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Sevik A, Gaisl T, Forrer A, Graf L, Ulrich S, Bloch KE, Lichtblau M, Furian M. High altitudes and partial pressure of arterial oxygen in patients with chronic obstructive pulmonary disease - A systematic review and meta-analysis. Pulmonology 2025; 31:2416860. [PMID: 39030093 DOI: 10.1016/j.pulmoe.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/13/2024] [Accepted: 06/04/2024] [Indexed: 07/21/2024] Open
Abstract
IMPORTANCE Prior study in healthy subjects has shown a reduction of partial pressure of arterial oxygen (PaO2) by -1.60 kPa/kilometre of altitude gain. However, the association of altitude-related change in PaO2 and altitude-related adverse health effects (ARAHE) in patients with chronic obstructive pulmonary disease (COPD) remain unknown. OBJECTIVE To provide an effect size estimate for the decline in PaO2 with each kilometre of altitude gain and to identify ARAHE in relation to altitude in patients with COPD. www.crd.york.ac.uk/prospero: CRD42020217938. DATA SOURCES A systematic search of PubMed and Embase was performed from inception to May 30, 2023. STUDY SELECTION Peer-reviewed and prospective studies in patients with COPD staying at altitudes >1500 m providing arterial blood gases within the first 3 days at the target altitude. DATA EXTRACTION AND SYNTHESIS Aggregate data (AD) on study characteristics were extracted, and individual patient data (IPD) were requested. Estimates were pooled using random-effects meta-analysis. MAIN OUTCOME AND MEASURES Relative risk estimates and 95 % confidence intervals for the association between PaO2 and altitude in patients with COPD. RESULTS Thirteen studies were included in the AD analysis, of which 6 studies (222 patients, 45.2 % female) provided IPD, thus were included in the quantitative analysis. The estimated effect size of PaO2 was -0.84 kPa [95 %CI, -0.92 to -0.76] per 1000 m of altitude gain (I2=65.0 %, P < 0.001). In multivariable regression analysis, COPD severity, baseline PaO2, age and time spent at altitude were predictors for PaO2 at altitude. Overall, 37.8 % of COPD patients experienced an ARAHE, whereas older age, female sex, COPD severity, baseline PaO2, and target altitude were predictors for the occurrence of ARAHE (area under ROC curve: 0.9275, P < 0.001). CONCLUSIONS AND RELEVANCE This meta-analysis, providing altitude-related decrease in PaO2 and risk of ARAHE in patients with COPD ascending to altitudes >1500 m, revealed a lower altitude-related decrease in PaO2 in COPD patients compared with healthy. However, these findings might improve patient care and facilitate decisions about initiating preventive measures against hypoxaemia and ARAHE in patients with COPD planning an altitude sojourn or intercontinental flight, i.e. supplemental oxygen or acetazolamide.
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Affiliation(s)
- A Sevik
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - T Gaisl
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - A Forrer
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - L Graf
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - S Ulrich
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Zurich, Bishkek, Switzerland, Kyrgyz Republic
| | - K E Bloch
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Zurich, Bishkek, Switzerland, Kyrgyz Republic
| | - M Lichtblau
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Zurich, Bishkek, Switzerland, Kyrgyz Republic
| | - M Furian
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Zurich, Bishkek, Switzerland, Kyrgyz Republic
- Research Department, Swiss University for Traditional Chinese Medicine, Bad Zurzach, Switzerland
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Farrell S, Mills TA, Lavender DT. Exploring parental knowledge, care-seeking, and support strategies for neonatal illness: an integrative review of the African Great Lakes region. Glob Health Action 2025; 18:2450137. [PMID: 39898689 PMCID: PMC11792144 DOI: 10.1080/16549716.2025.2450137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Accepted: 01/02/2025] [Indexed: 02/04/2025] Open
Abstract
BACKGROUND Sub-Saharan Africa shoulders much of the global burden of neonatal mortality. Quality postnatal care is often lacking due to availability, accessibility, mistrust of health systems, and socio-economic barriers, yet delays in care-seeking contribute to avoidable neonatal deaths. Research highlights the urgent need for improved health education about neonatal illness; however, contextual factors are rarely considered, and few interventions have been implemented. OBJECTIVES To critically examine the literature on parents' knowledge of neonatal illness and care-seeking behaviour and evaluate interventions supporting parental understanding in sub-Saharan African Great Lakes countries. METHODS Systematic searches were conducted in CINAHL, MEDLINE, Global Health, the Cochrane Library, and thesis repositories. Studies meeting inclusion criteria were critically analysed using Whittemore and Knafl's framework, and quality was assessed with Hawker et al.'s tool, following PRISMA guidelines. RESULTS Seventy studies (48 quantitative, 14 qualitative, eight mixed methods) were reviewed. The first theme, "poor knowledge of neonatal illness", showed parents struggled to recognise illness, with knowledge affected by maternity and socio-economic factors. The second theme, "sub-optimal healthcare-seeking behaviour", highlighted delayed care-seeking due to cultural, social, and economic factors. Finally, "strategies to support parents' understanding" emphasised the roles of community workers, health education phone calls, SMS, and videos, and neonatal monitoring systems. CONCLUSIONS Parental knowledge of neonatal illness is generally low, and care-seeking is influenced by beliefs, trust in healthcare, and logistical challenges. While community health workers and multi-media interventions appear effective, health education efforts must address contextual barriers and beliefs to improve recognition and care-seeking for neonatal illness.
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Affiliation(s)
- Sarah Farrell
- Centre for Childbirth, Women’s, and Newborn Health, International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tracey A. Mills
- Centre for Childbirth, Women’s, and Newborn Health, International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Dame Tina Lavender
- Centre for Childbirth, Women’s, and Newborn Health, International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Xu H, Cai M, Xu H, Shen XJ, Liu J. Role of periodontal treatment in pregnancy gingivitis and adverse outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2416595. [PMID: 39721768 DOI: 10.1080/14767058.2024.2416595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 09/25/2024] [Accepted: 10/09/2024] [Indexed: 12/28/2024]
Abstract
BACKGROUND Pregnancy gingivitis is a common oral health issue that affects both maternal and fetal health. This study aims to evaluate the effectiveness of periodontal treatment in preventing pregnancy gingivitis, preterm birth, and low birth weight through a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS A systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive literature search was performed across CINAHL, Scopus, Cochrane, and PubMed/Medline databases from 2000 to the present. Study selection and data extraction were independently carried out by two reviewers. Statistical analyses, including heterogeneity tests, sensitivity analysis, and publication bias assessment, were conducted using RevMan 5.4 and R software. RESULTS A total of 13 studies were included. The meta-analysis indicated that periodontal treatment might have a potential effect on preventing pregnancy gingivitis, but this was not statistically significant (OR = 0.85, 95% CI [0.68, 1.06], I2 = 51%). Subgroup analysis revealed that periodontal treatment significantly reduced the rates of preterm birth and low birth weight in lower-quality studies, but no significant effects were observed in higher-quality studies. Sensitivity analysis and publication bias tests confirmed the stability and reliability of the results. CONCLUSION While lower-quality studies suggest that periodontal treatment may positively impact pregnancy gingivitis, preterm birth, and low birth weight, these effects were not supported by higher-quality evidence. Further well-designed RCTs are needed to confirm these findings and ensure their reliability. Periodontal treatment could potentially be considered as part of prenatal care to improve maternal oral health and pregnancy outcomes.
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Affiliation(s)
- HaiHong Xu
- Department of Stomatoloy, The First People's Hospital of Wenling, Taizhou, China
| | - Minqiu Cai
- Department of Stomatoloy, The First People's Hospital of Wenling, Taizhou, China
| | - Hongmiao Xu
- Department of Stomatoloy, The First People's Hospital of Wenling, Taizhou, China
| | - Xuan-Jiang Shen
- Department of Stomatoloy, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Jia Liu
- Department of Stomatoloy, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
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Odat RM, Yousef Aldalati A, Hammadeh BM, Mohammad Hussein A, Idrees M, Marzouk H, Alshwayyat S, Hanifa H. Efficacy and safety of sofpironium in treatment of primary hyperhidrosis: a systematic review. J DERMATOL TREAT 2025; 36:2441258. [PMID: 39668771 DOI: 10.1080/09546634.2024.2441258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 12/08/2024] [Indexed: 12/14/2024]
Abstract
BACKGROUND Primary axillary hyperhidrosis has limited noninvasive and effective treatment, and we present the use of sofpironium bromide as a promising treatment option. We aimed to assess the efficacy and safety of sofpironium in patients with primary hyperhidrosis. METHODS We systematically searched the databases for Studies that assessed sofpironium bromide in patients with primary axillary hyperhidrosis. Methodological quality was determined using the Cochrane Risk of Bias Assessment tool and Newcastle-Ottowa scale. RESULTS Five studies were included (752 patients). They used 5% sofpironium, except for one study that used 5%, 10%, and 15% sofpironium. Studies have shown a significant difference in the incidence of patients with an HDSS score of 1 or 2 ranging from 53.9% to 86.7% and reported a greater reduction in the mean change in the DLQI score in the sofpironium group. They also noted a more significant reduction in the total gravimetric weight of sweat in the sofpironium group. A 1.5 point or greater improvement in HDSM-Ax score ranged from 48.2% to 69.1%. Serious adverse events were not observed in the intervention group. CONCLUSION Sofpironium gel provides notable improvements in symptom severity, sweat reduction, and quality of life, with mostly mild localized adverse events.Hyperhidrosis is relatively common, affecting 4.8% of the US population and negatively affects physical, social, and psychological well-being.Sofpironium bromide is recently approved by the FDA for the treatment of primary axillary hyperhidrosisSofpironium bromide showed promising results in terms of safety and efficacy for treating hyperhidrosisWe systematically assessed the use of sofpironium gel reported in five studies (752 patients)Sofpironium gel provides notable improvements in symptom severity, sweat reduction and quality of life, with mostly mild localized adverse events.
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Affiliation(s)
- Ramez M Odat
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Bara M Hammadeh
- Faculty of Medicine, Al-Balqa' Applied University, Salt, Jordan
| | | | - Muhammad Idrees
- Faculty of Medicine, Lahore General hospital Lahore, Punjab, Pakistan
| | - Hamza Marzouk
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sakhr Alshwayyat
- Research Center, King Hussein Cancer Center, Amman, Jordan
- Research Center, Princess Basma Teaching Hospital, Irbid, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Hamdah Hanifa
- Faculty of Medicine, University of Kalamoon, Al_Nabk, Syria
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Alosaimi A, Algarni A, Alharbi A, Alotaibi A, Alomairi A, Alsurayhi M, Alharbi W. Comparative efficacy of minoxidil alone versus minoxidil combined with low-level laser therapy in the treatment of androgenic alopecia: a systematic review and meta-analysis. J DERMATOL TREAT 2025; 36:2447355. [PMID: 39828269 DOI: 10.1080/09546634.2024.2447355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2024] [Accepted: 12/20/2024] [Indexed: 01/22/2025]
Abstract
OBJECTIVE This systematic review evaluates the efficacy of minoxidil alone versus minoxidil with low-level laser therapy (LLLT) for androgenic alopecia. STUDY DESIGN systematic review and meta-analysis. METHODS An online search of PubMed, Web of Science, and MEDLINE was conducted. Randomized clinical trials comparing minoxidil monotherapy with minoxidil and LLLT combination therapy were included based on predefined criteria. The Risk of Bias 2.0 (RoB 2.0) tool was used for quality assessment. RESULTS From 38 identified studies, 34 remained after excluding 4 duplicates. Further exclusions left 4 eligible studies comparing minoxidil alone with minoxidil and LLLT. The meta-analysis found no statistically significant differences in hair counts between the two groups at baseline, 12 weeks, and 8 weeks post-treatment [mean difference = -0.04, 95% CI -1.22 to 1.14, p = .95, I² = 0%]. Similarly, hair diameter showed no significant differences at the same time points [mean difference = 0.00, 95% CI -0.00 to 0.00, p = .98, I² = 38%]. CONCLUSION The combination of minoxidil and LLLT does not significantly improve outcomes compared to minoxidil alone for treating androgenic alopecia.
