scholarly journals Methods Used to Evaluate the Immediate Effects of Airway Clearance Techniques in Adults with Cystic Fibrosis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (22) ◽  
pp. 5280
Author(s):  
Naomi Chapman ◽  
Kathryn Watson ◽  
Tamara Hatton ◽  
Vinicius Cavalheri ◽  
Jamie Wood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cystic Fibrosis ◽  
Lung Function ◽  
Meta Analysis ◽  
Group Effect ◽  
Airway Clearance ◽  
Wet Weight ◽  
The Mean ◽  
Meta Regression ◽  
Review Reports

This review reports on methods used to evaluate airway clearance techniques (ACT) in adults with CF and examined data for evidence of any effect. Sixty-eight studies described ACT in adequate detail and were included in this review. Frequently reported outcomes were sputum expectoration (72%) and spirometric lung function (60%). Compared with cough alone, following any ACT, there was a trend for greater sputum wet weight, however FEV1 was not different. The mean (95% CI) within-group effect for sputum wet weight following any ACT was 12.43 g (9.28 to 15.58) (n = 30 studies) and for FEV1 was 0.03 L (−0.17 to 0.24) (n = 14 studies). Meta-regression demonstrated that, when compared with cough alone, greater sputum wet weight was reported in groups that received additional ACT by between 2.45 and 3.94 g (F3,66 = 2.97, p = 0.04). These data suggest the addition of ACT to cough alone may optimise sputum clearance; however, FEV1 lacked sensitivity to detect this change. Importantly, this review highlights the lack of appropriate measures to assess ACT efficacy.

scholarly journals 0960 Perception of Sleep Importance in Children With Cystic Fibrosis

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A364-A365
Author(s):  
K Reiling ◽  
A Patel
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Sleep Problems ◽  
Pulmonary Function Tests ◽  
Poor Sleep ◽  
Airway Clearance ◽  
The Mean ◽  
Nocturnal Cough ◽  
Perception Of Sleep

Abstract Introduction Children with cystic fibrosis (CF) are known to have poor sleep efficiency and increased nighttime awakenings secondary to factors such as nocturnal cough and time spent on therapies for airway clearance. Studies have shown that children with poor lung function have a higher Pediatric Daytime Sleepiness Score (PDSS). An increase in sleep disturbance has been associated with poorer perceived health in children with CF. There have been limited studies to date that report the perception of sleep importance in CF patients. We aim to characterize the perception of sleep importance in children with CF as measured through a self-reported questionnaire and identify barriers to sleep. Methods After IRB approval, subjects with CF aged 3-17 years were prospectively recruited from routine pulmonology clinic visits (n=28, 17 male). A questionnaire was provided consisting of 35 questions regarding sleep practices, perception of sleep importance, and PDSS. Recent pulmonary function tests (PFTs) were also collected. Results The mean PDSS was 11.3, with a range of 4 to 24. The questionnaire responses were as follows: 82% of participants reported sleep as “very important” overall, 92% reported sleep being “very important” for health, and 75% reported sleep being “very important” for lung function. In addition, 39% reported airway clearance as part of their nighttime routine and 89% reported utilizing electronic screens 2 hours prior to bed. The most frequent barriers to sleep identified were technology and bedtime resistance (14% each), and homework, excitability, and vest/airway treatments (11% each). 86% of participants had at least one symptom of disordered sleep. Conclusion Screening for sleep problems in the CF population may be beneficial and may contribute to improved quality of life. Further recruitment is ongoing. Support  

Obstructive sleep apnea in children and adolescents with cystic fibrosis and preserved lung function or mild impairment: a systematic review and meta-analysis of prevalence

2021 ◽  
Author(s):  
Luisa Pedrada de Sousa ◽  
Fernanda Mayrink Gonçalves Liberato ◽  
Fernanda Maria Vendrusculo ◽  
Márcio Vinícius Fagundes Donadio ◽  
Roberta Ribeiro Batista Barbosa
Keyword(s):  
Systematic Review ◽  
Cystic Fibrosis ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lung Function ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Obstructive Sleep ◽  
Mild Impairment

