-
International Journal of Chronic... 2021Diaphragm dysfunction is a significant extrapulmonary effect in chronic obstructive pulmonary disease (COPD), which is manifested by changes in diaphragm structure and... (Review)
Review
INTRODUCTION
Diaphragm dysfunction is a significant extrapulmonary effect in chronic obstructive pulmonary disease (COPD), which is manifested by changes in diaphragm structure and reduced diaphragm strength. Acupuncture is a traditional rehabilitation technique in China, which has been used in rehabilitation for COPD. But whether acupuncture can improve the diaphragm function of COPD patients remains to be verified.
OBJECTIVE
The objective of this study was to evaluate the rehabilitation effects of acupuncture on diaphragm dysfunction in patients with COPD.
METHODS
The authors retrieved in CNKI, VIP, SinoMed, PubMed, Ebsco, Web of Science, from inception to November 2020, for relevant randomized control trials. Two researchers independently screened the articles and extracted the data. The quality of the included studies was evaluated by Physiotherapy Evidence Database scale. The primary outcome measures were maximal inspiratory pressure and the scale for accessory respiratory muscle mobilization, the secondary outcome measures were pulmonary function-related indicators and arterial blood gas indicators.
RESULTS
Nine articles were finally obtained. Seven studies added acupuncture to standard treatment for patients with diaphragm dysfunction in COPD and found statistically significant changes in the maximum inspiratory pressure and the scale for accessory respiratory muscle mobilization. Two studies have proved that use acupuncture combined with other Traditional Chinese Medicine methods in the rehabilitation for COPD can effectively improve the diaphragm strength and diaphragmatic motor performance. Seven studies showed that acupuncture has obvious improvement in pulmonary ventilation function. Seven studies reported significant differences in arterial blood gas pre- to post-intervention.
CONCLUSION
This systematic review found that acupuncture can effectively enhance the diaphragm strength, relieve respiratory muscle fatigue, it can also play a promoting role in improving lung function, hypoxia, and carbon dioxide retention, as well as preventing and alleviating respiratory failure. The generalizability of these results is limited by the design of the included studies.
Topics: Acupuncture Therapy; Diaphragm; Humans; Pulmonary Disease, Chronic Obstructive; Respiration; Respiratory Muscles
PubMed: 34262271
DOI: 10.2147/COPD.S313439 -
Medicine Dec 2022Some studies have reported using ultrasonic evaluations to assess diaphragm function in patients with chronic obstructive pulmonary disease (COPD). However, they have... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Some studies have reported using ultrasonic evaluations to assess diaphragm function in patients with chronic obstructive pulmonary disease (COPD). However, they have limitations and thus cannot provide strong evidence to support ultrasound evaluations for diaphragm function and dysfunction severity assessments in this patient population. Additionally, quantitative studies on the relationship between ultrasound evaluations and diaphragm function do not exist. Therefore, we performed a systematic review and meta-analysis to explore the usefulness of ultrasonography for evaluating diaphragm function in patients with COPD.
METHODS
The Cochrane Library, PubMed, Embase, Web of Science, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Network, and Chinese Scientific Journal Database (i.e., VIP) databases were searched for literature about ultrasonic evaluations of diaphragm function in patients with COPD for systematic review. We extracted patient demographic, diaphragm mobility, diaphragm thickness, diaphragm thickening score, and other related parameter data using RevMan 5.3 software for the meta-analysis.
RESULTS
We included 13 articles in the systematic review, 8 of which (494 participants) were included in the meta-analysis. The degree of diaphragm offset in patients with COPD was significantly lower than that in healthy controls (weighted mean difference [WMD] = -1.34; 95% confidence interval [CI]: -2.15, 0.53; P < .05). The diaphragm deviation was lower in the severe COPD group than in the mild-to-moderate COPD group (WMD = 0.50; 95% CI: -0.01, 1.01; P = .06), but the difference was not significant.
CONCLUSION
Ultrasonography effectively evaluates diaphragm function in patients with COPD. The diaphragm offset can be used as an auxiliary diagnostic index for COPD, which is also related to disease severity.