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Affiliation(s)
- Abdulmajeed Alosaimi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Abdulrahman Alharbi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdulmalik Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah Alomairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Waleed Alharbi
- Dermatology Department, King Fahad Hospital Jeddah, Jeddah, Saudi Arabia
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Redondo P, Mazhari T, Khanolkar AR. Effectiveness of infrastructural interventions to improve access to safe drinking water in Latin America and the Caribbean on the burden of diarrhoea in children <5 years: a systematic literature review and narrative synthesis. Glob Health Action 2025; 18:2451610. [PMID: 39949281 PMCID: PMC11834799 DOI: 10.1080/16549716.2025.2451610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Accepted: 01/07/2025] [Indexed: 02/20/2025] Open
Abstract
Globally, Latin America and the Caribbean (LAC) has one of the lowest rates of equitable access to safely managed drinking water. This systematic literature review assessed the effectiveness of infrastructure interventions to provide equitable access to safely managed drinking water in LAC on the burden of diarrhoea in children <5 years. The review was conducted in February 2024 using Ovid MEDLINE, Embase, Global Health, and the Cochrane Library with inclusion criteria: quantitative study designs of intervention effectiveness on burden of diarrhoea in children; conducted in LAC; studies published since 1 January 2000; and full-text available in English. Study quality was assessed via the US Agency for Healthcare Research and Quality scale. Reported quantitative data for diarrhoea burden of disease were extracted, and thematic analysis informed a narrative synthesis. Six studies from three countries in LAC with >110,000 data-points were included. Water supply infrastructure interventions were effective at reducing the burden of diarrhoea in children <5 years. Household level, rather than community level, access to a piped water supply, a continuous reliable service with <1 day of service interruption per month, and cash transfer programs for environmental public health programs, were identified as key contributors to water infrastructure intervention effectiveness. Previous water supply infrastructure interventions which include the provision of a safe drinking water supply are effective in reducing burden of diarrhoea in children. Future studies are needed to develop a comprehensive understanding of the unique features which contribute to water infrastructure effectiveness.
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Affiliation(s)
- Philippa Redondo
- Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Tuba Mazhari
- Department of Population Health Sciences, School of Life Course & Population Sciences, Guy’s Campus, King’s College London, UK
| | - Amal R. Khanolkar
- Department of Population Health Sciences, School of Life Course & Population Sciences, Guy’s Campus, King’s College London, UK
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Zeng B, Jia D, Li S, Liu X, Zhu B, Zhang Y, Zhuang Y, Dai F. Biologics for eosinophilic oesophagitis: a systematic review and meta-analysis. Ann Med 2025; 57:2445192. [PMID: 39707826 DOI: 10.1080/07853890.2024.2445192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 09/20/2024] [Accepted: 11/27/2024] [Indexed: 12/23/2024] Open
Abstract
OBJECTIVE Advancing the understanding of the pathophysiology of eosinophilic oesophagitis (EoE) and other eosinophilic gastrointestinal diseases (EGIDs) has spurred research into targeted biological therapies, while the conclusive therapeutic efficacy of biologics remains uncertain. In this review, we conducted a meta-analysis of all RCTS of biologics in the treatment of EoE to evaluate their efficacy and safety and discussed their treatment of non-EoE EGIDs. METHODS We searched the PubMed, EMBASE, Cochrane Library, and Web of Science databases. Double-blind randomized controlled trials comparing biologics with placebo in patients with EoE and non-EoE EGIDs were collected and further screened for inclusion and exclusion. The caliber of the included literature was evaluated using the Cochrane risk assessment tool findings. Data extraction and meta-analysis were conducted using RevMan 5.4 and Stata 17.0. Clinical response and histological remission were the major endpoints. RESULTS Our search retrieved 3,237 articles. There were seven trials in total, comprising 792 people with EoE. Key outcomes of this meta-analysis include the following: Anti-IL-5 biologics exhibited statistically significant benefits in histological remission (RR 2.03 [CI 1.45-2.85]; p < 0.0001) compared to the placebo, but there was no significant difference in symptom relief (RR 1.06 [CI 0.88 to 1.28]; p = 0.53); anti-IL-4/13 biologics had significant effects on histologic improvement (RR 10.48 [CI 5.54-19.82]; p < 0.00001) and symptom related score reduction (RR 1.44 [CI 1.08-1.93]; p = 0.01), with a better outcome for endoscopic remission than with placebo (SMD-1.06 [CI-1.26-0.86], p < 0.00001); no statistically significant differences in adverse effects were observed between the intervention and control groups. CONCLUSIONS Our findings suggest that the biologics currently being investigated are considered safe and effective treatments for EoE, while their efficiency varies. However, the discussion of biologics in non-pharyngitis EGID is hampered by a lack of research, necessitating more research in high-quality trials.
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Affiliation(s)
- Beibei Zeng
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Doudou Jia
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shengen Li
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xuna Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Boxu Zhu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanqi Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Zhuang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fei Dai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Pitre T, Lupas D, Mah J, Stanbrook M, Blazer A, Zeraatkar D, Ho T. Biologic Therapies for Chronic Obstructive Pulmonary Disease: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. COPD 2025; 22:2449889. [PMID: 39877958 DOI: 10.1080/15412555.2025.2449889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 12/28/2024] [Accepted: 01/01/2025] [Indexed: 01/31/2025]
Abstract
BACKGROUND Despite limited breakthroughs in COPD pharmacotherapy, recent trials have shown promising results for biologics in COPD patients. However, robust evidence synthesis in this area is currently lacking. METHODS We conducted a systematic review of MEDLINE, EMBASE, and Cochrane CENTRAL from inception to July 17, 2024, to identify randomized trials of biologic medications in patients with COPD. We performed a random effects frequentist network meta-analysis and present the results using relative risk (RR) and 95% confidence intervals (CI). We used the GRADE framework to rate the certainty of the evidence. Outcomes of interest included exacerbations, change in FEV1, change in quality of life, and serious adverse events. RESULTS Dupilumab reduced exacerbations as compared to placebo (RR 0.68 [95% CI 0.59 to 0.79]) (high certainty). Benralizumab (RR 0.89 [95% CI 0.78 to 1]), itepekimab (RR 0.81 [95% CI 0.61 to 1.07]) and tezepelumab (RR 0.83 [95% CI 0.61 to 1.12]) may reduce exacerbations as compared to placebo (all low certainty). Dupilumab probably reduced exacerbations more than mepolizumab (RR 0.74 [95% CI 0.62 to 0.89]) (moderate certainty). Dupilumab may reduce exacerbations more than tezepelumab (RR 0.82 [95% CI 1.14]) (low certainty). For all patients, no treatment improved FEV1 above the pre-specified minimal clinically important difference (MCID) of 0.1 L. Dupilumab probably has no meaningful effect on FEV1 compared to placebo (MD 0.07 [95% CI 0.02 to 0.13]) (moderate certainty). However, in the subgroup of patients with blood eosinophils ≥300/mcL, both tezepelumab (MD 0.15 [95% CI 0.05 to 0.26]) and dupilumab (MD 0.13 [95% CI 0.06 to 0.19]) probably improved FEV1 above the MCID. CONCLUSION Dupilumab is effective at improving patient-relevant outcomes in COPD with higher eosinophil levels. Other biological therapies, including tezepelumab, have no important effect on patient-relevant outcomes.
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Affiliation(s)
- Tyler Pitre
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Daniel Lupas
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Jasmine Mah
- Department of Medicine, Dalhousie University, Halifax, ON, Canada
| | - Matthew Stanbrook
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alina Blazer
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dena Zeraatkar
- Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Anesthesiology, McMaster University, Hamilton, ON, Canada
| | - Terence Ho
- Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, Canada
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Chen X, Cai K, Xue Y, Ung COL, Hu H, Jakovljevic M. Using system dynamics modeling approach to strengthen health systems to combat cancer: a systematic literature review. J Med Econ 2025; 28:168-185. [PMID: 39764688 DOI: 10.1080/13696998.2025.2450168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 01/02/2025] [Accepted: 01/03/2025] [Indexed: 01/11/2025]
Abstract
AIM Dynamic cancer control is a current health system priority, yet methods for achieving it are lacking. This study aims to review the application of system dynamics modeling (SDM) on cancer control and evaluate the research quality. METHODS Articles were searched in PubMed, Web of Science, and Scopus from the inception of the study to 15 November 2023. Inclusion criteria were English original studies focusing on cancer control with SDM methodology, including prevention, early detection, diagnosis and treatment, and palliative care. Exclusion criteria were non-original research, and studies lacking SDM focus. Analysis involved categorization of studies and extraction of relevant data to answer the research question, ensuring a comprehensive synthesis of the field. Quality assessment was used to evaluate the SDM for cancer control. RESULTS Sixteen studies were included in this systematic review predominantly from the United States (7, 43.75%), with a focus on breast cancer research (5, 31.25%). Studies were categorized by WHO cancer control modules, and some studies may contribute to multiple modules. The results showed that included studies comprised two focused on prevention (1.25%), ten on early detection (62.50%), six on diagnosis and treatment (37.50%), with none addressing palliative care. Seven studies presented a complete SDM process, among which nine developed causal loop diagrams for conceptual models, ten utilized stock-flow charts to develop computational models, and thirteen conducted simulations. LIMITATIONS This review's macrofocus on SDM in cancer control missed detailed methodological analysis. The limited number of studies and lack of stage-specific intervention comparisons limit comprehensiveness. Detailed analysis of SDM construction was also not conducted, potentially overlooking nuances in cancer control strategies. CONCLUSION SDM in cancer control is underutilized, focusing mainly on early detection and treatment. Inconsistencies suggest a need for standardized SDM approaches. Future research should expand SDM's application and integrate it into cancer control strategies.
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Affiliation(s)
- Xianwen Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Kuangyuan Cai
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Yan Xue
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
- Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macao, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
- Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macao, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, China
| | - Mihajlo Jakovljevic
- UNESCO-TWAS, The World Academy of Sciences, Trieste, Italy
- Shaanxi University of Technology, Hanzhong, China
- Department of Global Health Economics and Policy, University of Kragujevac, Kragujevac, Serbia
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10
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Le J, Sun Y, Deng G, Dian Y, Xie Y, Zeng F. Immune checkpoint inhibitors in cancer patients with autoimmune disease: Safety and efficacy. Hum Vaccin Immunother 2025; 21:2458948. [PMID: 39894761 PMCID: PMC11792813 DOI: 10.1080/21645515.2025.2458948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Revised: 01/09/2025] [Accepted: 01/23/2025] [Indexed: 02/04/2025] Open
Abstract
The utilization of immune-checkpoint inhibitors (ICIs) in cancer immunotherapy frequently leads to the occurrence of immune-related adverse events (irAEs), making it generally not recommended for patients with preexisting autoimmune diseases. Hence, we conducted a meta-analysis on safety and efficacy of ICIs in cancer patients with preexisting autoimmune diseases to provide further insights. PubMed, EMBASE, and Cochrane Library were systematically searched until December 20, 2024. The main summary measures used were pooled rate and risk ratio (RR) with 95% confidential interval (CI), which were analyzed using R statistic software. A total of 52 articles were included in the study. When cancer patients with preexisting autoimmune diseases received ICIs treatment, the overall incidence was 0.610 (95% CI: 0.531-0.686) for any grade irAEs, 0.295 (95% CI: 0.248-0.343) for flares, 0.325 (95% CI: 0.258-0.396) for de novo irAEs, 0.238 (95% CI: 0.174-0.309) for grade ≥3 irAEs, and 0.143 (95% CI: 0.109-0.180) for discontinuation due to immunotoxicity. Compared with those without autoimmune diseases, cancer patients with autoimmune diseases experienced a higher risk of any-grade irAEs (RR: 1.23, 95% CI: 1.12-1.35) and discontinuation due to immunotoxicity (1.40, 95% CI: 1.11-1.78). However, no statistically significant differences were observed in the incidence of grade ≥3 irAEs, objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS) between the two groups. During ICIs treatment, irAEs are common among cancer patients with autoimmune diseases, but severe irAEs is relatively low. ICIs are effective in this population, but should be strictly monitored when used to avoid immunotoxicity.
