The Short-term Efficacy and Safety of Tolvaptan for the Heart Failure Patients with Resistance to Diuretics

Abstract Introduction Heart Failure (HF) is a pandemic chronic disease with a prevalence up to 3% in the general population, representing the main cause of hospitalization for people over 65. Self-care plays a central role in the management of patients with HF, showing evidence of effectiveness in reducing re-hospitalization rates and mortality. Methods We carried out a systematic review and meta-analysis to assess the efficacy of nurse-led educational interventions Vs usual care in improving self-care skills of patients with chronic HF. The main biomedical databases were searched for Randomized Control Trials (RCTs) of nurse-led educational interventions performed on adults with a previous diagnosis of HF. Improvement of HF self-management skills (self-care level) was summarized by calculating the standardized mean difference (SMD) and 95% confidence intervals (CI) stratified for the length of the follow-up. Results Globally, 14 RCTs were included involving 2078 participants. Ten studies showed the efficacy of the interventions at 3 months (short term) with a SMD of 0.78 (95% CI 0.38-1.18) in favor of the self-care education interventions. Five studies reported on self-care abilities at 6-9 months (medium term), not showing statistically significant results (SMD 0.35, 95%CI 0.11-0.81). The long-term effect of the educational interventions showed no statistically significant improvement in self-care behaviors (three studies, SMD 0.05, 95CI% 0.12 - 0.22). Conclusions These results show that nursing educational interventions improve self-care behaviors in HF, but mainly in the short term. Intensive educational interventions led by nurses, associated with appropriate continuity and transition of care, can determine the best outcomes for patients with HF, strengthening self-care behaviors over time. This approach could have a major impact not only on individual level, but on the general reduction of complications, hospitalization, medical costs and ultimately mortality. Key messages Nurse-led educational programs have a short-term efficacy in enhancing self-care behaviors among heart failure patients. Post-discharge repeated educational interventions, along with timely and shared plans ruling the transition between the hospital and the other providers, are strongly needed.

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Short-term use of adaptive servo ventilation improves renal function in heart failure patients with sleep-disordered breathing

Heart and Vessels ◽

10.1007/s00380-012-0303-0 ◽

2012 ◽

Vol 28 (6) ◽

pp. 728-734 ◽

Cited By ~ 14

Author(s):

Akiomi Yoshihisa ◽

Satoshi Suzuki ◽

Takashi Owada ◽

Shoji Iwaya ◽

Hiroyuki Yamauchi ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Sleep Disordered Breathing ◽

Short Term ◽

Adaptive Servo Ventilation ◽

Heart Failure Patients ◽

Disordered Breathing

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REDUCED RESTING OXYGEN CONSUMPTION INDEX IS ASSOCIATED WITH WORSE SHORT-TERM OUTCOMES IN ADVANCED HEART FAILURE PATIENTS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31368-8 ◽

2018 ◽

Vol 71 (11) ◽

pp. A827

Author(s):

Thomas Cascino ◽

Daniel Perry ◽

Gillian Grafton ◽

Todd M. Koelling

Keyword(s):

Heart Failure ◽

Oxygen Consumption ◽

Advanced Heart Failure ◽

Short Term ◽

Heart Failure Patients ◽

Consumption Index

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Efficacy and Safety of a Combination of Shenmai Injection plus Chemotherapy for the Treatment of Lung Cancer: A Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/7929165 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Guo-wei Qin ◽

Tong-tong Xu ◽

Xiang-wei Lv ◽

Shi-min Jiang ◽

Ke-jia Zhang ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Adverse Effects ◽

Meta Analysis ◽

Combined Treatment ◽

Efficacy And Safety ◽

Short Term ◽

Shenmai Injection ◽

Term Efficacy

Objective. To perform a systematic evaluation of the efficacy and safety of combined treatment of Shenmai injection and chemotherapy for lung cancer. Methods. A literature search for randomized controlled trials (RCTs) describing the treatment of lung cancer by Shenmai injection and chemotherapy or chemotherapy alone was performed using the PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Value In Paper (VIP), China BioMed, and Wanfang databases. The databases were searched for entries published before September 1, 2019. Results. Thirty-seven RCTs, comprising a total of 2808 cases, were included in the present meta-analysis. Of these, 1428 cases were treated by Shenmai injection plus chemotherapy, and 1380 cases were treated only by chemotherapy. The results of meta-analysis showed that the combined treatment (Shenmai injection plus chemotherapy) increased the short-term efficacy of treatment (relative risk [RR] = 1.183, 95% confidence interval [CI] = 1.043–1.343, P < 0.01 ) and improved patients’ quality of life (RR = 1.514, 95%CI = 1.211–1.891, P < 0.01 ) compared with chemotherapy alone. With regard to the adverse effects, the combined treatment markedly reduced the incidence of white blood cell (WBC) reduction (RR = 0.846, 95%CI = 0.760–0.941, P < 0.01 ), platelet reduction (RR = 0.462, 95% CI = 0.330–0.649, P < 0.01 ), and hemoglobin reduction (RR = 0.462, 95% CI = 0.330–0.649, P < 0.01 ) and alleviated drug-induced liver injury (RR = 0.677, 95%CI = 0.463–0.990, P < 0.05 ). However, it did not offer a significant protective effect (RR = 0.725, 95%CI = 0.358–1.468, P < 0.05 ). The effect of the combined treatment on the occurrence of vomiting was considerable (RR = 0.889, 95%CI = 0.794–0.996, P < 0.05 ), and the combined treatment markedly increased the immunity of patients with lung cancer. Conclusion. The combined treatment of Shenmai injection plus chemotherapy enhanced the short-term efficacy of chemotherapy, improved the patient quality of life, alleviated the adverse effects of chemotherapeutics, and increased the patient immunity. These results should be confirmed by large-scale, high-quality RCTs.

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