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International Journal of Cardiology Apr 2021To evaluate the risk for ventricular arrhythmia (VA) and sudden cardiac death (SCD) in patients with cardiac sarcoidosis (CS) and determine the prognostic factors. (Meta-Analysis)
Meta-Analysis
BACKGROUND
To evaluate the risk for ventricular arrhythmia (VA) and sudden cardiac death (SCD) in patients with cardiac sarcoidosis (CS) and determine the prognostic factors.
METHODS AND RESULTS
PUBMED, EMBASE and SCOPUS were searched up to 14th April 2020. Studies reporting the incidence of SCD, appropriate ICD therapy in CS patients, or relevant prognostic information in patients having undergone MRI, PET, or programmed electrical stimulation (PES) were included. Nineteen studies consisting of 1247 patients, reported the risk of ICD therapies or SCD over a follow-up period of 1.7-7 years. 22.7% (n = 9; 22.7, 95%CI [16.10-29.36]) of patients in primary and 58.4% (n = 9; 58.42, 95% CI [38.61-78.22]) in secondary prevention cohorts experienced appropriate device therapy or SCD events. 18% (n = 2; 18, 95%CI [14-23]) of patients received ≥5 appropriate therapies. 9 out of 664 patients with confirmed cardiac sarcoidosis but without implanted ICDs died suddenly. 17.9% of patients (n = 4; 17.9, 95%CI [10.80-25.03]) experienced inappropriate device therapy. Positive LGE-MRI and PES were associated with an 8.6-fold (n = 6; RR = 8.60, 95%CI [3.80-19.48]) and 9-fold (n = 5; RR = 9.07, 95%CI [4.65-17.68]) increased risk of VA respectively. Positive LGE-MRI and PET with associated with a 6.8-fold (n = 12; RR = 6.82, 95%CI [4.57-10.18]) and 3.4-fold (n = 7; RR = 3.41, 95%CI [2.03-5.74]) respectively for increased risk of major adverse cardiac events.
CONCLUSIONS
The risk of appropriate ICD therapy or sudden cardiac death is high in patients with CS. The presence of LGE-MRI and positive electrophysiology study identify patients at increased risk of ventricular arrhythmias. [CRD42019124220].
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Defibrillators, Implantable; Humans; Magnetic Resonance Imaging; Risk Factors; Sarcoidosis
PubMed: 33242509
DOI: 10.1016/j.ijcard.2020.11.044 -
Current Problems in Cardiology Mar 2021Use of implantable cardioverter defibrillators (ICDs) is the treatment of choice for heart failure patients with ejection fraction <35% to prevent sudden cardiac death.... (Review)
Review
Use of implantable cardioverter defibrillators (ICDs) is the treatment of choice for heart failure patients with ejection fraction <35% to prevent sudden cardiac death. Whether this benefit remains among patients with chronic kidney disease (CKD) or end stage renal disease (ESRD) is yet to be elucidated. We conducted a systematic review of studies in PubMed that have investigated the use of ICDs among patients with CKD or ESRD. From the 470 studies identified, we selected 42 for the current review. Patients with CKD/ESRD were more likely to get antitachycardia pacing or shocks and had higher cardiac and/or all-cause mortality compared to patients without CKD/ESRD. These associations had an inverse dose-response effect with worse outcomes with decreasing kidney function. In conclusion, use of ICDs in CKD/ESRD is associated with increased antitachycardia pacing/shocks and mortality suggesting that their routine use in this patient population may be associated with more adverse outcomes than benefits.
Topics: Death, Sudden, Cardiac; Defibrillators, Implantable; Heart Failure; Humans; Renal Insufficiency, Chronic
PubMed: 32624194
DOI: 10.1016/j.cpcardiol.2020.100639 -
Journal of Psychosomatic Research Dec 2018To systematically review of the available literature to (1) examine the association between death anxiety and hypochondriasis and (2) examine the association between...
OBJECTIVE
To systematically review of the available literature to (1) examine the association between death anxiety and hypochondriasis and (2) examine the association between death anxiety and medically unexplained symptoms (MUS).
METHODS
A systematic literature search was conducted in Embase, PsycINFO, Pubmed and Ovid databases and reference lists of selected articles. Articles were included when the research population concerned people with hypochondriasis and/or MUS in who death anxiety was assessed by a validated research method. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted relevant characteristics and data. The data were descriptively analysed.
RESULTS
Of the 1087 references identified in the search, six studies on the association between death anxiety and hypochondriasis and three studies on the association between death anxiety and MUS met inclusion criteria. All studies found a positive association of death anxiety with hypochondriasis and/or MUS. The design of all studies was cross-sectional and the overall quality of the studies was low. The influence of age or sex on these associations was not analysed in any of the studies. Given the diversity in setting, population, study design, and methods used, a meta-analysis was not possible.
