scholarly journals Does Conservative Kidney Management Offer a Quantity or Quality of Life Benefit Compared to Dialysis? A Systematic Review

2021 ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5.MethodsThe databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 treated with CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted.ResultsTwenty-four primary studies, all observational, were identified. All studies except one reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.53, 95% confidence interval 0.41-0.69). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis.ConclusionsIn general, patients with CKD5 live for a shorter time on CKM than on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

scholarly journals Does conservative kidney management offer a quantity or quality of life benefit compared to dialysis? A systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5. Methods The databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 who had chosen or were treated with either CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted. Results Twenty-five primary studies, all observational, were identified. All studies reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.47, 95 % confidence interval 0.34–0.65). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis. Conclusions In general, patients with CKD5 who have chosen or are on CKM live for a shorter time than patients who have chosen or are on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

scholarly journals Does Conservative Kidney Management Offer A quantity or Quality of Life Benefit Compared to Dialysis? A Systematic Review

2020 ◽  
Author(s):  
Louise Buur ◽  
Jens Madsen ◽  
Inge Eidemak ◽  
Elizabeth Krarup ◽  
Thomas Lauridsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review is to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5.Methods The databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 treated with CKM or dialysis. The primary outcomes were survival and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated and forest plots conducted.Results Twenty-four primary studies, all observational, were identified. All studies except one reported shorter survival in patients treated with CKM (pooled hazard ratio 0.53, 95% confidence interval 0.41-0.69). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis.Conclusions In general, patients with CKD5 live for a shorter time on CKM than on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

scholarly journals Effectiveness of massage therapy on fatigue and pain in patients with multiple sclerosis: A systematic review and meta-analysis

2021 ◽  
Vol 7 (2) ◽  
pp. 205521732110227
Author(s):  
Shahin Salarvand ◽  
Mohammad Eghbal Heidari ◽  
Kazem Farahi ◽  
Erfan Teymuri ◽  
Mohammad Almasian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Systematic Review ◽  
Massage Therapy ◽  
Pharmacological Therapy ◽  
Mean Difference ◽  
Cochrane Library ◽  
Clinical Value ◽  
Significant Trial

Background Fatigue and pain are prevalent symptoms of multiple sclerosis (MS) and frequent complaint in MS patients, which reduce their quality of life. This study aimed to assess the effect of massage therapy on pain and fatigue in MS Patients. Method The original and Persian databases were searched included PubMed, web of science, embase, ovid, scopus, and the Cochrane Library, SID, and Iranedex from inception to November 2020. Studies that reported the effect of massage on fatigue and pain were included. Two investigators extracted all relevant data, independently. For deriving analysis, mean difference (MD) and standardized mean difference (SMD) were used. Result Ten studies were eligible acoording criteria. The effect of massage on fatigue showed significant improvement (−1.62; 95% CL −2.40, −0.83; p < .00001), also results of the systematic review showed a significant reduction in pain severity. Conclusion Massage as a complementary and non-pharmacological therapy might have been associated with alleviating fatigue and pain in M.S. patients. Based on the current study, massage intervention for MS patients could have possible clinical value for palliating pain and fatigue and improving quality of life; however, this matter needs further and more significant trial studies.

scholarly journals Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5171
Author(s):  
Yusuke Handa ◽  
Kenya Okada ◽  
Hiroshi Takasaki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grade System ◽  
Cochrane Library ◽  
Forward Head Posture ◽  
Quality Of Evidence ◽  
Head Posture ◽  
Head Extension ◽  
The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

scholarly journals Traditional Chinese Herb Combined with Surgery versus Surgery for Varicocele Infertility: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Rong-liang Dun ◽  
Min Yao ◽  
Long Yang ◽  
Xue-jun Cui ◽  
Jian-min Mao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Chinese Herb ◽  
Chinese Herbs ◽  
Cochrane Library ◽  
Dichotomous Data ◽  
Surgery Group ◽  
Traditional Chinese Herb ◽  
The Cochrane Library

