse effects between the two groups.ConclusionsCurrent evidence shows that immunoglobulin is superior to conventional therapies both in adults and children patients of clinically diagnosed viral encephalitis. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Objective To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice. Methods A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables. Results The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS. Conclusions The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.