Minimally Invasive Treatments for Benign Prostatic Hyperplasia: Systematic Review and Network Meta-Analysis

PurposeTo review and to compare indirectly the outcomes of minimally invasive therapies for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia.Materials and MethodsA literature search via Medline and Cochrane Central databases was completed for randomized control studies published between January 2000 to April 2020 for the following therapies: Rezum, Urolift, Aquablation, and prostatic artery embolization (PAE). Data on the following variables were included: International prostate symptom score (IPSS), maximum urinary flow rate, quality of life, and postvoid residual (PVR). Standard mean differences between treatments were compared through a meta-analysis using transurethral resection of the prostate (TURP) to assess differences in treatment effect.ResultsThere was no significant difference in outcomes between therapies for IPSS at the 3, 6, and 12-month follow ups. Although outcomes for Rezum were only available out to 3 months, there were no consistently significant differences in outcomes when comparing Aquablation versus PAE versus Rezum. TURP PVR was significantly better than Urolift at 3, 6, and 12 months. No significant differences in minor or major adverse events were noted.ConclusionAlthough significant differences in outcomes were limited, Aquablation and PAE were the most durable at 12 months. PAE has been well studied on multiple randomized control trials with minimal adverse events while Aquablation has limited high quality data and has been associated with bleeding-related complications.     

Impact of a web-based personally tailored physical activity intervention on depression,anxiety, stress and quality of life: Secondary outcomes from a randomized controlled trial

BackgroundFew studies have investigated the impact of web-based physical activity interventions on mental health outcomes. Therefore, this study examined the impact of a web-based personally tailored physical activity intervention on depression, anxiety, stress and quality of life.Methods501 participants were randomised into either a control group or a pooled intervention condition who received a 3-month web-based personally tailored physical activity intervention. Previously, this intervention has demonstrated to improve self-reported physical activity, but not device-measured physical activity. At baseline, 3- and 9-months, depression, anxiety and stress were assessed using the DASS21, and quality of life was assessed using the SF-12V2. General linear mixed models examined differences between groups over time.ResultsMost participants (>80%) reported normal levels of depression, anxiety or stress. Relative to baseline levels, significant reductions of depression, anxiety, stress and the SF12 mental health component were observed in the pooled intervention group at 3 and 9 months. Relative to the control group, significant reductions were observed in the pooled intervention group for depression and stress (3-months only) and anxiety (3- and 9-months), but not quality of life.ConclusionA web-based physical activity intervention can result in positive mental health outcomes, even in the absence of device-measured physical activity improvements. However, these findings need to be confirmed in future studies.Trial registration numberACTRN12615000057583.     

营养教育在腹主动脉瘤患者根治术后的临床应用

目的 探讨营养教育在腹主动脉瘤患者根治术中的应用价值。 方法 选取2017年10月至2019年10月青岛市市立 医院收治的行根治术的腹主动脉瘤患者96例，采用随机数字表法分为对照组（48例，行常规护理）和观察组（48例，行常规护理 联合营养教育），比较两组康复效果、营养指标和生活质量，另参照焦虑自评量表（SAS）和抑郁自评量表（SDS）判定患者心理状 态。 结果 观察组首次排气时间、下床活动时间和住院时间短于对照组，心理状态评分低于对照组，依从性和生活质量综合评 定问卷评分高于对照组，差异有统计学意义（P<0.05）；观察组患者体重为(68.16±6.32) kg，体质指数为（23.02±0.54）kg/m2，血清 白蛋白水平为（37.2±2.4）g/L,血清转铁蛋白水平为（2.45±0.36）g/L，血清前白蛋白水平为（267.27±25.12）mg/L，总铁结合力为 （56.17±6.24）μmol/L，高于对照组的（64.32±5.44）kg、（21.72±0.78）kg/m2 、（32.1±1.8）g/L、（2.16±0.32）g/L、（215.12±22.26）mg/L和 （50.34±5.21）μmol/L，差异有统计学意义（P<0.05）。 结论 在腹主动脉瘤患者根治术中联合营养教育可促进患者术后康复，对 患者负面情绪有缓解作用，可提高患者依从性，改善营养不良状态，促进生活质量的提升。     