Topics: Humans; Diaphragm; Pulmonary Disease, Chronic Obstructive; Patient Acuity; China
PubMed: 36595865
DOI: 10.1097/MD.0000000000032560 -
ANZ Journal of Surgery Sep 2022Bochdalek hernia (BH) is characterized by the protrusion of viscera into thorax through the posterolateral section of the diaphragm. The aim of this study was to... (Review)
Review
BACKGROUND
Bochdalek hernia (BH) is characterized by the protrusion of viscera into thorax through the posterolateral section of the diaphragm. The aim of this study was to systematically review current literature concerning Bochdalek hernias in adults and elucidate their clinical characteristics and preferable treatment approach.
METHODS
A search of PubMed and Cochrane bibliographical databases for studies regarding BHs was conducted (last search: 31st March 2021).
RESULTS
Predefined inclusion criteria were met by 173 articles and concerned collectively 192 patients (50.5% males) with a mean age of 45.41 ± 20.26 years. Abdominal pain (62.0%) and pulmonary symptoms (41.1%) were the predominant symptomatology of included cases. BHs protruded mainly through the left side of the diaphragm (70.7%), with large intestine (42.7%) and stomach (37.1%) being the most commonly herniated abdominal organs. Most patients (53.8%) underwent an open surgical approach, while abdominal approach was preferred (64.8%). to the thoracic one. Thirty-day postoperative complication were encountered at 21.5% of patients, while 30-day mortality reached 4.4%.
CONCLUSION
BH is an extremely rare type of congenital diaphragmatic hernia. It rarely concerns adults, and it manifests with vague gastrointestinal or pulmonary symptoms. Surgical approach is the preferred method for their management with open procedures being preferable at emergency cases, while minimal invasive approach necessitates experienced centers. Further research is needed in order to clarify their true incidence and optimal therapeutic strategy.
Topics: Abdomen; Abdominal Cavity; Abdominal Pain; Adult; Aged; Female; Hernias, Diaphragmatic, Congenital; Humans; Male; Middle Aged; Stomach
PubMed: 35357073
DOI: 10.1111/ans.17651 -
Annals of Global Health 2022Sexually transmitted infections, including HIV, remain a significant public health challenge for low- and middle-income countries, and about 111 million unintended... (Review)
Review
BACKGROUND
Sexually transmitted infections, including HIV, remain a significant public health challenge for low- and middle-income countries, and about 111 million unintended pregnancies occur in these countries annually. The female condom is the only commonly available method that affords women and girls more control in protecting themselves from sexually transmitted infections, as well as unintended pregnancies. Yet, the female condom only accounts for 1.6% of total condom distribution worldwide.
OBJECTIVES
To help fill the gaps in an understanding of what works for improved acceptability and use of the female condom in low- and middle-income countries, we conducted a systematic review of the literature that focuses on acceptability of the FC, as examined in the specific settings of intervention programs or research in low- and middle-income countries.
METHODS
We conducted a preliminary search of two purposively selected databases (PubMed and POPLINE) for English language articles from 2009 to 2019 with the keyword "female condom." PubMed yielded 145 articles, while POPLINE yielded 164 articles. Included studies involve a purposive, interventional deployment of the female condom; have occurred in a low- or middle-income country, as defined by the World Bank; and have focused on acceptability of the female condom. Upon review of duplicates and abstracts, a total of 14 articles made the final selection.
FINDINGS
The included articles represent seven different countries: the Dominican Republic, El Salvador, China, Malaysia, Nicaragua, South Africa, and Uganda. We identified four key barriers to FC acceptability, including partner acceptability, functionality, aesthetics, and access. We identified four key facilitators to FC acceptability, including repeated use, supportive attitudes, protection confidence, and reproductive control.
CONCLUSION
Effective promotion and uptake of the female condom in low- and middle-income countries can be realized if novel strategies and approaches are implemented to tackle persistent barriers to acceptability.
Topics: Condoms, Female; Developing Countries; Female; Humans; Male; Pregnancy; Pregnancy, Unplanned; Sexually Transmitted Diseases; South Africa
PubMed: 35433283
DOI: 10.5334/aogh.3612 -
BMJ Open Respiratory Research Sep 2020Clinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pulmonary disease (COPD) has been widely investigated. However, there is no...
