In severe cases of COVID-19, patients experience rapid disease progression and can quickly progress to acute respiratory distress syndrome (ARDS) 2. ...an average ECMO procedure in the USA costs ...$73,122 USD, indicating that ECMO is a highly resource-demanding procedure 7. ...a further, larger sample size study and a comprehensive analysis of the medical value of using ECMO on COVID-19 patients are urgently required. 3, COVID-19 is a pandemic; all healthcare resources are stretched so that ECMO is not a therapy to be rushed to the frontline. ...interim treatment guidelines 5, 6 of recommending ECMO for critically ill COVID-19 patients should be taken cautiously.
Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women worldwide. Recently, studies have been published with inconsistent findings regarding whether ...sarcopenia is a risk factor for mortality in breast cancer patients. Therefore, the aim of this systematic review and meta-analysis was to systematically assess and quantify sarcopenia as a risk factor for mortality in breast cancer patients.
In a systematic literature review of PubMed, EMBASE, and the Cochrane CENTRAL Library, we searched for observational studies written in English (from database inception until April 30, 2019) that reported an association between sarcopenia and breast cancer in women who were 18 years or older.
A total of six studies (5497 participants) were included in this meta-analysis. Breast cancer patients with sarcopenia were associated with a significantly higher risk of mortality, compared to breast cancer patients without sarcopenia (pooled HR-hazard ratio = 1.71, 95% CI: 1.25-2.33, I
= 59.1%). In addition, the results of age subgroup analysis showed that participants younger than 55 years with sarcopenia had a lower risk of mortality than participants aged 55 years and older with sarcopenia (pooled HR = 1.46, 95% CI: 1.24-1.72 versus pooled HR = 1.99, 95% CI: 1.05-3.78), whereas both have an increased risk of mortality compared to non-sarcopenic patients. Subgroup analyses regarding stage at diagnosis revealed an increased risk of mortality in non-metastatic patients compared to participants without sarcopenia (pooled HR = 1.91, 95% CI: 1.32-2.78), whereas the association was not significant in metastatic breast cancer patients. Other subgroup analyses were performed using different follow-up periods (> 5 years versus ≤5 years) and the results were different (pooled HR = 1.81, 95% CI: 1.23-2.65 versus pooled HR = 1.70, 95% CI: 0.80-3.62).
The present study found that sarcopenia is a risk factor for mortality among female early breast cancer patients. It is imperative that more research into specific interventions aimed at treating sarcopenia be conducted in the near future in order to provide evidence which could lead to decreased mortality rates in breast cancer patients.
Background. This meta-analysis summarizes the results from recent studies that examined the use of virtual reality (VR)–based interventions on health-related outcomes in patients with cancer, and ...quantitatively evaluates the efficacy of VR-based interventions. Findings of this meta-analysis can provide direction for future symptom management research. Methods. The search terms included a combination of “virtual reality” OR “virtual environment” OR “head-mounted display” with “oncology” OR “cancer.” Three databases (Medline, PubMed, and CAJ Full-text Database), one search engine (Google Scholar), and the website of ResearchGate, covering the period from December 2013 to May 15, 2019, and including articles published in both English and Chinese, were searched. Data synthesis used the RevMan 5.3 to generate pooled estimates of effect size. Results. A total of 6 empirical studies met the eligibility criteria. VR-based interventions had statistically significant effects on reducing symptoms of anxiety, depression, pain, and cognitive function, whereas statistically significant benefit was observed for fatigue (Z = 2.76, P = .006). Conclusion. Most recent studies have primarily examined VR-based interventions for symptom management in the acute stages of cancer care. However, the management of late and long-term side effects is central to cancer survivorship care. There is burgeoning empirical support for further research to evaluate the efficacy of VR-based interventions in cancer rehabilitation.
Background:
Cancer and its treatment significantly impact the quality of life (QOL) of adolescent and young adult (AYA) patients. This meta-analysis examined the effects of exercise interventions on ...the generic and cancer-specific QOL of AYA cancer patients and survivors.
Methods:
Four databases were searched from January 2010 to September 2019. RevMan 5.3 was used to synthesize the effects of exercise intervention on the QOL of AYA cancer patients and survivors.
