Relieving from Breathlessness in the Wind: A Meta-Analysis and Subjective Report of Effectiveness of Fan Blowing in Patients with Cardiorespiratory Diseases or Cancer

Objectives Breathlessness is common among terminally ill patients with cardiorespiratory disease or cancer. The experience may induce secondary physiological and behavioral responses that limit patient well-being and independence and cause emotional distress. Methods We conducted a meta-analysis on randomized controlled trials (RCTs) that examined the effectiveness of fan blowing on breathlessness among patients with cardiorespiratory diseases or cancer. The PubMed, Cochrane Library, Embase, SCOPUS, and CINAHL databases were searched to retrieve potential articles. The primary outcome was breathlessness severity. The secondary outcomes were SpO2, anxiety, depression, and quality of life. Also, we presented the changes of vital signs and subjective feeling of a male patient who used fan blowing for relieving his breathlessness. Results Eight RCTs were available for analysis. The pooled results demonstrated no significant difference in breathlessness severity between fan-to-face blowing and control methods (standard mean difference: −0.21, 95% confidence interval: −.59 to .17); however, a significant reduction in breathlessness severity was observed in the short-time intervention compared with long-time intervention. A trend occurred toward significance in the reduction of respiratory rate in fan-to-face blowing compared with control methods (MD: −.64, 95% CI: −1.37 to .09). No differences were observed between groups in oxygen saturation, anxiety, depression, or QoL. The male patient who used fan blowing showed an improved vital signs and a satisfied subjective feeling. Conclusions Consistent short-time fan-to-face blowing is effective for relieving breathlessness among conscious terminally ill patients with cardiorespiratory diseases or cancer. The use of this convenient method for relieving breathlessness symptoms in terminally ill patients is recommended.

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The Effectiveness of Music Therapy for Terminally Ill Patients: A Meta-Analysis and Systematic Review

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2018.10.504 ◽

2019 ◽

Vol 57 (2) ◽

pp. 319-329 ◽

Cited By ~ 9

Author(s):

Yinyan Gao ◽

Yanping Wei ◽

Wenjiao Yang ◽

Lili Jiang ◽

Xiuxia Li ◽

...

Keyword(s):

Systematic Review ◽

Music Therapy ◽

Meta Analysis ◽

Terminally Ill ◽

Terminally Ill Patients

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Addition of Induction or Consolidation Chemotherapy in Definitive Concurrent Chemoradiotherapy Versus Concurrent Chemoradiotherapy Alone for Patients With Unresectable Esophageal Cancer: A Systematic Review and Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.665231 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jianing Wang ◽

Linlin Xiao ◽

Shuai Wang ◽

Qingsong Pang ◽

Jun Wang

Keyword(s):

