Many breast cancer patients suffer from hot flush and medical menopause as side effects of treatment. Some patients undergo acupuncture, rather than hormone therapy, to relieve these symptoms, but ...the efficacy of acupuncture is uncertain. This meta-analysis evaluated the efficacy of acupuncture on hot flush and menopause symptoms in women with breast cancer.
A literature search was performed, following the PRISMA Statement and without language restrictions, of 7 databases from inception through March 2017. All selected studies were randomized clinical trials (RCTs) that examined the effect of needle acupuncture on hot flush and menopause symptoms in patients with breast cancer. The methodological quality of these trials was assessed using Cochrane criteria, and meta-analysis software (RevMan 5.2) was used to analyze the data.
We examined 844 breast cancer patients (average age: 58 years-old) from 13 RCTs. The trials had medium-to-high quality, based on the modified Jadad scale. The meta-analysis showed that acupuncture had no significant effect on the frequency and the severity of hot flush (p = 0.34; p = 0.33), but significantly ameliorated menopause symptoms (p = 0.009). None of the studies reported severe adverse events.
Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objectives
Poor sleep quality is a common issue among older adults; it can lead to a poor quality of life and impairments in cognitive function and physical health. This study aimed to conduct a ...systematic review and meta‐analysis of the effect of listening to music on sleep quality in older adults.
Design
Systematic review and meta‐analyses.
Setting
Five databases, including Embase, Ovid Medline, Cochrane Library, Scopus, and the Index to Taiwan Periodical Literature System, were searched to identify studies assessing the efficacy of music therapy in older adults aged 60 years and older published through February 20, 2021.
Participants
Adults aged 60 years and older.
Measurements
We searched English‐ and Chinese‐language studies of randomized control trials. All studies were reviewed by two independent investigators. The primary sleep outcome was the Pittsburgh sleep quality index. The Cochrane Collaboration tool was used to assess the risk of bias, and Review Manager 5.3 software was used to conduct the meta‐analysis.
Results
Five randomized control trials were included in the meta‐analysis. Older adults who listened to music experienced significantly better sleep quality than those who did not listen to music mean difference (MD): −1.96, 95% CI −2.23 to −1.73, P = 0.003. The subgroup analysis revealed that older adults who listened to sedative music obtained a more effective improvement in sleep quality than those who listened to rhythm‐centered music (MD: −2.35, 95% CI –3.59 to −1.10, P = 0.0002). Furthermore, listening to music for longer than 4 weeks (MD: −2.61, 95% CI −4.72 to −0.50, P = 0.02) was to be effective at improving sleep quality.
Conclusions
Music therapy is safe and easy to administer and can effectively improve sleep quality among older adults, particularly those listening to more sedative music for at least a four‐week duration.
Aims
To evaluate the effect of earplugs and eye masks on the sleep quality of patients in intensive care unit (ICU).
Design
Systematic review and meta‐analysis.
Data Sources
Randomized controlled ...trial studies conducted before May 5, 2020 were searched for in Embase, MEDLINE, Cochrane Library, CINAHL and Index to Taiwan Periodical Literature System databases.
Review Methods
Analyses in this study were according to the PRISMA statement. The heterogeneity of the data was investigated through sub‐group analysis while a meta‐analysis was performed using the Review Manager 5.3 software.
Results
A total of 797 patients from 13 studies were included in this study. Without considering alone or combined use of earplugs and eye masks, the meta‐analysis supported that there was a significant effect on self‐reported sleep quality. The overall standardized mean difference of the effect size was 1.44 (95% confidence interval CI: 0.80, 2.09). Sub‐group analysis indicated that the use of earplugs alone had no significant effect on sleep quality (effect size: 0.07, 95% CI: −0.50, 0.64). The use of eye masks alone had a significant effect on sleep quality (effect size: 1.56, 95% CI: 1.08, 2.05). The use of both earplugs and eye masks proved to have the largest effect size on sleep quality (effect size: 2.08, 95% CI: 0.95, 3.21).
Conclusion
The combined use of earplugs and eye masks or the standalone use of eye masks is a non‐invasive, economical and effective way to promote sleep quality in adult ICU patients.
Impact
Clinical nurses could use this meta‐analysis as it recommends that nurses provide adult ICU patients with either one or both earplugs and eye masks to improve the patients’ sleep quality.
Study Registration
The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.York.ac.uk/Prospero with the registration number # CRD42021221185).
Aim
The aim of the study was to compare the effects of massage interventions on sleep quality among patients in the adult critical care unit.
Background
Massage interventions have positive effects ...when applied to manage sleep quality in critical care units. However, research identifying the effect of massage intervention is limited.
Design
This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.
