Immediate Effect of Fan Therapy in Terminal Cancer With Dyspnea at Rest: A Meta-Analysis

2019 ◽  
Vol 37 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Jun Kako ◽  
Masamitsu Kobayashi ◽  
Yasufumi Oosono ◽  
Kohei Kajiwara ◽  
Mika Miyashita
Keyword(s):  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Terminal Cancer ◽  
Cochrane Central Register ◽  
Patients With Cancer ◽  
Central Register ◽  
Nonmalignant Disease ◽  
The Cochrane Library

Background: Dyspnea is a common distressing symptom in patients with malignant and nonmalignant diseases. Fan therapy, which uses a fan to blow air toward the patient’s face, can alleviate dyspnea; however, its efficacy remains unclear. Aim: To examine the immediate efficacy of fan therapy for alleviation of dyspnea at rest. Design: Meta-analysis. Data sources: We searched the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE EBSCO, CINAHL EBSCO, and Scopus from January 1, 1987, to August 21, 2018 (PROSPERO-CRD42018108610). In addition, we hand-searched studies and used the similar articles feature on PubMed to search for articles. Randomized controlled trials comparing the effects of fan therapy with placebo or other interventions to alleviate dyspnea at rest, in which patients were aged ≥18 years, were eligible for inclusion in the review. We excluded articles on long-term intervention involving fan therapy and complex intervention (including fan therapy). The risk of bias assessment was conducted using the Cochrane tool, and the meta-analysis was performed using RevMan version 5.3. Results: We identified a total of 218 studies; 2 met our criteria for inclusion in the meta-analysis. Fan therapy significantly improved dyspnea at rest in terminally ill patients with cancer compared to control groups (mean difference: −1.31, 95% confidence interval: −1.79 to −0.83, P < .001). There were no studies that met the inclusion criteria regarding fan therapy for patients with nonmalignant disease. Conclusions: This meta-analysis demonstrated that fan therapy may be an effective intervention for dyspnea at rest in patients with terminal cancer.

scholarly journals Should Finasteride Be Routinely Given Preoperatively for TURP?

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
O. M. Aboumarzouk ◽  
M. Z. Aslam ◽  
A. Wedderburn ◽  
K. Turner ◽  
O. Hughes ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Vascular Endothelial ◽  
Central Register ◽  
Language Restriction ◽  
Randomised Controlled ◽  
Endothelial Growth Factor

Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966–November 2011), EMBASE (1980–November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. Four randomised controlled trials were included comparing finasteride to a placebo. A meta-analysis was not conducted due to the disparity present in the results between the studies. Three of the studies found that finasteride could reduce either intra- or postoperative bleeding after TURP. One study found finasteride to significantly lower the microvessel density (MVD) and vascular endothelial growth factor (VEGF). None of the studies reported any long-term complications related to either the medication or the procedure. Conclusion. finasteride reduces bleeding either during or after TURP.

Cochrane corner: ergonomic positioning or equipment for treating carpal tunnel syndrome

2013 ◽  
Vol 38 (5) ◽  
pp. 580-581 ◽  
Author(s):  
S. Buchan ◽  
R. Amirfeyz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Intervention ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Tunnel Syndrome ◽  
Mean Differences ◽  
The Cochrane Library

Background: Non-surgical treatments, including ergonomic positioning or equipment, are sometimes offered to people experiencing mild to moderate symptoms from carpal tunnel syndrome. The effectiveness and duration from ergonomic positioning or equipment interventions for treating carpal tunnel syndrome are unknown. Objectives: To assess the effects of ergonomic positioning compared with no treatment, a placebo or another non-surgical intervention in people with carpal tunnel syndrome. Search methods: We searched the Cochrane Neuromuscular Disease Group Specialized Register (14 June 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (2011, Issue 2, in The Cochrane Library), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL Plus (1937 to June 2011), and AMED (1985 to June 2011). We also reviewed the reference lists of randomized or quasi-randomized trials identified from the electronic search. Selection criteria: Randomized or quasi-randomized controlled trials comparing ergonomic positioning or equipment with no treatment, placebo or another non-surgical intervention in people with carpal tunnel syndrome. Data collection and analysis: Two review authors independently selected trials for inclusion, extracted data and assessed risk of bias of included studies. They calculated risk ratios and mean differences with 95% confidence intervals for the primary and secondary outcomes. Results of clinically and statistically homogeneous trials were pooled, where possible, to provide estimates of the effect of ergonomic positioning or equipment.

