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Surgery for stress urinary incontinence due to presumed sphincter deficiency after prostate surgery.The Cochrane Database of Systematic... Sep 2014Incontinence after prostatectomy for benign or malignant disease is a well-known and often a feared outcome. Although small degrees of incidental incontinence may go... (Review)
Review
BACKGROUND
Incontinence after prostatectomy for benign or malignant disease is a well-known and often a feared outcome. Although small degrees of incidental incontinence may go virtually unnoticed, larger degrees of incontinence can have a major impact on a man's quality of life.Conceptually, post-prostatectomy incontinence may be caused by sphincter malfunction or bladder dysfunction, or both. Most men with post-prostatectomy incontinence (60% to 100%) have stress urinary incontinence, which is involuntary urinary leakage on effort or exertion, or on sneezing or coughing. This may be due to intrinsic sphincter deficiency and may be treated with surgery for optimal management of incontinence. Detrusor dysfunction is more common after surgery for benign prostatic disease.
OBJECTIVES
To determine the effects of surgical treatment for urinary incontinence related to presumed sphincter deficiency after prostate surgery for:- men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) - transurethral resection of prostate (TURP), photo vaporisation of the prostate, laser enucleation of the prostate or open prostatectomy - and- men with prostate cancer - radical prostatectomy (retropubic, perineal, laparoscopic, or robotic).
SEARCH METHODS
We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE in process, ClinicalTrials.gov, and handsearching of journals and conference proceedings (searched 31 March 2014); MEDLINE (January 1966 to April 2014); EMBASE (January 1988 to April 2014); and LILACS (January 1982 to April 2014). We handsearched the reference lists of relevant articles and conference proceedings. We contacted investigators to locate studies.
SELECTION CRITERIA
Randomised or quasi-randomised trials that include surgical treatments of urinary incontinence after prostate surgery.
DATA COLLECTION AND ANALYSIS
Two authors independently screened the trials identified, appraised quality of papers, and extracted data.
MAIN RESULTS
Only one study with 45 participants met the inclusion criteria. Men were divided in two sub-groups (minimal or total incontinence) and each group was randomised to artificial urethral sphincter (AUS) implantation or Macroplastique injection. Follow-up ranged from six to 120 months. In the trial as a whole, the men treated with AUS were more likely to be dry (18/20, 82%) than those who had the injectable treatment (11/23, 46%) (odds ratio (OR) 5.67, 95% confidence interval (CI) 1.28 to 25.10). However, this effect was only statistically significant for the men with more severe ('total') incontinence (OR 8.89, 95% CI 1.40 to 56.57) and the CIs were wide. There were more severe complications in the group undergoing AUS, and the costs were higher. AUS implantation was complicated in 5/22 (23%) men: the implant had to be removed from one man because of infection and in one man due to the erosion of the cuff, in one man the pump was changed due to mechanical failure, in one man there was migration to the intraperitoneal region, and one man experienced scrotal erosion. In the injectable group, 3/23 (13%) men had a complication: one man treated with Macroplastique injection had to be catheterised because of urinary retention and two men developed urinary tract infections.
AUTHORS' CONCLUSIONS
The evidence available at present was of very low quality because we identified only one small randomised clinical trial. Although the result was favourable for the implantation of AUS in the group with severe incontinence, this result should be considered with caution due to the small sample size and uncertain methodological quality of the study found.
Topics: Dimethylpolysiloxanes; Humans; Male; Prostatectomy; Prostatic Neoplasms; Randomized Controlled Trials as Topic; Transurethral Resection of Prostate; Urinary Incontinence, Stress; Urinary Sphincter, Artificial
PubMed: 25261861
DOI: 10.1002/14651858.CD008306.pub3 -
SAGE Open Medicine 2021Occupational respiratory symptoms are manifestations of respiratory diseases because of exposure to dust or chemicals such as asbestos, silicon and aluminium in the... (Review)
Review
INTRODUCTION
Occupational respiratory symptoms are manifestations of respiratory diseases because of exposure to dust or chemicals such as asbestos, silicon and aluminium in the workplace like cement factory, tannery, textile and/or street sweeping, all of which affect the health condition and productivity. In Ethiopia, several primary studies were conducted regarding the magnitude of occupational respiratory symptoms with the prevalence of 68.89% in street sweepers and associated factors with inconsistent results. This meta-analysis aimed to pool the prevalence of respiratory symptoms and their associated factors among Ethiopian adults working in different workplaces.