Methods
Five databases were searched from their inception to 15 April 2022 (the last search was conducted on 15 November 2022, but it yielded no additional eligible studies). The literature search was conducted using Embase, MEDLINE, the Cochrane Library, CINAHL, PsycINFO and additional sources such as Google Scholar. The Cochrane risk of bias tool for randomised trials (RoB 2.0) was used to assess the risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system assessed the certainty of evidence and recommendations.
Results
In total, ten randomised controlled trials comprising 569 participants were used in the systematic review, and eight trials were included in the meta‐analysis. Subgroup analysis revealed significant effects of foot reflexology massage on subjective sleep quality. Massage therapy for a two‐night duration in cardiac care unit patients exhibited a significant effect on subjective sleep quality. The overall GRADE certainty of evidence was low.
Conclusion
Massage intervention, particularly foot reflexology massage, with a two‐night duration showed improvement in subjective sleep quality among critically ill patients. Although evidence quality was low, the results suggest that massage interventions provide a non‐invasive, low‐cost and effective way to promote sleep quality in critically ill adult patients.
Relevance to clinical practice
Massage interventions can enable nurses to recommend and implement strategies promoting and improving sleep quality among critically ill patients.
Study registration
The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.York.ac.uk/Prospero with the registration number # CRD42022332371).
Patient or public contribution
No patient or public contribution if such details are not necessary or do not apply to your work and state why.
Summary
Background
Post‐operative complications after anti‐tumour necrosis agent treatment for Crohn's disease (CD) have been analysed with conflicting results.
Aim
To assess the effects of ...pre‐operative anti‐tumour necrosis factor (TNF) therapy on post‐operative complications within 30 days post‐operatively in patients with CD undergoing abdominal surgery.
Methods
Systematic review with meta‐analysis was performed on articles found in MEDLINE, Embase, Cochrane Library, Scopus, and the International Clinical Trials Registry Platform until September 2018.
Results
Twenty studies (7115 patients) were included. Without confounder adjustment, pre‐operative anti‐TNF therapy in patients with CD undergoing abdominal surgery was associated with increased rates of infectious complications (unadjusted odds ratio, OR, 1.49; 95% CI, 1.08‐2.06). After confounder adjustment, Pre‐operative anti‐TNF therapy was significantly associated with both increased rates of total and infectious complications (adjusted OR, 1.53 and 2.09; 95% CI, 1.11‐2.09 and 1.19‐3.65, respectively). After subgroup analyses, the association between anti‐TNF agents and total complications was significant in high incidence countries (adjusted OR, 1.86; 95% CI, 1.43‐2.42) but not in low incidence countries (adjusted OR, 0.77; 95% CI, 0.48‐1.25).
Conclusions
Exposure to anti‐TNF agents is an independent risk factor for post‐operative infectious complications in patients with CD, especially in countries with a high incidence of Crohn's disease. We suggest postponing elective surgery or carefully monitoring these patients post‐operatively.
Purpose
To conduct a systematic review and meta-analysis of current studies to determine whether exercise affects chemotherapy-induced peripheral neuropathy (CIPN) symptoms in cancer patients.
Design
...The Medline, Embase, Cochrane Library, CINAHL, PubMed, and National Central Library databases, and the reference lists of the included studies were surveyed. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for non-pharmacologic treatment was used to evaluate the literature.
Setting and participants
Exercise interventions offered in hospitals or at home. A total of 178 participants from 5 studies were assessed in the meta-analysis, with their mean age ranging from 48.56 to 71.82 years.
Methods
The randomized control trials were summarized in a systematic review. The effects of the exercise interventions were compiled for meta-analysis. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference.
Results
The pooled results indicated that exercise interventions significantly improved the CIPN symptoms of the participants (mean difference: 0.5319; 95% confidence interval: 0.2295 to 0.8344;
Z
= 3.45;
P
= 0.0006). A combination of exercise protocols including a nerve gliding exercise intervention was found to have improved CIPN symptoms. In addition, a sensorimotor-based exercise intervention was found to have reduced CIPN-induced loss of postural stability.
Conclusions and implications
The findings indicated that the effects of exercise could improve CIPN symptoms in cancer patients. Nevertheless, further investigations of different exercise protocols and intensity of intervention utilizing larger sample sizes and more specific outcome measures will further inform the best practices for cancer patients.
The benefit of inpatient comprehensive geriatric assessment on patient survival and function has been demonstrated among frail older patients. However, the influence of outpatient geriatric ...evaluation and management (GEM) on clinical outcomes remains debated. This study aimed to update the research evidence detailing the effect of outpatient GEM on survival and nursing-home admission through a comparison with conventional care.
