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Wang H, Wu S, D'Oria M, Pan D, Hu L, Zhang H, Guo J, Gu Y. Comparison of Different Endovascular Treatments of Femoropopliteal Artery In-Stent Restenosis: A Systematic Review and Bayesian Network Meta-Analysis. Ann Vasc Surg 2024; 104:205-216. [PMID: 38492725 DOI: 10.1016/j.avsg.2023.12.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/18/2023] [Indexed: 03/18/2024]
Abstract
BACKGROUND This Bayesian network meta-analysis (NMA) sought to evaluate the efficacy of different endovascular treatments for femoropopliteal artery in-stent restenosis (FP-ISR). METHODS PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of science for clinical trials from database inception to March 31, 2023, with no language restrictions to retrieve randomized controlled trials or cohort studies evaluating the impact of any kind of endovascular treatments for FP-ISR. Pair-wise meta-analysis and Bayesian NMA were performed to pool the outcome estimates different endovascular treatments. The primary end points under consideration were primary patency rates at both 6-month and 12-month follow-up. RESULTS A total of 15 studies with 1,424 patients were ultimately enrolled to be analyzed, 7 types of endovascular treatment were identified for comparison. In terms of primary patency and freedom from target lesion revascularization (TLR) at 6-month and12-month follow-up, the direct meta-analysis findings showed that drug-coated balloons (DCB) and covered stent (CS) are considerably superior to plain old balloon angioplasty (POBA), Excimer laser atherectomy (ELA) + DCB is significantly better than DCB. According to the meta-analysis based on Bayesian theory, during the 6-month and 12-months follow-up, we could not find significant difference between the different treatments in terms of the primary patency and the freedom from TLR, based on the surface values under the cumulative ranking curve (SUCRA), CS was considered the best treatment in terms of primary patency (6 months SUCRA = 85.2; 12 months SUCRA = 78.9) and freedom from TLR (6 months SUCRA = 84.9; 12 months SUCRA = 70.9); directional atherectomy + POBA may lead to higher survival rate at 12 months (SUCRA = 89.1) than others treatments; in addition, both ELA + POBA and ELA + DCB have higher limb salvage than POBA. CONCLUSIONS The findings of this NMA suggest that CS showed positive encouraging results in primary patency and TLR in FP-ISR at 6 and 12 months. However, due to the potential influence of certain confounding factors, the long-term results necessitate validation through numerous randomized controlled trials.
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Affiliation(s)
- Hui Wang
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - SenSen Wu
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, University of Trieste, Trieste, Italy
| | - Dikang Pan
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lefan Hu
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hanyu Zhang
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jianming Guo
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongquan Gu
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Mornsaeng I, Sripichyakan K, Sansiriphun N, Chaloumsuk N. Prenatal passive smoking at home: The experiences of women in Thailand. BELITUNG NURSING JOURNAL 2024; 10:48-55. [PMID: 38425690 PMCID: PMC10900058 DOI: 10.33546/bnj.3014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/07/2023] [Accepted: 12/15/2023] [Indexed: 03/02/2024] Open
Abstract
Background Passive smoking poses a threat to the well-being of an unborn baby; however, women's understanding and practice in this regard remain unclear. Objective This study aimed to describe prenatal passive smoking at home based on the experiences of women in Thailand. Methods A qualitative descriptive approach was employed. Data were collected between September 2020 and April 2022 through semi-structured in-depth interviews with 16 postpartum women purposively selected from five hospitals. Thematic analysis was used for data analysis. Results Three themes emerged. The first theme, 'safeguard for an unborn baby,' was performed through smoking reduction, far distance, abstinence from smoke/odor inhalation, and residual elimination since harm was highly aware. However, justifying safety from the absence of smoke and foul odor was misperceived. The second theme, 'intervention for smoking cessation,' was attempted through various methods, including acquired empathy, persuasion, compromise, and supportiveness. They also needed family/friend assistance in warning and professional care in terms of advice, health education, learning materials, cessation therapy, care continuation, and dealing with complex situations. The last theme, 'maternal perseverance,' was acquired by the motives of safety goals, rights/responsibilities, changeable norms, and a golden period. Conclusion Pregnant women persistently aimed to prevent their husbands from smoking and safeguard their unborn babies from passive smoking. However, misunderstandings and improper practices were observed. Healthcare and nursing services need comprehensive approaches to enhance understanding, perseverance, and tailored practices catering to women's needs.
