M.bennett at 04:55, 21 December 2021

2021-12-21T04:55:43Z

M.bennett at 04:54, 21 December 2021

2021-12-21T04:54:58Z

M.bennett: Created page with " '''The addition of hyperbaric oxygen to treatment with donepezil did not importantl..."

2021-12-21T04:45:33Z

Created page with " '''The addition of hyperbaric oxygen to treatment with donepezil did not importantl..."

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'''The addition of hyperbaric oxygen to treatment with donepezil did not importantly improve cognitive outcomes in patients with vascular dementia.'''

'''Clinical bottom line:'''

#Hyperbaric resulted in improved Mini Mental State Examination (MMSE) scores
#Hyperbaric also resulted in increased serum humanin levels which may have a correlation with cognitive function

----

'''Citation/s:'''1. Xu Y, Wang Q, Qu Z, Yang J, Zhang X, Zhao Y. Protective effect of hyperbaric oxygen therapy on cognitive function in patients with vascular dementia. Cell Transplantation 2019; 28(8):1071-1075.

'''Lead author’s name and fax:'''Y. Zhao : zhao_yuwu2005@126.com

'''Three-part Clinical Question:'''In patients with vascular dementia, does treatment with hyperbaric oxygen and donepezil in comparison to donepezil alone result in an improvement in cognitive function?

'''Search Terms:'''Vascular dementia; cognitive function; humanin

'''The Study:'''Non-blinded non-concealed randomised controlled trial with intention-to-treat.

'''The Study Patients:'''Patients who met DSM-5 diagnostic criteria for vascular dementia. Patients with other forms of dementia, mental illness, brain trauma and severe systemic diseases were excluded.

'''Control group'''(N = 79; 79 analysed): Donepezil hydrochloride 5mg daily.

'''Experimental group'''(N = 79; 79 analysed): Donepezil hydrochloride 5mg daily and HBO 100% O2 at 2.0 ATA for 60 minutes 5 days per week for 12 weeks for a total of 60 sessions.

'''The Evidence:'''

{| class="MsoTableGrid" style="width:450.8pt; border-collapse:collapse; border:solid windowtext 1.0pt" width="0"
|- style="height:21.55pt"
| rowspan="2" style="width:63.55pt; border:solid windowtext 1.0pt" width="85" | '''Measure'''
| colspan="2" style="width:92.15pt; border:solid windowtext 1.0pt; border-left:none" width="123" | '''Control group'''
| colspan="2" style="width:4.0cm; border:solid windowtext 1.0pt; border-left:none" width="151" | '''HBOT group'''
| rowspan="2" style="width:77.95pt; border:solid windowtext 1.0pt; border-left:none" width="104" | '''Difference'''
| rowspan="2" style="width:103.75pt; border:solid windowtext 1.0pt; border-left:none" width="138" | '''95% CI'''
|- style="height:33.5pt"
| style="width:42.55pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="57" | '''Mean value'''
| style="width:49.6pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="66" | '''SD'''
| style="width:2.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="76" | '''Mean value'''
| style="width:2.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="76" | '''SD'''
|- style="height:15.5pt"
| style="width:63.55pt; border:solid windowtext 1.0pt; border-top:none" width="85" |
'''MMSE'''

| style="width:42.55pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="57" | 20.1
| style="width:49.6pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="66" | 2.8
| style="width:2.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="76" | 21.7
| style="width:2.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="76" | 2.4
| style="width:77.95pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="104" | 1.6
| style="width:103.75pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="138" | -0.4 to 3.7
|- style="height:15.5pt"
| style="width:63.55pt; border:solid windowtext 1.0pt; border-top:none" width="85" |
'''Humanin'''

| style="width:42.55pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="57" | 143.1
| style="width:49.6pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="66" | 8.6
| style="width:2.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="76" | 146.5
| style="width:2.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="76" | 9.4
| style="width:77.95pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="104" | 3.4
| style="width:103.75pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="138" | -22.1 to 28.9
|}

'''Comments:'''

#The authors’ treated MMSE scores as continuous and normally distributed – this is probably not appropriate. Their analysis suggests the difference between means is statistically significant (P<0.001), but we cannot confirm that on our analysis. Neither can we confirm the significant humanin analysis. The reason for the discrepancy is unclear.
#The authors identified a correlation between MMSE scores and humanin levels after adjusting for confounding factors. Humanin has no definitive clinical application currently.
#No blinding means there is a possibility of bias in this study through participation in the HBO arm.
#Donezepil is a cholinesterase inhibitor used to treat Alzheimer’s Disease (not vascular dementia).
#Outc0omes are very short-term (2 days after treatment completion.

 

'''Appraised by:'''Hannah Rubinstein h.rubinstein@student.unsw.edu.au; Monday, 29 November 2021

'''Kill or Update By:'''November 2025

@@ Line 67: / Line 67: @@
 #<span style="font-size:medium;"><span style="font-family:">No blinding means there is a possibility of bias in this study through participation in the HBO arm.</span></span>
 #<span style="font-size:medium;"><span style="font-family:">Donezepil is a cholinesterase inhibitor used to treat Alzheimer’s Disease (not vascular dementia).</span></span>
-#<span style="font-size:medium;"><span style="font-family:">Outc0omes are very short-term (2 days after treatment completion.</span></span>
+#<span style="font-size:medium;"><span style="font-family:">Outcomes are very short-term (2 days after treatment completion).</span></span>
 &nbsp;
@@ Line 73: / Line 73: @@
 <span style="font-size:medium;">'''<span style="font-family:">Appraised by:</span>'''<span style="font-family:">Hannah Rubinstein h.rubinstein@student.unsw.edu.au; Monday, 29 November 2021</span></span>
-'''<span style="font-family:">Kill or Update By:</span>'''<span style="font-size: medium; font-family:">November 2025</span>
+<span style="font-size:medium;">'''Kill or Update By:&nbsp;'''November 2025</span>
 <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Neuro_-_miscellaneous|BACK]]</span></p>

Xu2019 - Revision history

M.bennett at 04:55, 21 December 2021

M.bennett at 04:54, 21 December 2021

M.bennett: Created page with " '''The addition of hyperbaric oxygen to treatment with donepezil did not importantl..."