BACKGROUND
Clinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pulmonary disease (COPD) has been widely investigated. However, there is no systematic review assessing the clinical values of non-cardiac US techniques in COPD.
METHODS
We systematically searched electronic databases from inception to 24 June 2020. Two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines extracted data. A narrative synthesis of the results was conducted considering non-cardiac US techniques that looked for diaphragm, muscles and bones in patients with COPD.
RESULTS
In total, 2573 abstracts were screened, and 94 full-text papers were reviewed. A total of 54 studies met the inclusion criteria. Thirty-five studies assessed the diaphragm, while 19 studies evaluated different muscles, including limb muscles and pulmonary lesions in COPD using US. Of the 54 included studies, 30% (16/54) evaluated the changes in either limb muscles or diaphragmatic features before and after physical interventions; 67% (36/54) assessed the correlations between sonographic features and COPD severity. Indeed, 14/15 and 9/13 studies reported a significant reduction in diaphragm excursion and thickness in COPD compared with healthy subjects, respectively; this was correlated significantly with the severity and prognosis of COPD. Three studies reported links between diaphragm length and COPD, where lower diaphragm length correlated with poorer prognosis and outcomes. Quadriceps (rectus femoris), ankle dorsiflexor (tibialis anterior) and vastus lateralis were the most common muscles in COPD assessed by US. More than 70% (12/17) of the studies reported a significant reduction in the cross-sectional area (CSA) of the rectus femoris, rectus femoris and vastus lateralis thickness in COPD compared with healthy subjects. Quadriceps CSA and thickness correlated positively with COPD prognosis, in which patients with reduced quadriceps CSA and thickness have higher risk of exacerbation, readmission and death.
CONCLUSION
US measurements of diaphragm excursion and thickness, as well as lower limb muscles strength, size and thickness, may provide a safe, portable and effective alternative to radiation-based techniques in diagnosis and prognosis as well as tracking improvement postintervention in patients with COPD.
Topics: Diaphragm; Humans; Lower Extremity; Muscle Strength; Muscle, Skeletal; Pulmonary Disease, Chronic Obstructive; Ultrasonography
PubMed: 32978244
DOI: 10.1136/bmjresp-2020-000717 -
Aerospace Medicine and Human Performance Feb 2017Flights to high altitude can lead to exposure and unique pathology not seen in normal commercial aviation. (Review)
Review
INTRODUCTION
Flights to high altitude can lead to exposure and unique pathology not seen in normal commercial aviation.
METHODS
This paper assesses the potential for point-of-care ultrasound to aid in management and disposition of injured crewmembers from a high altitude incident. This was accomplished through a systematic literature review regarding current diagnostic and therapeutic uses of ultrasound for injuries expected in high altitude free fall and parachuting.
RESULTS
While current research supports its utility in diagnostics, therapeutic procedures, and triage decisions, little research has been done regarding its utility in high altitude specific pathology, but its potential has been demonstrated.
DISCUSSION
An algorithm was created for use in high altitude missions, in the event of an emergency descent and traumatic landing for an unconscious and hypotensive pilot, to rule out most life threatening causes. Each endpoint includes disposition, allowing concise decision-making.Galdamez LA, Clark JB, Antonsen EL. Point-of-care ultrasound utility and potential for high altitude crew recovery missions. Aerosp Med Hum Perform. 2017; 88(2):128-136.
