The effect of music during bronchoscopy: A meta-analysis.

Bronchoscopy is considered a stressful procedure performed on patients. Hence, the use of music to ease the anxiety of patients has been examined in various studies, but the results have been inconclusive. The aim of this review is to synthesize the findings of previous studies on the effects of music therapy on the physiological outcomes of patients undergoing bronchoscopy. An electronic database search was performed to identify the literature. Random-effects model was used to combine the results, and meta-regression was used to explore the heterogeneity. Seven studies with 829 subjects were included. Results showed that the combined mean differences (95% confidence interval) for systolic and diastolic blood pressure were -11.99 (-15.82, -6.57) and -4.84 (-7.78, -1.90) mm Hg, respectively, whereas that for heart rate was -10.57 (-16.63, -4.51) beats per minute. In conclusion, listening to music reduced blood pressure and heart rate among patients undergoing bronchoscopy.

The incidence of cancer deaths among hypertensive patients in a large Chinese population: a cohort study.

Current evidence is mixed regarding the association between antihypertensive prescriptions and cancer mortality. We evaluated this association in a large Chinese hypertensive population. We followed for five years all patients who were prescribed their first-ever antihypertensive agents between 2001 and 2005 in a public healthcare sector of Hong Kong. The association between antihypertensive drug class and cancer mortality was evaluated by Cox proportional hazard models with propensity score matching. Age, gender, socioeconomic status, service settings, district of residence, proportion of days covered reflecting medication adherence, and the number of comorbidities were adjusted. From 217,910 eligible patients, 9500 (4.4%) died from cancer within five years after their first-ever antihypertensive prescription. Most cancer deaths occurred in the digestive (38.9%) and respiratory system (30.4%); the breast (6.2%); and the lympho-hematopoietic tissues (5.3%). The proportion of patients who died from cancer was the highest in the calcium channel blocker (CCB) group (6.5%), followed by thiazide diuretics (4.4%), angiotensin converting enzyme inhibitors (4.2%) and ß-blockers (2.6%). When compared with ß-blockers, patients prescribed CCBs (Adjusted Hazard Ratio [AHR]=1.406, 95% C.I. 1.334-1.482, p<0.001) were more likely to die from cancer. Thiazide users were also more likely to suffer from cancer deaths (AHR=1.364, 95% C.I. 1.255-1.483, p<0.001), but became insignificant in stratified analysis. The association between cancer mortality and use of CCB, and perhaps thaizide, may alert physicians to the need for more meticulous and comprehensive care of these patients in clinical practice. We recommend prospective studies to evaluate cause-and-effect relationships of these associations.

Efficacy of auricular therapy for pain management: a systematic review and meta-analysis.

Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [-2.36, -0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain.

The sustaining effects of Tai chi Qigong on physiological health for COPD patients: a randomized controlled trial.

OBJECTIVES: To evaluate the sustaining effects of Tai chi Qigong in improving the physiological health for COPD patients at sixth month. DESIGN: A randomized controlled trial. Subjects were in three randomly assigned groups: Tai chi Qigong group, exercise group, and control group. SETTING: The 206 subjects were recruited from five general outpatient clinics. INTERVENTIONS: Tai chi Qigong group completed a 3-month Tai chi Qigong program. Exercise group practiced breathing and walking as an exercise. Control group received usual care. MAIN OUTCOME MEASURES: Primary outcomes included six-minute walking distance and lung functions. Secondary outcomes were dyspnea and fatigue levels, number of exacerbations and hospital admissions. RESULTS: Tai chi Qigong group showed a steady improvement in exercise capacity (P<.001) from baseline to the sixth month. The mean walking distance increased from 298 to 349 meters (+17%). No significant changes were noted in the other two groups. Tai chi Qigong group also showed improvement in lung functions (P<.001). Mean forced expiratory volume in 1s increased from .89 to .99l (+11%). No significant change was noted in the exercise group. Deterioration was found in the control group, with mean volume decreased from .89 to .84l (-5.67%). Significant decreased in the number of exacerbations was observed in the Tai chi Qigong group. No changes in dyspnea and fatigue levels were noted among the three groups. CONCLUSIONS: Tai chi Qigong has sustaining effects in improving the physiological health and is a useful and appropriate exercise for COPD patients.

Add-on effect of chinese herbal medicine on mortality in myocardial infarction: systematic review and meta-analysis of randomized controlled trials.