METHODS
PubMed, African Journals Online, Google Scholar, Cochrane Library and Direct Google were systematically searched to identify primary studies. Two authors performed data abstraction and quality assessment for each included study independently. Cochran's Q-statistic and I (I-squared) statistic were used to check heterogeneity. DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and associated factors of respiratory symptoms. Publication bias was checked by funnel plot and Egger's test, and also sensitivity analyses were performed.
RESULTS
Ten primary studies with 3441 study participants were included for the narrative synthesis and meta-analysis of the pooled prevalence of occupational respiratory symptoms. The pooled prevalence of overall occupational respiratory symptom was 54.58% (95% CI: 45.37-63.79). Dry cough was the most encountered respiratory symptom [34.93, 95% CI: 29.52-40.35], followed by breathlessness [28.67%, 95% CI: 20.13-37.22]. Work experience of over 5 years [OR = 2.24, 95% CI: 1.21-4.16] and educational level of Grade 8 and lower [OR = 1.28, 95% CI: 1.06-1.55] were significantly associated with occupational respiratory symptoms.
CONCLUSION
In this review, the pooled prevalence of occupational respiratory symptoms was high. The findings of this study dictate the need for the implementation of workplace safety measures. Special attention is required to employees with lower educational level and longer duration of work experience.
PROSPERO REGISTRATION
CRD42020176826.
PubMed: 34094559
DOI: 10.1177/20503121211018121 -
Immunotherapy Oct 2021We aimed to quantify the effects of immune checkpoint inhibitors (ICIs) on the prognosis of COVID-19. A meta-analysis was conducted and the hospitalization, severe... (Meta-Analysis)
Meta-Analysis
We aimed to quantify the effects of immune checkpoint inhibitors (ICIs) on the prognosis of COVID-19. A meta-analysis was conducted and the hospitalization, severe disease and mortality rates were assessed. Thirteen studies comprising of 4614 cancer patients with COVID-19 were included. When compared with cancer patients without prior ICI exposure, patients with prior ICI treatment exhibited a higher rate of hospitalization (odds ratio [OR] 2.0, 95% CI 1.19-3.38, p = 0.01). However, the OR of severe disease and mortality in ICI exposed cases was similar to non-ICI exposed patients (OR 1.55, 95% CI 0.69-3.51, p = 0.29; OR 1.12, 95% CI 0.85-1.48, p = 0.42, respectively). It is uncertain whether prior exposure to ICIs increases the risk of severe disease and death, however the observed OR suggest a higher rate of hospitalization.
Topics: COVID-19; Humans; Immune Checkpoint Inhibitors; Prognosis; SARS-CoV-2
PubMed: 34431319
DOI: 10.2217/imt-2021-0007 -
The Lancet. Diabetes & Endocrinology Nov 2015Technosphere inhaled insulin is a non-invasive alternative to subcutaneous injectable insulin for adults with type 1 or 2 diabetes. In this systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Technosphere inhaled insulin is a non-invasive alternative to subcutaneous injectable insulin for adults with type 1 or 2 diabetes. In this systematic review and meta-analysis of randomised controlled trials, we aimed to establish the efficacy, safety, and patient acceptability of Technosphere inhaled insulin in patients with diabetes.
METHODS
We searched MEDLINE, the Cochrane Central Register of Controlled Clinical Trials, ClinicalTrials.gov, and relevant US regulatory documents for reports of randomised trials published in English up to May 30, 2015, that compared mealtime Technosphere inhaled insulin with placebo, subcutaneous insulin, or oral antidiabetic drugs in people with type 1 or type 2 diabetes. Two reviewers independently extracted data for outcomes of interest and risk of bias. Endpoints included changes in HbA1c concentration and bodyweight, and safety outcomes, including severe hypoglycaemia and pulmonary toxicity. When three or more studies provided relevant data, we did a meta-analysis for the outcome using a profile-likelihood random-effects model.
FINDINGS
13 trials met the inclusion criteria for qualitative systematic review; 12 met the inclusion criteria for quantitative meta-analysis (n=5273; age range 18-80). HbA1c decrease from baseline was greater with subcutaneous insulin than with Technosphere inhaled insulin (net difference 0·16%, 95% CI 0·06-0·25; eight trials). However, inhaled insulin was associated with less weight gain (net difference -1·1 kg, -2·1 to -1·6; three trials) and a smaller risk of severe hypoglycaemia (odds ratio 0·61, 95% CI 0·35-0·92; five trials). Incidence of mild transient cough was increased in people allocated to inhaled insulin (odds ratio 7·82, 6·14-10·15; seven trials) compared with those allocated to active comparator groups, as was the decrease in forced expiratory volume in 1 s (net difference -0·038 L, -0·049 to -0·026; five trials). Quality of life and overall patient satisfaction did not differ significantly between inhaled insulin groups and active comparator groups (no numerical estimate).