Systematic review and meta-analysis of Altruistic and Game-playing Love

2020 ◽  
Author(s):  
Hossein Dabiriyan Tehrani ◽  
Sara Yamini
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Game Playing ◽  
Love Styles ◽  
Collectivistic Culture ◽  
Meta Regression ◽  
Collectivistic Cultures ◽  
The Relationship

This systematic review aimed to find attitudes toward Altruistic and Game-playing love styles across individualistic and collectivistic cultures. Addressing major moderators concerning Altruistic and Game-playing love styles are the secondary objectives of this review. This review included 102 articles comprising samples from 37 countries (N = 41997). The findings of this meta-analysis show that there is a collectivistic and individualistic difference in Game-playing but not in the Altruistic love style. Collectivistic and individualistic cultures, on average, demonstrate the same perception concerning the Altruistic love style, whereas collectivistic culture shows the Game-playing love style more strongly. To explain the role of moderators in key measures, the subgroup analysis and meta-regression show that both Game-playing and Altruistic love styles decline by increasing the length of the relationship. Likewise, having children affects these love styles such that the Altruistic love style is improved, and the Game-playing love style is reduced by the presence of children in families.

scholarly journals Outcomes of Oblique Lateral Interbody Fusion for Adult Spinal Deformity: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822097914
Author(s):  
Lei Zhu ◽  
Jun-Wu Wang ◽  
Liang Zhang ◽  
Xin-Min Feng
Keyword(s):  
Systematic Review ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Perioperative Complications ◽  
Adult Spinal Deformity ◽  
Meta Analysis ◽  
Fusion Rate ◽  
The Mean ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design: A systematic review and meta-analysis. Objectives: To evaluate clinical and radiographic outcomes, and perioperative complications of oblique lateral interbody fusion (OLIF) for adult spinal deformity (ASD). Methods: We performed a systematic review and meta-analysis of related studies reporting outcomes of OLIF for ASD. The clinical outcomes were assessed by visual analogue scale (VAS) and Oswestry Disability Index (ODI). The radiographic parameters were evaluated by sagittal vertical axis (SVA), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence-lumbar lordosis (PI-LL), Cobb angle and fusion rate. A random effects model and 95% confidence intervals (CI) were performed to investigate the results. Results: A total of 16 studies involving 519 patients were included in the present study. The mean difference of VAS-back score, VAS-leg score and ODI score before and after surgery was 5.1, 5.0 and 32.3 respectively. The mean correction of LL was 20.6°, with an average of 6.9° per level and the mean correction of Cobb was 16.4°, with an average of 4.7° per level. The mean correction of SVA, PT, SS, TK and PI-LL was 59.3 mm, 11.7°, 6.9°, 9.4° and 20.6° respectively. The mean fusion rate was 94.1%. The incidence of intraoperative and postoperative complications was 4.9% and 29.6% respectively. Conclusions: OLIF is an effective and safe surgery method in the treatment of mild or moderate ASD and it has advantages in less intraoperative blood loss and lower perioperative complications.

scholarly journals Effect modification of the association between comorbidities and severe course of COVID-19 disease by age of study participants: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathalie Verónica Fernández Villalobos ◽  
Jördis Jennifer Ott ◽  
Carolina Judith Klett-Tammen ◽  
Annabelle Bockey ◽  
Patrizio Vanella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Icu Admission ◽  
Vaccination Strategies ◽  
Relative Risks ◽  
Quantitative Synthesis ◽  
Meta Regression ◽  
Behavioural Factors ◽  
Study Participants