Systematic Review ◽

Esophageal Cancer ◽

Concurrent Chemoradiotherapy ◽

Meta Analysis ◽

Standard Of Care ◽

Distant Metastases ◽

Cochrane Library ◽

Consolidation Chemotherapy ◽

Metastasis Rate ◽

Short Time

BackgroundConcurrent chemoradiotherapy (CCRT) has become the standard of care in esophageal carcinoma patients who are not surgical candidates. The efficacy of induction chemotherapy (IC) or consolidation chemotherapy (CCT) for unresectable esophageal cancer (EC) treated with CCRT is unclear. We performed a systematic review and meta-analysis of published papers to evaluate the potential benefit of IC or CCT for patients with EC.MethodsEligible studies of IC followed by CCRT (IC-CCRT) vs. CCRT alone or CCRT followed by CCT (CCRT-CCT) vs. CCRT alone were retrieved through extensive searches of the PubMed, Science Direct, Embase, and Cochrane Library databases from the establishment of the database to July 31, 2021. Data such as 1-, 2-, 3-, and 5-year overall survival (OS), local recurrence rate (LRR), and distant metastasis rate (DMR) were collected for meta-analysis to evaluate the efficacy of IC/CCT.ResultsFour studies of IC-CCRT vs. CCRT including 836 EC patients and six studies of CCRT-CCT vs. CCRT including 1,339 patients with esophageal squamous cell carcinoma (ESCC) were finally identified in our analysis. Both IC-CCRT group [hazard ratio (HR) 0.446, 95% CI 0.286–0.693; p < 0.001] and CCRT-CCT group (HR 0.542, 95% CI 0.410–0.716; p < 0.001) exhibited statistically significant improvement in 1-year OS rate compared to that of CCRT, while the 2-year OS rate of IC-CCRT (HR 0.803, 95% CI 0.589–1.095; p = 0.166) or CCRT-CCT (HR 0.783, 95% CI 0.600–1.022; p = 0.072) was similar with that of CCRT. And the 3-year OS rate between IC-CCRT and CCRT was similar (HR 1.065, 95% CI 0.789–1.439; p = 0.680). However, comparing with CCRT alone, the CCRT-CCT group had lower DMR [odds ratio (OR) 1.562, 95% CI 1.090–2.240; p = 0.015] and higher 3-year OS rate (HR 0.786, 95% CI 0.625–0.987; p = 0.039). Besides, no differences were observed between the CCRT-CCT and CCRT groups in 5-year OS rate (HR 0.923, 95% CI 0.706–1.205; p = 0.555) and LRR (OR 0.899, 95% CI 0.686–1.179; p = 0.441).ConclusionThe study revealed the short-time survival benefit of additional IC or CCT compared to CCRT alone for patients with unresectable EC, and CCRT followed by CCT could significantly reduce the risk of distant metastases.

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Transit Time and Recovery in Prehospital Emergency Care: Meta-analysis

10.21203/rs.2.23879/v1 ◽

2020 ◽

Author(s):

xing fu ◽

Philip Wilson ◽

Wing Sun Faith Chung

Keyword(s):

Transit Time ◽

Symptom Onset ◽

Meta Analysis ◽

Mean Transit Time ◽

Cochrane Library ◽

Prehospital Emergency Care ◽

Forest Plot ◽

Long Time ◽

Prehospital Emergency ◽

Short Time

Abstract Background: People living in rural areas usually suffer comparatively disadvantaged emergency health care than those living in urban areas, reasons including long transit time due to geographic factors. Implementation of technology is suggested to improve the access to medical care for the rural population, such as remotely-supported ultrasound and satellite/cellular communications. Methods: Screening of eligible studies were conducted based on inclusion an exclusion criteria. A comprehensive search was conducted by using following database: EMBASE, Medline, Cochrane library and Scopus. Quality assessment tool for observational cohort and cross-sectional study is used for assessing the risk of bias. Transit time was mostly classified into two-stage time symptom onset-balloon time and door-balloon time. In symptom onset-balloon time, we divided into short time group and long time group in our study. The time group were defined based on the median or mean transit time among patients and we also used same way to set up time groups among door-balloon time. The collected data were used for quantitative analysis, they were inputted into Review Manager Software (v5.3) to produce summary results. Results: Ten studies representing 71099 patients were included in the meta-analysis. All studies were retrospective and prospective observational studies and RCTs in which patients experienced ST-elevation myocardial infarction (STEMI) and were treated with percutaneous coronary intervention (PCI). Combined in meta-analysis the odds ratio for mortality in onset-balloon and door-balloon time was 0.82 (CI 0.70, 0.96) and 0.62 (CI 0.53, 0.74) respectively. The forest plot of both onset-balloon time and door-balloon time showed a moderate heterogeneity, with I2 = 31%, P =0.18 and I2 = 67%, P <0.05 respectively. Conclusion: Results from Meta-analysis report less mortality in shorter transit time than that in longer transit time. The demographic characteristics and the sample size of the difference between the long time and short time groups may be the reasons for heterogeneity. The result of the review may potentially support the application of remotely-supported ultrasound and satellite/cellular in prehospital emergency for better health outcome in long transit time.