INTERPRETATION
Glycaemic efficacy of Technosphere inhaled insulin is lower than that of subcutaneous insulin, but inhaled insulin has a lower risk of severe hypoglycaemia and weight gain. Long-term outcomes and safety with Technosphere insulin should be further investigated. Until further data for safety become available, Technosphere inhaled insulin should be reserved for healthy adults with diabetes who do not have pulmonary disease and who would otherwise delay initiating or intensifying insulin therapy because they are unwilling or unable to use injectable insulin.
FUNDING
None.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Dry Powder Inhalers; Female; Humans; Hypoglycemic Agents; Insulin; Male; Middle Aged; Randomized Controlled Trials as Topic; Registries; Technology, Pharmaceutical; Treatment Outcome; Young Adult
PubMed: 26341170
DOI: 10.1016/S2213-8587(15)00280-6 -
BMC Infectious Diseases Aug 2023In 2019, the Coronavirus (SARS-CoV-2) virus was identified, also defined as novel coronavirus or severe acute respiratory syndrome coronavirus 2. The Corona VIrus...
In 2019, the Coronavirus (SARS-CoV-2) virus was identified, also defined as novel coronavirus or severe acute respiratory syndrome coronavirus 2. The Corona VIrus Disease (COVID-19) pandemic generated several changes in society in 2020 as a result of its rapid spread in humans. The main symptoms are high fever (≥ 37.8 °C), dry cough, dyspnea, upper respiratory symptoms, myalgia, fatigue and diarrhea in the most uncommon cases. Considering the emergency situation caused by the COVID-19 pandemic and the effects attributed to it, rehabilitation professionals have a fundamental role in the functional recovery of patients, independence and improvement of quality of life. This is a systematic review of the literature, with the aim of discussing the main findings on physical therapy management in functional changes in post-COVID-19 patients. Pubmed, Scielo, Sciencedirect, BVS and PEDro databases were used. The terms MESH/DECs used for the searches were: Rehabilitation, Physical Therapy Modalities, Covid-19, Post-acute Syndromes COVID-19 and Physical Fitness, the keywords were also used: rehabilitation, physiotherapy, Covid-19, post- acute syndrome COVID-19 and functional capacity. To cross the terms, Boolean operators (AND and OR) were used. Randomized trials, recommendations, quasi-randomized or prospective controlled trials, reports, guidelines, and field updates were included. As for the selected population, studies were included in individuals of both sexes, with no age restriction, that evaluated physiotherapeutic interventions in patients who had COVID-19. Literature reviews, case studies, conferences, abstracts of articles published in conference proceedings and letters to the editor were excluded from the research. To measure methodological quality, the PEDro scale was used.Searches for articles were performed restricting the period of publication between the years 2019 to 2022. The electronic search strategy identified a total of 364 records from the selected databases. After screening for duplicates, 14 articles were excluded, followed by screening by titles and abstracts, another 298 articles were excluded, of these 47 potentially relevant records were submitted to full text review and of these 5 randomized clinical trials were included in this review. In view of the findings of this study, it can be concluded that physical therapy rehabilitation should continue after hospital discharge, with the aim of improving physical performance and activities of daily living (ADL) in post-COVID-19 patients.
Topics: Female; Male; Humans; Patient Discharge; COVID-19; Activities of Daily Living; Pandemics; Prospective Studies; Quality of Life; SARS-CoV-2; Virus Diseases; Hospitals
PubMed: 37587411
DOI: 10.1186/s12879-023-08313-w -
Postgraduate Medicine Jun 2019Pulmonary lymphangitis carcinomatosis (PLC) is a life-threating complication in patients suffering from malignancies. Misleading and nonspecific symptoms often result in... (Meta-Analysis)
Meta-Analysis
Pulmonary lymphangitis carcinomatosis (PLC) is a life-threating complication in patients suffering from malignancies. Misleading and nonspecific symptoms often result in a delayed diagnosis. This review was aimed at evaluating epidemiology, clinical manifestations, and survival of patients with PLC reported in the literature. According to our knowledge, this study is the first such extensive analysis of PLC. We searched for the literature in the PubMed database for articles published from 1970 to 2018 using keywords: lung, pulmonary, lymphangitic, carcinoma, carcinomatosis. Pulmonary lymphangitis carcinomatosis rarely occurs, thus all data were extracted from case reports and case series consisted of a method for identifying individual-level patient data. In the final analysis, 108 articles (139 individual patient cases) were included. The mean age of PLC occurrence is 49.21 years. There is no difference in the prevalence between men and women. The most common underlying primary tumors coexisting with PLC are breast (17.3%), lung (10.8%), and gastric cancers (10.8%). Dyspnea and dry cough were the most common symptoms occurring in 59.0% and 33.8% of patients, respectively. In half the patients, PLC developed in fewer than ten months after first diagnosis of cancer. Pulmonary lymphangitis carcinomatosis diagnosis is associated with a poor prognosis: approximately half of patients die within two months of their first respiratory symptoms and three weeks from admission to hospital. Regarding survival time, we observed better results achieved in patients described between 2000 and 2018 compared to 1970 through 1999. In the presence of progressive dyspnea, cough, and lesions comparable to interstitial lung disease, diagnosis of PLC should be considered. Pulmonary lymphangitis carcinomatosis can be the first manifestation of primary occult neoplasm and may occur at any age. Adenocarcinoma, especially primary lung, breast, and gastric cancers is the most common cancer coexisting with PLC.
