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Nursing in Critical Care May 2024Ventilator-associated pneumonia (VAP) is one of the common complications in patients in the intensive care unit. Abdominal massage may prevent the development of VAP by...
BACKGROUND
Ventilator-associated pneumonia (VAP) is one of the common complications in patients in the intensive care unit. Abdominal massage may prevent the development of VAP by reducing residual gastric volume in enterally fed patients.
OBJECTIVE
The purpose of this study is to review the literature on randomized controlled and quasi-experimental studies evaluating the effectiveness of abdominal massage in preventing VAP.
METHODS
The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) criteria were taken as the basis for creating the protocol of the systematic review and writing the article. The systematic review was performed using the Google Scholar, PubMed, Web of Science, Scopus, CINAHL and Cochrane Library databases from December 2023 to January 2024. Studies were selected by determining inclusion and exclusion criteria according to the PICOS method. The studies were evaluated using the Joanna Briggs Institute (JBI) tool for quality assessment.
RESULTS
Three randomized controlled and one quasi-experimental study with a total of 225 participants met the inclusion criteria. The four studies conducted on patients in the intensive care unit showed that abdominal massage reduced VAP. The studies reported no adverse effects of abdominal massage.
CONCLUSION
Promising evidence was found for the effect of abdominal massage in preventing VAP. However, scientific studies with larger samples, of higher quality, and using randomized controls and blinding methods are needed to evaluate the unknown dimensions of abdominal massage and determine its beneficial effects on patients.
RELEVANCE TO CLINICAL PRACTICE
Several non-pharmacological methods may decrease VAP incidence and mortality. Abdominal massage may decrease VAP incidence and mortality.
PubMed: 38711391
DOI: 10.1111/nicc.13083 -
The Journal of Clinical Endocrinology... May 2024The correlation between visceral obesity index (VAI) and diabetes and accuracy of early prediction of diabetes are still controversial.
CONTENT
The correlation between visceral obesity index (VAI) and diabetes and accuracy of early prediction of diabetes are still controversial.
OBJECTIVE
This study aims to review the relationship between high level of VAI and diabetes, and early predictive value of diabetes.
DATA SOURCES
The databases of PubMed, Cochrane, Embase, and Web of Science were searched until October 17, 2023.
STUDY SELECTION
After adjusting for confounding factors, the original study on the association between VAI and diabetes was analyzed.
DATA EXTRACTION
We extracted odds ratio (OR) between VAI and diabetes management after controlling for mixed factors, and the sensitivity, specificity and diagnostic four grid table for early prediction of diabetes.
DATA SYNTHESIS
53 studies, comprising 595,946 participants were included. The findings of the meta-analysis elucidated that in cohort studies, a high VAI significantly increased the risk of diabetes mellitus in males (OR = 2.83 (95% CI: 2.30-3.49)) and females (OR = 3.32 (95% CI: 2.48-4.45)). The ROC, sensitivity, and specificity of VAI for early prediction of diabetes in males were 0.64 (95% CI: 0.62-0.66), 0.57 (95% CI: 0.53-0.61), and 0.65 (95% CI: 0.61-0.69), respectively, and 0.67 (95% CI: 0.65-0.69), 0.66 (95% CI: 0.60-0.71), and 0.61 (95% CI: 0.57-0.66) in females, respectively.
CONCLUSIONS
VAI is an independent predictor of the risk of diabetes, yet its predictive accuracy remains limited. In future studies, determine whether VAI can be utilized in conjunction with other related indicators to early predict the risk of diabetes, to enhance the accuracy of prediction of the risk of diabetes.
PubMed: 38709677
DOI: 10.1210/clinem/dgae303 -
JAMA Pediatrics Jun 2024Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and exclusivity. There are connections between lactation and mental health.
OBJECTIVE
To appraise all available evidence on whether the provision of relaxation interventions to lactating individuals improves lactation and well-being.
DATA SOURCES
Embase, MEDLINE, CINAHL, Allied and Complementary Medicine Database, Web of Science, and the Cochrane Library were searched on September 30, 2023, and topic experts were consulted.