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Imran M, Kamran A, Al-Dardery NM, Farooq DA, El-Samahy M, Ali Farho M. Intravenous Ringer's lactate versus usual care during labor in nulliparous women: a systematic review and meta-analysis of randomized controlled trials. Curr Med Res Opin 2024; 40:141-149. [PMID: 37994865 DOI: 10.1080/03007995.2023.2287608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Due to limited research on the effectiveness and safety of intravenous (IV) fluids administered during labor, there are no guidelines available. Thus, this meta-analysis aims to evaluate efficacy of IV Ringer's lactate during labor as compared to usual care. METHODS Six databases were searched for the randomized controlled trials (RCTs) comparing the effects of IV Ringer's lactate at 125 mL/h or 250 mL/hr during labor in nulliparous women at term as compared to usual care, and the search results were imported to Covidence for screening of the articles. All the concerned outcomes were pooled as risk ratios (RR) or mean difference (MD) with 95% CI in the meta-analysis models using RevMan 5.4. RESULTS Pooled data from 7 RCTs with 967 nulliparous women showed that the active stage of labor duration (MD -32.16 with 95% CI [40.43 to -23.90], p < 0.00001), need of oxytocin augmentation (RR 0.72 with 95% CI [0.54 to 0.96], p = 0.03) and incidence of prolonged labor (RR 0.57 with 95% CI [0.34 to 0.95], p = 0.03) was significantly lower with IV Ringer's lactate. However, the total duration of labor (p = 0.23), duration of second stage of labor (p = 0.31) and cesarean section rate (p = 0.070) did not differ between the two groups. The test for subgroup analysis based on infusion rate was significant (p = 0.01) for the active stage of labor. CONCLUSION IV Ringer's lactate reduced the duration of active labor, the need for oxytocin augmentation and the prolonged labor incidence. However, it did not differ in effect on immediate neonatal health but was found to have more potential for reducing maternal vomiting as compared to usual care with unrestricted oral intake. Further research is needed to explore its effects in the larger and more diverse populations and with different IV fluids for evidence-based guidelines.
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Affiliation(s)
- Muhammad Imran
- University College of Medicine and Dentistry, University of Lahore, Lahore, Pakistan
| | - Ateeba Kamran
- Karachi Medical and Dental College, Karachi, Pakistan
| | | | - Dawood Azam Farooq
- University College of Medicine and Dentistry, University of Lahore, Lahore, Pakistan
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El-Samahy M, Mouffokes A, Badawy MM, Amro S, Fayad T, Abdelwahab OA. Safety and efficacy of oxybutynin in patients with hyperhidrosis: systematic review and meta-analysis of randomized controlled trials. Arch Dermatol Res 2023; 315:2215-2226. [PMID: 36869926 PMCID: PMC10462517 DOI: 10.1007/s00403-023-02587-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/04/2022] [Accepted: 02/16/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Sweating is a physiologic mechanism of human thermoregulation. Hyperhidrosis is defined as a somatic disorder where the sweating is exaggerated in an exact area because the sweat glands are hyperfunctioning. It negatively affects the quality of life of the patients. We aim to investigate patient satisfaction and the effectiveness of oxybutynin in treating hyperhidrosis. METHODS We prospectively registered the protocol of this systematic review and meta-analysis on PROSPERO (CRD 42022342667). This systematic review and meta-analysis were reported according to the PRISMA statement guidelines. We searched three electronic databases (PubMed, Scopus, Web of Science) from inception until June 2, 2022, using MeSH terms. We include studies comparing patients with hyperhidrosis who received oxybutynin or a placebo. We assessed the risk of bias using the Cochrane risk of bias assessment tool (ROB2) for randomized controlled trials. The risk ratio was calculated for categorical variables, and the mean difference was calculated for continuous variables using the random effect model with 95% confidence intervals (CI). RESULTS Six studies were included in the meta-analysis, with a total of 293 patients. In all studies, patients were assigned to receive either Oxybutynin or Placebo. Oxybutynin represented an HDSS improvement (RR = 1.68 95% CI [1.21, 2.33], p = 0.002). It also can improve the quality of life. There is no difference between oxybutynin and placebo regarding dry mouth (RR = 1.68 95% CI [1.21, 2.33], p = 0.002). CONCLUSION Our study suggests that using oxybutynin as a treatment for hyperhidrosis is significant and needs to be highlighted for clinicians. However, more clinical trials are needed to grasp the optimum benefit.