Topics: Adult; Breast Neoplasms; Carcinoma; Female; Humans; Lung Neoplasms; Lymphangitis; Male; Middle Aged; Neoplasm Metastasis; Stomach Neoplasms
PubMed: 30900501
DOI: 10.1080/00325481.2019.1595982 -
International Journal of Environmental... Dec 2022People spend a considerable portion of their lives indoors; thus, the quality of the indoor environment is crucial. Semi-volatile organic compounds (SVOCs) are among the... (Review)
Review
People spend a considerable portion of their lives indoors; thus, the quality of the indoor environment is crucial. Semi-volatile organic compounds (SVOCs) are among the primary indoor pollutants responsible for various health risks. This paper systematically reviews the impact of SVOC exposure on human health in Chinese built environments. Based on a set of criteria, we judged 12 publications as providing sufficient information on both SVOC exposure and health effects to inform the relationship. Out of six studies on polycyclic aromatic hydrocarbons (PAHs), three observed a positive association between PAH exposure and lung cancer. Out of six studies of phthalate exposure, two studies reported a significant positive association between DEP and DiBP and asthma, between DEP and DEHP and dry cough among children, and between DBP and rhinitis among younger adults. The results of this review suggest that there might be a link between phthalate exposure and asthma and allergies, as well as a link between PAH exposure and lung cancer. However, due to the limited number of studies conducted, more evidence is necessary to definitively guide the establishment of standards for SVOC control in China.
Topics: Adult; Child; Humans; Air Pollutants; Air Pollution, Indoor; Asthma; Environmental Exposure; Lung Neoplasms; Phthalic Acids; Polycyclic Aromatic Hydrocarbons; Volatile Organic Compounds; China
PubMed: 36613006
DOI: 10.3390/ijerph20010678 -
BMJ Open Respiratory Research Jun 2023Emerging evidence in both developed and developing countries indicate that occupational health hazards and diseases among construction workers constitute a significant...
BACKGROUND
Emerging evidence in both developed and developing countries indicate that occupational health hazards and diseases among construction workers constitute a significant public health challenge. While occupational health hazards and conditions in the construction sector are diverse, a burgeoning body of knowledge is emerging about respiratory health hazards and diseases. Yet, there is a notable gap in the existing literature in terms of comprehensive syntheses of the available evidence on this topic. In light of this research gap, this study systematically reviewed the global evidence on occupational health hazards and related respiratory health conditions among construction workers.
METHODS
Using meta-aggregation, guided by the Condition (respiratory health conditions), Context (construction industry) and Population (construction workers) (CoCoPop) framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, literature searches were conducted on Scopus, PubMed, Web of Science and Google Scholar for relevant studies on respiratory health conditions affecting construction workers. Four eligibility criteria were used in scrutinising studies for inclusion. The quality of the included studies was assessed based on Joanna Briggs Institute's Critical Appraisal tool, while the reporting of the results was guided by the Synthesis Without Meta-analysis guidelines.
RESULTS
From an initial pool of 256 studies from the various databases, 25 studies published between 2012 and October 2022 were identified as meeting the inclusion criteria. In all, 16 respiratory health conditions were identified, with cough (ie, dry and with phlegm), dyspnoea/breathlessness and asthma emerging as the top three respiratory conditions among construction workers. The study identified six overarching themes of hazards that are associated with respiratory health conditions among construction workers. These hazards include exposure to dust, respirable crystalline silica, fumes, vapours, asbestos fibres and gases. Smoking and extended period of exposure to the respiratory hazard were found to increase the risk of contracting respiratory diseases.