STUDY SELECTION
Two independent reviewers screened for eligibility. Inclusion criteria were full-text, peer-reviewed publications with a randomized clinical trial design. Techniques that were entirely physical (eg, massage) were excluded. A total of 7% of initially identified studies met selection criteria.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers extracted data and assessed risk of bias with the Cochrane Risk of Bias 2 tool. Fixed-effects meta-analysis and Grading of Recommendations, Assessment, Development, and Evaluations guidelines were used to synthesize and present evidence.
MAIN OUTCOMES AND MEASURES
Prespecified primary outcomes were human milk quantity, length and exclusivity of human milk feeding, milk macronutrients/cortisol, and infant growth and behavior.
RESULTS
A total of 16 studies were included with 1871 participants (pooled mean [SD] age for 1656 participants, 29.6 [6.1] years). Interventions were music, guided relaxation, mindfulness, and breathing exercises/muscle relaxation. Provision of relaxation was not associated with a change in human milk protein (mean difference [MD], 0 g/100 mL; 95% CI, 0; 205 participants). Provision of relaxation was associated with an increase in human milk quantity (standardized mean difference [SMD], 0.73; 95% CI, 0.57-0.89; 464 participants), increased infant weight gain in breastfeeding infants (MD, z score change = 0.51; 95% CI, 0.30-0.72; 226 participants), and a slight reduction in stress and anxiety (SMD stress score, -0.49; 95% CI, -0.70 to -0.27; 355 participants; SMD anxiety score, -0.45; 95% CI, -0.67 to -0.22; 410 participants).
CONCLUSIONS AND RELEVANCE
Results of this systematic review and meta-analysis suggest that provision of relaxation was associated with an increase in human milk quantity and infant weight gain and a slight reduction in stress and anxiety. Relaxation interventions can be offered to lactating parents who would like to increase well-being and improve milk supply or, where directly breastfeeding, increase infant weight gain.
Topics: Humans; Relaxation Therapy; Milk, Human; Breast Feeding; Lactation; Infant, Newborn; Female; Infant
PubMed: 38709505
DOI: 10.1001/jamapediatrics.2024.0814 -
Medicine May 2024Chronic fatigue syndrome (CFS) is a long-term and complex chronic disease that seriously affects the physical and mental health and quality of life of patients. Massage,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic fatigue syndrome (CFS) is a long-term and complex chronic disease that seriously affects the physical and mental health and quality of life of patients. Massage, as one of the methods in traditional Chinese medicine, can treat both symptoms and root causes and is widely used to treat CFS. The main purpose is to systematically evaluate the impact of massage therapy on the efficacy and safety of CFS patients, providing a reference for clinical practice.
METHODS
By searching for literature published in PubMed, Cochrane Library, Web of Science, Embase, Wanfang Database, VIP Database, and China National Knowledge Infrastructure Database until November 2023, randomized controlled trial studies were selected according to the established inclusion and exclusion criteria. The Cochrane system evaluation manual was used to evaluate the quality of the included studies, and RevMan5.4 software was used for meta-analysis.
RESULTS
32 randomized controlled trials were included, with a total of 2594 CFS patients. Meta-analysis showed that the total score of the fatigue scale (FS-14) in the treatment group, MD = -1.59, 95% CI (-1.84, -1.34), P < .00001; Physical fatigue score, MD = -1.30, 95% CI (-1.60, -1.00), P < .00001; Mental fatigue score, MD = -0.84, 95% CI (-0.99, -0.72), P < .0001]; Effective rate [RR = 1.23, 95% CI (1.19,1.28), P < .00001]; all indicators were superior to the control group, Only one study reported adverse reactions, including local swelling, skin bruising, and nausea.
CONCLUSION
Our research findings suggest that massage therapy has a significant therapeutic effect on CFS, avoiding adverse reactions and improving fatigue symptoms. Therefore, massage therapy for chronic fatigue syndrome should be further promoted and applied.
Topics: Humans; Massage; Fatigue Syndrome, Chronic; Randomized Controlled Trials as Topic; Quality of Life; Treatment Outcome
PubMed: 38701244
DOI: 10.1097/MD.0000000000037973 -
Frontiers in Immunology 2024The efficacy and safety of different immunosuppressants combined with chemotherapy in treating patients with small-cell lung cancer (extensive-disease small-cell lung... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The efficacy and safety of different immunosuppressants combined with chemotherapy in treating patients with small-cell lung cancer (extensive-disease small-cell lung cancer, limited-disease small-cell lung cancer and relapsed small-cell lung cancer) are still unknown, and there are no reports directly comparing the efficacy and safety of other immunotherapies.