Abstract Background Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, intensive care unit (ICU) admission, and death due to COVID-19 is required for deriving national and international recommendations on primary targets for non-pharmacological interventions (NPI) and vaccination strategies. Methods We performed a rapid systematic review and meta-analysis on studies and publicly accessible data to quantify associations between predisposing health conditions, demographics, behavioural factors on the one hand and hospitalisation, ICU admission, and death from COVID-19 on the other hand. We provide ranges of reported and calculated effect estimates and pooled relative risks derived from a meta-analysis and meta-regression. Results Seventy-five studies were included in qualitative and 74 in quantitative synthesis, with study populations ranging from 19 to 44,672 COVID-19 cases. The risk of dying from COVID-19 was significantly associated with cerebrovascular [pooled relative risk (RR) 2.7 (95% CI 1.7–4.1)] and cardiovascular [RR 3.2 (CI 2.3–4.5)] diseases, hypertension [RR 2.6 (CI 2.0–3.4)], and renal disease [RR 2.5 (CI 1.8–3.4)], with high heterogeneity in pooled estimates, partly but not solely explained by age of study participants. For some comorbidities, our meta-regression showed a decrease in effect on the severity of disease with a higher median age of the study population. Compared to death, associations between several comorbidities and hospitalisation and ICU admission were less pronounced. Conclusions We obtained robust estimates on the magnitude of risk for COVID-19 hospitalisation, ICU admission, and death associated with comorbidities, demographic, and behavioural risk factors and show that these estimates are modified by age of study participants. This interaction is an important finding to be kept in mind for current vaccination strategies and for the protection of individuals with high risk for a severe COVID-19 course.

The analgesic efficacy of liposomal bupivacaine compared with bupivacaine hydrochloride for the prevention of postoperative pain: a systematic review and meta-analysis with trial sequential analysis

2021 ◽  
pp. rapm-2020-102427
Author(s):  
Hanns-Christian Dinges ◽  
Thomas Wiesmann ◽  
Berit Otremba ◽  
Hinnerk Wulf ◽  
Leopold H Eberhart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Pain Score ◽  
Meta Analysis ◽  
End Points ◽  
Liposomal Bupivacaine ◽  
Bupivacaine Hydrochloride ◽  
Pain Scores ◽  
Score Difference ◽  
The Mean

Background/ImportanceLiposomal bupivacaine (LB) is a prolonged release formulation of conventional bupivacaine designed for prolonging local or peripheral regional single injection anesthesia. To this day, the benefit of the new substance on relevant end points is discussed controversial.ObjectiveThe objective was to determine whether there is a difference in postoperative pain scores and morphine consumption between patients treated with LB and bupivacaine hydrochloride in a systematic review and meta-analysis.Evidence reviewRandomized controlled trials (RCT) were identified in Embase, CENTRAL, MEDLINE and Web of Science up to May 2020. Risk of bias was assessed using Cochrane methodology. Primary end points were the mean pain score difference and the relative morphine equivalent (MEQ) consumption expressed as the ratio of means (ROM) 24 and 72 hours postoperatively.Findings23 RCTs including 1867 patients were eligible for meta-analysis. The mean pain score difference at 24 hours postoperatively was significantly lower in the LB group, at −0.37 (95% CI −0.56 to −0.19). The relative MEQ consumption after 24 hours was also significantly lower in the LB group, at 0.85 (0.82 to 0.89). At 72 hours, the pain score difference was not significant at −0.25 (−0.71 to 0.20) and the MEQ ratio was 0.85 (0.77 to 0.95).ConclusionThe beneficial effect on pain scores and opioid consumption was small but not clinically relevant, despite statistical significance. The effect was stable among all studies, indicating that it is independent of the application modality.

scholarly journals Sporting participation following the operative management of chondral defects of the knee at mid-term follow up: a systematic review and meta-analysis

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
P. G. Robinson ◽  
T. Williamson ◽  
I. R. Murray ◽  
K. Al-Hourani ◽  
T. O. White
Keyword(s):  
Systematic Review ◽  
Autologous Chondrocyte Implantation ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Osteochondral Allograft ◽  
Chondral Defects ◽  
Chondrocyte Implantation ◽  
The Mean ◽  
Autologous Chondrocyte