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A Meta-Analysis and Systematic Review of the Efficacy of Twice Daily PPIs versus Once Daily for Treatment of Gastroesophageal Reflux Disease

Gastroenterology Research and Practice ◽

10.1155/2017/9865963 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Hongying Zhang ◽

Zhiping Yang ◽

Zhen Ni ◽

Yongquan Shi

Keyword(s):

Ph Monitoring ◽

Meta Analysis ◽

Symptom Relief ◽

Random Effect ◽

Random Effect Model ◽

Mucosal Healing ◽

Cochrane Library ◽

Once Daily ◽

Effect Model ◽

Short Time

Background. To investigate whether PPIs BID is superior to QD for treatment of GERD in a short time. Methods. We searched PubMed, Cochrane Library, Scopus, EMBASE, Ovid, EBSCO, and Web of Science databases (from 1998 to May 2016) to select RCTs, which compared the efficacy of PPIs BID versus QD for GERD. The primary outcomes were symptom relief or esophageal mucosal healing at weeks 4 and 8. The M-H method with fixed-effect or random-effect model was used to calculate RR and 95% CIs. Results. Seven RCTs were enrolled. The esophageal healing rates were higher in PPIs BID group (P=0.01), and rabeprazole 20 mg BID can achieve better mucosal healing than 20 mg QD after 8 weeks (P<0.05). However, no significant differences were observed in heartburn relief (P=0.27), sustained symptom relief rates at week 4 (P=0.05), 24 h pH monitoring after treatment (P=0.11), endoscopic response at week 4 (P=0.22), and adverse events (P=0.18). Conclusion. PPIs BID more effectively improve endoscopic healing rate at week 8 than PPIs QD. But there are no significant differences in symptom relief, 24 h pH monitoring, sustained symptom relief, and endoscopic response at week 4.

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Anxiety, depression, and strain among caregivers of terminally ill patients

Egyptian Journal of Psychiatry ◽

10.7123/01.ejp.0000419667.93575.14 ◽

2013 ◽

Vol 34 (2) ◽

pp. 77 ◽

Cited By ~ 4

Author(s):

Fadia Zyada ◽

Mohamed sheta ◽

Hanaa El Degwi ◽

Rasha Saad

Keyword(s):

Terminally Ill ◽

Terminally Ill Patients ◽

Anxiety Depression

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Dezocine prevents sufentanil-induced cough during general anesthesia induction: a meta-analysis of randomised controlled trials

10.21203/rs.2.17370/v1 ◽

2019 ◽

Cited By ~ 1

Author(s):

Zhencheng Xiong ◽

Ping Yi ◽

Jipeng Song ◽

Mingsheng Tan

Keyword(s):

General Anesthesia ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Vital Signs ◽

Cochrane Library ◽

Controlled Trials ◽

Anesthesia Induction ◽

China National Knowledge Infrastructure ◽

Randomised Controlled ◽

The Cochrane Library

Abstract Background Sufentanil is one of the opioids currently used to induce general anesthesia, and cough is one of the most common complications. Many drugs have been used to prevent sufentanil-induced cough (SIC), and dezocine is one of them. The purpose of our meta-analysis is to evaluate the efficacy of dezocine on SIC.Methods We searched multiple databases including PubMed, Embase, ScienceDirect, the Cochrane Library, and China National Knowledge Infrastructure databases (CNKI) to identify studies that met the inclusion criteria. This meta-analysis focused on the incidence and severity of SIC after dezocine intervention, as well as adverse effects.Results Five randomised controlled trials (RCTs) were identified, including 890 patients. Each study was a comparison of dezocine with an equal volume of 0.9% saline. When the injection dose of dezocine was 0.1 mg/kg, the incidence (pooled risk ratio [RR]=0.03, [95% CI: 0.02 to 0.07], P<0.00001, I2=0%) and severity (mild: RR=0.07, [95% CI: 0.03 to 0.18], P<0.00001, I2=0%; moderate: RR=0.05, [95% CI: 0.02 to 0.16], P<0.00001, I2=0%; severe: RR=0.04, [95% CI: 0.01 to 0.16], P<0.00001, I2=0%) of SIC were significantly decreased. There were no statistically significant differences in vital signs between the two groups based on the results of the pooled analysis.Conclusion This meta-analysis showed that dezocine significantly reduced the incidence and severity of SIC in the induction of general anesthesia, but had no significant effect on vital signs. More high-quality RCTs are needed to complement existing conclusions.

