In patients with IPF, pulmonary rehabilitation showed short-term effects in enhancing exercise capacity and health-related quality of life, while it had no detectable effects at long-term follow-up.

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Purpose: Intrathecal dexmedetomidine (DEX) has been used to improve the quality and duration of spinal anesthesia. The aim of this meta-analysis is to evaluate whether intrathecal DEX could prolong the duration of sensory and motor block during spinal anesthesia. Methods: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library for randomized controlled trials that investigated the facilitatory effects of intrathecal administration of DEX compared with those of a placebo on spinal anesthesia from inception to April 2019. Sensory and motor block durations, sensory and motor block onset times, time to first analgesic request, and DEXrelated adverse effects were evaluated. Results were combined using fixed-effects or random effects modeling when appropriate. Findings: A total of 1478 patients from 25 clinical studies were included in the analysis. Compared with placebo, intrathecal DEX significantly prolonged the durations of both sensory block (weighted mean difference [WMD] ¼ 134.42 min; 95% CI, 109.71e159.13 min; P < 0.001) and motor block (WMD ¼ 114.27 min; 95% CI, 93.18e135.35 min; P < 0.001). It also hastened the onset of sensory block (WMD ¼ −0.80 min; 95% CI, −1.21 to −0.40; P < 0.001) and motor block (WMD ¼ −1.03 min; 95% CI, −1.51 to −0.56 min; P < 0.001). Furthermore, it delayed the time to first analgesic request (WMD ¼ 216.90 min; 95% CI, 178.90e254.90 min; P < 0.001) and reduced the incidence of shivering (risk ratio [RR] ¼ 0.39; 95% CI, 0.27e0.55; P < 0.001). DEX was associated with increased risk of transient bradycardia (RR ¼ 1.59; 95% CI, 1.07e2.37; P ¼ 0.022) and hypotension (RR ¼ 1.40; 95% CI, 1.04e1.89; P ¼ 0.026) but did not increase the incidence of postoperative nausea and vomiting (RR ¼ 0.87; 95% CI, 0.62e1.24; P ¼ 0.45). Implications: Intrathecal DEX can prolong the duration of sensory block, the duration of motor block, and the time to first analgesic request associated with spinal anesthesia.

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Objectives: Although dental caries has been widely reported in individuals with sickle cell disease (SCD), there is still controversial in the literature regarding the association between SCD and dental caries. The aim of this systematic review was to investigate whether individuals with SCD have more dental caries than individuals with non-SCD. Methods: PubMed and Embase databases were searched for eligible studies. The parameters of the permanent decayed, missing and filled teeth (DMFT) index and the permanent decayed, missing and filled surface (DMFS) index were considered as outcome measures. The overall meta-analyses of the DMFT and DMFS index and various subgroup analyses (caries components, age, and genotypes) of DMFT index were performed to calculate the weighted mean differences (WMD) between patients with SCD and non-SCD individuals. Results: A total of 9 studies covering 1478 individuals were included in this meta-analysis. The results of overall meta-analyses indicated that the scores of the DMFT and DMFS index were not significantly different between patients with SCD and non-SCD participants. The results of subgroup analyses by caries components, age, and genotypes showed no significant difference in most items. The result of the missing teeth was significantly lower in patients with SCD than in non-SCD individuals (WMD, −0.14; 95% confidence interval [CI], −0.25 to −0.03; P = 0.01). Discussion and Conclusions: The results revealed that compared with non-SCD individuals, patients with SCD did not suffer from worse dental caries. Considering the limitations, further well-designed studies are necessary to reveal the association between SCD and dental caries. KEYWORDS Sickle cell disease; sickle cell anemia; dental caries; oral health; sickle hemoglobin S; decayed, missing and filled teeth; decayed, missing and filled surface; meta-analysis