Meta-analysis of the effect of exercise intervention on cognitive function in elderly patients with type 2 diabetes mellitus.

OBJECTIVE: Cognitive dysfunction is a common complication of diabetes after central nervous system involvement. The impact of exercise, as an important non-pharmacological intervention strategy, on cognitive function remains controversial. Thus, we conducted a meta-analysis to assess the impact of exercise on cognitive function of elderly patients with type2 diabetes mellitus (T2DM). METHODS: We computer searched PubMed, Web of Science, Embase, CINAHL, Cochrane Library, CNKI, Wanfang date, and VIP, and traced back the references included in the literature from 1974 to July 2024. We used RevMan5.4 software for data analysis, and also conducted sensitivity, subgroup, and publication bias analyses. RESULTS: Eight eligible studies with a combined total of 747 elderly patients with T2DM were included. Meta-analysis showed that the combined effect size of exercise intervention on cognitive improvement in elderly patients with T2DM was significant [SMD = 0.65, 95% CI (0.48, 0.82), P < 0.01]. The following three factors had significant effects on the overall cognitive function of participants: subgroups (MoCA group [MD = 2.22 95% CI (1.26, 3.18), P < 0.01] and MMSE group [MD = 1.81, 95% CI (0.71,2.90), P = 0.001]); intervention times (3-month intervention [MD = 3.14, 95% CI (2.50, 3.78), P < 0.01], 6-month intervention [SMD = 0.32, 95% CI (0.12. 0.52), P = 0.002], and > 6 month intervention [SMD = 0.21, 95% CI (0.45, 0.81), P < 0.01]); intervention forms (single exercise [SMD = 0.21, 95% CI (0.45, 0.81), P < 0.01] and multiple exercise [SMD = 0.86, 95% CI ( 0.39,1.33), P < 0.0001]). CONCLUSION: Exercise intervention may improve cognitive function in elderly patients with T2DM.

Effect of peer support interventions in patients with type 2 diabetes: A systematic review.

OBJECTIVE: This study aims to assess the effectiveness of a peer support intervention on the quality of life (QOL), self-management, self-efficacy, glycated hemoglobin (HbA1c), and depression in patients with type 2 diabetes mellitus (T2DM). METHODS: A systematic review was conducted by searching 10 databases, namely PubMed, The Cochrane Library, Embase, Medline, CINHAL, Web of Science, Sinomed, CNKI, WanFang Data, and VIP for articles published from January 1974 to April 2023. RESULTS: A total of 12 studies were included. A narrative synthesis of the results showed that peer support significantly improved QOL, self-management, self-efficacy, and HbA1c control in patients with T2DM, but had no significant effect on depression. CONCLUSION: Peer support is an effective intervention for individuals with T2DM. Future research should focus on more rigorously designed and larger-sample studies. PRACTICE IMPLICATIONS: Peer support proves to be effective for managing patients with T2DM. Current peer support interventions can provide valuable ideas that can guide the direction of future research.

Factors Related to Activation in Chinese Patients With Chronic Obstructive Pulmonary Disease: A Cross-Sectional Survey Study.

BACKGROUND: Improving patient activation can lead to better health outcomes among patients with chronic obstructive pulmonary disease (COPD). However, no studies have focused on the issue of activation in patients with COPD in China. PURPOSE: This study was designed to explore the status of activation in patients with COPD in China and explicate the significant influencing factors. METHODS: One hundred seventy patients with COPD were recruited using a convenience sampling method from eight tertiary and secondary hospitals in Nanjing, China. Sociodemographic, clinical, and patient-reported factor data were collected. Univariate analysis and multivariate linear regression were performed. RESULTS: Only 10.6% of the patients were identified as activated for self-management. Multivariate linear regression analysis revealed four explanatory elements as significantly associated with patient activation, including social support (ß = .463, p < .001), free medical insurance (ß = .173, p = .007), smoking status (ß = -.195, p = .002), and health status (ß = -.139, p = .04). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study indicate that a minority of patients with COPD are activated for self-management in China. Having a higher level of patient activation was associated with having better social support, having free medical insurance, being a nonsmoker, and having a better health status. Creating a supportive environment, promoting smoking cessation, and improving medical security and health status may be considered as potential strategies to activate patients into better self-management.

Video versus direct laryngoscopy on successful first-pass endotracheal intubation in ICU patients.

BACKGROUND: Airway management in intensive care unit (ICU) patients is challenging. The aim of this study was to compare the rate of successful first-pass intubation in the ICU by using the direct laryngoscopy (DL) and that by using the video laryngoscopy (VL). METHODS: A randomized, non-blinded trial comparing first-pass success rate of intubation between VL and DL was performed. Patients were recruited in the period from August 2014 to August 2016. All physicians working at ICU received hands-on training in the use of the video and direct laryngoscope. The primary outcome measure was the first-pass intubation success. RESULTS: A total of 163 ICU patients underwent intubation during the study period (81 patients in VL group and 82 in DL group). The rate of successful first-pass intubation was not significantly different between the VL and the DL group (67.9% vs. 69.5%, P=0.824). Moreover, the overall intubation success and total number of attempts to achieve intubation success did not differ between the two groups. In patients with successful first-pass intubation, the median duration of the intubation procedure did not differ between the two groups. The Cormack-Lehane grades and the percentage of glottic opening score were similar, and no significant differences were found between the two groups. There were no statistical differences between the VL and the DL group in intubation complications (all P>0.05). CONCLUSION: Among ICU patients requiring intubation, there was no significant difference in the rate of successful first-pass intubation between VL and DL.

Efficacy of intermittent pneumatic compression for venous thromboembolism prophylaxis in patients undergoing gynecologic surgery: A systematic review and meta-analysis.

We sought to comprehensively assess the efficacy of Intermittent Pneumatic Compression (IPC) in patients undergoing gynecologic surgery. A computerized literature search was conducted in Pubmed, Embase and Cochrane Library databases. Seven randomized controlled trials involving 1001 participants were included. Compared with control, IPC significantly lowered the deep vein thrombosis (DVT) risk [risk ratio (RR) = 0.33, 95% confidence interval (CI): 0.16 - 0.66]. The incidence of DVT in IPC and drugs group was similar (4.5% versus. 3.99%, RR = 1.19, 95% CI: 0.42 - 3.44). With regards to pulmonary embolism risk, no significant difference was observed in IPC versus control or IPC versus drugs. IPC had a lower postoperative transfusion rate than heparin (RR = 0.53, 95% CI: 0.32 - 0.89), but had a similar transfusion rate in operating room to low molecular weight heparin (RR = 1.06, 95% CI: 0.69 - 1.63). Combined use of IPC and graduated compression stockings (GCS) had a marginally lower risk of DVT than GCS alone (RR = 0.38, 95% CI: 0.14 - 1.03). In summary, IPC is effective in reducing DVT complications in gynecologic surgery. IPC is neither superior nor inferior to pharmacological thromboprophylaxis. However, whether combination of IPC and chemoprophylaxis is more effective than IPC or chemoprophylaxis alone remains unknown in this patient population.