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Affiliation(s)
- Jiayuan Le
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuming Sun
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guangtong Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yating Dian
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanli Xie
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Furong Zeng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Wang Z, Li J, Kong Q, Yan H, Zhang Y, Zhou X, Yu Z, Huang H, Luo X. Endovascular therapy versus best medical care for acute ischemic stroke with distal medium vessel occlusion: a systematic review and meta-analysis. Ann Med 2025; 57:2447407. [PMID: 39749641 DOI: 10.1080/07853890.2024.2447407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 08/12/2024] [Accepted: 12/02/2024] [Indexed: 01/04/2025] Open
Abstract
BACKGROUND With the refinement of catheter technology, distal medium vessel occlusions (DMVOs) are now viewed as amenable to endovascular treatment (EVT) but its efficacy and safety remains unclear in AIS patients with DMVO. METHODS We conducted a systematic search of PubMed, Embase databases and Cochrane Library up to December 2023 using keywords to identify studies comparing EVT versus BMT in AIS with DMVOs. The assessed clinical outcomes were excellent functional outcome, good functional outcome, 90-day mortality, symptomatic intracranial hemorrhage (sICH), and early neurological improvement (ENI) after treatment. RESULTS Overall, 31 studies were included. There were no significant differences in excellent functional outcome (OR: 1.21, 95% CI: 0.99-1.47), good functional outcome (OR: 1.03, 95% CI: 0.82-1.30) and 90-day mortality (OR: 1.17, 95% CI: 0.84-1.62). Additionally, EVT led to higher sICH (OR: 1.64, 95% CI: 1.09-2.47) and better ENI (OR: 1.50, 95% CI: 1.02-2.19) compared to BMT. In individuals with M2 occlusion receiving EVT showed better excellent functional outcomes (OR: 1.48, 95% CI: 1.07-2.03). Those patients with PCA occlusion showed no significant difference in functional outcomes. In individuals with ACA occlusion, EVT resulted in reduced functional independence (OR: 0.55, 95% CI: 0.31-0.98). For NIHSS < 6, BMT achieved better functional independence compared to EVT (OR: 0.71, 95% CI: 0.51-0.98) and EVT showed higher sICH (OR: 3.44, 95% CI: 1.42-8.31). CONCLUSION For patients with AIS and DMVO occlusion, EVT fails to improve functional prognosis while increasing sICH incidence. More randomized controlled trials are needed in the future to confirm these results.
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Affiliation(s)
- Ziyue Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiacheng Li
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qianqian Kong
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Yan
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xirui Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyuan Yu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
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Yang H, An T, Zhao Y, Shi X, Wang B, Zhang Q. Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis. Ann Med 2025; 57:2455536. [PMID: 39838595 PMCID: PMC11755742 DOI: 10.1080/07853890.2025.2455536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 01/02/2025] [Accepted: 01/11/2025] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND AND OBJECTIVE Janus kinase (JAK) inhibitors (JAKinibs) are effective for inflammatory bowel disease (IBD), but their cardiovascular safety is inconclusive. We aim to assess the cardiovascular risks associated with JAKinibs in IBD patients. PATIENTS AND METHODS Systematic searches of seven databases and ClinicalTrials.gov from inception to February 2024 were conducted. Outcomes included major adverse cardiovascular events (MACE), venous thromboembolism events (VTE) and cardiovascular events (CVE), which were separately evaluated based on whether or not the dose was considered. P-score was applied to rank interventions. RESULTS A total of 26 trials involving 10,537 IBD patients were included, and results showed no significantly increased risk of MACE, VTE and CVE was associated with JAKinibs. However, when the dose was considered, Tofacitinib 5 mg BID (versus placebo) showed a trend towards an increased risk of MACE [odds ratio (OR)=1.05, 95% confidence interval (CI): 0.23-4.82], as well as Upadacitinib 30 mg QD (versus placebo) showed a trend towards increased risks of VTE (OR=1.36, 95% CI: 0.23-8.03) and CVE (OR=1.08, 95% CI: 0.24-4.85), and ranked higher than placebo for the risk of VTE [P-score=0.766 (versus 0.722)]. Notably, Deucravacitinib ranked lowest for all cardiovascular risks, and significantly decreased the risks of VTE (OR=0.03, 95% CI: 0.00-0.87) and CVE (OR=0.03, 95% CI: 0.00-0.87) compared with placebo. CONCLUSIONS Although a trend of increased cardiovascular risks was found considering dose, no significantly increased cardiovascular risk was associated with JAKinibs in IBD patients, and Deucravacitinib significantly decreased the risks of VTE and CVE.
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Affiliation(s)
- Huibin Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ting An
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxuan Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaojing Shi
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qingyu Zhang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
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Morvati D, Solbakken R, Vaag J, Hilli Y. Nurses' and nurse leaders' perspectives on a health-promoting work environment: a meta-ethnographic study. Int J Qual Stud Health Well-being 2025; 20:2460255. [PMID: 39887313 PMCID: PMC11789224 DOI: 10.1080/17482631.2025.2460255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 01/24/2025] [Indexed: 02/01/2025] Open
Abstract
PURPOSE The purpose of this meta-ethnography is to integrate and synthesize nurses' and nurse leaders' perspectives on a health-promoting work environment to enhance understanding of its essential aspects. METHODS A meta-ethnographic approach developed by Noblit and Hare was conducted. FINDINGS Line of argument synthesis led to the development of an overarching tree metaphor: "cultivating a flourishing environmental tree rooted in values, held stable by leadership, and nurtured by safe working conditions." This metaphor illustrates that a health-promoting work environment is imbued with three interdependent aspects: 1) core values as the roots of the tree, including respect, recognition, community, and engagement 2) value-conscious leadership as the trunk of the tree, meaning a leader who is conscious of their power position and responsibilities and 3) safe working conditions as fertile soil for the tree, comprising the physical and administrative dimensions of the work environment. CONCLUSIONS Collaboration between nurses and leaders is crucial for cultivating a health-promoting work environment. However, nurse leaders, due to their influential positions, have the responsibility to facilitate this environment. Consequently, leaders need to receive adequate resources and support from their superiors to foster an environment that enhances nurses' health and job satisfaction.
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Affiliation(s)
- Diako Morvati
- Faculty of Nursing and Health Science, Nord University, Bodø, Norway
| | - Rita Solbakken
- Faculty of Nursing and Health Science, Nord University, Bodø, Norway
| | - Jonas Vaag
- Department of Psychology, Inland School of Business and Social Sciences, University of Inland Norway, Lillehammer, Norway
| | - Yvonne Hilli
- Faculty of Nursing and Health Science, Nord University, Bodø, Norway
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14
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Ibrahim R, Aranjani JM, Kalikot Valappil V, Nair G. Unveiling the potential bacteriophage therapy: a systematic review. Future Sci OA 2025; 11:2468114. [PMID: 39976508 PMCID: PMC11845108 DOI: 10.1080/20565623.2025.2468114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 01/21/2025] [Indexed: 02/23/2025] Open
Abstract
INTRODUCTION Antimicrobial resistance renders conventional therapy, demanding the need for alternative therapeutic techniques. A potential strategy for treating infections caused by multi-drug-resistant bacteria is using bacteriophages, viruses that only multiply and infect specific bacteria. This review aims to evaluate the findings of clinical studies on phage therapy for bacterial illnesses. METHODS A comprehensive search method was utilized to identify 11 appropriate trials, which were then assessed for safety, efficacy, and treatment outcomes. The Joann-Briggs-Institute checklist and PRISMA criteria were used to evaluate these studies thoroughly. The results were summarized by extracting and analyzing data on trial design, treatment outcomes, safety profiles, and therapeutic effectiveness. RESULTS Phage treatment had a strong safety profile, with few side effects recorded across many routes, including oral, intravenous, and topical. Clinical studies demonstrated its effectiveness in lowering bacterial loads, resolving infections, and destroying biofilms. However, diversity in trial designs hampered the generalizability of the findings. CONCLUSION This study emphasizes the promise of phage therapy as a safe and efficient treatment for bacterial-illnesses. Despite its potential, there are still significant gaps in clinical application, long-term efficacy assessment, and trial standardization. Addressing these issues is critical to developing phage therapy as an effective alternative treatment for multidrug-resistant-illnesses.
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Affiliation(s)
- Rafwana Ibrahim
- Department of Pharmaceutical Biotechnology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Jesil Mathew Aranjani
- Department of Pharmaceutical Biotechnology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Vipin Kalikot Valappil
- Department of Pharmaceutics, College of Pharmaceutical Sciences, Government Medical College, Kannur, India
| | - Gouri Nair
- Department of Pharmacology, Faculty of Pharmacy, Ramaiah University of Applied Sciences, Bengaluru, India
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15
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Tzanaki I, Makrigiannakis A, Lymperopoulou C, Al-Jazrawi Z, Agouridis AP. Pregnancy-associated plasma protein A (PAPP-A) as a first trimester serum biomarker for preeclampsia screening: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2448502. [PMID: 39757003 DOI: 10.1080/14767058.2024.2448502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Revised: 12/20/2024] [Accepted: 12/26/2024] [Indexed: 01/07/2025]
Abstract
OBJECTIVE The aim of this study is to systematically examine the role of the pregnancy-associated plasma protein A (PAPP-A) serum biomarker in the first trimester screening of preeclampsia (PE). MATERIALS AND METHODS A systematic search of the literature was conducted on PubMed via Medline, and Cochrane Library up to 8 November 2022, for prospective studies evaluating PAPP-A serum levels in first trimester pregnant women as a screening biomarker for PE. Eligible were all prospectively designed case-control or cohort studies, published in English. Two investigators independently examined the studies and the studies' characteristics were extracted. Newcastle-Ottawa Scale (NOS) for case-control and cohort studies were applied to assess the risk of bias. For the quantitative analysis of the studies, a meta-analysis was also performed. RESULTS A total of 22 studies including 33,651 pregnant women were assessed, of whom, 2001 were diagnosed with PE. A meta-analysis was performed, showing that PAPP-A levels in the first trimester were significantly lower in early onset preeclamptic women (MD: -0.24, 95% CI: -0.37, -0.11, p = .0002), late onset (MD: -0.15, 95% CI: -0.25, -0.05, p = .03), and total preeclamptic cases (MD = -0.17, 95% CI = -0.23, -0.11, p < .00001) when compared with controls. CONCLUSIONS Our results suggest that PAPP-A can be a promising predictor in early screening for PE; hence, women at risk can be diagnosed early in their pregnancy stage and benefit from individualized PE treatment before it progresses.
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Affiliation(s)
- Ismini Tzanaki
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- Department of Obstetrics and Gynecology, University Hospital of Heraklion, Crete, Greece
| | - Antonis Makrigiannakis
- Department of Obstetrics and Gynecology, University Hospital of Heraklion, Crete, Greece
| | | | | | - Aris P Agouridis
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- Department of Internal Medicine, German Medical Institute, Limassol, Cyprus
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Zhao S, Wang W, Li S, He J, Duan W, Fang Z, Ma X, Li Z, Guo C, Wang W, Wu H, Zhang T, Huang X. The prevalence of low-level viraemia and its association with virological failure in people living with HIV: a systematic review and meta-analysis. Emerg Microbes Infect 2025; 14:2447613. [PMID: 39727007 PMCID: PMC11722027 DOI: 10.1080/22221751.2024.2447613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 12/18/2024] [Accepted: 12/22/2024] [Indexed: 12/28/2024]
Abstract
Low-level viraemia (LLV) following antiretroviral therapy (ART) in people living with HIV (PLWH) has not received sufficient attention. To the determine the prevalence of LLV and its association with virological failure (VF), we systematically reviewed evidence-based interventions for PLWH. We searched PubMed, the Cochrane Library, Embase, and Web of Science from inception to 22 May 2024. Cohorts with samples sizes smaller than 1000 in size were excluded. Data from 16 cohort studies, encompassing 13,49,306 PLWH, revealed a pooled prevalence of LLV of 13.81%. Relative risk (RR) and 95% confidence intervals (CI) identified the following risk factors for LLV: viral load (VL) ≥ 105 copies/mL at baseline (1.79, 1.11-2.88), AIDS-defined illness at baseline (1.24, 1.10-1.40), and protease inhibitor-based regimen at ART initiation (1.53, 1.45-1.62) are the risk factors for LLV. Conversely, CD4 count ≥200 cells/μL at baseline (0.90, 0.82-0.98), non-nucleoside reverse transcriptase inhibitor-based regimen (0.81, 0.68-0.96) and the integrase strand transfer inhibitor (INSTI)-based regimen (0.60, 0.42-0.85) were associated with a reduced risk of LLV. Pooling the adjusted hazard ratio (aHR) and the 95% CI, we found that LLV increased the risk of VF with rising VL among 96,711 PLWH (aHR 2.77, 95% CI 2.03-3.76) and increased the risk of all-cause mortality at high VL levels among 14,229 PLWH (aHR 1.66, 95% CI 1.16-2.37). Therefore, the prevalence of LLV in PLWH should not be overlooked. This study aims to guide better management strategies to improve clinical outcomes in patients with LLV.
