scholarly journals Emergency department attendance by patients with cancer in the last month of life: a systematic review and meta-analysis

The Lancet ◽  
2015 ◽  
Vol 385 ◽  
pp. S41 ◽  
Author(s):  
Lesley Henson ◽  
Wei Gao ◽  
Irene Higginson ◽  
Melinda Smith ◽  
Joanna Davies ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Meta Analysis ◽  
Emergency Department Attendance ◽  
Patients With Cancer

scholarly journals Bidirectional brain–gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis

Gut ◽  
2021 ◽  
pp. gutjnl-2021-325985
Author(s):  
Keeley M Fairbrass ◽  
Jessica Lovatt ◽  
Brigida Barberio ◽  
Yuhong Yuan ◽  
David J Gracie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Psychological Health ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Subsequent Development ◽  
Adverse Outcomes ◽  
Emergency Department Attendance ◽  
Relative Risks ◽  
The Brain

ObjectiveThe role of the brain–gut axis is of increasing interest in IBD, as the link between common mental disorders and GI inflammation may be bidirectional. We performed a systematic review examining these issues.DesignWe searched EMBASE Classic and EMBASE, Medline, and APA PsychInfo (to 11 July 2021) for longitudinal follow-up studies examining effect of symptoms of anxiety or depression on subsequent adverse outcomes in IBD, or effect of active IBD on subsequent development of symptoms of anxiety or depression. We pooled relative risks (RRs) and HRs with 95% CIs for adverse outcomes (flare, escalation of therapy, hospitalisation, emergency department attendance, surgery or a composite of any of these) according to presence of symptoms of anxiety or depression at baseline, or RRs and HRs with 95% CIs for new onset of symptoms of anxiety or depression according to presence of active IBD at baseline.ResultsWe included 12 separate studies, recruiting 9192 patients. All 12 studies examined brain-to-gut effects. Anxiety at baseline was associated with significantly higher risks of escalation of therapy (RR=1.68; 95% CI 1.18 to 2.40), hospitalisation (RR=1.72; 95% CI 1.01 to 2.95), emergency department attendance (RR=1.30; 95% CI 1.21 to 1.39), or a composite of any adverse outcome. Depression at baseline was associated with higher risks of flare (RR=1.60; 95% CI 1.21 to 2.12), escalation of therapy (RR=1.41; 95% CI 1.08 to 1.84), hospitalisation (RR=1.35; 95% CI 1.17 to 1.57), emergency department attendance (RR=1.38; 95% CI 1.22 to 1.56), surgery (RR=1.63; 95% CI 1.19 to 2.22) or a composite of any of these. Three studies examined gut-to-brain effects. Active disease at baseline was associated with future development of anxiety or depression (RR=2.24; 95% CI 1.25 to 4.01 and RR=1.49; 95% CI 1.11 to 1.98, respectively).ConclusionBidirectional effects of the brain–gut axis are present in IBD and may influence both the natural history of the disease and psychological health.

scholarly journals Correlation between PD-L1 expression ON CTCs and prognosis of patients with cancer: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 1938476
Author(s):  
Defeng Kong ◽  
Wen Zhang ◽  
Zhenrong Yang ◽  
Guoliang Li ◽  
Shujun Cheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Patients With Cancer

Use of opioids in patients with cancer with hepatic impairment—a systematic review

2021 ◽  
pp. bmjspcare-2021-003065
Author(s):  
Lewis Thomas Hughes ◽  
David Raftery ◽  
Paul Coulter ◽  
Barry Laird ◽  
Marie Fallon
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Hepatic Impairment ◽  
Evaluation System ◽  
Meta Analysis ◽  
Hepatic Function ◽  
Cochrane Central Register ◽  
Assessment Development ◽  
Patients With Cancer ◽  
Central Register

PurposeOpioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in patients with cancer with hepatic impairment.MethodsA systematic review was conducted and the following databases searched: AMED (−2021), MEDLINE (−2021), EMBASECLASSIC + EMBASE (−2021) and Cochrane Central Register of Controlled Trials (−2021). Eligible studies met the following criteria: patients with cancer-related pain, taking an opioid (as defined by the WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents); >18 years of age; patients with hepatic impairment defined using recognised or study-defined definitions; clinical outcome hepatic impairment related; and primary studies. All eligible studies were appraised using the Grading of Recommendations Assessment, Development and Evaluation system.ResultsThree studies (n=95) were eligible but heterogeneity meant meta-analysis was not possible. Each individual study focused on only one each of oxycodone±hydrocotarnine, oxycodone/naloxone and morphine. No recommendations could be formulated on the preferred opioid in patients with hepatic impairment.ConclusionsMorphine is the preferred opioid in hepatic impairment owing to clinical experience and pharmacokinetics. This review, however, found little clinical evidence to support this. Dose adjustments of morphine and the oxycodone formulations reviewed remain necessary in the absence of quality evidence. Overall, the quality of existing evidence on opioid treatments in cancer pain and hepatic impairment is low and there remains a need for high-quality clinical studies examining this.

scholarly journals A Systematic Review and Meta‐analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

2018 ◽  
Vol 25 (10) ◽  
pp. 1086-1097 ◽  
Author(s):  
Nicholas Karlow ◽  
Charles H. Schlaepfer ◽  
Carolyn R. T. Stoll ◽  
Michelle Doering ◽  
Christopher R. Carpenter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Acute Pain ◽  
Meta Analysis
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