OBJECTIVE
This study aimed to compare the efficacy and safety of first-line immunotherapy combined with chemotherapy in patients with small-cell lung cancer.
METHOD
We searched Pubmed, Embase, Cochrane Library, CNKI, and Wanfang databases for relevant articles published from inception to November 11, 2020. The risk of bias of the included studies was conducted using the Cochrane risk-of-bias (RoB) tool. Multiple Bayesian network meta-analyses were performed. They conducted data analysis using R Studio and STATA version 15.1. The outcomes comprised overall survival (OS), progression-free survival (PFS), stability of response (SOR), duration of response (DOR) and adverse events of grade 3 or higher (AE grade≥3). A 95% confidence interval (CI) was provided for each estimate.
RESULTS
This meta-analysis included 16 RCT studies with 5898 patients. For OS, relative to chemotherapy (MD=-4.49; 95%CI [-7.97, -1.03]), durvalumab plus tremelimumab (MD=-4.62; 95%CI [-9.08, -0.11]), ipilimumab (MD=-4.26; 95%CI [-8.01, -0.3]) and nivolumab(MD=-5.66; 95%CI [-10.44, -1.11]) and nivolumab plus ipilimumab (MD=-4.56; 95%CI [-8.7, -0.1]), serplulimab can significantly increase the OS of SCLC patients. There was no significant difference between PFS, SOR and DOR. Analysis of AE showed that different immunotherapy combined chemotherapy regimens were similar to single chemotherapy regarding the overall incidence of AE grade≥3. However, after the cumulative ranking of the common symptoms of different adverse reactions, it was found that nivolumab ranked first in the occurrence probability of anemia (99.08%), fatigue (84.78%), and decreased appetite (89.66%). durvalumab was the most likely in nausea (75.4%). Pembrolizumab (76.24%) was most likely to cause pruritus. Chemotherapy combined with immunotherapy caused less diarrhea than chemotherapy alone (80.16%).
CONCLUSIONS
According to our analysis, serplulimab combined with chemotherapy is more likely to show better efficacy with a manageable safety profile for small-cell lung cancer. However, the evidence for this comparison shows some limitations due to the number of literature.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023486053.
Topics: Humans; Small Cell Lung Carcinoma; Lung Neoplasms; Network Meta-Analysis; Antineoplastic Combined Chemotherapy Protocols; Immunotherapy; Treatment Outcome; Immune Checkpoint Inhibitors
PubMed: 38694505
DOI: 10.3389/fimmu.2024.1362537 -
Brain & Spine 2024The effectiveness of post-surgical rehabilitation following lumbar disc herniation (LDH) surgery is unclear. (Review)
Review
INTRODUCTION
The effectiveness of post-surgical rehabilitation following lumbar disc herniation (LDH) surgery is unclear.
RESEARCH QUESTION
To investigate the effectiveness and safety of rehabilitation interventions initiated within three months post-surgery for adults treated surgically for LDH.
MATERIAL AND METHODS
This systematic review searched seven databases from inception to November 2023. Independent reviewers screened studies, assessed and extracted data, and rated the certainty of the evidence using the GRADE approach.
RESULTS
This systematic review retrieved 20,531 citations and included 25 randomized controlled trials. The high certainty evidence suggests that adding Pilates exercise to routine care and cognitive behavioral therapy may improve function immediately post-intervention (1 RCT), and that adding whole-body magnetic therapy to exercise, pharmacological and aquatic therapy may reduce low back pain intensity (1 RCT) immediately post-intervention. Compared to placebo, pregabalin did not reduce low back pain or leg pain intensity (1 RCT) (moderate to high certainty evidence). We found no differences between: 1) behavioral graded activity vs. physiotherapy (1 RCT); 2) exercise and education vs. neck massage or watchful waiting (1 RCT); 3) exercise, education, and in-hospital usual care vs. in-hospital usual care (1 RCT); 4) functional or staged exercise vs. usual post-surgical care including exercise (2 RCTs); and 5) supervised exercise with education vs. education (1 RCT). No studies assessed adverse events.