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Affiliation(s)
- Shengnan Zhao
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Wenjing Wang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Sibo Li
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jiaze He
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Wenshan Duan
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhen Fang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaoran Ma
- School of Life Sciences, Tianjin University, Tianjin, People’s Republic of China
| | - Zhen Li
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Caiping Guo
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Wen Wang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Hao Wu
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaojie Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
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Salsabila S, Khairinisa MA, Wathoni N, Sufiawati I, Mohd Fuad WE, Khairul Ikram NK, Muchtaridi M. In vivo toxicity of chitosan-based nanoparticles: a systematic review. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2025; 53:1-15. [PMID: 39924869 DOI: 10.1080/21691401.2025.2462328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 01/08/2025] [Accepted: 01/27/2025] [Indexed: 02/11/2025]
Abstract
Chitosan nanoparticles have been extensively utilised as polymeric drug carriers in nanoparticles formulations due to their potential to enhance drug delivery, efficacy, and safety. Numerous toxicity studies have been previously conducted to assess the safety profile of chitosan-based nanoparticles. These toxicity studies employed various methodologies, including test animals, interventions, and different routes of administration. This review aims to summarise research on the safety profile of chitosan-based nanoparticles in drug delivery, with a focus on general toxicity tests to determine LD50 and NOAEL values. It can serve as a repository and reference for chitosan-based nanoparticles, facilitating future research and further development of drugs delivery system using chitosan nanoparticles. Publications from 2014 to 2024 were obtained from PubMed, Scopus, Google Scholar, and ScienceDirect, in accordance with the inclusion and exclusion criteria.The ARRIVE 2.0 guidelines were employed to evaluate the quality and risk-of-bias in the in vivo toxicity studies. The results demonstrated favourable toxicity profiles, often exhibiting reduced toxicity compared to free drugs or substances. Acute toxicity studies consistently reported high LD50 values, frequently exceeding 5000 mg/kg body weight, while subacute studies typically revealed no significant adverse effects. Various routes of administration varied, including oral, intravenous, intraperitoneal, inhalation, and topical, each demonstrating promising safety profiles.
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Affiliation(s)
- Shela Salsabila
- Department of Pharmaceutical Analysis and Medicinal Chemistry, Faculty of Pharmacy, Padjadjaran University, Sumedang, Indonesia
| | - Miski Aghnia Khairinisa
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang, Indonesia
| | - Nasrul Wathoni
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
| | - Irna Sufiawati
- Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Sumedang, Indonesia
| | - Wan Ezumi Mohd Fuad
- Programme of Biomedicine, School of Health Sciences, USM Health Campus, Kubang Kerian, Kelantan, Malaysia
| | | | - Muchtaridi Muchtaridi
- Department of Pharmaceutical Analysis and Medicinal Chemistry, Faculty of Pharmacy, Padjadjaran University, Sumedang, Indonesia
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Seemann K, Silas U, Bosworth Smith A, Münch T, Saunders SJ, Veloz A, Saunders R. The burden of venous thromboembolism in ten countries: a cost-of-illness Markov model on surgical and ICU patients. J Med Econ 2025; 28:1-12. [PMID: 39611872 DOI: 10.1080/13696998.2024.2436797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 11/27/2024] [Accepted: 11/28/2024] [Indexed: 11/30/2024]
Abstract
AIM The objective of this study was to assess the burden of hospital-acquired venous thromboembolism (VTE) on healthcare systems and patients across ten countries. METHODS A multi-methodological approach was taken to estimate the burden of hospital-acquired VTE across five key clinical specialties and ten countries (Australia, Brazil, China, France, Mexico, South Korea, Spain, Taiwan, Thailand, and the United Kingdom). Surveys with healthcare professionals (surgeons, hematologists, and hospital management) were conducted to identify clinical specialties of interest. A systematic literature review and interviews were conducted to identify data for incidences and costs. A health-economic model was developed, using a decision tree and Markov model to estimate 1-year costs. Costs are presented in 2022 USD. RESULTS Orthopedics, oncology, long-term ICU, cardiology, and obstetrics and gynecology were identified as the clinical specialties of interest. The total cost burden of hospital-acquired VTE was estimated to be $41,280 million, which equals $503 per patient at risk. Expressed as a share of 2022 GDP, an average spending per country of 0.05% to 0.18% was observed. The VTE-associated mortality was substantial, accounting for 150,081 deaths in a 74.2 million population, translating into an average mortality rate of 2.02 (0.64-3.05) per 1,000 patients at risk. LIMITATIONS There were limited data available concerning VTE incidences in some countries and clinical specialties. Where data were available, there was heterogeneity of incidence definitions across the identified studies. Generalizations, imputations, and the country-agnostic structure of the model might have contributed to biases. CONCLUSIONS The burden of hospital-acquired VTE is substantial both from an economic and from a patient perspective in all countries evaluated.
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Affiliation(s)
- Kim Seemann
- Health Economics, Coreva Scientific, Koenigswinter, Germany
| | - Ubong Silas
- Health Economics, Coreva Scientific, Koenigswinter, Germany
| | | | - Tobias Münch
- Health Economics, Coreva Scientific, Koenigswinter, Germany
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Tahrat H, Munir A, Marchetti F. Rotavirus vaccine coverage, completion, and compliance: A systematic literature review. Hum Vaccin Immunother 2025; 21:2442780. [PMID: 39751000 DOI: 10.1080/21645515.2024.2442780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 11/28/2024] [Accepted: 12/12/2024] [Indexed: 01/04/2025] Open
Abstract
Rotavirus, a leading cause of severe acute gastroenteritis in children, is largely preventable through immunization with two internationally licensed oral rotavirus vaccines (RVVs) included in national programs across over 100 countries. These RVVs are administered in either two (Rotarix™; 2D-RV) or three (RotaTeq®; 3D-RV) doses. We aimed to assess the global coverage, completion, and compliance of 2D-RV and 3D-RV in various settings, and to identify factors influencing vaccine coverage. We conducted a systematic review of PubMed and Embase for articles published between 2006 and 2021. We included 74 publications across 31 countries. RVV coverage rates and the factors associated with coverage varied widely among countries based on income level, RVV used, and the year of vaccination. Due to market bias and insufficient studies, valid RVVs coverage comparisons couldn't be made. However, 2D-RV had better completion/compliance rates than 3D-RV in Italy, Mexico, and the US.
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Fernández-Alonso AM, López-Baena MT, García-Alfaro P, Pérez-López FR. Systematic review and meta-analysis on the association of metabolic syndrome in women with overactive bladder. Gynecol Endocrinol 2025; 41:2445682. [PMID: 39743909 DOI: 10.1080/09513590.2024.2445682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 12/11/2024] [Accepted: 12/12/2024] [Indexed: 01/04/2025] Open
Abstract
AIMS A systematic review and meta-analysis were performed to determine the association of metabolic syndrome (METS) in women with and without overactive bladder (OAB). METHODS PRISMA guidelines were followed and the protocol was registered at PROSPERO (CRD42024606398). We searched PubMed, Embase, Cochrane Library, and LILACS databases to obtain relevant articles for studies reporting METS outcomes related to OAB published through October 2024. A meta-analysis was performed of available studies using random effect models. Results are reported as mean difference (MD), standardized MD (SMD), or odds ratio (OR) and their 95% confidence interval (CI). Heterogeneity was described with the I2 statistic. The quality of studies was assessed using the Newcastle-Ottawa Scale. RESULTS Of the 108 non-duplicated retrieved citations, after successive selection, four case-control studies with low or moderate risk of bias reported information about the association of METS in women assessed with the 8-item OAB Symptom Bother Scale. OAB patients displayed higher body mass index (BMI, MD: 3.27, 95% CI: 2.12, 4.43), waist circumference (MD: 7.96, 95% CI: 4.41, 11.52), fasting blood glucose (SMD: 1.26, 95% CI: 0.18, 2.34), triglycerides (SMD: 0.24, 95% CI: 0.01, 0.47), and LDL-cholesterol (SMD: 0.30, 95%CI: 0.06, 0.54) levels. In addition to low HDL-cholesterol levels (SMD: -0.40, 95% CI: -0.74, -0.06) compared to the control group. There were no significant differences in circulating total cholesterol levels and rates of hypertension, hysterectomy, postmenopausal status, and constipation in women with and without OAB. CONCLUSION Women with OAB display associations with age, BMI, waist circumference, and METS factors.
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Affiliation(s)
- Ana M Fernández-Alonso
- Department of Obstetrics and Gynecology, Torrecárdenas University Hospital, Almería, Spain
| | - María T López-Baena
- Aragón Health Sciences Research Institute, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | - Pascual García-Alfaro
- Department of Obstetrics and Gynecology, Dexeus University Hospital, Barcelona, Spain
| | - Faustino R Pérez-López
- Aragón Health Sciences Research Institute, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
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21
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Zeng Y, Hu R, Lu J, Qi Y, Chen D, Yang C, Wu J. Prenatal genetic detection in foetus with gallbladder size anomalies: cohort study and systematic review of the literature. Ann Med 2025; 57:2440638. [PMID: 39670967 DOI: 10.1080/07853890.2024.2440638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 10/14/2024] [Accepted: 11/07/2024] [Indexed: 12/14/2024] Open
Abstract
OBJECTIVES The aim of the study was to evaluate the detection rate of genetic abnormalities in cases of foetal gallbladder (FGB) size abnormalities to determine whether these abnormalities justify prenatal diagnosis. METHODS Two hundred and twenty-seven foetuses with gallbladder (GB) size anomalies who underwent prenatal diagnosis between January 2015 and June 2024 were included in the study. All these patients underwent chromosomal microarray and/or karyotyping, and 37 cases also underwent whole exome sequencing (WES). Two hundred and eight cases were followed up for postnatal outcomes. Then, we reviewed the literature of FGB anomalies cases with confirmed chromosomal results. RESULTS The study included 227 foetuses, comprising 60 cases with isolated GB size anomalies and 167 cases with non-isolated GB size anomalies. Non-isolated GB size anomalies were associated with findings such as hyperechogenic bowel, ventriculomegaly, foetal growth restriction (FGR), cardiac anomalies, renal dysplasia and single umbilical artery. The overall diagnostic yield of genetic tests was 10.57% (24/227). Aneuploidies were identified in seven foetuses. Pathogenic/likely pathogenic copy number variations (CNVs) were found in nine foetuses, and α0-thalassemia in five foetuses. Additionally, three pathogenic single-nucleotide variants (SNVs) were detected through WES. Foetuses with non-isolated GB size anomalies showed a higher rate of detecting genetic abnormalities compared to those with isolated GB size anomalies, with a significant difference in statistical analysis (13.2% vs. 3.3%, p = .033, Chi-square test). A total of eight studies, involving 407 cases met the criteria for inclusion in the systematic review. Overall, 28 foetuses were identified to have chromosomal abnormalities (6.9%, 28/407). CONCLUSIONS This study indicates that parents of foetuses with GB size anomalies should be informed about the potential for aneuploidy, pathogenic CNVs and SNVs, and genetic testing should be recommended in cases of non-isolated foetal GB size anomalies.
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Affiliation(s)
- Yimo Zeng
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Rong Hu
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jian Lu
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yiming Qi
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Dan Chen
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Chaoxiang Yang
- Medical Imaging Department, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jing Wu
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
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22
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Bekele D, Martínez-Hernáez A. Qualitative studies on men with prostate cancer: a systematic meta-synthesis. Int J Qual Stud Health Well-being 2025; 20:2436720. [PMID: 39719863 DOI: 10.1080/17482631.2024.2436720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 11/27/2024] [Indexed: 12/26/2024] Open
Abstract
PURPOSE Prostate cancer (PCa) is the second most common cancer among men. Despite advancements in clinical interventions and improvements in public health outreach, a multi-dimensional lack of understanding of the lived experiences of men diagnosed with PCa continues. Improving the quantity and quality of knowledge about this subject could guide clinical decisions and interventions for this group. METHODS This paper reviews qualitative studies focusing on PCa patients using the Critical Appraisal Skills Programme tool (CASP), synthesizes the data, and maps the overarching themes through a systematic meta-synthesis. RESULTS The authors identified 3546 manuscripts, of which 103 met the inclusion criteria. Six themes were identified that addressed: support needs, diagnosis, and treatment experiences, lived experiences, information accessibility, care, and threats to masculinity. CONCLUSION Treatment side-effects caused a re-configuration and re-evaluation of masculine ideologies. Men mainly relied on close family and support groups to cope with their feelings of stigma, uncertainty, and recovery. Professional healthcare and consultation quality eased their anxiety concerning long-term treatment and other factors associated with their condition. The studies were socio-demographically heterogeneous. Thus, researchers could use qualitative research to explore knowledge gaps in the following interconnected themes: masculinity care, masculinity support, masculinity information, and incorporating a more diverse socio-demographical sample.