Topics: Aerospace Medicine; Altitude; Aviation; Barotrauma; Cardiac Tamponade; Clinical Decision-Making; Contusions; Decompression Sickness; Diaphragm; Emergency Medical Services; Fractures, Bone; Humans; Pericardial Effusion; Pleural Effusion; Pneumothorax; Point-of-Care Systems; Pulmonary Atelectasis; Pulmonary Edema; Surgery, Computer-Assisted; Ultrasonography
PubMed: 28095957
DOI: 10.3357/AMHP.4640.2017 -
Life (Basel, Switzerland) Jun 2021COVID-19 is a viral disease characterized as a pandemic by the World Health Organization in March 2020. Since then, researchers from all over the world have been looking... (Review)
Review
COVID-19 is a viral disease characterized as a pandemic by the World Health Organization in March 2020. Since then, researchers from all over the world have been looking for ways to fight this disease. Many cases of complications arise from insufficient immune responses due to low immunity, with intense release of pro-inflammatory cytokines that can damage the structure of organs such as the lung. Thus, the hypothesis arises that photobiomodulation therapy (PBMT) with the use of a low-level laser (LLLT) may be an ally approach to patients with COVID-19 since it is effective for increasing immunity, helping tissue repair, and reducing pro-inflammatory cytokines. This systematic review was performed with the use of PubMed/MEDLINE, Web of Science, Scopus and Google Scholar databases with the following keywords: "low-level laser therapy OR photobiomodulation therapy AND COVID-19". The inclusion criteria were complete articles published from January 2020 to January 2021 in English. The exclusion criteria were other languages, editorials, reviews, brief communications, letters to the editor, comments, conference abstracts, and articles that did not provide the full text. The bibliographic search found 18 articles in the Pubmed/MEDLINE database, 118 articles on the Web of Science, 23 articles on Scopus, and 853 articles on Google Scholar. Ten articles were included for qualitative synthesis, of which four commentary articles discussed the pathogenesis and the effect of PBMT in COVID-19. Two in vitro and lab experiments showed the effect of PBMT on prevention of thrombosis and positive results in wound healing during viral infection, using the intravascular irradiation (ILIB) associated with Phthalomethyl D. Two case reports showed PBMT improved the respiratory indexes, radiological findings, and inflammatory markers in severe COVID-19 patients. One case series reported the clinical improvement after PBMT on 14 acute COVID-19 patients, rehabilitation on 24 patients, and as a preventive treatment on 70 people. One clinical trial of 30 patients with severe COVID-19 who require invasive mechanical ventilation, showed PBMT-static magnetic field was not statistically different from placebo for the length of stay in the Intensive Care Unit, but improved diaphragm muscle function and ventilation and decreased the inflammatory markers. This review suggests that PBMT may have a positive role in treatment of COVID-19. Still, the necessity for more clinical trials remains in this field and there is not sufficient research evidence regarding the effects of PBMT and COVID-19 disease, and there is a large gap.
PubMed: 34207199
DOI: 10.3390/life11060580 -
American Journal of Obstetrics and... Nov 2017Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with repeated teenage pregnancy through a metaanalytical consensus.
DATA SOURCES
We used PubMed, EMBASE, CINAHL, ProQuest, PsychINFO, ScienceDirect, Scopus, and Web of Science databases from 1997-2015 and the reference list of other relevant research papers and related reviews.
STUDY ELIGIBILITY CRITERIA
Eligibility criteria included (1) epidemiologic studies that analyzed factors associated with repeated pregnancy or birth among adolescents <20 years of age who were nulliparous or experienced at least 1 pregnancy, and (2) experimental studies with an observational component that was adjusted for the intervention.
STUDY APPRAISAL AND SYNTHESIS METHODS
We performed narrative synthesis of study characteristics, participant characteristics, study results, and quality assessment. We also conducted random-effects and quality-effects metaanalyses with meta-regression to obtain pooled odds ratios of identified factors and to determine sources of between-study heterogeneity.
RESULTS
Twenty-six eligible epidemiologic studies, most from the United States (n=24), showed >47 factors with no evidence of publication bias for each metaanalysis. Use of contraception (pooled odds ratio, 0.60; 95% confidence interval, 0.35-1.02), particularly long-acting reversible contraceptives (pooled odds ratio, 0.19; 95% confidence interval, 0.08-0.45), considerably reduced repeated teenage pregnancy risk. Among studies about contraception, the number of follow-up visits (adjusted coefficient, 0.72; P=.102) and country of study (unadjusted coefficient, 2.57; permuted P=.071) explained between-study heterogeneity. Education-related factors, which included higher level of education (pooled odds ratio, 0.74; 95% confidence interval, 0.60-0.91) and school continuation (pooled odds ratio, 0.53; 95% confidence interval, 0.33-0.84), were found to be protective. Conversely, depression (pooled odds ratio, 1.46; 95% confidence interval, 1.14-1.87), history of abortion (pooled odds ratio, 1.66; 95% confidence interval, 1.08-2.54), and relationship factors, such as partner support, increased the repeated teenage pregnancy risk.
