Hassan, Abdul Rhman

Advanced heart failure (HF) significantly diminishes quality of life (QoL) due to severe symptom burden and psychological distress. This meta-analysis investigates the impact of palliative care interventions on QoL, psychological well-being, symptom burden, and mortality in adults with advanced HF. A systematic search of major databases through August 2024 identified 13 randomized controlled trials involving 1541 participants from the USA, China, Iran, and Sweden. Palliative care significantly improved QoL scores compared with usual care [mean difference (MD) = 1.36; 95% confidence interval (CI), 0.89–1.83; P < 0.00001], with notable improvements using the Kansas City Cardiomyopathy Questionnaire. Palliative care significantly reduced anxiety scores (MD = −0.39; 95% CI, −0.66 to −0.11), P = 0.006), especially when assessed with the Edmonton Symptom Assessment Scale. While no significant differences were observed for dyspnea or depression ( P =0.56, P = 0.23, respectively). Mortality rates did not differ significantly between groups ( P = 0.61). These findings highlight the potential of palliative care, particularly interventions incorporating symptom management and psychological support, to enhance QoL and reduce anxiety in advanced HF patients. However, further research is required to standardize these interventions and evaluate their long-term outcomes.

Background: Pulsatile perfusion is a developing technique that attempts to mimic the natural pulsatile flow of blood during cardiopulmonary bypass (CBP). Purpose: Our meta-analysis was done to evaluate the effects of pulsatile perfusion in CPB compared to non-pulsatile on hospital stay, ICU stay, and intubation time. Methods: Randomized control trials that evaluated the implementation of pulsatile perfusion during CPB were identified by a literature search of the following databases (PubMed, Web of Science, Scopus, Central, and Embase) up to February 2024. Results: Our search yielded 33 trials with 3174 patients, the analysis showed that pulsatile perfusion led to a significant decrease in hospital stay [MD = -1.38, 95% CI (-2.51, -0.25), P = 0.016], ICU stay [MD = -0.47, 95% CI (-0.82, -0.13), P = 0.007], intubation time [MD = -3.73, 95% CI (-5.42, -2.04), P < 0.001]. However, no significant difference between the two regimens was detected in the adult subgroup when we performed sungroup analysis based on the age for hospital stay and ICU stay outcomes [MD = -0.31, 95% CI (-0.95, 0.33), P = 0.334] and [MD = -3.73, 95% CI (-5.42, -2.04), P < 0.001] respectively. Conclusion: Pulsatile perfusion showed positive effects on hospital stay, ICU stay, and intubation time. However, there was no difference between the two methods on hospital and ICU stay in the adult’s subgroup. Also, the outcomes showed significant heterogeneity, which requires more robust RCTs to be conducted to increase the quality and the certainty of evidence.

Background and Objectives: Proteomics encompasses the exploration of protein composition, regulation, function, and pathways. Its influence spans diverse clinical fields and holds promise in addressing various women’s health conditions, including cancers, osteoporosis, and cardiovascular disorders. However, no comprehensive summary of proteomics and menopausal health exists. Our objective was to summarize proteomic profiles associated with diseases and disorders in peri- and postmenopausal women. Materials and Methods: We conducted a comprehensive search of databases including PubMed, Google Scholar, the Cochrane database, Elsevier, and ScienceDirect until 2022. A total of 253 studies were identified, and 41 studies met the inclusion criteria to identify data of interest. These included the study design, disease, and proteomics/proteins of significance, as described by the authors. Results: The 41 studies covered diverse areas, including bone disorders (10 studies), cardiovascular diseases (5 studies), oncological malignancies (10 studies), and various conditions, such as obesity, nonalcoholic liver disease, the effects of hormone replacement therapy, and neurological diseases (16 studies). The results of our study indicate that proteomic profiles correlate with heart disease in peri- and postmenopausal women, with distinct sex differences. Furthermore, proteomic profiles significantly differ between women with and without osteoporosis. Additionally, patients with breast, ovarian, and endometrial cancer exhibit notable variations in proteomic profiles compared to those without these conditions. Conclusions: Proteomics has the potential to enhance risk assessment and disease monitoring in peri- and postmenopausal women. By analyzing unique protein profiles, clinicians can identify individuals with heightened susceptibility to specific diseases or those already affected by established conditions. This review suggests that there is sufficient preliminary data related to proteomics in peri- and postmenopausal women for early identification of cardiovascular disease, osteoporosis, and cancers, disease monitoring, and tailoring individualized therapies. Rigorous validation studies involving large populations are essential before drawing definitive conclusions regarding the clinical applicability of proteomic findings.