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Affiliation(s)
- Deborah Bekele
- Department of Anthropology, Philosophy, and Social Work, Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Angel Martínez-Hernáez
- Department of Anthropology, Philosophy, and Social Work, Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
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Han X, Zhang B. Comparison of the value of transvaginal ultrasonography and MRI in the diagnosis of cesarean scar pregnancy: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2445661. [PMID: 39762030 DOI: 10.1080/14767058.2024.2445661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025]
Abstract
OBJECTIVE To compare the diagnostic value of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in cesarean scar pregnancy (CSP) by a method of meta-analysis. METHODS Studies on TVS and MRI for CSP were collected from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang data, and Chinese Scientific Journal Database (VIP database) until April 1, 2024. Stata 15.0 software was used for data analysis. Mann-Whitney U-test was applied to compare the diagnostic efficiency of the TVS and MRI groups. RESULTS Nine articles with 713 subjects were involved in this review. The pooled sensitivity (0.96, 95%CI: 0.94-0.97), specificity (0.90, 95%CI: 0.84-0.94), and DOR (197.28, 95%CI: 99.71-390.31) in the MRI group were higher than those (Sensitivity = 0.83, 95%CI: 0.77-0.87; Specificity= 0.74, 95%CI: 0.63-0.83; DOR = 13.66, 95%CI: 7.84-23.79) in the TVS group. The positive likelihood ratio and negative likelihood ratio of the MRI group were 9.56 (95%CI: 8.82-15.72) and 0.05 (95%CI: 0.03-0.07), while those of the TVS group were 3.21 (95%CI:2.18-4.74) and 0.24 (95%CI: 0.18-0.31), respectively. In the MRI and TVS groups, the area under the curve (AUC) of the summary receiver operating characteristic was 0.9497 and 0.86, respectively. The results of Mann-Whitney U-tests of the two groups showed significant differences in the pooled sensitivity (Z= -3.311, p < 0.001), specificity (Z= -2.123, p = 0.034), and DOR (Z= -3.272, p = 0.001). CONCLUSION Both MRI and TVS can effectively diagnose CSP. However, compared with TVS, MRI has better diagnostic accuracy for CSP, with higher sensitivity and specificity. Considering the good diagnostic accuracy of ultrasound, patients with ultrasound suspicion of CSP should be sent to a reference center where MRI can express its full diagnostic potential regarding depth, topography of invasion and myometral residue, which is useful for subsequent management.
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Affiliation(s)
- Xiao Han
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
| | - Boyang Zhang
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
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Arshad A, Qureshi MAM, Masood MA, Zahoor HS, Nazakat A, Fatima A, Iqbal J. Comparative efficacy of sodium oxybate versus placebo on improvement of nighttime sleep in adult patients with narcolepsy: A systematic review and meta-analysis. Sleep Med X 2025; 9:100136. [PMID: 39811427 PMCID: PMC11728066 DOI: 10.1016/j.sleepx.2024.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 11/06/2024] [Accepted: 12/14/2024] [Indexed: 01/16/2025] Open
Abstract
Background Narcolepsy, a central hypersomnolence disorder, disrupts sleep regulation. Sodium oxybate, a CNS (central nervous system) depressant, is widely used as a treatment, but there are surprisingly very few rigorous studies comparing its effectiveness to placebo in adults. Objectives To measure the comparative efficacy of sodium oxybate at a dosage regimen of 9 g versus placebo in improving nighttime sleep quality, reducing nocturnal arousals and sleep stage shifts, and enhancing the overall refreshed nature of sleep in adult patients with narcolepsy. Methods The methodology included a literature review of PubMed, Cochrane, Scopus, Google Scholar, and Clinicaltrials.gov, retrieving 53 randomized controlled trials (RCT) after removing 14 duplicates. Four studies met the criteria for gauging the efficacy of sodium oxybate compared to placebo in the adult population with narcolepsy. The primary efficacy outcome was improved sleep quality, whereas secondary outcomes were reduced nocturnal arousals and sleep stage shifts with an overall refreshed sleep nature. Analyses used RevMan 5.3 software, and SMD (standardized mean differences) with 95 % CI (confidence intervals) were calculated. Risk and publication biases were measured with Cochrane risk of bias tools and Comprehensive Meta-Analysis Software. Evidence certainty was measured using GRADEpro. Results Four RCT involving 1079 participants were analyzed for said outcomes, and relevant forest plots were generated. Statistical analysis showed a substantial improvement in sleep quality [SMD = 0.74(95%Cl:0.53,0.95; p < 0.00001; I2 = 0 %; (high certainty)] and refreshing nature of sleep [SMD = 0.81(95%CI:0.51,1.11; P < 0.00001; I2 = 0 %; (moderate certainty)], reduction in nocturnal arousals [SMD = -0.62(95%CI: 0.92,-0.32; p < 0.00001; I2 = 0 %; (moderate certainty)] and sleep stage shifts [SMD = -1.22(95%CI: 1.46,-0.98; p < 0.00001; I2 = 0 %; (high certainty)]. The risk of bias was located high for one study. Symmetrical funnel plots and Egger's regression intercepts testified to no significant publication bias. Conclusions The results showed that sodium oxybate considerably improved the quality of nocturnal sleep, resulting in substantial restorative advantages as well as a decrease in nocturnal arousals and sleep stage transitions. Significant results with low heterogeneity and p-values <0.05, showing consistent effects, were obtained from the analysis. However, overall reliability may be impacted by a high risk of bias in one study.
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Affiliation(s)
- Adina Arshad
- Quaid-e-Azam Medical College, Bahawalpur, Punjab, Pakistan
| | | | | | | | - Ayesha Nazakat
- Quaid-e-Azam Medical College, Bahawalpur, Punjab, Pakistan
| | - Anfal Fatima
- Quaid-e-Azam Medical College, Bahawalpur, Punjab, Pakistan
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Wang Q, Lu Y, Mi X, Yang C, Ma W, Xia C, Wang H. Antidepressant activity of flavones from traditional Chinese medicine: a meta-analysis. PHARMACEUTICAL BIOLOGY 2025; 63:156-169. [PMID: 39996320 PMCID: PMC11864034 DOI: 10.1080/13880209.2025.2467374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 01/26/2025] [Accepted: 02/10/2025] [Indexed: 02/26/2025]
Abstract
CONTEXT Flavones, the key active components in Traditional Chinese Medicine (TCM), have demonstrated antidepressant activity. Given the numerous animal studies conducted, a systematic analysis is essential to provide a valuable reference for future research. OBJECT This study investigated the antidepressant activity of flavones based on animal models and summarized the underlying mechanisms. METHODS We systematically searched 7 bibliographic Databases as of August 12, 2023, such as Web of Science, PubMed, China National Knowledge Infrastructure, etc. The meta-analysis was performed using either the random or fixed-effect model, supplemented by trial sequential analysis (TSA). The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to assess the quality of evidence. RESULTS A total of 25 studies involving 458 mice were included, identifying five flavones (baicalin, baicalein, apigenin, luteolin, vitexin) with antidepressant activity. Compared to the control group, flavones significantly reduced immobility time in forced swimming and tail suspension tests. Flavones also decreased serum and hippocampal levels of interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α), reduced nuclear factor kappa B (NF-κB) levels, and increased brain-derived neurotrophic factor (BDNF) levels. Relative to the positive group, flavones raised IL-6, sucrose preference rate, and corticosterone (CORT) levels, with no significant differences in other factors. The TSA showed the efficacy of flavones for treating depression with adequate 'information size' for the primary outcome. CONCLUSIONS The results demonstrate that flavones exert protective effects against depression in mice, primarily by stimulating neurotrophic factors and modulating inflammatory pathways. These findings emphasize their potential as promising candidates for the development of novel antidepressant therapies.
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Affiliation(s)
- Qing Wang
- College of Pharmacy, Ningxia Medical University, Yinchuan, China
- Department of Pharmacy, The First People’s Hospital of Yinchuan, Yinchuan, China
| | - Youyuan Lu
- College of Pharmacy, Ningxia Medical University, Yinchuan, China
- Ningxia Regional Characteristic Traditional Chinese Medicine Collaborative Innovation Center Co-constructed by the Province and Ministry, Ningxia Engineering and Technology Research Center for Modernization of Regional Characteristic Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
| | - Xue Mi
- College of Pharmacy, Ningxia Medical University, Yinchuan, China
- Department of Pharmacy, The First People’s Hospital of Yinchuan, Yinchuan, China
| | - Caiyan Yang
- Department of Pharmacy, The First People’s Hospital of Yinchuan, Yinchuan, China
| | - Wei Ma
- Department of Pharmacy, The First People’s Hospital of Yinchuan, Yinchuan, China
| | - Changbo Xia
- Department of Pharmacy, Central’s Hospital of Xinxiang, Xinxiang, China
| | - Hanqing Wang
- College of Pharmacy, Ningxia Medical University, Yinchuan, China
- Ningxia Regional Characteristic Traditional Chinese Medicine Collaborative Innovation Center Co-constructed by the Province and Ministry, Ningxia Engineering and Technology Research Center for Modernization of Regional Characteristic Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Ningxia Minority Medicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China
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Meier N, Ammann D, Pletscher M, Probst J, Schwenkglenks M. Systematic review of cost-effectiveness modelling studies for haemophilia. J Med Econ 2025; 28:89-104. [PMID: 39693522 DOI: 10.1080/13696998.2024.2444157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 12/10/2024] [Accepted: 12/16/2024] [Indexed: 12/20/2024]
Abstract
AIMS Haemophilia is a rare genetic disease that hinders blood clotting. We aimed to review model-based cost-effectiveness analyses (CEAs) of haemophilia treatments, describe the sources of clinical evidence used by these CEAs, summarize the reported cost-effectiveness of different treatment strategies, and assess the quality and risk of bias. METHODS We conducted a systematic literature review of model-based CEAs of haemophilia treatments by searching databases, the Tufts Medical Center CEA registry, and grey literature. We summarized and qualitatively synthesized the approaches and results of the included CEAs, without a meta-analysis due the diversity of the studies. RESULTS 32 eligible studies were performed in 12 countries and reported 53 pairwise comparisons. Most studies analysed patients with haemophilia A rather than haemophilia B. Comparisons of prophylactic versus on-demand treatment indicated that prophylaxis may not be cost-effective, but there was no clear consensus. Emicizumab was generally cost-effective compared with clotting factor treatments and was always dominant for patients with inhibitors. Immune tolerance induction following a Malmö protocol was found to be cost-effective compared to bypassing agents, while there was no consensus for the other protocols. Gene therapies as well as treatment with extended half-life coagulation factors were always cost-effective over their comparators. Studies were highly heterogenous regarding their time horizons, model structures, the inclusion of bleeding-related mortality and quality-of-life impacts. This heterogeneity limited the comparability of the studies. 19 of the 32 included studies received industry funding, which may have biased their results. LIMITATIONS It was not possible to perform a quantitative synthesis of the results due to the heterogeneity of the underlying studies. CONCLUSION Differences in results between previous CEAs may have been driven by heterogeneity in modelling approaches, clinical input data, and potential funding biases. A more consistent evidence base and modelling approach would enhance the comparability between CEAs.
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Affiliation(s)
- Niklaus Meier
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Daniel Ammann
- Institute of Health Economics and Health Policy, Bern University of Applied Sciences, Bern, Switzerland
| | - Mark Pletscher
- Institute of Health Economics and Health Policy, Bern University of Applied Sciences, Bern, Switzerland
| | - Jano Probst
- Institute of Health Economics and Health Policy, Bern University of Applied Sciences, Bern, Switzerland
| | - Matthias Schwenkglenks
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
- Health Economics Facility, Department of Public Health, University of Basel, Basel, Switzerland
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Valenti VE, Chagas ADS, Chedraui P, de Souza IS, Porto AA, Sorpreso ICE, Soares Júnior JM, Zangirolami-Raimundo J, Garner DM, Raimundo RD. Effect of combined aerobic exercise and resistance training on postmenopausal women with type 2 diabetes: a systematic review and meta-analysis. Gynecol Endocrinol 2025; 41:2450338. [PMID: 39797630 DOI: 10.1080/09513590.2025.2450338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Revised: 12/27/2024] [Accepted: 12/30/2024] [Indexed: 01/13/2025] Open
Abstract
BACKGROUND There is no strong evidence demonstrating whether or not aerobic exercise in conjunction with resistance exercise improves metabolic diabetes markers in postmenopausal women. OBJECTIVE To evaluate the effect of aerobic exercise and resistance training on metabolic markers in postmenopausal women with type 2 diabetes mellitus (T2DM) by means of a systematic review and meta-analysis. METHODS The searches were completed using EMBASE, MEDLINE/PubMed, Scopus and Web of Science databases. This study included non-blinded, single or double-blinded randomized control trials and postmenopausal women diagnosed with T2DM. The imposed intervention was aerobic exercise plus any training protocol to strengthen muscle groups for resistance intervention. The outcomes of interest were the blood glucose levels, insulin secretion, homeostasis model assessment-insulin resistance index (HOMA-IR) and glycated hemoglobin (HbA1c). Risk of Bias tools and GRADE were obligatory. RESULTS Three studies were included (83 participants). Exercise intervention ranged between two to four days per week. Compared to the control group, in the group submitted to aerobic exercise + resistance training, no significant change was noted for HbA1c (subtotal = mean difference - 0.35 [95% CI: -0.85, 0.15], p = .17, and heterogeneity = 0%) (GRADE: very low), nevertheless, HOMA-IR index was significantly improved (subtotal = mean difference -0.52 [95% CI: -0.99, -0.05], p = .03, and heterogeneity = 0%) (GRADE: very low). CONCLUSION Despite the very low certainty found in the quality of evidences, our analysis showed that aerobic exercise along with strength exercise seems to improve some metabolic diabetes markers in postmenopausal women with T2DM. There is a need for further studies to support our preliminary findings.