CONCLUSION
Contraceptive use, educational factors, depression, and a history of abortion are the highly influential predictors of repeated teenage pregnancy. However, there is a lack of epidemiologic studies in low- and middle-income countries to measure the extent and characteristics of repeated teenage pregnancy across more varied settings.
Topics: Abortion, Induced; Adolescent; Aftercare; Contraception; Contraceptive Agents; Depression; Drug Implants; Educational Status; Female; Humans; Intrauterine Devices; Odds Ratio; Parity; Pregnancy; Pregnancy in Adolescence; Protective Factors; Recurrence; Regression Analysis; Risk Factors; Sexual Partners; Social Support; Young Adult
PubMed: 28433733
DOI: 10.1016/j.ajog.2017.04.021 -
Australian Critical Care : Official... Jan 2024Diaphragm and lung ultrasound (DLUS) is emerging as an important point-of-care respiratory assessment tool and is being used in clinical care by trained respiratory... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Diaphragm and lung ultrasound (DLUS) is emerging as an important point-of-care respiratory assessment tool and is being used in clinical care by trained respiratory physiotherapists, both in Australia and internationally. However, the impact of DLUS on physiotherapists' clinical decision-making remains largely unknown. This systematic review aims to review the evidence for implementing DLUS in acute respiratory physiotherapy management.
REVIEW METHOD USED
We conducted a systematic review.
DATA SOURCES
We searched PubMed, Embase, CINAHL, CENTRAL, and Scopus from inception to 18th April 2023 for all original clinical studies reporting on the physiotherapy clinical decision-making, following a DLUS examination and/or where DLUS was used to evaluate the effect of respiratory physiotherapy, in adults over 18 years of age.
REVIEW METHODS
Two authors independently performed study selection and data extraction. Individual study risk of bias was assessed using the Newcastle-Ottawa Scale, and certainty in outcomes was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.
RESULTS
A total of seven observational studies (n = 299) were included, all of which were in the intensive care setting. DLUS changed physiotherapy diagnosis, management, and treatment in 63.9% (50-64%), 16.8% (15-50%), and 48.4% (25-50%) of patients, respectively. There was a significant improvement in the lung ultrasound score post respiratory physiotherapy treatment (mean difference -2.31, 95% Confidence Interval (95% CI) -4.42 to -0.21; very low certainty) compared to before respiratory physiotherapy treatment. Moderate risk of bias was present in six studies, and there was variance in the DLUS methodology across included studies.
CONCLUSIONS
The findings of this review suggest DLUS influences physiotherapy clinical decision-making and can be used to evaluate the effects of acute respiratory physiotherapy treatment. However, the available data is limited, and further high-quality studies are needed.
TRIAL REGISTRATION
This study is registered with the International Prospective Register of Systematic Reviews; CRD42023418312.
Topics: Adult; Humans; Adolescent; Diaphragm; Lung; Physical Therapy Modalities; Clinical Decision-Making; Australia
PubMed: 38036384
DOI: 10.1016/j.aucc.2023.10.001 -
Journal of Cardiothoracic Surgery May 2016Bronchogenic cysts (BC) are congenital abnormalities that occur most commonly within the mediastinum, and rarely occur within the diaphragm. We present the 21st case of... (Review)
Review
Bronchogenic cysts (BC) are congenital abnormalities that occur most commonly within the mediastinum, and rarely occur within the diaphragm. We present the 21st case of an intradiaphragmatic bronchogenic cyst in the English literature, and review all previous published cases. Analysis includes presenting clinical symptoms, relevant radiologic studies, surgical approaches to resection, and management of the diaphragm, among other relevant data. These lesions should remain on the differential diagnosis in cases of unusual masses in the region of the diaphragm.
Topics: Adult; Bronchogenic Cyst; Diagnosis, Differential; Diaphragm; Humans; Magnetic Resonance Imaging; Male
PubMed: 27150959
DOI: 10.1186/s13019-016-0444-9