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Affiliation(s)
- Mohamed El-Samahy
- Medical Research Group of Egypt, Cairo, Egypt.
- Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Adel Mouffokes
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Medicine, University of Oran, Ahmed Ben Bella 1, Oran, Algeria
| | - Marwa M Badawy
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Medicine, October 6 University, Giza, Egypt
| | - Sarah Amro
- Medical Research Group of Egypt, Cairo, Egypt
- Al-Najah National University, Nablus, Palestine
| | - Taha Fayad
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Oral and Dental Medicine, Sinai University, Al-Arish, North Sinai, Egypt
| | - Omar Ahmed Abdelwahab
- Medical Research Group of Egypt, Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Tran DD, Davis JP, Ring C, Buch K, Fitzke RE, Pedersen ER. Informing the development of interventions for e-cigarette use and prevention of transition to cigarette smoking in young adults: A qualitative study. Prev Med Rep 2023; 35:102332. [PMID: 37519444 PMCID: PMC10382918 DOI: 10.1016/j.pmedr.2023.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023] Open
Abstract
E-cigarette use in young individuals may increase risk for cigarette smoking initiation. Over half of young adults who use e-cigarettes voiced their desire to quit e-cigarettes. Mobile-based interventions may allow for an easy-to-use platform to engage young adults in cessation services and reduce risk for cigarette uptake. To inform development of such programs, this study sought to gather information about what young adults want to see included in e-cigarette cessation interventions that also target future smoking risk. Nine online focus groups (n = 33) were conducted in July and August 2022 with young adults who either (1) currently used e-cigarettes, (2) formerly used e-cigarettes, or (3) initiated nicotine use with e-cigarettes but subsequently smoked cigarettes (dual use). Two research team members independently coded the transcripts and identified themes. A third researcher independently reviewed the coding and thematic analysis. Participants believed that mobile-based interventions should include peer support, ways to track cessation progress, education about the harms of e-cigarettes, gamification, and incentivization. They also believed that to prevent future cigarette smoking, interventions need to include education about the harms of smoking, teach refusal skills for offers to smoke, and incorporate personal anecdotes from former smokers. To increase their readiness, motivation, and self-efficacy to quit, participants who continue to use e-cigarettes reported needing effective substitutions to replace e-cigarettes, barriers to hinder their access to e-cigarettes, and social support. Findings from this study may be useful to incorporate when developing interventions designed to reduce e-cigarette use and risk of progression to smoking for young adults.
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Affiliation(s)
- Denise D. Tran
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
| | - Jordan P. Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th Street, Los Angeles, CA 90089, USA
| | - Colin Ring
- Loma Linda University School of Behavioral Health, Department of Psychology, 11130 Anderson Street, Loma Linda, CA 92354, USA
| | - Keegan Buch
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
| | - Reagan E. Fitzke
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
| | - Eric R. Pedersen
- University of Southern, California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street Suite #2200, Los Angeles, CA 90033, USA
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Yuan P, Westmaas JL, Thrul J, Toussaert S, Hilton JF, White JS. Effectiveness of Peer-Support Interventions for Smoking Cessation: A Systematic Review and Meta-analysis. Nicotine Tob Res 2023; 25:1515-1524. [PMID: 37042206 DOI: 10.1093/ntr/ntad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/23/2023] [Accepted: 04/10/2023] [Indexed: 04/13/2023]
Abstract
INTRODUCTION Peer support has been recommended to promote smoking cessation, but results from prior meta-analyses have not established its efficacy. We conducted a systematic review and meta-analysis to assess current evidence and identify potential modifiers of efficacy. METHODS Randomized controlled trials of peer-support interventions with a smoking cessation outcome were identified in January 2022 from PubMed and references listed in identified studies. The meta-analysis outcome measure was mean risk ratio (RR, 95% confidence interval [CI]) for abstinence at the longest follow-up timepoint between 3 and 9 months from baseline. Potential modifiers tested were peer smoking status (former, current, or unknown), follow-up