ABSTRACT
Background: Inhaled hypertonic saline (HS) reduces pulmonary exacerbations in patients with cystic fibrosis (CF) aged 6 or more years. However, the effectiveness of HS in improving clinical outcomes in younger children aged 6 or less years is not established. This study examines the efficacy of HS in younger CF patients. Methods: Searches were conducted across three databases (Medline, Cochrane Central and EMBASE) from inception through July 2022. Randomized controlled trials assessing the impact of HS in younger CF patients were included. Trials involving only patients greater than 6 years or control group other than isotonic saline (IS) were excluded. Outcomes measured included lung clearance index (LCI), cystic fibrosis questionnaire (CFQ-R) score, spirometry measures, oxygen saturation, respiratory rate, height and weight. Outcomes were reported as mean differences (MDs) with 95% confidence intervals. Results: Seven studies (n = 390 patients) were included in this review. HS significantly reduced the LCI (MD: -0.67; 95%CI, -1.05 to 0.29, P = 0.0006) compared to IS. In addition, HS was associated with significant improvements in height (MD: 2.23; 95%CI, -0.00 to 4.46, P = 0.05) and CFQ-R (MD: 4.30; 95%CI, 0.65-7.95, P = 0.02), but not in oxygen saturation (MD: -0.15; 95%CI, -0.54 to 0.25, P = 0.47), respiratory rate (MD: -0.21; 95%CI, -2.19 to 1.77, P = 0.83) or weight (MD: 0.70; 95%CI, -0.47 to 1.87, P = 0.24). Furthermore, HS did not significantly improve spirometry measures, including FEV1 (MD: -0.11; 95%CI, -0.21 to 0.43, P = 0.51) and forced vital capacity (MD: 0.27; 95%CI, -0.49 to 1.04, P = 0.48), but significantly improved FEF25-75 (MD: 0.12; 95% CI, 0.05-0.20; P = 0.002). Discussion: Treatment with HS in younger children with CF improves lung clearance, symptoms and quality of life. FEF25-75 may prove a more sensitive measure for assessing intervention related improvements in pediatric CF trials. Conclusion: The findings support HS as a therapeutic method in CF-affected children.
ABSTRACT
OBJECTIVE: Preventing hospital-acquired pressure injuries (PI) in critically ill patients remains a significant clinical challenge because of its associated high risk for comorbid conditions. We assessed the preventive effectiveness of silicone dressings among patients admitted in intensive care units and non-intensive care units settings. METHODS: A literature search was conducted across 3 electronic databases (MEDLINE, EMBASE, Cochrane Central) from inception through December 2021. Studies assessing the effectiveness of silicone dressing on the incidence of PI on the sacral area were included. Evaluations were reported as risk ratios (RRs) with 95% confidence interval, and analysis was performed using a random-effects model. RESULTS: Of the 1056 articles retrieved from the initial search, 11 studies were included in the final analysis. Silicone dressings significantly reduced the incidence of PI compared to usual care (RR: 0.30, 95% CI: 0.19-0.45, P<0.01). We found no significant difference between results of studies conducted in intensive care settings (RR=0.25, 95% CI: 0.15-0.43, P<0.01) and non-intensive care settings (RR=0.38, 95% CI: 0.17-0.83, P=0.01) (P-interaction: 0.39). Silicone dressings reduced the risk of developing PI among patients using five-layer foam Border dressing (Mepilex® Sacrum) (RR: 0.31, 95% CI: 0.20-0.48, P<0.01), and dressing Allevyn Gentle Border® (RR: 0.10, 95% CI: 0.01-0.73, P=0.02) with no significant difference upon subgroup analysis (P-interaction: 0.27). CONCLUSION: The present meta-analysis suggests that silicone dressings consistently reduce the incidence of PI in intensive as well as in non-intensive care settings, regardless of the type of dressing used.