Cochrane Library, EMBASE, and MEDLINE databases were searched up to January 29th, 2022, to identify randomized controlled trials (RCTs) including older people over age 55 that compared outpatient GEM with conventional care on mortality (primary outcome) and nursing-home admission (secondary outcome) during a follow-up period of 12 to 36 months.
Nineteen reports from 11 studies that recruited 7,993 participants (mean age 70-83) were included. Overall, outpatient GEM significantly reduced mortality (risk ratio (RR) = 0.87, 95% confidence interval (CI) = 0.77-0.99, I
= 12%). For the subgroup analysis categorized by different follow-up periods, its prognostic benefit was only disclosed for 24-month mortality (RR = 0.68, 95% CI = 0.51-0.91, I
= 0%), but not for 12- or 15 to 18-month mortality. Furthermore, outpatient GEM had significantly trivial effects on nursing-home admission during the follow-up period of 12 or 24 months (RR = 0.91, 95% CI = 0.74-1.12, I
= 0%).
Outpatient GEM led by a geriatrician with a multidisciplinary team improved overall survival, specifically during the 24-month follow-up period. This trivial effect was demonstrated in rates of nursing-home admission. Future research on outpatient GEM involving a larger cohort is warranted to corroborate our findings.
Background: Breast cancer–related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect ...the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (−1.90; 95% confidence interval = −5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.
Background: Chemotherapy-induced peripheral neuropathy (CIPN) has no cure, but acupuncture may provide relief through its known neuromodulation or neuroendocrine adjustment. This review aimed to ...assess the efficacy of acupuncture in treating CIPN. Method: A literature review following the PRISMA Statement was performed, searching 7 databases from inception through August 2019. All studies were clinical trials of the effect of acupuncture on CIPN. The methodological quality of these trials was assessed using Cochrane criteria; meta-analysis software (RevMan 5.2) was used to analyze the data. Data Sources: The databases searched were the following: MEDLINE (Ovid), Embase, Cochrane CENTRAL, Scopus, World Health Organization International Clinical Trials Registry Platform, CNKI (China National Knowledge Infrastructure), and Wanfang Med Online. Results: We examined 386 cancer patients from 6 randomized control trials, which had high quality, based on the modified Jadad scale. Meta-analysis showed that acupuncture led to significant improvements in pain scores (−1.21, 95% confidence interval CI = −1.61 to −0.82, P < .00001) and nervous system symptoms based on Functional Assessment of Cancer Therapy/Neurotoxicity questionnaire scores (−2.02, 95% CI = −2.21 to −1.84, P < .00001). No significant change was noted in nerve conduction velocity (1.58, 95% CI = −2.67 to 5.83, P = .47). Conclusion: Acupuncture can effectively relieve CIPN pain and functional limitation. The limited number of subjects warrants a larger scale study.
Low serum zinc level is associated with hepatic encephalopathy (HE), but the efficacy of zinc supplementation remains uncertain. This study aimed to investigate the effects of zinc supplementation on ...HE treatment in patients with cirrhosis.
We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (Cochrane CENTRAL) and Scopus from inception to December 2018; without publication date or language restrictions. Randomized controlled trials of zinc supplementation versus placebo or other treatment for the management of HE in adult patients with cirrhosis were selected. The primary outcome was the degree of HE as assessed by clinical signs or specialized psychometric tests. The secondary outcomes included serum ammonia levels, adverse events, or the length of hospital stay and costs. We carried out a meta-analysis with random effects model and summarized continuous outcomes using standardized mean differences (SMD) or mean differences (MD) with 95% confidence intervals (95% CI). The risk of bias was assessed using the Cochrane risk of bias tool, and the certainty of evidence for each outcome was evaluated with the Grading of Recommendations, Assessment, Development, and Evaluation approach.
Four trials with 247 patients were included. In patients with cirrhosis who had mild HE (≤ grade II), the available evidence suggested that the combination treatment of zinc supplementation and lactulose over 3 to 6 months significantly improved performance in the number connection test (SMD: -0.97; 95% CI: - 1.75 to - 0.19; P = 0.01; moderate certainty), reported in three trials (n = 227). However, compared with lactulose therapy alone, additional zinc supplementation demonstrated no significant difference in the digit symbol test (SMD: 0.44; 95% CI: - 0.12 to 1.00; P = 0.12; very low certainty) or serum ammonia levels (MD: -10.86; 95% CI: - 25.73 to 4.01; P = 0.15; very low certainty), reported in two trials (n = 137). None of the included trials reported adverse events or effects on hospitalization.
In conclusion, a combination of zinc supplementation and lactulose over 3 to 6 months may improve the number connection test in cirrhotic patients with low grade HE, compared with lactulose only.
PROSPERO: CRD42017080955 . Registered 23 November 2017.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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