DISCUSSION AND CONCLUSION
Evidence on effective and safe post-surgical rehabilitation interventions is sparse. This review identified two interventions with potential short-term benefits (Pilates exercises, whole-body magnetic therapy) but safety is unclear, and one with an iatrogenic effect (pregabalin).
PubMed: 38690091
DOI: 10.1016/j.bas.2024.102806 -
Journal of Palliative Medicine Apr 2024Palliative care, a cornerstone of comprehensive healthcare, prioritizes quality of life for individuals with life-threatening illnesses. Aromatherapy, with its holistic... (Review)
Review
Palliative care, a cornerstone of comprehensive healthcare, prioritizes quality of life for individuals with life-threatening illnesses. Aromatherapy, with its holistic approach and patient-reported benefits, emerges as a promising complementary therapy for managing symptoms and enhancing well-being in palliative care. The objective of this systematic review is to assess the efficacy of aromatherapy interventions in symptom management, with a focus on pain, anxiety, nausea, and sleep disturbances among palliative care patients. A comprehensive search was conducted across various databases to identify relevant studies. Eligibility criteria were applied, resulting in the inclusion of eight studies for analysis. The review assessed the efficacy of aromatherapy interventions, primarily through massage, in symptom management. Variations in intervention procedures and outcome measures were noted, necessitating a critical examination of the findings. The review's findings suggest promising outcomes associated with aromatherapy in palliative care. Aromatherapy interventions demonstrated significant efficacy in reducing pain, anxiety, nausea, and improving sleep quality among patients. However, considerable heterogeneity was observed across studies, highlighting the need for standardized methodologies and larger-scale trials. This systematic review underscores the potential of aromatherapy as a complementary intervention in palliative care. While the findings support its efficacy in symptom management, methodological inconsistencies across studies warrant further research. Standardized approaches and larger trials are essential to validate the tailored effectiveness of aromatherapy for different symptoms encountered in palliative care, ultimately enhancing its clinical utility and integration into therapeutic practices.
PubMed: 38686521
DOI: 10.1089/jpm.2024.0019 -
International Journal of Exercise... 2024The aim of the present study was to identify the different interventions for hamstring flexibility among university students with hamstring tightness and to determine... (Review)
Review
Effects of Different Physical Therapy Interventions in Improving Flexibility in University Students with Hamstring Tightness - A Systematic Review and Network Meta-analysis.
UNLABELLED
The aim of the present study was to identify the different interventions for hamstring flexibility among university students with hamstring tightness and to determine the better treatment method.
DESIGN
Systematic review and network meta-analysis. An electronic search of the databases: Medline, Pubmed, Cochrane, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro) was conducted. A total of 11 articles were included in the review. Of these articles, 02 were case-control studies, 02 were interventional pre-post studies and 07 were RCTs. The 07 RCTs were included for network meta-analysis. The findings of the initial network meta-analysis (NMA) which compared control i.e., no intervention with other interventions revealed that all the physical therapy interventions: stretching, electrotherapy combined with stretching, massage, dry needling and neurodynamic exercises combined with stretching and neurodynamics alone were superior to control. Since most studies included stretching as an intervention, a second NMA was conducted to compare the different physical therapy interventions with stretching. The results suggested that US-guided neuromodulation (WMD: -5.80, CI: -12.11, 0.51) had large effects on hamstring flexibility compared to stretching and stretching combined with electrotherapy i.e., cryotherapy and ultrasound (WMD: 0.25, CI: -1.14 to 1.64), MET (WMD: 3.10, CI: -3.28 to 9.48) and massage (WMD: 8.05, CI: -11.90 to 27.18) were inferior to stretching. To further investigate the effects of these interventions three meta-analysis were performed. The results revealed that stretching was more effective (SMD 2.27, 95% 0.72 to 3.81, < 0.01) compared to control (no intervention). Neurodynamic exercises combined with stretching and neurodynamics alone were found to be superior to stretching alone ((SMD -0.69, 95% -1.35 to -0.03, < 0.01) and stretching combined with electrotherapy was not significantly better than stretching alone ((SMD -0.07, 95% -1.00 to 0.87, =0.88). Neurodynamic exercises combined with stretching and neurodynamics alone showed to be superior to the other physical therapy interventions in improving hamstring flexibility for hamstring tightness among university students, however, the reliability of the evidence is low.