Cochrane corner: water for wound cleansing

2012 ◽  
Vol 37 (4) ◽  
pp. 375-376 ◽  
Author(s):  
J. Henton ◽  
A. Jain
Keyword(s):  
Tap Water ◽  
Data Extraction ◽  
Healing Process ◽  
Cost Effective ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Central Register ◽  
The Cochrane Library

Background: Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and does not interfere with the normal healing process. Tap water is commonly used in the community for cleansing wounds because it is easily accessible, efficient and cost effective; however, there is an unresolved debate about its use. Objectives: The objective of this review was to assess the effects of water compared with other solutions for wound cleansing. Search strategy: For this update we searched the Cochrane Wounds Group Specialised Register (Searched 22 February 2010); The Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library, 2010 Issue 1); Ovid MEDLINE – 2007 to February Week 2 2010; Ovid MEDLINE – In-Process & Other Non-Indexed Citations (Searched19 February 2010); Ovid EMBASE – 2007 to 2010 Week 06; EBSCO CINAHL – 2007 to 22 February 2010. Selection criteria: Randomized and quasi-randomized controlled trials that compared the use of water with other solutions for wound cleansing were eligible for inclusion. Additional criteria were outcomes that included objective or subjective measures of wound infection or healing. Data collection and analysis: Two review authors independently carried out trial selection, data extraction and quality assessment. We settled differences in opinion by discussion. We pooled some data using a random-effects model.

scholarly journals Acupuncture for Spasticity after Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Sung Min Lim ◽  
Junghee Yoo ◽  
Euiju Lee ◽  
Hyun Jung Kim ◽  
Seungwon Shin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Knowledge Resources ◽  
Randomized Controlled ◽  
Modified Ashworth Scale ◽  
The Cochrane Library

The aim of this systematic review was to determine how effective acupuncture or electroacupuncture (acupuncture with electrical stimulation) is in treating poststroke patients with spasticity. We searched publications in Medline, EMBASE, and the Cochrane Library in English, 19 accredited journals in Korean, and the China Integrated Knowledge Resources Database in Chinese through to July 30, 2013. We included randomized controlled trials (RCTs) with no language restrictions that compared the effects of acupuncture or electroacupuncture with usual care or placebo acupuncture. The two investigators assessed the risk of bias and statistical analyses were performed. Three RCTs in English, 1 in Korean, and 1 in Chinese were included. Assessments were performed primarily with the Modified Ashworth Scale (MAS). Meta-analysis showed that acupuncture or electroacupuncture significantly decreased spasticity after stroke. A subgroup analysis showed that acupuncture significantly decreased wrist, knee, and elbow spasticity in poststroke patients. Heterogeneity could be explained by the differences in control, acupoints, and the duration after stroke occurrence. In conclusion, acupuncture could be effective in decreasing spasticity after stroke, but long-term studies are needed to determine the longevity of treatment effects.

scholarly journals Long-term oncologic outcomes of transanal TME compared with transabdominal TME for rectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jae Young Moon ◽  
Min Ro Lee ◽  
Gi Won Ha
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Oncologic Outcomes ◽  
Cochrane Library ◽  
Transanal Total Mesorectal Excision ◽  
Random Effects Models ◽  
The Cochrane Library

Abstract Background Transanal total mesorectal excision (TaTME) appears to have favorable surgical and pathological outcomes. However, the evidence on survival outcomes remains unclear. We performed a meta-analysis to compare long-term oncologic outcomes of TaTME with transabdominal TME for rectal cancer. Methods PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effects models. Outcome measures were overall survival (OS), disease-free survival (DFS), and local and distant recurrence. Results We included 11 nonrandomized studies that examined 2,143 patients for the meta-analysis. There were no significant differences between the two groups in OS, DFS, and local and distant recurrence with a RR of 0.65 (95% CI 0.39–1.09, I2 = 0%), 0.79 (95% CI 0.57–1.10, I2 = 0%), 1.14 (95% CI 0.44–2.91, I2 = 66%), and 0.75 (95% CI 0.40–1.41, I2 = 0%), respectively. Conclusion In terms of long-term oncologic outcomes, TaTME may be an alternative to transabdominal TME in patients with rectal cancer. Well-designed randomized trials are warranted to further verify these results.

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.