In China, Chinese herbal medicine (CHM) is widely used as an adjunct to biomedicine (BM) in treating myocardial infarction (MI). This meta-analysis of RCTs evaluated the efficacy of combined CHM-BM in the treatment of MI, compared to BM alone. Sixty-five RCTs (12,022 patients) of moderate quality were identified. 6,036 patients were given CHM plus BM, and 5,986 patients used BM only. Combined results showed clear additional effect of CHM-BM treatment in reducing all-cause mortality (relative risk reduction (RRR) = 37%, 95% CI = 28%-45%, I(2) = 0.0%) and mortality of cardiac origin (RRR = 39%, 95% CI = 22%-52%, I(2) = 22.8). Benefits remained after random-effect trim and fill adjustment for publication bias (adjusted RRR for all-cause mortality = 29%, 95% CI = 16%-40%; adjusted RRR for cardiac death = 32%, 95% CI = 15%-46%). CHM is also found to be efficacious in lowering the risk of fatal and nonfatal cardiogenic shock, cardiac arrhythmia, myocardial reinfarction, heart failure, angina, and occurrence of total heart events. In conclusion, addition of CHM is very likely to be able to improve survival of MI patients who are already receiving BM. Further confirmatory evaluation via large blinded randomized trials is warranted.

Tai chi Qigong improves lung functions and activity tolerance in COPD clients: a single blind, randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of a Tai chi Qigong (TCQ) program in enhancing respiratory functions and activity tolerance in clients with chronic obstructive pulmonary disease (COPD). DESIGN: A single-blind, randomized controlled trial. SETTING: Five general outpatient clinics in Hong Kong. INTERVENTION: In total, 206 COPD clients were randomly assigned into one of the three groups, namely, TCQ, exercise, and control group. Subjects in the TCQ group received a TCQ program consisting of two 60-min sessions each week for three months. Subjects in the exercise group were taught to practice breathing techniques combined with walking as an exercise. Subjects in the control group were instructed to maintain their usual activities. Data collection was performed at baseline and at the 6-week and 3-month marks. OUTCOMES: Lung functions, 6-min walk test, and COPD exacerbation rate. RESULTS: Results of repeated measures of analysis of covariance demonstrated that there were significant interaction effects between time and group in forced vital capacity (p=.002, η(2)=.06), forced expiratory volume in 1s (p<.001, η(2)=.02), walking distance (p<.001), and exacerbation rate (p=.006, η(2)=.06) at 3 months. Improvements were noted in the TCQ group. No changes were observed in the exercise group, while a decline in lung functions was noticed in the control group. CONCLUSION: Tai chi Qigong was able to improve respiratory functions and activity tolerance level in COPD clients. The breathing and walking exercise helped maintain lung functions and slow down disease progression.

Effectiveness of a Tai chi Qigong program in promoting health-related quality of life and perceived social support in chronic obstructive pulmonary disease clients.

PURPOSE: This paper evaluates the effectiveness of a 3-month Tai chi Qigong (TCQ) program in promoting the psychosocial functional health of clients with chronic obstructive pulmonary disease (COPD) in Hong Kong. METHODS: This study employed a single-blind, randomized controlled trial. Two hundred and six COPD clients were randomly assigned into three groups, namely, TCQ group, exercise group, and control group. Subjects in the TCQ group received a TCQ program, consisting of two 60-min sessions each week for 3 months. Subjects in the exercise group were taught to practice breathing techniques combined with walking as an exercise. Subjects in the control group received their usual care. Data collections were performed at baseline, on the sixth week and on the third month. The primary outcomes were health-related quality of life using St. George Respiratory Questionnaire-Hong Kong Chinese version and perceived social support using the Multidimensional Scale of Perceived Social Support-Chinese version. RESULTS: The TCQ group showed greater improvements in the symptom (F4, 404=3.351, P=0.010) and activity domains (F4, 404=2.611, P=0.035). No differences were detected in perceived social support among the three groups. CONCLUSIONS: Tai chi Qigong promoted health outcomes with respect to clients' perception of their respiratory symptoms. Moreover, TCQ decreased disturbances to their physical activities.

Effect of music on procedure time and sedation during colonoscopy: a meta-analysis.

AIM: To integrate results from different studies in examining the effectiveness of music in reducing the procedure time and the amount of sedation used during colonoscopic procedure. METHODS: An electronic search in various databases was performed to identify related articles. Study quality was evaluated by the Jadad's scale. The random effect model was used to pool the effect from individual trials and the Cohen Q-statistic was used to determine heterogeneity. Egger's regression was used to detect publication bias. RESULTS: Eight studies with 722 subjects were included in this meta-analysis. The combined mean difference for the time taken for the colonoscopy procedure between the music and control groups was -2.84 with 95% CI (-5.61 to -0.08), implying a short time for the music group. The combined mean difference for the use of sedation was -0.46 with 95%CI (-0.91 to -0.01), showing a significant reduction in the use of sedation in the music group. Heterogeneity was observed in both analyses but no publication bias was detected. CONCLUSION: Listening to music is effective in reducing procedure time and amount of sedation during colonoscopy and should be promoted.