CONCLUSION
All studies found a positive association of death anxiety with hypochondriasis and/or MUS. Acknowledging that death anxiety may play a prominent role in hypochondriasis/MUS populations, future research should address (potentially modifiable) determinants of death anxiety in these populations.
Topics: Adult; Anxiety; Cross-Sectional Studies; Death; Female; Humans; Hypochondriasis; Medically Unexplained Symptoms; Middle Aged; Young Adult
PubMed: 30470318
DOI: 10.1016/j.jpsychores.2018.10.002 -
Journal of Pain and Symptom Management May 2023Religiosity/spirituality/religious-spiritual coping (RS) are resources used by cancer patients with cancer to help cope with the disease and may influence the preference... (Review)
Review
CONTEXT
Religiosity/spirituality/religious-spiritual coping (RS) are resources used by cancer patients with cancer to help cope with the disease and may influence the preference and receipt of end-of-life (EOL) treatment.
OBJECTIVES
To examine the relationship between RS and the EOL care preferred or received by cancer patients.
METHODS
This review protocol is registered on (International Prospective Register of Systematic Review, CRD42021251833) and follows the recommendations of the preferred reporting items for systematic reviews and meta-analyses checklist. Embase, Proquest, PubMed, Scopus, and Web of Science databases were consulted. Google Scholar was consulted for additional publications and gray literature. Quantitative studies including adults with any cancer type/stage were eligible. The paper selection was performed by two independent reviewers; the methodological quality was measured using the Newcastle Ottawa scale.
RESULTS
Seventeen studies were included in the review. In general, RS is related to the preference or receipt of aggressive EOL care and with less advance care planning. Spiritual care by the medical team is related to higher referral to hospice and less aggressive care; in contrast, high spiritual support from religious communities is associated with less hospice and more aggressive care. Religious denominations influenced health care preferences, as Catholics were less likely to sign a do-not-resuscitate order and Buddhists or Taoists received more aggressive interventions at the EOL. Most studies (70%) were of high quality according to the Newcastle Ottawa scale.
CONCLUSION
RS is associated with more aggressive EOL treatments, as well as with lower rates of ACP in cancer patients. On the other hand, spiritual care provided by the medical team seems to be associated with less aggressive EOL care.
Topics: Adult; Humans; Spirituality; Religion; Terminal Care; Hospice Care; Advance Care Planning; Death; Neoplasms
PubMed: 36758908
DOI: 10.1016/j.jpainsymman.2023.01.017 -
Forensic Science International Aug 2018Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack... (Review)
Review
Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack of healthcare resources contribute to the high burden of disease. In some cases death due to infection can be acute and aggressive, and death may occur without a diagnosis whilst the person is still alive. These deaths may ultimately lead to a medico-legal autopsy being performed. There are various mechanisms by which sudden death due to infection may occur. In addition, there are many risk factors associated with sudden death due to infection, which differ between infants and older individuals. However, it is unclear which pathogens and risk factors are most frequently associated with sudden death due to infection. Therefore a systematic review of articles and case reports published between 1 January 2000 and 30 June 2016 was undertaken in order to (1) explore the relationship between pathogens and their causative role and (2) identify the relationship between predisposing and/or risk factors associated with sudden death due to infection. Major databases were searched and after critical appraisal 143 articles were identified. It was found that respiratory infections and deaths involving bacterial pathogens were most commonly associated with these deaths. In addition the most common risk factors in infants were exposure to tobacco smoke and co-sleeping. In adults the most common risk factors were co-morbid conditions and illnesses. This information aids in a better understanding of these deaths and highlights the need for more research in this field, particularly in developing countries.
Topics: Causality; Death, Sudden; Forensic Medicine; Humans; Infections; Parasitic Diseases; Risk Factors; Virus Diseases
PubMed: 29860163
DOI: 10.1016/j.forsciint.2018.05.023 -
BMJ Open Respiratory Research Jun 2021Over 1 billion individuals worldwide experience some form of sleep apnoea, and this number is steadily rising. Obstructive sleep apnoea (OSA) can negatively influence... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Over 1 billion individuals worldwide experience some form of sleep apnoea, and this number is steadily rising. Obstructive sleep apnoea (OSA) can negatively influence one's quality of life and potentially increase mortality risk. However, the association between OSA and mortality has not been reliably estimated. This meta-analysis estimates the risk of all-cause and cardiovascular mortality in individuals with OSA.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
MEDLINE, Cochrane Library, Scopus and Joanna Briggs Institute Evidence-Based Practice databases were searched from inception through 1 January 2020.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included observational studies assessing the association of sudden deaths in individuals with and without OSA.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers (AES and ESH) extracted data and assessed the risk of bias using the Newcastle-Ottawa Scale quality assessment tool. Data were pooled using the random-effects models and reported as risk ratios (RRs) with 95% CIs. Heterogeneity was quantified with I statistic.