PubMed: 38665684
DOI: No ID Found -
BMC Geriatrics Apr 2024The National Institute for Health and Care Excellence guidelines state that psychosocial interventions should be the first line of treatment for people with dementia who...
BACKGROUND
The National Institute for Health and Care Excellence guidelines state that psychosocial interventions should be the first line of treatment for people with dementia who are experiencing distress behaviours, such as agitation and depression. However, little is known about the characteristics and outcomes of psychosocial interventions or the facilitators and barriers to implementation on inpatient mental health dementia wards which provide care for people with dementia who are often experiencing high levels of distress.
METHODS
A systematic search was conducted on MEDLINE, CINAHL, PsycINFO, Psychology and Behavioural Sciences Collection, and Scopus in May 2023, following PRISMA guidelines. Reference and citation searches were conducted on included articles. Peer-reviewed literature of any study design, relating to psychosocial interventions in inpatient mental health dementia wards, was included. One author reviewed all articles, with a third of results reviewed independently by a second author. Data were extracted to a bespoke form and synthesised using a narrative review. The quality of included studies was appraised using the Mixed Methods Appraisal Tool.
RESULTS
Sixteen studies were included in the synthesis, which together included a total of 538 people with dementia. Study methods and quality varied. Psychosocial interventions delivered on wards included music therapy (five studies), multisensory interventions (four studies), multicomponent interventions (two studies), technology-based interventions (two studies), massage interventions (two studies) and physical exercise (one study). Reduction in distress and improvement in wellbeing was demonstrated inconsistently across studies. Delivering interventions in a caring and individualised way responding to patient need facilitated implementation. Lack of staff time and understanding of interventions, as well as high levels of staff turnover, were barriers to implementation.
CONCLUSION
This review highlights a striking lack of research and therefore evidence base for the use of psychosocial interventions to reduce distress in this vulnerable population, despite current healthcare guidelines. More research is needed to understand which psychosocial interventions can reduce distress and improve wellbeing on inpatient mental health dementia wards, and how interventions should be delivered, to establish clinical and cost effectiveness and minimise staff burden.
Topics: Humans; Dementia; Psychosocial Intervention; Inpatients; Psychiatric Department, Hospital
PubMed: 38654223
DOI: 10.1186/s12877-024-04965-8 -
Geriatric Nursing (New York, N.Y.) 2024This systematic review aims to assess the effectiveness, acceptability, and sustainability of non-pharmacological pain management interventions for older adults in...
The effectiveness, acceptability, and sustainability of non-pharmacological interventions for chronic pain management in older adults in mainland China: A systematic review.
OBJECTIVES
This systematic review aims to assess the effectiveness, acceptability, and sustainability of non-pharmacological pain management interventions for older adults in mainland China.
MATERIALS AND METHODS
Articles searching was conducted across six databases, including MEDLINE, PubMed, PsycINFO, Web of Science, China National Knowledge Infrastructure (CNKI), and WanFangdata. Quality appraisal was performed using the revised Cochrane risk of bias tool.
RESULTS
A total of 26 articles met the inclusion criteria, involving 2,197 participants with a mean age of 69.19 years. The participants' ages ranged from 63.85 to 81.75 years. The evaluated non-pharmacological interventions included psychotherapy, acupuncture, exercise, massage, neurotherapy, and multidisciplinary interventions. The overall changes in pain intensity varied from -5.19 to -0.65 on a numeric rating scale ranging from zero to ten.
CONCLUSIONS
Non-pharmacological interventions proved effective in alleviating pain intensity among older adults in mainland China. The findings suggest that mindfulness, exercise and pain education can be promoted as viable strategies for enhancing the well-being of the elderly population.
Topics: Humans; China; Pain Management; Chronic Pain; Aged; Aged, 80 and over; Middle Aged
PubMed: 38640646
DOI: 10.1016/j.gerinurse.2024.04.008