Subject(s)
Pressure Ulcer , Silicones , Humans , Bandages , Intensive Care Units , Pressure Ulcer/prevention & control , Pressure Ulcer/epidemiology , HospitalizationABSTRACT
Objective: To gain information on the marijuana experiences and expectancies of youth in an urban Indian area, which may be used for forming the framework for the development of effective primary prevention strategies in the future. Method: This was a cross-sectional study conducted in various colleges of Mumbai; 260 students from three colleges who were above 18 years were selected by systematic random sampling. The participant had to fill a sociodemographic questionnaire and marijuana effect expectancy questionnaire (MEEQ-B) and it was analyzed by using the SPSS software. Results: A significant association was found between negative marijuana expectancies and type of family, with cannabis users and non-users, who want to try cannabis and those who are aware of the legal issues and harmful effects of cannabis. Conclusion: Preventive drug education should begin in early adolescence and should deter or delay drug use through changes in knowledge, attitude, behavior, and expectation. Adolescent drug education must meet the needs of those naive to drugs as well as those experiencing initial drug exposure. This is the first study which highlights the youth experiences and expectancies about marijuana in India.
ABSTRACT
Objetivo: La prevención de las lesiones por presión (LPP) adquiridas en el hospital en pacientes críticos sigue siendo un reto clínico importante debido a su alto riesgo de comorbilidad asociada. Se evaluó la eficacia preventiva de los apósitos de silicona en los pacientes ingresados en las unidades de cuidados intensivos y en entornos no relacionados con dichas unidades. Métodos: Se realizó una búsqueda bibliográfica en 3bases de datos electrónicas (MEDLINE, EMBASE, Cochrane Central) desde el inicio hasta diciembre de 2021. Se incluyeron los estudios que evaluaban la eficacia de los apósitos de silicona en la incidencia de LPP en la zona sacra. Las evaluaciones se informaron como ratios de riesgo relativo (RR) con intervalos de confianza al 95% y el análisis se hizo mediante un modelo de efectos aleatorios. Resultados: De los 1.056 artículos recuperados en la búsqueda inicial, se incluyeron 11estudios en el análisis final. Los apósitos de silicona redujeron significativamente la incidencia de LPP en comparación con la atención habitual (RR: 0,30; IC 95%: 0,19-0,45; p<0,01). No se encontraron diferencias significativas entre los resultados de los estudios en contextos de cuidados intensivos (RR=0,25; IC 95%: 0,15-0,43; p<0,01) y en contextos de cuidados no intensivos (RR=0,38; IC 95%: 0,17-0,83; p=0,01) (interacción de p: 0,39). Los apósitos de silicona redujeron el riesgo de desarrollar LPP entre los pacientes que utilizaron el apósito de espuma de 5capas Border (Mepilex® Sacrum) (RR: 0,31; IC 95%: 0,20-0,48; p<0,01) y el apósito Allevyn Gentle Border® (RR: 0,10; IC 95%: 0,01-0,73; p=0,02) sin diferencias significativas tras el análisis de subgrupos (interacción de p: 0,27). Conclusión: El presente metaanálisis señala que los apósitos de silicona reducen de forma consistente la incidencia de las LPP en entornos de cuidados intensivos y no intensivos, independientemente del tipo de apósito utilizado.(AU)
Objective: Preventing hospital-acquired pressure injuries (PI) in critically ill patients remains a significant clinical challenge because of its associated high risk for comorbid conditions. We assessed the preventive effectiveness of silicone dressings among patients admitted in intensive care units and non-intensive care units settings. Methods:A literature search was conducted across 3electronic databases (MEDLINE, EMBASE, Cochrane Central) from inception through December 2021. Studies assessing the effectiveness of silicone dressing on the incidence of PI on the sacral area were included. evaluations were reported as risk ratios (RRs) with 95% confidence interval, and analysis was performed using a random-effects model. Results: Of the 1,056 articles retrieved from the initial search, 11studies were included in the final analysis. Silicone dressings significantly reduced the incidence of PI compared to usual care (RR: 0.30, 95%CI: 0.19-0.45, P<0.01). We found no significant difference between results of studies conducted in intensive care settings (RR=0.25, 95%CI: 0.15-0.43, P<0.01) and non-intensive care settings (RR=0.38, 95%CI: 0.17-0.83, P=0.01) (P-interaction: 0.39). Silicone dressings reduced the risk of developing PI among patients using five-layer foam Border dressing (Mepilex® Sacrum) (RR: 0.31, 95%CI: 0.20-0.48, P<0.01), and dressing Allevyn Gentle Border® (RR: 0.10, 95%CI: 0.01-0.73, P=0.02) with no significant difference upon subgroup analysis (P-interaction: 0.27). Conclusion: The present meta-analysis suggests that silicone dressings consistently reduce the incidence of PI in intensive as well as in non-intensive care settings, regardless of the type of dressing used.(AU)