RESULTS
We identified 22 observational studies (n=42 099 participants). The mean age was 62 years and 64% were men. OSA was associated with all-cause sudden death (RR=1.74, 95% CI: 1.44 to 2.10, I=72%) and cardiovascular mortality (RR=1.94, 95% CI: 1.39 to 2.70, I=32%). A marginally significant dose-response relationship between severity of OSA and the risk of death was observed (p for interaction=0.05): mild OSA (RR=1.16, 95% CI: 0.70 to 1.93), moderate OSA (RR=1.72, 95% CI: 1.11 to 2.67) and severe OSA (RR=2.87, 95% CI: 1.70 to 4.85). Meta-regression analysis showed that older age was a significant contributing factor in the relationship between OSA and mortality. The median study methodological quality was considered high.
CONCLUSIONS
OSA is a significant risk factor for all-cause mortality and cardiac mortality. Prevention and treatment strategies to optimise survival and quality of life in individuals with OSA are urgently needed.
PROSPERO REGISTRATION NUMBER
CRD42020164941.
Topics: Aged; Death, Sudden; Humans; Male; Middle Aged; Quality of Life; Risk Factors; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 34108135
DOI: 10.1136/bmjresp-2020-000656 -
BMJ Supportive & Palliative Care Dec 2022Without a well-rounded syllabus to teach end-of-life (EOL) communication, medical providers find it challenging to enhance their patients' quality of life at the final... (Review)
Review
BACKGROUND
Without a well-rounded syllabus to teach end-of-life (EOL) communication, medical providers find it challenging to enhance their patients' quality of life at the final stage of life.
AIM
The aim of this scoping review was to explore studies about the teaching of EOL communication and to detail how educators can approach the teaching of EOL communication.
METHODS
A scoping review of both qualitative and quantitative studies was conducted according to the methodological framework of scoping review. The PsycINFO, PubMed, ERIC, CINAHL and EMBASE databases were searched for studies using the keywords 'teach', 'educat*', 'end of life', 'terminal care', 'communication' and 'palliative care'. Sixteen studies were appraised, and none was rejected on the grounds of quality.
RESULTS
The search strategy yielded 22 278 entries and 16 studies were included. Two themes were identified from the priorities in teaching EOL communication: (1) challenges to teaching EOL communication and (2) methods of teaching EOL communication. To present a comprehensive overview of EOL communication teaching, we provide directions for priorities of topics and approaches when teaching EOL communication.
CONCLUSIONS
The review detailed the complexity of teaching EOL communication, which indicates the need for a well-rounded syllabus that includes skills such as non-verbal social cues, communication strategies and understanding EOL communication in various cultural contexts to facilitate a well-rounded EOL communication experience for students' future practice.
Topics: Humans; Quality of Life; Terminal Care; Palliative Care; Death
PubMed: 34649838
DOI: 10.1136/bmjspcare-2020-002725 -
Medical Sciences (Basel, Switzerland) Apr 2021: Antidepressants are one of the most prescribed medications, particularly for patients with mental disorders. Nevertheless, there are still limited data regarding the... (Meta-Analysis)
Meta-Analysis
: Antidepressants are one of the most prescribed medications, particularly for patients with mental disorders. Nevertheless, there are still limited data regarding the risk of ventricular arrhythmia (VA) and sudden cardiac death (SCD) associated with these medications. Thus, we performed systemic review and meta-analysis to characterize the risks of VA and SCD among patients who used common antidepressants. A literature search for studies that reported risk of ventricular arrhythmias and sudden cardiac death in antidepressant use from MEDLINE, EMBASE, and Cochrane Database from inception through September 2020. A random-effects model network meta-analysis model was used to analyze the relation between antidepressants and VA/SCD. Surface Under Cumulative Ranking Curve (SUCRA) was used to rank the treatment for each outcome. The mean study sample size was 355,158 subjects. Tricyclic antidepressant (TCA) patients were the least likely to develop ventricular arrhythmia events/sudden cardiac deaths at OR 0.24, 0.028-1.2, OR 0.32 (95% CI 0.038-1.6) for serotonin and norepinephrine reuptake inhibitors (SNRI), and OR 0.36 (95% CI 0.043, 1.8) for selective serotonin reuptake inhibitors (SSRI), respectively. According to SUCRA analysis, TCA was on a higher rank compared to SNRI and SSRI considering the risk of VA/SCD. Our network meta-analysis demonstrated the low risk of VA/SCD among patients using antidepressants for SNRI, SSRI and especially, TCA. Despite the relatively lowest VA/SCD in TCA, drug efficacy and other adverse effects should be taken into account in patients with mental disorders.