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Affiliation(s)
| | | | - Peter Chedraui
- Escuela de Postgrado en Salud, Universidad Espíritu Santo, Samborondón, Ecuador
| | - Ingrid Soares de Souza
- Centro Universitário Faculdade de Medicina do ABC (FMABC), São Paulo, Santo André, Brazil
| | - Andrey Alves Porto
- Autonomic Nervous System Center, Sao Paulo State University, UNESP, Marília, SP, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Laboratory for Medical Research in Structural and Molecular Gynecology, Discipline of Gynecology, Department of Gynecology and Obstetrics, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jose Maria Soares Júnior
- Laboratory for Medical Research in Structural and Molecular Gynecology, Discipline of Gynecology, Department of Gynecology and Obstetrics, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Juliana Zangirolami-Raimundo
- Centro Universitário Faculdade de Medicina do ABC (FMABC), São Paulo, Santo André, Brazil
- Laboratory for Medical Research in Structural and Molecular Gynecology, Discipline of Gynecology, Department of Gynecology and Obstetrics, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - David M Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Rodrigo Daminello Raimundo
- Centro Universitário Faculdade de Medicina do ABC (FMABC), São Paulo, Santo André, Brazil
- Laboratory for Medical Research in Structural and Molecular Gynecology, Discipline of Gynecology, Department of Gynecology and Obstetrics, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Zhao Y, Fu Y, Zhang W, Zhao S, Li H. Evidence summary on management strategies for gastroesophageal reflux symptoms in patients following esophageal cancer surgery. Asia Pac J Oncol Nurs 2025; 12:100639. [PMID: 39811449 PMCID: PMC11732502 DOI: 10.1016/j.apjon.2024.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 12/05/2024] [Accepted: 12/05/2024] [Indexed: 01/16/2025] Open
Abstract
Objective This study aimed to summarize evidence-based strategies for the self-management of gastroesophageal reflux symptoms (GERS) at home among patients who have undergone esophageal cancer surgery, providing practical references for clinical practice. Methods A systematic evidence summary was conducted based on the reporting standards of the Fudan University Center for Evidence-based Nursing. Literature was retrieved from international and Chinese databases, including guidelines, expert consensus, systematic reviews, and original studies. The search covered the period from the inception of the databases to June 30, 2024. Two independent reviewers appraised the quality of evidence and synthesized recommendations across six domains: reflux symptoms, assessment, treatment, health education, follow-up, and outcome indicators. Results A total of 25 high-quality studies were included, comprising 10 guidelines, 10 expert consensus documents, two systematic reviews, and three original studies. Thirty-four evidence items were synthesized, emphasizing a combination of pharmacological treatments, lifestyle modifications, and health education to improve self-management outcomes. Conclusions This evidence synthesis highlights effective strategies for home-based self-management of GERS after esophageal cancer surgery. Future research should focus on culturally tailored interventions and large-scale studies to further enhance the applicability and reliability of these findings. Trial registration This study was registered at the Fudan University Center for Evidence-Based Nursing (Registration No. ES202446701).
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Affiliation(s)
- Yuqing Zhao
- Esophageal Oncology Department, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yaxin Fu
- Esophageal Oncology Department, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Wei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shengjiang Zhao
- Nursing Department, Tianjin Second People’s Hospital, Tianjin, China
| | - Huixia Li
- Esophageal Oncology Department, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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29
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Comini G, Dowd E. A systematic review of progenitor survival and maturation in Parkinsonian models. Neural Regen Res 2025; 20:3172-3178. [PMID: 39589166 DOI: 10.4103/nrr.nrr-d-24-00894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 10/08/2024] [Indexed: 11/27/2024] Open
Abstract
Stem cell-based brain repair is a promising emergent therapy for Parkinson's disease based on years of foundational research using human fetal donors as a cell source. Unlike current therapeutic options for patients, this approach has the potential to provide long-term stem cell-derived reconstruction and restoration of the dopaminergic input to denervated regions of the brain allowing for restoration of certain functions to patients. The ultimate clinical success of stem cell-derived brain repair will depend on both the safety and efficacy of the approach and the latter is dependent on the ability of the transplanted cells to survive and differentiate into functional dopaminergic neurons in the Parkinsonian brain. Because the pre-clinical literature suggests that there is considerable variability in survival and differentiation between studies, the aim of this systematic review was to assess these parameters in human stem cell-derived dopaminergic progenitor transplant studies in animal models of Parkinson's disease. A defined systematic search of the PubMed database was completed to identify relevant studies published up to March 2024. After screening, 76 articles were included in the analysis from which 178 separate transplant studies were identified. From these, graft survival could be assessed in 52 studies and differentiation in 129 studies. Overall, we found that graft survival ranged from < 1% to 500% of cells transplanted, with a median of 51% of transplanted cells surviving in the brain; while dopaminergic differentiation of the cells ranged from 0% to 46% of cells transplanted with a median of 3%. This systematic review suggests that there is considerable scope for improvement in the differentiation of stem cell-derived dopaminergic progenitors to maximize the therapeutic potential of this approach for patients.
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Affiliation(s)
- Giulia Comini
- Pharmacology & Therapeutics and Galway Neuroscience Center, University of Galway, Galway, Ireland
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Rath MM, Anirvan P, Varghese J, Tripathy TP, Patel RK, Panigrahi MK, Giri S. Comparison of standard vs auxiliary (contrast or elastography) endoscopic ultrasound-guided fine needle aspiration/biopsy in solid pancreatic lesions: A meta-analysis. World J Methodol 2025; 15:97415. [DOI: 10.5662/wjm.v15.i3.97415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 11/03/2024] [Accepted: 12/02/2024] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is the most common modality for tissue acquisition from pancreatic masses. Despite high specificity, sensitivity remains less than 90%. Auxiliary techniques like elastography and contrast-enhanced EUS may guide tissue acquisition from viable tumor tissue and improve the diagnostic outcomes theoretically. However, data regarding the same have shown conflicting results.
AIM To compare the diagnostic outcomes of auxiliary-EUS-FNA/B to standard EUS-FNA/B for pancreatic lesions.
METHODS The electronic databases of MEDLINE, EMBASE, and Scopus were searched from inception to February 2024 for all relevant studies comparing diagnostic outcomes of auxiliary-EUS-FNA/B to standard EUS-FNA/B for pancreatic lesions. A bivariate hierarchical model was used to perform the meta-analysis.
RESULTS A total of 10 studies were identified. The pooled sensitivity, specificity, and area under the receiver-operated curve (AUROC) for standard EUS-FNA/B were 0.82 (95%CI: 0.79-0.85), 1.00 (95%CI: 0.96-1.00), and 0.97 (95%CI: 0.95-0.98), respectively. The pooled sensitivity, specificity, and AUROC for EUS-FNA/B with auxiliary techniques were 0.86 (95%CI: 0.83-0.89), 1.00 (95%CI: 0.94-1.00), and 0.96 (95%CI: 0.94-0.98), respectively. Comparing the two diagnostic modalities, sensitivity [Risk ratio (RR): 1.04, 95%CI: 0.99-1.09], specificity (RR: 1.00, 95%CI: 0.99-1.01), and diagnostic accuracy (RR: 1.03, 95%CI: 0.98-1.09) were comparable.
CONCLUSION Analysis of the currently available literature did not show any additional advantage of EUS-FNA/B with auxiliary techniques for pancreatic solid lesions over standard EUS-FNA/B. Further randomized studies are required to demonstrate the benefit of auxiliary techniques before they can be recommended for routine practice.
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Affiliation(s)
- Mitali Madhumita Rath
- Department of Pathology, IMS and SUM Hospital Campus-2, Bhubaneshwar 754001, Odisha, India
| | - Prajna Anirvan
- Department of Gastroenterology, Kalinga Gastroenterology Foundation, Cuttack 753001, Odisha, India
| | - Jijo Varghese
- Department of Gastroenterology, NS Memorial Institute of Medical Sciences, Kollam 691020, Kerala, India
| | - Tara Prasad Tripathy
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneshwar 751019, Odisha, India
| | - Ranjan K Patel
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneshwar 751019, Odisha, India
| | - Manas Kumar Panigrahi
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneshwar 751019, Odisha, India
| | - Suprabhat Giri
- Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
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Kodali R, Parasar K, Anand U, Singh BN, Kant K, Arora A, Karthikeyan V, Anwar S, Saha B, Wadaskar S. Evidence-based approach for intraabdominal drainage in pancreatic surgery: A systematic review and meta-analysis. World J Methodol 2025; 15:99080. [DOI: 10.5662/wjm.v15.i3.99080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Revised: 11/09/2024] [Accepted: 12/05/2024] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade, there has been debate over the routine usage of drains.
AIM To assess the necessity of intra-abdominal drain placement, identify the most effective drain type, and determine the optimal timing for drain removal.
METHODS A systematic review of electronic databases, including PubMed, MEDLINE, PubMed Central, and Google Scholar, was conducted using Medical Subject Headings and keywords until December 2023. From an initial pool of 1910 articles, 48 were included after exclusion and screening. The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula (CR-POPF), delayed gastric emptying (DGE), overall morbidity, and mortality. Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.
RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE. Conversely, patients who did not have drains placed experienced a significant reduction in morbidity, readmission rates, and reoperations. No significant differences were observed between active and passive drain types. Early drain removal (< 3 days) yielded favorable outcomes compared to delayed removal.
CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection, potentially contributing to increased morbidity and mortality. The decision to use drains should be left to the discretion of the operating surgeon. However, early drain removal can substantially reduce morbidity.
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Affiliation(s)
- Rohith Kodali
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Kunal Parasar
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Utpal Anand
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Basant Narayan Singh
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Kislay Kant
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Abhishek Arora
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Venkatesh Karthikeyan
- Department of Community Medicine, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Saad Anwar
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Bijit Saha
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Siddhali Wadaskar
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
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Nunez DA, Guo RC. Acquired sensorineural hearing loss, oxidative stress, and microRNAs. Neural Regen Res 2025; 20:2513-2519. [PMID: 39314173 PMCID: PMC11801280 DOI: 10.4103/nrr.nrr-d-24-00579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/25/2024] Open
Abstract
Hearing loss is the third leading cause of human disability. Age-related hearing loss, one type of acquired sensorineural hearing loss, is largely responsible for this escalating global health burden. Noise-induced, ototoxic, and idiopathic sudden sensorineural are other less common types of acquired hearing loss. The etiology of these conditions is complex and multi-factorial involving an interplay of genetic and environmental factors. Oxidative stress has recently been proposed as a likely linking cause in most types of acquired sensorineural hearing loss. Short non-coding RNA sequences known as microRNAs (miRNAs) have increasingly been shown to play a role in cellular hypoxia and oxidative stress responses including promoting an apoptotic response. Sensory hair cell death is a central histopathological finding in sensorineural hearing loss. As these cells do not regenerate in humans, it underlies the irreversibility of human age-related hearing loss. Ovid EMBASE, Ovid MEDLINE, Web of Science Core Collection, and ClinicalTrials.gov databases over the period August 1, 2018 to July 31, 2023 were searched with "hearing loss," "hypoxamiRs," "hypoxia," "microRNAs," "ischemia," and "oxidative stress" text words for English language primary study publications or registered clinical trials. Registered clinical trials known to the senior author were also assessed. A total of 222 studies were thus identified. After excluding duplicates, editorials, retractions, secondary research studies, and non-English language articles, 39 primary studies and clinical trials underwent full-text screening. This resulted in 11 animal, in vitro , and/or human subject journal articles and 8 registered clinical trial database entries which form the basis of this narrative review. MiRNAs miR-34a and miR-29b levels increase with age in mice. These miRNAs were demonstrated in human neuroblastoma and murine cochlear cell lines to target Sirtuin 1/peroxisome proliferator-activated receptor gamma coactivator-1-alpha (SIRT1/PGC-1α), SIRT1/p53, and SIRT1/hypoxia-inducible factor 1-alpha signaling pathways resulting in increased apoptosis. Furthermore, hypoxia and oxidative stress had a similar adverse apoptotic effect, which was inhibited by resveratrol and a myocardial inhibitor-associated transcript, a miR-29b competing endogenous mRNA. Gentamicin reduced miR-182-5p levels and increased cochlear oxidative stress and cell death in mice - an effect that was corrected by inner ear stem cell-derived exosomes. There is ongoing work seeking to determine if these findings can be effectively translated to humans.