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Efficacy of tuina, cupping and acupuncture therapy on pain, anxiety, depression and quality of life in patients with neck pain: A protocol for systematic review and network meta-analysis

10.21203/rs.3.rs-966738/v1 ◽

2021 ◽

Author(s):

Shi-xin Qin ◽

An Li ◽

Mao-Lin Zhan ◽

Yi-Cheng Wu ◽

Yong-Hua Zhao ◽

...

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Pain Anxiety ◽

Assessment Development ◽

Future Clinical Practice ◽

Randomised Controlled ◽

Anxiety Depression

Abstract Background: Neck pain is a common disorder and is more frequent in females than in males worldwide. Recently, more attention is being paid to precautions for and treatment of neck pain. Current therapeutic methods for neck pain include pharmaceutical, complementary and alternative therapies. Tuina, acupuncture and cupping are effective in the treatment of neck pain, which enrich patients’ options. In this study, we aim to evaluate the efficacy of different interventions using randomised controlled trials to identify a prioritised treatment for neck pain.Methods: We will search five English databases (Web of Science, MEDLINE, EMBASE, OVID and Cochrane Library) and four Chinese databases (CNKI, SinoMed, Wanfang Database and VIP) from database inception to December 2020. Two reviewers will independently perform article screening (title, keywords, abstract and full text); data extraction; risk of bias (RoB) assessment and grading of recommendations assessment, development and evaluation. We will use RevMan 5.3 software to carry out statistical analysis of the RoB and risk ratio to analyse the dichotomous data. Finally, we will use GeMTC V.0.8.1 package of R-3.3.2 software for network meta-analysis based on a Bayesian framework.Discussion: We will compare these three interventions to determine the most effective therapy for neck pain in terms of improving pain, anxiety, depression and QoL. In this way, we will provide powerful evidence for future clinical practice guidelines for patients with neck pain who want to receive a suitable treatment.Systematic review registration: PROSPERO CRD42020206853.

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Effects of mobile mindfulness meditation on mental health of university students: Systematic review and meta-analysis (Preprint)

10.2196/preprints.33882 ◽

2021 ◽

Author(s):

Hong Chen ◽

Bin Chen ◽

Ting Yang

Keyword(s):

Mental Health ◽

Systematic Review ◽

University Students ◽

Mindfulness Meditation ◽

Meta Analysis ◽

Well Being ◽

Cochrane Library ◽

Control Groups ◽

Registration Number ◽

Anxiety Depression

BACKGROUND Mobile mindfulness meditation (MMM) is mindfulness meditation intervention implemented by mobile devices like smart phones and apps. MMM has been used to help managing mental health of university students. OBJECTIVE The purpose of this study was to evaluate the effectiveness of MMM on mental health of university students in the areas of stress, anxiety, depression, mindfulness, well-being, and resilience. METHODS We conducted a systematic review and meta-analysis of the effectiveness of MMM on mental health of university students. An electronic literature search using the PubMed, Web of Science, EBSCO, Cochrane Library, and EMBASE from inception to July 16, 2021 was conducted to identify studies that reported the effects of MMM on stress, anxiety, depression, mindfulness, well-being, and resilience. Two reviewers retrieved articles, evaluated quality and extracted data independently. The methodological quality of the selected studies was determined using the Cochrane criteria for risk-of-bias assessment. The RevMan Version 5.3 was used to perform meta-analysis. RESULTS A total of 10 studies, including 958 university students, were selected for meta-analysis. Results showed that MMM was more effective than the control groups in decreasing stress (SMD=-0.41, 95% CI [-0.59, -0.23], P<0.0001), alleviating anxiety (SMD=-0.29, 95% CI [-0.50, -0.09], P=0.004), enhancing well-being (SMD=0.30, 95% CI [0.11, 0.50], P=0.003), and improving mindfulness (SMD=2.66, 95% CI [0.77, 4.55], P=0.006). However, there was no difference between MMM and the control groups in depression (SMD=-0.14, 95% CI [-0.30, 0.03], P=0.11), and resilience (SMD=-0.06, 95% CI [-0.26, 0.15], P=0.59). CONCLUSIONS MMM was an effective method to reduce stress, anxiety, and to increase well-being, mindfulness of university students, further studies are needed to confirm our findings. CLINICALTRIAL review article, no trail registration number.