Abstract Purpose The purpose of this study was to perform a systematic review of the reparticipation in sport at mid-term follow up in athletes who underwent biologic treatment of chondral defects in the knee and compare the rates amongst different biologic procedures. Methods A search of PubMed/Medline and Embase was performed in May 2020 in keeping with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The criteria for inclusion were observational, published research articles studying the outcomes and rates of participation in sport following biologic treatments of the knee with a minimum mean/median follow up of 5 years. Interventions included microfracture, osteochondral autograft transfer (OAT), autologous chondrocyte implantation (ACI), matrix-induced autologous chondrocyte implantation (MACI), osteochondral allograft, or platelet rich plasma (PRP) and peripheral blood stem cells (PBSC). A random effects model of head-to-head evidence was used to determine rates of sporting participation following each intervention. Results There were twenty-nine studies which met the inclusion criteria with a total of 1276 patients (67% male, 33% female). The mean age was 32.8 years (13–69, SD 5.7) and the mean follow up was 89 months (SD 42.4). The number of studies reporting OAT was 8 (27.6%), ACI was 6 (20.7%), MACI was 7 (24.1%), microfracture was 5 (17.2%), osteochondral allograft was 4 (13.8%), and one study (3.4%) reported on PRP and PBSC. The overall return to any level of sport was 80%, with 58.6% returning to preinjury levels. PRP and PBSC (100%) and OAT (84.4%) had the highest rates of sporting participation, followed by allograft (83.9%) and ACI (80.7%). The lowest rates of participation were seen following MACI (74%) and microfracture (64.2%). Conclusions High rates of re-participation in sport are sustained for at least 5 years following biologic intervention for chondral injuries in the knee. Where possible, OAT should be considered as the treatment of choice when prolonged participation in sport is a priority for patients. However, MACI may achieve the highest probability of returning to the same pre-injury sporting level. Level of evidence IV

A systematic review of short metaphyseal loading cementless stems in hip arthroplasty

2019 ◽  
Vol 101-B (5) ◽  
pp. 502-511 ◽  
Author(s):  
S. Lidder ◽  
D. J. Epstein ◽  
G. Scott
Keyword(s):  
Systematic Review ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Ethical Practice ◽  
Term Survival ◽  
The Mean ◽  
Review Reports ◽  
Femoral Implants ◽  
Hip Arthroplasties

Aims Short-stemmed femoral implants have been used for total hip arthroplasty (THA) in young and active patients to conserve bone, provide physiological loading, and reduce the incidence of thigh pain. Only short- to mid-term results have been presented and there have been concerns regarding component malalignment, incorrect sizing, and subsidence. This systematic review reports clinical and radiological outcomes, complications, revision rates, and implant survival in THA using short-stemmed femoral components. Materials and Methods A literature review was performed using the EMBASE, Medline, and Cochrane databases. Strict inclusion and exclusion criteria were used to identify studies reporting clinical and radiological follow-up for short-stemmed hip arthroplasties. Results A total of 28 studies were eligible for inclusion. This included 5322 hips in 4657 patients with a mean age of 59 years (13 to 94). The mean follow-up was 6.1 years (0.5 to 20). The mean Harris Hip Score improved from 46 (0 to 100) to 92 (39 to 100). The mean Oxford Hip Score improved from 25 (2 to 42.5) to 35 (12.4 to 48). The mean Western Ontario & McMaster Universities Osteoarthritis Index improved from 54 (2 to 95) to 22 (0 to 98). Components were aligned in a neutral coronal alignment in up to 90.9% of cases. A total of 15 studies reported component survivorship, which was 98.6% (92% to 100%) at a mean follow-up of 12.1 years. Conclusion Short-stemmed femoral implants show similar improvement in clinical and radiological outcomes compared with conventional length implants. Only mid-term survivorship, however, is known. An abundance of short components have been developed and used commercially without staged clinical trials. Long-term survival is still unknown for many of these components. There remains tension between innovation and the moral duty to ensure that the introduction of new implants is controlled until safety and patient benefit are demonstrated. Implant innovation and subsequent use should be driven by proven clinical outcomes, rather than market and financial forces, and ethical practice must be ensured. Cite this article: Bone Joint J 2019;101-B:502–511.

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