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Affiliation(s)
- Desmond A. Nunez
- Division of Otolaryngology – Head & Neck Surgery, Department of Surgery, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Division of Otolaryngology – Head & Neck Surgery, Gordon & Leslie Diamond Health Care Centre, Vancouver General Hospital, Vancouver, BC, Canada
| | - Ru C. Guo
- Faculty of Medicine – The University of British Columbia, Vancouver, BC, Canada
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Bulut H, Altin O, Salduz I, Salduz A. Meta-analysis of complications and functional outcomes in cosmetic limb lengthening. J Orthop 2025; 65:41-45. [PMID: 39801900 PMCID: PMC11718411 DOI: 10.1016/j.jor.2024.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Accepted: 12/10/2024] [Indexed: 01/16/2025] Open
Abstract
Introduction Short stature, defined as height below the 3rd percentile for age and gender, affects approximately 200 million people worldwide. It can have profound psychological effects, influencing self-esteem, social interactions, and overall life satisfaction, particularly during adolescence. These individuals often face challenges in both professional and romantic lives, increasing their risk of depression and suicidal ideation. Surgical interventions such as limb lengthening can provide life-changing results for individuals facing psychological distress due to short stature. This meta-analysis reviews the literature on cosmetic stature surgery, focusing on Paley outcomes and psychosocial satisfaction, and compares external fixation (EF) and intramedullary nailing (IMN) techniques. Methods This study adhered to PRISMA guidelines. Eligibility criteria included studies with more than five patients, the use of the Paley classification for outcome assessment, and a focus on cosmetic limb lengthening with either EF or IMN. Data from PubMed were extracted using standardized forms and analyzed for complication rates, functional outcomes, and psychosocial satisfaction. The Paley complication system categorized problems, obstacles, and complications, and risk of bias was assessed using the STROBE checklist. Data synthesis was performed using JAMOVI software with effect size and confidence interval calculations. Results Seven studies were included, with a total of 489 patients undergoing EF or IMN for cosmetic limb lengthening. Procedure-related mortality was zero across all studies. EF was associated with higher rates of Paley problems (56 %), obstacles (48 %), and complications (10 %) compared to IMN, which had 37 % problems and 42 % obstacles, with no significant complications reported. Patient satisfaction was generally high, with EF studies reporting satisfaction rates of up to 95 %. Conclusion EF and IMN are both viable options for cosmetic limb lengthening. While EF may present more complications, it maintains high patient satisfaction, whereas IMN offers a safer profile with fewer complications. A collaborative approach, combining surgical options with psychosocial and psychiatric support, can help individuals achieve improved physical and emotional well-being.
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Affiliation(s)
- Halil Bulut
- Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Omer Altin
- Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Irem Salduz
- School of Medicine, Bezmialem University, Istanbul, Turkey
| | - Ahmet Salduz
- Department of Orthopedics, Istanbul University, Istanbul, Turkey
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Ou YC, Peng XY, Yang JX, Chen BY, Chen PF, Liu M. Efficacy of catheter-based ultrasound renal denervation in the treatment of hypertension. World J Clin Cases 2025; 13:102853. [DOI: 10.12998/wjcc.v13.i16.102853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 12/25/2024] [Accepted: 01/18/2025] [Indexed: 02/10/2025] Open
Abstract
BACKGROUND Hypertension (HTN) is a prevalent chronic health condition that significantly increases the risk of cardiovascular diseases-associated mortalities. Despite the use of antihypertensive medications, numerous patients fail to achieve guideline-recommended blood pressure (BP) targets.
AIM To evaluates the efficacy of catheter-based ultrasound renal denervation (uRDN) for the treatment of HTN.
METHODS Relevant studies were identified through searches in PubMed, Embase, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure, with a cut-off date at April 1, 2024. A random-effects model was employed in this study to mitigate potential biases. The risk of bias for included studies was assessed using the Cochrane Risk of Bias assessment tool. Statistical analyses were conducted using Review Manager version 5.3. This meta-analysis incorporated four studies encompassing a total of 627 patients. The reporting bias of this study was deemed acceptable.
RESULTS Compared to the Sham group, the uRDN group demonstrated a significant reduction in daytime ambulatory systolic BP (SBP) [mean difference (MD) -3.87 mmHg, 95% confidence interval (CI): -7.02 to -0.73, P = 0.02], office SBP (MD -4.13 mmHg, 95%CI: -7.15 to -1.12, P = 0.007), and home SBP (MD -5.51 mmHg, 95%CI: -8.47 to -2.55, P < 0.001). However, there was no statistically significant reduction observed in either 24-hour or nighttime ambulatory SBP levels. Subgroup analysis shows that uRDN can significantly reduce the SBP in patients with non-resistant HTN (MD -6.19 mmHg, MD -6.00 mmHg, MD -7.72 mmHg, MD -5.02 mmHg, MD -3.61 mmHg).
CONCLUSION The current evidence suggests that uRDN may effectively reduce home, office, and daytime SBP in patients with HTN, particularly in those with non-resistant HTN.
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Affiliation(s)
- Yi-Chao Ou
- Department of Cardiology, Cardiovascular Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xin-Yuan Peng
- Department of Cardiology, Cardiovascular Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing-Xi Yang
- Department of Cardiology, Cardiovascular Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Bo-Yu Chen
- Department of Cardiology, Cardiovascular Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Peng-Fei Chen
- Department of Cardiology, Cardiovascular Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Mao Liu
- Department of Cardiology, Cardiovascular Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Doody O, Graham M, Hegarty O, Marie Sloane A, Walsh P, Synnott M, Russell M, Dunworth T, Sheridan J, Murphy L. Identifying the landscape and contribution of advanced nurse practitioners in supporting healthcare provision in Ireland in the 21st century: An integrative review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2025; 8:100304. [PMID: 40018051 PMCID: PMC11867301 DOI: 10.1016/j.ijnsa.2025.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 01/29/2025] [Accepted: 01/29/2025] [Indexed: 03/01/2025] Open
Abstract
Background In Ireland the role of advanced nurse practitioner has developed significantly since 2001. This evolution is rooted in the growing recognition of the need for highly skilled nursing professionals to address complex healthcare demands and improve patient outcomes. Objective To scope the landscape and identify the effect of advanced nurse practitioners on healthcare provision in Ireland. Design A systematic search of eight academic databases (CINAHL, Embase, PsycINFO, Scopus, Medline and Academic Search Complete, Cochrane, Web of Science) relevant to nursing and health care were performed. Settings Nursing care environment. Participants Advanced nurse practitioners delivering care. Methods A pre-defined systematic search of eight academic databases was conducted, and two reviewers screened each study against the inclusion criteria. Additional hand-searching of the reference lists (backward chaining) and citations (forward chaining) of papers that met the inclusion criteria was conducted. The methodological details of each paper were extracted and assessed for quality and rigour utilising the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for appraising grey literature. Data were mapped and analysed onto the six domains of advanced nurse practitioner practice, and the review was reported in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Results All papers included in this review spanned across the last 20 years. In total, 45 papers met the inclusion criteria: quantitative (n = 11), qualitative (n = 15), mixed methods (n = 4), and discussion/clinical cases (n = 15) papers. Advanced nurse practitioners in Ireland contribute substantial impacts on management and team competence, clinical-decision making, leadership and professional scholarship, professional values and conduct, communication and interpersonal competence, and knowledge and cognitive competence domains. Advanced nurse practitioners in Ireland enhance healthcare outcomes through expertise, coordination, and patient-centred approaches, emphasising their critical role in healthcare delivery and system improvements. Conclusions We have highlighted the active role advanced nurse practitioners play in enhancing patient care, improving management and team coordination, and advancing professional scholarship. These insights have provided a foundation for future research and policy development to optimise the advanced nurse practitioner role.
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Affiliation(s)
- Owen Doody
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Nursing & Midwifery, University of Limerick, Limerick, Ireland
| | - Margaret Graham
- School of Nursing & Midwifery, University of Limerick, Limerick, Ireland
| | - Orla Hegarty
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Anne Marie Sloane
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Pauline Walsh
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Mary Synnott
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Mary Russell
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Trudy Dunworth
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Jill Sheridan
- HSE Mid West Mental Health Services, St. Joseph's Hospital, Mulgrave Street, Limerick, Ireland
| | - Louise Murphy
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Nursing & Midwifery, University of Limerick, Limerick, Ireland
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Howland K, Edvardsson K, Lees H, Hooker L. Telehealth use in the well-child health setting. A systematic review of acceptability and effectiveness for families and practitioners. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2025; 8:100277. [PMID: 39734584 PMCID: PMC11681896 DOI: 10.1016/j.ijnsa.2024.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 11/28/2024] [Accepted: 12/02/2024] [Indexed: 12/31/2024] Open
Abstract
Background Universal well-child health nursing services in high-resource countries promote the health and well-being of children and families while preventing health inequities. The COVID-19 pandemic and technological advancements have led to the increased use of telehealth in this field. To enhance policies and practices, it's important to understand the acceptability and effectiveness of telehealth, as well as the barriers and enablers to its implementation, and to determine when its use is appropriate and safe. Objective To explore the global evidence on the use of telehealth in well-child health settings within high-income countries. Focussing on the effectiveness and acceptability of telehealth, along with the factors affecting its implementation and the considerations for safety from the perspectives of both providers and families. Design A mixed methods systematic review. Methods A systematic review was conducted following PRISMA guidelines. The inclusion criteria for the review included: primary research papers written in English, conducted in high-income countries, focused on telehealth in the well-child health setting, and involving children under six years of age. The search, which was completed in July 2023, systematically explored the CINAHL, ProQuest Central, PubMed, and Web of Science bibliographic databases. Studies were critically appraised for quality, and relevant data extracted. A convergent segregated approach was employed to synthesise both quantitative and qualitative data, which is presented in a narrative format. Results A total of 4,354 records were identified and screened, and 169 full-text papers were assessed for eligibility, resulting in 20 papers for inclusion. Telehealth acceptability among families was reported in 13 of the 20 studies reviewed, with participants expressing high satisfaction regarding its use as a complement to standard care. Only three studies examined practitioners' acceptance, revealing mixed responses. Effectiveness was observed in 15 studies, with no significant differences found between the control and telehealth groups, suggesting that telehealth may achieve outcomes like those of standard care. Four studies identified both enablers and barriers to the implementation of telehealth, though none addressed concerns regarding safety and appropriateness. Conclusions Telehealth shows promise for well-child health services, but there is limited evidence of its effectiveness and safety. The COVID-19 pandemic increased its use, yet risks need further exploration. To validate telehealth in this field, we must identify effective applications, tackle implementation barriers, and ensure client safety. Additional research is essential for developing evidence-based policies for future practices.
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Affiliation(s)
- Kim Howland
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Kristina Edvardsson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Helen Lees
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Justi LHZ, Silva JF, Santana MS, Laureano HA, Pereira ME, Oliveira CS, Guiloski IC. Non-steroidal anti-inflammatory drugs and oxidative stress biomarkers in fish: a meta-analytic review. Toxicol Rep 2025; 14:101910. [PMID: 39901883 PMCID: PMC11788796 DOI: 10.1016/j.toxrep.2025.101910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 01/07/2025] [Accepted: 01/12/2025] [Indexed: 02/05/2025] Open
Abstract
Drug residues have been detected in aquatic environments around the world and non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most used classes. Therefore, it is important to verify the physiological effects of these products on exposed non-target organisms such as fish. Through a meta-analytic review, we evaluated the effects of NSAIDs on oxidative stress biomarkers in fish. Overall, Diclofenac was the most frequently tested drug in the systematically selected studies while acute and hydric exposure types were the most prevalent among these studies. The meta-analysis revealed that (1) chronic and subchronic exposures to NSAIDs decreased catalase (CAT) activity, and acute exposure increased glutathione peroxidase (GPx) activity; (2) hydric exposure increased GPx activity; (3) exposure to low concentrations of NSAIDs increased GPx and superoxide dismutase (SOD) activity; (4) Paracetamol exposure increased GPx and SOD activity and lipid peroxidation levels, but reduced glutathione S-transferase (GST) activity; (5) Diclofenac exposure increased GPx activity. In conclusion, our results demonstrated that fish are sensitive to NSAIDs exposure presenting significant alterations in oxidative stress biomarkers, especially in the GPx enzyme. This enzyme exhibits strong potential as a biomarker of NSAIDs exposure in fish. Paracetamol stood out as the NSAID that altered the largest number of oxidative stress biomarkers, drawing attention to its risk to fish. In contrast, ibuprofen did not change the biomarkers evaluated. These data demonstrate the important impact of emerging contaminants such as NSAIDs on aquatic organisms and the need for strategies to mitigate these effects.