Results:
A total of 11 eligible studies have been included in this paper. Direct outcome comparisons found that pooled overall effects on generic QOL were in favor of exercise interventions, but only with marginal significance (Z= 1.96, P = 0.05). When performing the subscale analysis of the generic QOL, three trials assessed the effects of exercise interventions on the emotional domain of QOL, and the weighted mean difference (WMD) for the overall intervention effect was 3.47 (95% confidence interval CI = 0.42 to 6.51). Additionally, exercise interventions increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors (Z= 2.88, P = 0.004).
Conclusion:
Exercise interventions had positive effects on generic QOL and increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors. In addition, exercise intervention programs appear to be safe, as there were no studies that reported adverse events. Future research, with rigorous methodological standards and larger sample sizes, should be designed to confirm the positive effects of exercise interventions on the QOL of AYA cancer patients and survivors.
Abstract
Background
The evidence of sarcopenia based on CT-scan as an important prognostic factor for critically ill patients has not seen consistent results. To determine the impact of sarcopenia on ...mortality in critically ill patients, we performed a systematic review and meta-analysis to quantify the association between sarcopenia and mortality.
Methods
We searched studies from the literature of PubMed, EMBASE, and Cochrane Library from database inception to June 15, 2020. All observational studies exploring the relationship between sarcopenia based on CT-scan and mortality in critically ill patients were included. The search and data analysis were independently conducted by two investigators. A meta-analysis was performed using STATA Version 14.0 software using a fixed-effects model.
Results
Fourteen studies with a total of 3,249 participants were included in our meta-analysis. The pooled prevalence of sarcopenia among critically ill patients was 41 % (95 % CI:33-49 %). Critically ill patients with sarcopenia in the intensive care unit have an increased risk of mortality compared to critically ill patients without sarcopenia (OR = 2.28, 95 %CI: 1.83–2.83; P < 0.001; I
2
= 22.1 %). In addition, a subgroup analysis found that sarcopenia was associated with high risk of mortality when defining sarcopenia by total psoas muscle area (TPA, OR = 3.12,95 %CI:1.71–5.70), skeletal muscle index (SMI, OR = 2.16,95 %CI:1.60–2.90), skeletal muscle area (SMA, OR = 2.29, 95 %CI:1.37–3.83), and masseter muscle(OR = 2.08, 95 %CI:1.15–3.77). Furthermore, critically ill patients with sarcopenia have an increased risk of mortality regardless of mortality types such as in-hospital mortality (OR = 1.99, 95 %CI:1.45–2.73), 30-day mortality(OR = 2.08, 95 %CI:1.36–3.19), and 1-year mortality (OR = 3.23, 95 %CI:2.08 -5.00).
Conclusions
Sarcopenia increases the risk of mortality in critical illness. Identifying the risk factors of sarcopenia should be routine in clinical assessments and offering corresponding interventions may help medical staff achieve good patient outcomes in ICU departments.
This study examines the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors, to identify the most effective way of improving ...metabolic syndrome and preventing cardiovascular disease. We searched EMBASE, the Cochrane Library, PubMed, MEDLINE, Ovid, the Chinese Biological Medicine Database (CBM), the Wanfang Database, the China National Knowledge Infrastructure (CNKI) database, and the Chinese Scientific Journal Database (VIP), for randomized controlled trials (RCTs), identifying 15 comparing the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors (e.g., glucose, triglyceride, blood pressure, body mass index, etc.). We assessed the quality of the articles and performed a network meta-analysis with a Bayesian random effects model to synthesize direct and indirect evidence. Combined exercise was most effective at controlling glucose and total triglyceride (TG) levels. Aerobic, resistance, and combined exercise groups achieved significant effects regarding body fat. Aerobic exercise was superior to resistance exercise regarding body mass index (BMI). There was no statistically significant difference in weight, waist circumference (WC), levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), insulin, systolic blood pressure (SBP), and diastolic blood pressure (DBP) among the exercise groups. Combined exercise was the best exercise scheme for improving weight, WC, DBP, TG, TC, glucose, and insulin levels. Resistance exercise was most effective at ameliorating body fat, LDL-C levels, and SBP. Aerobic exercise was the optimal way of improving BMI and HDL-C levels. This network meta-analysis suggests combined exercise is the most effective choice in improving the metabolic syndrome and cardiovascular risk parameters, whereas aerobic exercise reveals the minimum effect. Further studies should certify the role resistance exercises play in metabolic syndrome and cardiac rehabilitation.