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Online interventions for reducing anxiety, depression, and stress among adolescents: A systematic review and meta-analysis (Preprint)

10.2196/preprints.29248 ◽

2021 ◽

Author(s):

Dabok Noh ◽

Hyunlye Kim

Keyword(s):

Mental Health ◽

Systematic Review ◽

Meta Analysis ◽

Online Intervention ◽

Cochrane Library ◽

Universal Prevention ◽

Online Interventions ◽

Meta Analyses ◽

Anxiety Depression ◽

Selective Prevention

BACKGROUND As the coronavirus 2019 disease pandemic has emerged as a threat to mental health, demand is increasing for online interventions that can replace face-to-face programs to prevent mental health problems. Adolescents not only have willingness to use an online mental health intervention, but also have generally positive perceptions of online intervention. However, there is still no general agreement regarding the effects of online interventions on adolescent mental health. OBJECTIVE This study aimed to evaluate the effectiveness of online interventions for reducing anxiety, depression, and stress among adolescents through a systematic review and meta-analysis. METHODS A systematic search of studies was performed using PubMed, EMBASE, and Cochrane Library CENTRAL. The Cochrane Collaboration’s tool was used for assessing risk of bias in randomized controlled trials (RCT). We performed meta-analyses to synthesize effect sizes of the included studies, which were calculated as standardized mean differences (SMD) with 95% confidence intervals (CI). RESULTS A total of 19 studies met the inclusion criteria, and 16 studies that reported sufficient numerical data were used for quantitative data synthesis. Regarding prevention level in the included interventions, universal prevention for general adolescents and selective prevention for vulnerable adolescents were conducted by 12 and seven studies, respectively. Among the interventions in this review, cognitive behavior therapy (CBT) and family-based interventions were most often used. In the result of a meta-analysis, online interventions have shown beneficial effect on reducing depression (SMD, -0.096; 95% CI. -0.175 to -0.017). Subgroup meta-analyses by preventive level found a significant effect of universal prevention on reducing depression (SMD, -0.102; 95% CI, -0.197 to -0.008) but no statistically significant effect of selective prevention on reducing depression (SMD, -0.082; 95% CI, -0.224 to 0.061). The effects of online interventions in reducing anxiety (SMD, -0.107; 95% CI, -0.231 to 0.018) and stress (SMD, -0.071; 95% CI, -0.157 to 0.016) among adolescents were not statistically significant in meta-analyses. CONCLUSIONS The findings of meta-analyses showed that online interventions significantly reduced depression among adolescents, and especially that universal prevention interventions significantly reduced depression. However, there is limited evidence for the effectiveness of online interventions for reducing anxiety and stress among adolescents. We suggest further RCTs regarding effectiveness of online intervention for adolescent anxiety and stress.

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Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis

Frontiers in Immunology ◽

10.3389/fimmu.2021.709155 ◽

2021 ◽

Vol 12 ◽

Author(s):

Huoyan Liang ◽

Heng Song ◽

Ruiqing Zhai ◽

Gaofei Song ◽

Hongyi Li ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Evaluation Methodology ◽

Cochrane Library ◽

Assessment Development ◽

Short Time ◽

Long Term Mortality

ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf

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