Nonpharmacologic Interventions for Improving Sleep Disturbances in Patients With Lung Cancer: A Systematic Review and Meta-analysis

Context: Lung cancer patients experience higher levels of sleep disturbances compared to other cancer patients, and this leads to greater distress, poorer function, and lower quality of life. Nonpharmacologic interventions have demonstrated improvements in the context of breast cancer, but their efficacy in the lung cancer population is unclear. Objectives: The aim of this review was to determine the effects of any nonpharmacologic intervention on sleep quality of lung cancer patients. Methods: Intervention studies of any design that reported primary or secondary outcomes on sleep quality were included. Databases searched were Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and PsycINFO. Risk of bias was assessed regarding randomization, allocation concealment, blinding, incomplete outcome data, selective reporting, and other biases. Results: Twenty-two studies were identified with a total of 1272 participants. Pittsburgh Sleep Quality Index was the most common instrument used. Statistically significant results were observed for all intervention categories examined in the short-term follow-up period: exercise and rehabilitation programs (standardized mean difference [SMD]: −0.43, 95% CI: −0.68, −0.19, P = 0.0005); information, psychoeducation, and symptom screening interventions (SMD: −0.87, 95% CI: −1.21, −0.54, P < 0.00001); and mind-body interventions (SMD: −0.88, 95% CI: −1.59, −0.16, P = 0.02). However, effectiveness was lower and nonsignificant when evaluated over one month after completion. Conclusion: Limitations include the high heterogeneity of interventions and outcome measures, in addition to small sample sizes and high risk of bias within studies. Because they do not allow for a clear interpretation of the results, it is recommended that every patient should be assessed individually to guide a possible referral. © 2018 American Academy of Hospice and Palliative Medicin

Emerging Trichinella britovi infections in free ranging pigs of Greece

Trichinella infections in humans and pigs have been documented in Greece since 1945 and a high prevalence of infection in pigs occurred in the 1950s. Up to 1984 only sporadic infections in humans were documented, and this zoonosis was not considered as a public health problem until 2009 when a human outbreak caused by the consumption of pork from an organic pig farm occurred. In the present study, we describe the re-emergence of Trichinella spp. infections in free-ranging pigs from organic farms of 3 counties (Dramas, Evros and Kavala) in Northern-Eastern Greece during the period 2009-2012. Totally 37 out of 12,717(0.29%) free-ranging pigs which were tested during the period in question, were positive for Trichinella spp. larvae. The etiological agent was identified as Trichinella britovi. The average larval burden was 13.7 in the masseter, 6.2 in the foreleg muscles and 7.5 in the diaphragm. The 37 positive animals originated from seven free range pig farms. The practice of organic pig production systems in Greece has grown in popularity over the last years due to the increasing interest of consumers for products considered as traditional. However, this type of pig production increases the risk for Trichinella spp. infections, since animals can acquire the infection by feeding on carcasses or the offal of hunted or dead wild animals. The awareness and education of hunters and farmers is extremely important to reduce the transmission among free ranging pigs and the risk for humans. (C) 2013 Elsevier B.V. All rights reserved