Breast cancer is the most common type of cancer among women worldwide. Diagnosis and treatment of breast cancer pose an array of physical and psychological threats to the survivors. Exercise ...interventions may be particularly appropriate for cancer survivors because they have the potential to improve physical and psychological functioning. The review aims to examine the effectiveness of exercise intervention on the quality of life (QOL) of breast cancer survivors. Five databases (Medline, CINAHL, Scopus, The Cochrane Library, and CAJ Full-text Database) were searched from 2003 to July 2013. Clinical controlled trials of exercise interventions for breast cancer survivors who were at least 18 years old and had completed active cancer treatment were included. A total of 25 trials were included in this study, of which 19 were pooled together statistically. Subjects in the exercise interventions had higher overall QOL than subjects in the control group. The standardized mean difference (SMD) for changes in overall general QOL scores was 0.70 (95 % CI 0.21, 1.19). The SMD for changes in cancer-specific QOL scores was 0.38 (95 % CI 0.03, 0.74). For cancer-specific QOL domains, there were positive but non-significant trends in two QOL domains (breast symptoms:
Z
score = 1.12,
p
= 0.26; arm symptoms:
Z
score = 1.32,
p
= 0.19). This study provides updated findings supporting the idea that exercise interventions have statistically significant effects on overall QOL in breast cancer survivors, as well as positive trends for cancer site-specific QOL domains (breast and arm symptoms).
A rapid, sensitive and selective liquid chromatography-electrospray ionization-tandem mass spectrometric method was developed and validated for the quantification of scopoletin in rat plasma. After ...the addition of the internal standard xanthotoxin, plasma samples were pretreated by a simple one-step protein precipitation with acetonitrile-methanol (2:1, v/v). Chromatographic separation was achieved on a Diamonsil ODS chromatography column using gradient elution with the mobile phase consisting of acetonitrile and 0.1% formic acid. The determination was performed by positive ion electrospray ionization in multiple reaction monitoring mode. The calibration curve was linear over the concentration range of 5-1000 ng/mL (r = 0.9996). The intra- and inter-day precision (RSD%) was less than 6.1%, and the accuracy (RE%) was from -3.0%-2.5%. This method was successfully applied to the pharmacokinetic research of scopoletin in rats after intravenous (5 mg/kg) or oral (5, 10 and 20 mg/kg) administration. The result showed that oral bioavailability with a dose of 5 mg/kg was 6.62% ± 1.72%, 10 mg/kg, 5.59% ± 1.16%, and 20 mg/kg, 5.65% ± 0.75%.
There is a growing concern about mental health issues in new fathers, such as postpartum depression (PPD). Factors associated with PPD in men include personality traits and perceived stress. This ...study examined a set of hypothesized paths using perceived stress, neuroticism, and psychological inflexibility to predict depressive symptoms. A total of 189 participants took part. The mean age of these first-time fathers was 36.12 years (SD = 2.39). Perceived stress, neuroticism, and psychological inflexibility positively predicted new fathers’ depressive symptoms (B = 0.13, 0.37, and 0.31, respectively). These predictors explained 48% (R2 = 0.48) of the variance in the measured outcome of depressive symptoms in these new Chinese fathers. The total standardized direct effects of the three variables on depressive symptoms were 0.47 (95% CI 0.38, 0.53). In conclusion, this study provides novel information about the chain mediating role played by neuroticism and psychological inflexibility in the relationship between perceived stress and PPD. Perceived stress significantly predicted neuroticism and psychological inflexibility, which in turn significantly predicted depressive symptoms in new Chinese fathers. The relationship between perceived stress and depressive symptoms was also mediated by each of psychological inflexibility or neuroticism alone.
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