RESUMEN
BACKGROUND: Post-traumatic stress disorder (PTSD) is a debilitating disorder that is often accompanied by alterations in the hypothalamic-pituitary (HPA) axis. While there is abundant evidence for the efficacy of psychological therapies in reducing post-traumatic stress symptoms, barely anything is known about pharmacological interventions. Given the role of the HPA axis in the pathophysiology of PTSD, the aim of this study was to provide the first meta-analysis of Hydrocortisone as a potential treatment for this condition. METHOD: A systematic review of randomized-controlled trials (RCTs) was conducted to investigate the efficacy of hydrocortisone in the prevention and curative treatment of post-traumatic stress symptoms. This study was pre-registered with the OSF (doi:10.17605/OSF.IO/GJAZF). FINDINGS: Eight studies (9 effect sizes) covering 362 participants met our inclusion criteria. We found that Hydrocortisone as compared to placebo significantly reduced PTSD symptoms (d = 0.96, 95% Cl 0.22-1.69 p = 0.011) and PTSD incidence (logRR = 0.85, 95% CI 1.12-1.59, p = 0.023). Subgroup analyses revealed a significant effect of Hydrocortisone when it was administered in a preventative context (d = 1.50; 95%CI 0.30-2.69, p = 0.014), but not when it was administered in a curative context (d = 0.28; 95%CI -0.11 to 0.66, p = 0.161). CONCLUSION: Hydrocortisone appears to be a promising and efficient low-cost medication for the prevention of PTSD. However, the small number of included studies and their limited methodological quality emphasize the need for further rigorous studies in this field.
Asunto(s)
Hidrocortisona , Trastornos por Estrés Postraumático , Humanos , Hidrocortisona/administración & dosificación , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/prevención & control , Resultado del TratamientoRESUMEN
Wind conditions are well-known to affect results of ski jumping competitions. To alleviate effects of different head or tail winds and differences in inrun length due to jury or coaches' decisions, the FIS (Féderation Internationale de Ski) has adopted a wind and gate compensation system since January 2010. However, the accuracy and fairness of the resulting compensation points are often questioned by athletes, spectators, and media commentators alike but have not yet been thoroughly investigated. In the present meta-analysis, we present evidence for systematic negative associations of wind points but positive associations of gate points with round scores across all World Cup and World Championship competitions of men in the ski jumping seasons 2016/2017 and 2017/2018 (k = 35 and 30, respectively). Moreover, our results indicate that absolute correlations between wind points and round scores increased in presence of larger wind point variability, thus indicating lower accuracy of compensation systems when conditions are more variable. Additionally, there was a trend for larger wind point malcompensations on larger jumping hills. Our results suggest that the current wind point compensation formula as well as gate factors should be reevaluated to prevent systematically biased point awards within and across competitions.