Objective. The objective of this study was to conduct a systematic review to assess the effectiveness and safety of traditional Chinese herb combined with surgery for male varicocele infertility compared to surgery.Methods. Randomized controlled trials (RCTs) data of traditional Chinese herbs combined with surgery for male varicocele fertility versus surgery were collected by searching the Cochrane Library, Embase, PubMed, and Chinese databases. The risk of bias was assessed using Cochrane Handbook. Study outcomes were presented as risk ratios (RRs) for dichotomous data.Results. Seventeen of 72 potentially relevant trials met the inclusion criteria. The methodological qualities of the RCTs were low. Compared with the surgery group, the traditional Chinese herb combined with surgery group had superiority in pregnancy rate at 3-month (RR=1.76, andP=0.008), 6-month (RR=1.58, andP=0.0005), and 2-year (RR=1.58, andP=0.0005) follow-ups. No RCT was found to describe the side effects.Conclusion. On considering the low methodological quality of RCTs, there was no enough evidence on traditional Chinese herb with surgery for male varicocele infertility, and more high-quality RCTs of large sample sizes are required.

Rikkunshito for Upper Gastrointestinal Syndrome in Patients With Cancer: A Systematic Review and Meta-analysis Protocol

2021 ◽  
Author(s):  
Hong Liu ◽  
Yifeng Ren ◽  
Yuting Wang ◽  
Yu Yang ◽  
Chuan Zheng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Gastrointestinal Symptoms ◽  
Cochrane Library ◽  
Complete Control ◽  
Patients With Cancer ◽  
Treatment Interruptions ◽  
Phase 0 ◽  
Upper Gastrointestinal

Abstract BackgroundUpper gastrointestinal syndrome including nausea, vomiting, and anorexia is a common side effect of chemotherapy, which are associated with treatment interruptions, reduced food intake, decreased functionality and a worse quality of life. Rikkunshito is a traditional herbal medicine that has gained increasing attention in recent years for its effect on relieving gastrointestinal disorders in various digestive diseases, while its efficacy for upper gastrointestinal syndrome induced by chemotherapy remains uncertain. MethodsDatabases including PubMed, EMBASE, MEDLINE, Cochrane Library, Chinese databases, and Japanese database will be systematically searched from their inception onwards. Randomized controlled trials will be assessed. The primary outcome parameters are the complete control (CC) rate, complete response (CR) rate, and complete protection (CP) rate in the overall phase (0–120 hours). The secondary outcomes include: (I) the CC rate, CR rate and CP rate during the acute phase (0–24 hours) and delayed phase (24–120 hours); (II) the score and frequency of vomiting, nausea, and anorexia occurring; (III) the daily dietary intake and body weight; (IV) plasma ghrelin level; (V) quality of life; (VI) incidence of adverse events. The overall quality of the data will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. Risk of bias will be evaluated by the Cochrane tool. Reporting bias will be estimated using Begg and Egger tests. Heterogeneity will be evaluated by the I2 statistic and Q test. If I2 > 50%, sensitivity analysis and subgroup analysis of different items will be performed. DiscussionFrom the study, we will ascertain the efficacy and safety of rikkunshito in chemotherapy-induced upper gastrointestinal syndrome. This review may provide evidence for rikkunshito as an adjuvant to treat upper gastrointestinal symptoms in patients with cancer. Systematic review registrationCRD42020214299 in PROSPERO.

Association Between Spirituality/religiousness and Quality of Life Among Healthy Adults: A Systematic Review 

2020 ◽  
Author(s):  
CEZIMAR CORREIA BORGES ◽  
PATRÍCIA ROBERTA DOS SANTOS ◽  
POLISSANDRO MORTOZA ALVES ◽  
RENATA CUSTÓDIO MACIEL BORGES ◽  
GIANCARLO LUCCHETTI ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Chronic Diseases ◽  
Academic Research ◽  
Positive Association ◽  
Healthy Adults ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Cross Sectional