COVID-19: A literature review of the impact on diagnostic radiography students

IntroductionCOVID-19 is a highly contagious viral disease declared a global pandemic in March 2020. Throughout the pandemic, radiography students have been working in hospitals on the frontline. The review aimed to search for evidence of the impact COVID-19 has had on diagnostic radiography students and consider whether additional support and learning needs to be implemented.MethodsA literature search strategy applied keywords, BOOLEAN search operators, and eligibility criteria on PubMed, Medline, and Google Scholar databases. Cormack's (2000) critique framework was chosen to methodologically appraise the mixed-method studies to evaluate the quality, validity and rigour.ResultsThe search decisions were displayed in a PRISMA flowchart to evidence the process to identify the found articles comprised of two surveys, two semi-structured interviews and one case study. The findings identified common and reoccurring themes of personal protective equipment, mental wellbeing, accommodation and travel, assessments and learning, and transitioning to registration.ConclusionThe literature suggests that students felt positive impacts of the pandemic, such as being prepared for registration. However, negative effects included the fear of contracting the virus, anxieties of working with ill patients, impracticalities of accommodation and travel during clinical placement, and the adaption to online learning.Implications for practiceClinical staff and universities need to work together to ensure students are mentally and physically supported during the pandemic. Regular meetings and agreed channels of communication with students will allow any issues to be brought to attention and addressed. In addition, employers should recognise that newly qualified radiographers will need extra support.     

瘀热型慢性前列腺炎与心理性因素及性功能的相关性

目的分析瘀热型慢性前列腺炎(CP)临床症状与心理性因素及性功能的相关性。方法收集2020年6月至2021年6月在南京市江宁中医院泌尿外科门诊诊治的91例瘀热型CP患者的临床资料进行回顾性分析,使用美国国立卫生研究院慢性前列腺炎症状指数评分表(NIH-CPSI)、中医证候量表、7项广泛性焦虑障碍量表(GAD-7)、抑郁症筛查量表(PHQ-9)、疼痛灾难化量表(PCS)、国际勃起功能评分表(IIEF-5)和早泄诊断量表(PEDT)对患者进行评估,对量表评定结果进行Pearson相关性分析和多元线性回归分析。结果(1)症状量表:NIH-CPSI总分与中医量表总分、GAD-7总分呈正相关,中医证候量表总分与CPSI、GAD-7、PHQ-9、PCS、PEDT总分呈正相关(P<0.05);CPSI总分随中医量表总分递增而升高,中医证候量表总分随CPSI疼痛症状、PHQ-9总分递增而升高(P<0.05)。(2)情绪量表:GAD-7总分与CPSI、中医证候量表总分、排尿症状、PHQ总分、PEDT总分呈正相关,PHQ-9总分与中医证候量表总分、疼痛及排尿症状、PCS总分、PEDT总分呈正相关,PCS总分与中医证候量表总分及疼痛症状分值呈正相关(P<0.05);GAD-7总分随PHQ-9总分递增而升高;PHQ-9总分随中医证候量表排尿症状、GAD-7、PCS分值递增而升高;PCS总分随中医证候量表疼痛症状、PHQ-9分值递增而升高(P<0.05)。(3)性功能量表:IIEF-5总分与中医证候量表疼痛分值呈负相关,PEDT总分与中医证候量表总分及疼痛症状、GAD-7、PHQ-9分值呈正相关(P<0.05);IIEF-5总分随中医证候量表疼痛症状分值递减而升高(P<0.05)。结论瘀热型CP患者表现为以疼痛为主,伴随排尿异常、情绪异常、认知障碍和性功能障碍的系列症状,同时使用中医证候量表及CPSI评估能较好的反映其病情的严重程度。     

The longitudinal associations between mental health indicators and digital media use and physical activity during adolescence: A latent class approach

IntroductionEvidence for the relationship between movement behaviors and mental health among adolescents is inconclusive. We aimed to identify profiles of digital media use (including related bedtime delay) and leisure-time physical activity (LTPA) in adolescence, and to examine whether preadolescent mental health predicted later behavior profiles.MethodsThis study included 1285 participants assessed at 11 years of age, and followed-up four years later. Participants completed the Self-Perception Profile for Children (SPPC), Center for Epidemiological Studies Depression Scale for Children (CES-DC) and Screen for Child Anxiety-Related Emotional Disorders (SCARED) at baseline, and reported digital media use (active and passive use, gaming, and related bedtime delays) and LTPA at follow-up. A latent class approach was employed to identify behavior profiles, membership of which was then predicted with mental health and covariates, including baseline digital media use and LTPA.ResultsWe identified four behavior profiles: 1) high digital media use/moderate LTPA (20% of adolescents; 78% boys), 2) moderate digital media use/high LTPA (31%; 28%), 3) high digital media use/high LTPA (26%; 15%), 4) high passive digital media use and gaming/low LTPA (23%; 89%). After adjusting for covariates, higher LTPA and better perception of athletic competence at baseline associated with higher odds of belonging to any other profile than to the unhealthiest profile (4) at follow-up. Symptoms of depression or anxiety did not associate with later behavior profiles.ConclusionsLTPA and related self-esteem seem to be stronger predictors of future digital media use and LTPA behavior during adolescence than mental health symptoms alone.