timepoint, abstinence measure, and cumulative engagement time between peers and smokers ("dose"). Studies were assessed for risk of bias and certainty of evidence. RESULTS We identified 16 trials, which varied in abstinence effect size (RR 0.61-3.07), sample size (23-2121), dose (41-207 minutes), and follow-up timepoint (<1-15 months). Across 15 trials with follow-up between 3 and 9 months (N = 8573 participants; 4565 intervention, 4008 control), the pooled Mantel-Haenszel RR was 1.34 (95% CI: 1.11-1.62). Effect sizes were greatest among interventions with formerly smoking peers (RR 1.43, 95% CI 1.17-1.74; five trials). We found positive effects for follow-up timepoints ≥3 months but no effect of intervention dose. The overall quality of evidence was deemed "very low." CONCLUSIONS Peer-support interventions increased smoking abstinence. There remains a lack of consensus about how to define a peer. Intervention features such as peer smoking status appear to have explanatory power. Additional high-quality and more comparable trials are needed. IMPLICATIONS This study reviewed the latest evidence from randomized controlled trials and found that peer-support interventions enhance smoking cessation. Efficacy varies with key intervention features such as peer smoking status and follow-up timepoint, which may be used to facilitate development of more effective peer-support interventions. Future trials and reviews would benefit from careful consideration and clear reporting of peer smoking status, length of follow-up, abstinence measures, and intervention dose.
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Affiliation(s)
- Patrick Yuan
- Cancer Clinical Trials Office, Stanford University, Palo Alto, CA, USA
| | - J Lee Westmaas
- Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | | | - Joan F Hilton
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Justin S White
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Xia M, He Q, Ying G, Fei X, Zhou W, He X. Clinical Efficacy and Safety of Massage for the Treatment of Restless Leg Syndrome in Hemodialysis Patients: A Meta-Analysis of 5 Randomized Controlled Trials. Front Psychiatry 2022; 13:843263. [PMID: 35479488 PMCID: PMC9035587 DOI: 10.3389/fpsyt.2022.843263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Aim We conducted this meta-analysis to evaluate the clinical efficacy and safety of massage for the treatment of hemodialysis patients with restless leg syndrome (RLS). Methods A comprehensive literature search was performed using the PubMed database, EMBASE database (via OVID), and the Cochrane Library in order to identify eligible randomized controlled trials (RCTs) published before August 31, 2021. After extracted essential data and assessed risk of bias of each eligible study, we calculated the pooled estimate of RLS score and safety after treatment. Statistical analysis was performed by using Review Manager 5.3. Results Five studies involving 369 hemodialysis patients with RLS were analyzed. The RLS score after treatment [mean difference (MD), -12.01; 95% confidence interval (CI), -14.91 to -9.11] and mean difference of RLS score at the beginning and end of treatment [mean difference (MD), -11.94; 95% confidence interval (CI), -15.45 to -8.43] in a massage group was significantly better than that in route care group. Subgroup analysis suggested that massage with lavender oil also significantly reduced the RLS score after treatment (MD, -14.22; 95% CI, -17.81 to -10.63) and mean difference of RLS score at the beginning and end of treatment (MD, -14.87; 95% CI, -18.29 to -11.45) compared with route care. Meanwhile, massage regime significantly relieved RLS severity compared with route care but did not increase adverse events. Conclusion Massage may be a preferred treatment modality for hemodialysis patients with RLS because it effectively reduces RLS symptoms, relieves RLS severity, and does not increase the risk of adverse events. However, future study with a larger sample size is warranted due to the fact that only limited number of eligible studies with small sample size are enrolled.
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Affiliation(s)
- Min Xia
- Department of Nephrology, Beilun People’s Hospital, Ningbo, China
| | - Qien He
- Department of Nephrology, Beilun People’s Hospital, Ningbo, China
| | - Guanghui Ying
- Department of Nephrology, Beilun People’s Hospital, Ningbo, China
| | - Xiapei Fei
- Department of Nephrology, Beilun People’s Hospital, Ningbo, China
| | - Wenjing Zhou
- Department of Nephrology, Beilun People’s Hospital, Ningbo, China
| | - Xuelin He
- Department of Nephrology, Beilun People’s Hospital, Ningbo, China
- Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, China
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