Clinical Aspects of Palliative Sedation in Prospective Studies. A Systematic Review

Background. The involvement of patients in decision making about their healthcare plans is being emphasized. In the context of palliative sedation, it is unclear how these decisions are made and who are involved in. The aim of the study is to understand how this decision-making is taken. Method. Information from a systematic review on clinical aspects of palliative sedation prospective studies were included. PubMed, CINAHL, Cochrane, MEDLINE, and EMBASE were searched (January 2014–December 2019). Data extraction and analysis regarded: (a) When and by whom the decision-making process is initiated; (b) patient involvement; (c) family involvement and (d) healthcare involvement. Results. Data about decision making were reported in 8/10 included articles. Palliative sedation was reported in 1137 patients (only 16 of them were non-cancer). Palliative sedation was introduced by the palliative care team during the disease process, at admission, or when patients experienced refractory symptoms. Only two studies explicitly mentioned the involvement of patients in decision making. Co-decision between families and the regular health care professionals was usual, and the health care professionals involved had been working in palliative care services. Conclusion. Patient participation in decision making appeared to be compromised by limited physical or cognitive capacity and family participation is described. The possibility of palliative sedation should be discussed earlier in the disease process.

Download Full-text

Relatives' Experiences towards Continuous Palliative Sedation: A Systematic Review

10.26226/morressier.5c76c8b5e2ea5a7237612043 ◽

2019 ◽

Author(s):

Sharon Oude Veldhuis

Keyword(s):

Systematic Review ◽

Palliative Sedation ◽

Continuous Palliative Sedation

Download Full-text

Oligorecurrent Prostate Cancer and Stereotactic Body Radiotherapy: Where Are We Now? A Systematic Review and Meta-analysis of Prospective Studies

European Urology Open Science ◽

10.1016/j.euros.2021.02.008 ◽

2021 ◽

Vol 27 ◽

pp. 19-28

Author(s):

Giulia Marvaso ◽

Stefania Volpe ◽

Matteo Pepa ◽

Matteo Augugliaro ◽

Giulia Corrao ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Prospective Studies ◽

Stereotactic Body Radiotherapy ◽

Meta Analysis

Download Full-text

Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-021-00815-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Antonio Rodríguez-Fernández ◽

Joan Lobo-Prat ◽

Josep M. Font-Llagunes

Keyword(s):

Systematic Review ◽

Clinical Efficacy ◽

Lower Limb ◽

Gait Training ◽

Health Conditions ◽

Current Evidence ◽

Clinical Aspects ◽

Gait Rehabilitation ◽

Comprehensive Overview ◽

Walking Aids

AbstractGait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

Download Full-text

Association Between One-carbon Metabolism-related Vitamins and Risk of Breast Cancer: A Systematic Review and Meta-analysis of Prospective Studies

Clinical Breast Cancer ◽

10.1016/j.clbc.2020.02.012 ◽

2020 ◽

Vol 20 (4) ◽

pp. e469-e480 ◽

Cited By ~ 1

Author(s):

Jie Zeng ◽

Yi Gu ◽

Hongjuan Fu ◽

Chang Liu ◽

Yixin Zou ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Prospective Studies ◽

Carbon Metabolism ◽

Meta Analysis ◽

One Carbon Metabolism

Download Full-text

Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies

Public Health Nutrition ◽

10.1017/s1368980014000949 ◽

2014 ◽

Vol 18 (4) ◽

pp. 695-704 ◽

Cited By ~ 37

Author(s):

Rosana Poggio ◽

Laura Gutierrez ◽

María G Matta ◽

Natalia Elorriaga ◽

Vilma Irazola ◽

...

Keyword(s):

Systematic Review ◽

Relative Risk ◽

General Population ◽

Prospective Studies ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Meta Regression ◽

Cvd Mortality

AbstractObjectiveThe purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality.DesignWe performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed.SettingsMEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study.SubjectEleven prospective studies with 229 785 participants and average follow-up period of 13·37 years (range 5·5–19 years).ResultsHigher Na intake was significantly associated with higher CVD mortality (relative risk=1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality.ConclusionsHigher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.

Download Full-text