Abstract Background: Health-related quality of life (HRQoL) is determined by multiple factors that include components such as spirituality and religiousness (S/R). Even though various systematic reviews have investigated the association between S/R and improved health outcomes in the most different groups, healthy young individuals are seldom addressed. The aim this study was to evalue the association between S/R and HRQoL among young, healthy individuals.Methods: Systematic review of papers published in the last ten years and indexed in four academic research databases (PubMed, Web of Science, Cochrane Library, and Scopus) and two gray literature databases. Inclusion criteria were studies assessing S/R and HRQoL using validated instruments and assessing healthy adults (i.e., non-clinical patients, not belonging to any specific group of chronic diseases), aged between 18 and 64 years old. Results: Ten out of 1,952 studies met the inclusion criteria: nine cross-sectional and one longitudinal cohort study, in which 89% of the participants were college students. Nine studies report a positive association between S/R and HRQoL, while one study did not report any significant association. The main HRQoL domains associated with S/R were the psychological, social relationships, and environment domains, while the S/R most influent facets/components were optimism, inner strength, peace, high control, hope, and happiness. Conclusions: Higher S/R levels among healthy adult individuals were associated with higher HRQoL levels, suggesting the S/R can be an important strategy to deal with adverse environmental situations even among those without chronic diseases, enhancing the wellbeing of individuals. Registration of systematic review: PROSPERO - CRD42018104047

scholarly journals Itch in Chronic Wounds: Pathophysiology, Impact, and Management

Medicines ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 112 ◽  
Author(s):  
Michela Iannone ◽  
Agata Janowska ◽  
Valentina Dini ◽  
Giulia Tonini ◽  
Teresa Oranges ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Wounds ◽  
Management Strategies ◽  
Relevant Information ◽  
Cochrane Library ◽  
Tissue Edema ◽  
Practical Guidelines ◽  
The Cochrane Library ◽  
The Impact

Background: The aims of this review are to analyze the current literature regarding the characteristics and pathophysiological mechanisms of itch in chronic wounds, to assess the impact on quality of life and delayed-healing, to focus on the best strategies of prevention and treatment, to highlight the importance of on-going research in order to fully understand the pathophysiology, and to improve the management of target therapies. Methods: A systematic literature review was performed using MEDLINE, PubMed, Embase, Scopus, ScienceDirect, and the Cochrane Library. We included a total of 11 articles written in English with relevant information on the pathophysiology of itch in chronic wounds and on management strategies. Results: Itch in chronic wounds was found to be correlated with xerosis, larger wound areas, necrotic tissue and amount of exudate, peripheral tissue edema, sclerosis, granulation tissue, contact dermatitis, and bacterial burden, as well as with lower quality of life. Conclusions: Although there are several aspecific pharmacological and non-pharmacological approaches, there appears to be no validated prevention or management strategy for itch in chronic wounds. Further studies are needed to clarify the association and pathophysiology of itch in chronic wounds, to evaluate the safety and efficacy of topical treatments on perilesional skin to reduce itch, to characterize multidimensional sensations of itch in chronic wounds, to identify specific cytokine and chemokine expressions that are correlated to a tailored-based approach, and to develop practical guidelines.

scholarly journals Efficacy and Safety of PARACHUTE® Device: systematic review

2018 ◽  
Vol 64 (9) ◽  
pp. 853-860 ◽  
Author(s):  
Roberta da Silva Teixeira ◽  
Bruna Medeiros Gonçalves de Veras ◽  
Kátia Marie Simões e Senna ◽  
Rosângela Caetano
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Systematic Review ◽  
Left Ventricular ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Frequent Event

SUMMARY INTRODUCTION Heart failure due to an acute myocardial infarction is a very frequent event, with a tendency to increase according to improvements in the treatment of acute conditions which have led to larger numbers of infarction survivors. OBJECTIVE The aim of this study is to synthesize the evidence, through a systematic review, on efficacy and safety of the device in patients with this basic condition. METHODS Studies published between January 2002 and October 2016 were analysed, having as reference databases Embase, Medline, Cochrane Library, Lilacs, Web of Science and Scopus. The selection of studies, data extraction and methodological quality assessment of studies were examined by two independent reviewers, with disagreements resolved by consensus. RESULTS Only prospective studies without control group were identified. Six studies were included, with averages of 34 participants and follow-up of 13 months. Clinical, functional, hemodynamic and quality of life outcomes were evaluated. The highest mortality rate was 8.4% with 12-month follow-up for unspecified cardiovascular reasons, and heart failure rehospitalization was 29.4% with 36-month follow-up. Statistically significant improvements were found only in some of the studies which evaluating changes in left ventricular volume indices, the distance measured by the six-minute walk test, New York Heart Association functional classification, and quality of life, in pre and post-procedure analysis. CONCLUSIONS The present review indicates that no available quality evidence can assert efficacy and safety of PARACHUTE® in the treatment of heart failure after apical or anterior wall myocardial infarction.

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