Topics: Antidepressive Agents; Antidepressive Agents, Tricyclic; Death, Sudden, Cardiac; Humans; Network Meta-Analysis; Norepinephrine; Selective Serotonin Reuptake Inhibitors; Serotonin and Noradrenaline Reuptake Inhibitors
PubMed: 33922524
DOI: 10.3390/medsci9020026 -
British Journal of Clinical Pharmacology Oct 2021Concerns exist regarding the cardiovascular safety of domperidone. However, many of the previous studies addressing this issue had important limitations. We aimed to... (Meta-Analysis)
Meta-Analysis Review
AIMS
Concerns exist regarding the cardiovascular safety of domperidone. However, many of the previous studies addressing this issue had important limitations. We aimed to examine domperidone and the risks of sudden cardiac death and ventricular arrhythmia through a systematic review and meta-analysis of observational studies, including an in-depth methodological assessment.
METHODS
We systematically searched MEDLINE, PubMed, EMBASE, Scopus and CINAHL Plus to identify observational studies examining the association of domperidone and sudden cardiac death and/or ventricular arrhythmia. We assessed study quality in duplicate using the ROBINS-I tool supplemented by an assessment of specific biases and the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. Data were pooled across studies using DerSimonian and Laird random-effects models.
RESULTS
Six case-control studies, 1 case-crossover study and 1 retrospective cohort study were included (n = 480 395). Based on ROBINS-I, 3 studies had moderate risk of bias, 4 had serious risk, and 1 had critical risk. The overall GRADE rating is moderate. When data were pooled across nonoverlapping studies, domperidone was associated with an increased risk of composite endpoint of sudden cardiac death or ventricular arrhythmia compared to nonuse (adjusted odds ratio: 1.69; 95% confidence interval: 1.46, 1.95; I : 0%; τ : 0). This association persisted when restricted to higher-quality studies (odds ratio: 1.60; 95% confidence interval: 1.30, 1.97; I : 0%; τ : 0).
CONCLUSION
Domperidone is associated with an increased risk of sudden cardiac death and ventricular arrhythmia compared to nonuse. Further investigation comparing domperidone to an active comparator and in younger populations are warranted.
Topics: Antiemetics; Arrhythmias, Cardiac; Cross-Over Studies; Death, Sudden, Cardiac; Domperidone; Humans; Retrospective Studies
PubMed: 33439512
DOI: 10.1111/bcp.14737 -
The Journal of Maternal-fetal &... Aug 2022This is the first comprehensive review to focus on currently available evidence regarding maternal, fetal and neonatal mortality cases associated with Coronavirus...
OBJECTIVE
This is the first comprehensive review to focus on currently available evidence regarding maternal, fetal and neonatal mortality cases associated with Coronavirus Disease 2019 (COVID-19) infection, up to July 2020.
METHODS
We systematically searched PubMed, Scopus, Google Scholar and Web of Science databases to identify any reported cases of maternal, fetal or neonatal mortality associated with COVID-19 infection. The references of relevant studies were also hand-searched.
RESULTS
Of 2815 studies screened, 10 studies reporting 37 maternal and 12 perinatal mortality cases (7 fetal demise and 5 neonatal death) were finally eligible for inclusion to this review. All maternal deaths were seen in women with previous co-morbidities, of which the most common were obesity, diabetes, asthma and advanced maternal age. Acute respiratory distress syndrome (ARDS) and severity of pneumonia were considered as the leading causes of all maternal mortalities, except for one case who died of thromboembolism during postpartum period. Fetal and neonatal mortalities were suggested to be a result of the severity of maternal infection or the prematurity, respectively. Interestingly, there was no evidence of vertical transmission or positive COVID-19 test result among expired neonates.
CONCLUSION
Current available evidence suggested that maternal mortality mostly happened among women with previous co-morbidities and neonatal mortality seems to be a result of prematurity rather than infection. However, further reports are needed so that the magnitude of the maternal and perinatal mortality could be determined more precisely.
Topics: COVID-19; Female; Humans; Infant Mortality; Infant, Newborn; Infectious Disease Transmission, Vertical; Maternal Mortality; Perinatal Death; Pregnancy; Pregnancy Complications, Infectious; SARS-CoV-2
PubMed: 32799712
DOI: 10.1080/14767058.2020.1806817