CONCLUSIONS
Our systematic review indicates that construction workers are exposed to hazards and conditions that have adverse effects on their health and well-being. Given the considerable impact that work-related health hazards can have on the health and socioeconomic well-being of construction workers, we suggest that the implementation of a comprehensive occupational health programme is essential. Such a programme would extend beyond the mere provision of personal protective equipment and would incorporate a range of proactive measures aimed at controlling the hazards and mitigating the risk of exposure to the occupational health hazards.
Topics: Humans; Occupational Exposure; Construction Industry; Respiratory Tract Diseases
PubMed: 37364917
DOI: 10.1136/bmjresp-2023-001736 -
Journal of Clinical Medicine May 2020The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide outbreak of respiratory illness. This review aims to evaluate the effectiveness and adverse... (Review)
Review
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide outbreak of respiratory illness. This review aims to evaluate the effectiveness and adverse events of herbal medicines for the treatment of COVID-19.
METHODS
Twelve databases were searched through 12 May 2020. Randomized controlled trials (RCTs) and quasi-RCTs assessing the effects of herbal medicines for the treatment of COVID-19 were eligible. The study selection and data extraction were performed by two independent reviewers. The Cochrane risk of bias tool was used for the assessment of the risk of bias in all included RCTs. Mean differences (MDs), risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and the effect sizes of the studies were pooled.
RESULTS
Seven RCTs with a total of 855 patients were included. All included trials compared the combined therapy of herbal medicine with Western medicine to Western medicine alone. The combined therapy significantly improved the total effective rate (RR 1.23, 95% CI 1.13 to 1.34, < 0.001), cough symptom disappearance rate (RR 1.45, 95% CI 1.12 to 1.89, = 0.005), and sputum production symptom disappearance rate (RR 1.73, 95% CI 1.19 to 2.50, = 0.004). Beneficial effects of the combined therapy were also seen in TCM syndrome score of cough (MD -1.18, 95% CI -1.34 to -1.03, < 0.001), fever (MD -0.62, 95% CI -0.79 to -0.45, < 0.001), dry and sore throat (MD -0.83, 95% CI -1.45 to -0.20, = 0.009), and fatigue (MD -0.60, 95% CI -1.04 to -0.17, = 0.007). The overall risk of bias of the included studies was unclear. No serious adverse events were reported.
CONCLUSION
Significant effects of the combined therapy of herbal medicine with Western medicine were found, and revealed the potential role of herbal medicine in treating COVID-19. More high-quality RCTs are needed to further validate the effectiveness and adverse events of herbal medicine in the treatment of COVID-19.
PubMed: 32456123
DOI: 10.3390/jcm9051583 -
Cureus Feb 2021At present, the novel coronavirus disease (COVID-19) is causing a major pandemic. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)....
At present, the novel coronavirus disease (COVID-19) is causing a major pandemic. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In COVID-19, the patient usually presents with fever, dry cough, and respiratory manifestations. However, the involvement of other systems has also been reported in the literature. Abdominal pain, diarrhea, vomiting, and nausea are the predominant gastrointestinal (GI) manifestations underlined in the literature. We conducted a literature search using four databases (PubMed, Web of Science, Google Scholar, and Clinicaltrials.gov). Our search strategy included Medical Subject Headings (MeSH) terms and keywords for COVID-19, SARS-CoV-2, and GI system from inception to October 2020. After excluding duplicates, review articles, and non-relevant articles, we included 20 studies out of 842 articles reporting GI manifestations in COVID-19 patients. Using Cochrane RevMan version 5.4 (Cochrane, London, UK), a compute pooled analysis using a random-effect model was performed. Our study included 6,022 patients with a median age of 49.5 years. Pooled analysis via random effect model revealed an increased risk of severe COVID-19 in patients manifesting GI symptoms with an odds ratio (OR) of 2.07 (95% Confidence Interval [CI]: 1.34-3.18) with I=41%). Odds of mortality in COVID-19 with GI manifestation and hepatic abnormalities included 0.92 (95% CI: 0.50-1.69) (I=57%) and 1.26 (95% CI: 0.67-2.37) (I=0%), respectively. Severe COVID-19 may have a strong association with GI manifestations and have a significant impact on GI practice. Holistic knowledge of the spectrum of the GI consequences in COVID-19 is crucial to get a hold of virus spread. In this article, we have summarized the association of GI manifestations in severe COVID-19 patients.
PubMed: 33738161
DOI: 10.7759/cureus.13317