632 SUTURED VERSUS MESH-AUGMENTED HIATUS HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Josipa Petric ◽  
Tim Bright ◽  
David Liu ◽  
Melissa Wee ◽  
David Watson
Keyword(s):  
Systematic Review ◽  
Hiatus Hernia ◽  
Mesh Repair ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Absorbable Mesh ◽  
Hiatal Closure

Abstract   Repair of large hiatus hernias is increasingly being performed. However, there is no consensus for the optimal technique for hiatal closure between sutured versus mesh-augmented (absorbable or non-absorbable) repair. This meta-analysis systematically reviewed published randomized control trials (RCTs) comparing sutured versus mesh-augmented hiatus hernia (HH) repair. Our primary endpoint was HH recurrence at short- and long-term follow-up. Secondary endpoints were: surgical complications, operative times, dysphagia and quality of life. Methods A systematic review of Medline, Scopus (which encompassed Embase), Cochrane Central Register of Controlled Trials, Web of Science and PubMed was performed to identify relevant studies comparing mesh-augmented versus sutured HH repair. Data were extracted and compared by meta-analysis, using odds ratio and mean differences with 95% confidence intervals. Results Seven RCTs were found which compared mesh-augmented (non-absorbable mesh: n = 296; absorbable mesh: n = 92) with sutured repair (n = 347). There were no significant differences for short-term hernia recurrence (defined as 6–12 months, 10.1% mesh versus 15.5% sutured, P = 0.22), long-term hernia recurrence (defined as 3–5 years, 30.7% mesh vs 31.3% sutured, P = 0.69), functional outcomes and patient satisfaction. The only statistically significant difference was that the mesh repair required a longer operation time (P = 0.05, OR 2.33, 95% CI 0.03–24.69). Conclusion Mesh repair for hiatus hernia does not offer any advantage over sutured hiatal closure. As both techniques deliver good and comparable clinical outcomes, a suture only technique is still an appropriate approach.

scholarly journals Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Zhao ◽  
Chuantao Peng ◽  
Hafiz Arbab Sakandar ◽  
Lai-Yu Kwok ◽  
Wenyi Zhang
Keyword(s):  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Tnf Α ◽  
Ifn Γ ◽  
The Mean ◽  
Regulatory Effects ◽  
Mean Differences ◽  
Necrosis Factor

Lactobacillus (L.) plantarum strains, belong to lactic acid bacteria group, are considered indispensable probiotics. Here, we performed meta-analysis to evaluate the regulatory effects of L. plantarum on the immunity during clinical trials. This meta-analysis was conducted by searching across four most common literature databases, namely, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PubMed. Clinical trial articles that met the inclusion and exclusion criteria were analyzed by Review Manager (version 5.3). p-value &lt; 0.05 of the total effect was considered statistically significant. Finally, total of 677 references were retrieved, among which six references and 18 randomized controlled trials were included in the meta-analysis. The mean differences observed at 95% confidence interval: interleukin (IL)-4, −0.48 pg/mL (−0.79 to −0.17; p &lt; 0.05); IL-10, 9.88 pg/mL (6.52 to 13.2; p &lt; 0.05); tumor necrosis factor (TNF)-α, −2.34 pg/mL (−3.5 to −1.19; p &lt; 0.05); interferon (IFN)-γ, −0.99 pg/mL (−1.56 to −0.41; p &lt; 0.05). Therefore, meta-analysis results suggested that L. plantarum could promote host immunity by regulating pro-inflammatory and anti-inflammatory cytokines.

scholarly journals Impact of Ketamine on Pain Management in Cesarean Section: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. 135-148
Author(s):  
Zifeng Xu
Keyword(s):  
Cesarean Section ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Control Effect ◽  
Randomized Controlled ◽  
Time Required ◽  
The Cochrane Library

Background: The pain control effect of ketamine versus control in women during cesarean operation is not well determined. Objectives: The present meta-analysis aimed to evaluate the clinical efficacy of ketamine versus control in cesarean section anesthesia for reducing the postoperative pain and analgesia. Study Design: We used meta-analysis to address this concern. Setting: Meta-analysis-based study. Methods: The databases PubMed, Embase, and the Cochrane Library were systematically searched to identify the relevant randomized controlled trials (RCTs) of ketamine versus control in controlling pain after cesarean section from inception to August 2018. Based on the Cochrane Handbook, the combined analysis was performed using Revman 5.3 software. Results: A total of 20 RCTs with 1,737 patients who underwent cesarean section were included. Meta-analysis showed that the pain score in the ketamine group was less than that of the control group (mean difference [MD], –1.10; 95% confidence interval [CI], –1.61, –0.59; P < 0.0001). Application of ketamine during cesarean section also resulted in decreased consumption of morphine when compared with the control group (MD, –6.11 mg; 95% CI, –9.93, –2.29; P = 0.002). In addition, the first time required for analgesia was significantly longer in the ketamine group than that of the control group (MD, 72.48 minutes; 95% CI, 50.85, 94.11; P < 0.00001). Limitations: Limited patients were included with moderate strength. Conclusions: Ketamine supplementation during cesarean section reduces pain and morphine consumption and prolongs the postoperative analgesia. Key words: Ketamine, cesarean section, randomized controlled trials, meta-analysis

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