ABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Bronchial asthma is regarded as one of the most common diseases burdening young children worldwide. Family-focused interventions show promising results in achieving asthma control.<br /></p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This meta-analysis was conducted to determine the effectiveness of family-focused interventions among patients with bronchial asthma on 1) prevention of ED visit, 2) improvement of quality of life, 3) improvement of lung function, 4) limitation of activities and 5) family-related outcomes.<br /></p><p style="text-align: justify;"><strong>METHODS:</strong> This is a meta analysis of randomized controlled studies on the effectiveness of family interventions in the control of asthma of pediatric patients. Eligible studies for the meta-analysis were searched on electronic databases of Pubmed, Cochrane, Grey Literature and by cross referencing. These studies were reviewed by two investigators. These studies were then grouped into educational and psychological interventions. Similar outcomes such as asthma control, lung function and QOL were compared between groups.<br /></p><p style="text-align: justify;"><strong>RESULTS:</strong> There were no statistically significant differences between intervention and control groups in the studies that used educational intervention (RR 0.93 [0.64, 1.93], I² = 0) and studies that used psychosocial intervention (RR= 0.99 [0.98,1.01], I²=0) with regards to ED visits. Limitation of activity improved after initiation of psychosocial therapy (SMD score of -0.71 [-1.02, -0.40], I² = 0). Lung Function improved after psychosocial interventions (SMD 0.49 [0.27, 0.71], I²=3%). There was no observed difference in participant QOL between the two groups. Family knowledge and attitude did not significantly improve after intervention however caregiver QOL scores and Family Environment Scale showed statistically significant changes after intervention was performed.<br /></p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Family-based therapies, specifically psychosocial interventions, improve lung function, limitation of activity and caregiver QOL. Family-physicians need to strengthen these strategies to better help asthma patients.</p>
Subject(s)
Humans , AsthmaABSTRACT
Serum albumin levels have been used extensively as an indicator of morbidity in patients with end-stage renal disease. Recent evidence suggests that albumin levels vary considerably in hemodialysis patients depending on the laboratory method used, but formulas for comparing albumin values by different methods have not been developed. We prospectively evaluated the effects of measuring albumin by three different methods on paired plasma and serum from 23 patients on continuous ambulatory peritoneal dialysis (CAPD) and 53 patients on chronic maintenance hemodialysis. Plasma and serum gave virtually identical results independent of method used. In CAPD patients, bromcresol green and nephelometry gave nearly identical albumin measurements through the entire range of plasma levels. In contrast, bromcresol purple gave values that were 9.9 percent +/- 1.3 percent lower (P < 0.05). Hemodialysis patients showed a similar pattern with close agreement between bromcresol green and nephelometry, but bromcresol purple gave lower albumin levels by 19.1 percent +/- 1.2 percent (P < 0.05). The discrepancy in albumin in CAPD patients was significantly less than in the hemodialysis patients (P < 0.05), suggesting that there were fewer interfering substances in the blood of CAPD patients than in hemodialysis patients. Linear regression analysis was used to develop simple formulas for comparing albumin values obtained by the different methods in CAPD and hemodialysis patients. These studies show that values for albumin in blood vary significantly by method of analysis in CAPD and hemodialysis patients. By the use of these formulas, it becomes possible to compare albumin values between centers using different methods for the purpose of quality management.