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Affiliation(s)
- Luiz Henrique Zaniolo Justi
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, PR, Brazil
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil
| | - Juliana Ferreira Silva
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, PR, Brazil
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil
| | | | | | - Meire Ellen Pereira
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, PR, Brazil
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil
| | - Cláudia Sirlene Oliveira
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, PR, Brazil
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil
| | - Izonete Cristina Guiloski
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, PR, Brazil
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil
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Ganse-Dumrath A, Chohan A, Samuel S, Bretherton P, Haenschel C, Fett AK. Systematic review and meta-analysis of early visual processing, social cognition, and functional outcomes in schizophrenia spectrum disorders. Schizophr Res Cogn 2025; 40:100351. [PMID: 40028174 PMCID: PMC11872129 DOI: 10.1016/j.scog.2025.100351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 02/07/2025] [Accepted: 02/07/2025] [Indexed: 03/05/2025]
Abstract
Non-affective psychotic disorders are marked by cognitive and sensory processing abnormalities, including in early visual processing and social cognition. Understanding the relationships between these deficits and their impact on daily-life functional outcomes may help to improve outcomes in affected individuals. This systematic review and meta-analysis aimed to summarise the existing evidence on the relationships between early visual processing, social cognition, and functional outcomes, and to assess the evidence regarding the mediating role of social cognition in the association between early visual processing and functional outcomes in individuals with schizophrenia spectrum disorders. A comprehensive search across five databases identified 364 potentially eligible studies, with eight articles meeting all inclusion criteria. Meta-analytic techniques were employed to synthesise effect sizes and assess a meta-mediation model. Three random-effects meta-analyses revealed significant associations between all three domains of interest. Social cognition partially mediated the relationship between early visual processing and functional outcomes. The direct effect of early visual processing on functional outcomes remained significant, albeit with a reduced effect size. The findings suggest that interventions targeting both early visual processing and social cognition concurrently may improve functional outcomes more effectively than focusing on either domain alone.
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Affiliation(s)
- Akke Ganse-Dumrath
- Department of Psychology, School of Health and Medical Sciences, City St George's, University of London, UK
| | - Anya Chohan
- Department of Psychology, School of Health and Medical Sciences, City St George's, University of London, UK
| | - Steven Samuel
- Department of Psychology, School of Health and Medical Sciences, City St George's, University of London, UK
| | - Paul Bretherton
- Department of Psychology, School of Health and Medical Sciences, City St George's, University of London, UK
| | - Corinna Haenschel
- Department of Psychology, School of Health and Medical Sciences, City St George's, University of London, UK
| | - Anne-Kathrin Fett
- Department of Psychology, School of Health and Medical Sciences, City St George's, University of London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
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Hong I, Bigam KD, McConnell BM, Özelsel TJP, Sondekoppam RV. Sevoflurane and its metabolic byproduct compound A induce nephrotoxicity: a systematic review and meta-analysis of animal studies. Med Gas Res 2025; 15:254-265. [PMID: 39829162 DOI: 10.4103/mgr.medgasres-d-24-00080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 10/07/2024] [Indexed: 01/22/2025] Open
Abstract
Animal models investigating sevoflurane or compound A and renal function serve as the initial basis for concerns regarding renal injury following sevoflurane anesthesia and subsequent recommendations of minimum fresh gas flow, but this evidence basis has not been critically appraised. Primary literature searches were performed in MEDLINE OVID, PubMed, EMBASE, the Cochrane Library), the Cochrane Central Register of Controlled Trials, the International HTA Database, CINAHL, and Web of Science to identify randomized controlled trials and quasi-experimental studies in animals utilizing sevoflurane or compound A. The primary outcomes included renal function as determined by blood urea nitrogen, serum creatinine, creatinine clearance, and urine volume. The secondary outcomes included the serum fluoride concentration and histopathological findings. A total of 2537 records were screened, and 21 randomized controlled trials and 9 quasi-experimental animal studies were identified. No associations between sevoflurane exposure and subsequent changes in renal function (blood urea nitrogen, serum creatinine or changes in urine volume) were noted. A similar effect on renal function was observed following compound A exposure, but urine volume was elevated following compound A exposure. In addition, the histopathological damage following compound A exposure was observed only at concentrations that are unachievable in clinical practice. Our review of evidence from animal models revealed that sevoflurane usage was not associated with changes in renal function tests or urine volume. Histopathologic changes after sevoflurane exposure were either nonexistent or minor. Studies on compound A did not reveal an alteration in renal function, although histopathological evidence of injury was present when compound A was administered at very high, unphysiologic concentrations. In light of the existing evidence, the initial concerns of sevoflurane-related nephrotoxicity based on animal studies that leads to minimum fresh gas flow recommendations are called into question.
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Affiliation(s)
- Intek Hong
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin D Bigam
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Brie M McConnell
- Davis Centre Library, University of Waterloo, Waterloo, Ontario, Canada
| | - Timur J P Özelsel
- Department of Anesthesia and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Rakesh V Sondekoppam
- Department of Anesthesia, Pain and Perioperative Medicine, Stanford University, Stanford, CA, USA
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Molina TC, Martinez WD, Pereira VA, Lima ARDA, Brienze VMS, Roberto dos Santos E, Júnior VCS, Borge C, André JC. Toward evidence-informed medical curricula: A scoping review protocol on social skills and emotional regulation. MethodsX 2025; 14:103161. [PMID: 39897643 PMCID: PMC11787439 DOI: 10.1016/j.mex.2025.103161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 01/06/2025] [Indexed: 02/04/2025] Open
Abstract
Medical education is considered psychologically challenging, and medical students often report higher levels of psychological distress compared to non-medical students and the general population. This scoping review aims to identify and map the available scientific evidence on social skills and emotional regulation in medical students, characterize existing studies, identify knowledge gaps, and provide a synthesis of evidence to inform educational practice and curriculum development. This scoping review will follow the methodological frameworks proposed by the Joanna Briggs Institute (JBI) and the PRISMA-ScR checklist. Relevant studies will be searched in electronic databases (EMBASE, ERIC, PubMed, Science Direct, Scopus, and Web of Science) and gray literature sources. The search strategy will use descriptors in English, Portuguese, and Spanish, combined with Boolean operators. Two reviewers will independently screen titles, abstracts, and full-texts for inclusion. Data will be extracted using a standardized form and synthesized narratively. Qualitative and quantitative analyses, including thematic analysis and meta-analysis analysis (if appropriate), will be employed to provide a comprehensive overview of the evidence. The review will provide a comprehensive overview of the available scientific evidence on social skills and emotional regulation in medical students, identifying study characteristics, knowledge gaps, and areas for future research. The findings of this scoping review may inform educational practice and guide the development of strategies to promote the well-being and performance of medical students by addressing social skills and emotional regulation in medical curricula. The review protocol will be registered in the Open Science Framework (OSF).
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Affiliation(s)
- Thaysa Castro Molina
- Postgraduate Program in Health Sciences, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil
- Center for Studies and Development of Health Education, Faculty of Medicine of São José do Rio Preto, Brazil
| | - William Donegá Martinez
- Center for Studies and Development of Health Education, Faculty of Medicine of São José do Rio Preto, Brazil
| | - Vinicíus Araújo Pereira
- Postgraduate Program in Health Sciences, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil
- Center for Studies and Development of Health Education, Faculty of Medicine of São José do Rio Preto, Brazil
| | - Alba Regina de Abreu Lima
- Center for Studies and Development of Health Education, Faculty of Medicine of São José do Rio Preto, Brazil
| | | | - Emerson Roberto dos Santos
- Center for Studies and Development of Health Education, Faculty of Medicine of São José do Rio Preto, Brazil
| | - Valdir Carlos Severino Júnior
- Postgraduate Program in Health Sciences, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil
| | - Camila Borge
- Postgraduate Program in Health Sciences, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil
| | - Júlio César André
- Center for Studies and Development of Health Education, Faculty of Medicine of São José do Rio Preto, Brazil
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Wong KL, Chua WL, Griffiths P, Goh QLP, Low KWC, Tan JQA, Liaw SY. Teamwork between registered nurses and unlicensed assistive personnel in acute care settings: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2025; 8:100293. [PMID: 39906753 PMCID: PMC11791319 DOI: 10.1016/j.ijnsa.2025.100293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 01/02/2025] [Accepted: 01/12/2025] [Indexed: 02/06/2025] Open
Abstract
Background Unlicensed assistive personnel are increasingly employed to support the nursing workforce in providing bedside care. Aim To scope the literature on the factors influencing teamwork between registered nurses and unlicensed assistive personnel in acute care settings. Methods A scoping review was conducted using the Arksey and O'Malley (2005) framework. Eight electronic databases were searched from inception of each database to August 2024 to locate studies that reported issues relating to teamwork between registered nurses and unlicensed assistive personnel on patient care in general wards of acute care settings. Two reviewers independently screened titles, abstracts, and full text for eligibility. The data were extracted, analysed, and synthesised using the data-based convergent qualitative synthesis. Results Thirty-eight studies were included. Five themes were generated: (1) role clarity, (2) delegation, (3) communication, (4) ward culture and practice, and (5) interpersonal relationships. Challenges in registered nurses-unlicensed assistive teamwork include unclear roles and responsibilities, ineffective delegation, and communication barriers. Work culture that excludes unlicensed assistive personnel from shift handovers were found to hinder shared goals for patient care. The importance of interpersonal relationships between registered nurses and unlicensed assistive personnel was highlighted to aid in the power disparity between them. Conclusions This review found suboptimal teamwork between registered nurses and unlicensed assistive personnel. Teamwork between registered nurses and unlicensed assistive personnel can be improved through clearly defined roles and responsibilities, better delegation practices, effective communication, and improved interpersonal relationships. Future research should focus on optimising communication processes and enhancing registered nurses' delegation skills through education.
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Affiliation(s)
- Kang Lynn Wong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Peter Griffiths
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- International Journal of Nursing Studies, King's College London, London, United Kingdom
| | - Qin Ling Pearlyn Goh
- Department of Nursing, National Healthcare Group, Khoo Teck Puat Hospital, Yishun Health Campus, Singapore, Singapore
| | - Kye Wern Chelsea Low
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jia Qi Apphia Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Rivera-Valdés JJ, Sifuentes-Franco S, Ramírez-Meza SM, Íñiguez-Mosqueda O, Morales-Núñez JJ, Ramírez-Evangelista ML, Reyes-Pérez IV, Graciano-Machuca O. Association between microsatellite polymorphism in the Heme Oxygenase-1 (HMOX1) gene promoter and type 2 diabetes: an updated meta-analysis. J Diabetes Metab Disord 2025; 24:63. [PMID: 39917725 PMCID: PMC11794720 DOI: 10.1007/s40200-025-01575-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 01/26/2025] [Indexed: 02/09/2025]
Abstract
Over a decade has passed since the first meta-analysis examining (GT)n repeats in the HMOX1 promoter region and their association with Type 2 Diabetes (T2D) was conducted. Since then, new studies on this topic have been published, prompting this updated meta-analysis to further clarify these associations. A systematic review conducted through December 2024 using the search term: (HMOX1 OR HMOX1 OR HMOX1D OR "HO-1" OR HSP32 OR bk286B10) AND (polymorphisms OR polymorphism OR "genetic variant" OR "genetic variants") AND (Diabetes) in the PubMed, Web of Science, and Scopus databases identified nine studies comprising 2,027 cases and 2,840 controls. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using either a fixed-effect model (FEM) for homogeneous data or a random-effect model (REM) for other cases, as appropriate. Sensitivity analysis and publication bias were also assessed. The SS genotype was identified as being inversely associated with T2D in both SS:SL + LL and SS:LL genetic models (OR = 0.769, p = 0.003; OR = 0.726, p = 0.003; respectively). These findings suggest that SS genotype (< 25 GT repeats) may have a protective role against T2D; however, further studies are needed to elucidate the mechanisms by which HMOX1 influences T2D pathogenesis. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-025-01575-y.
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Affiliation(s)
- Juan José Rivera-Valdés
- Institute of Translational Nutrigenetics and Nutrigenomics, Department of Molecular Biology and Genomics, University Center of Health Sciences, University of Guadalajara, 44340 Guadalajara, Jalisco Mexico
| | - Sonia Sifuentes-Franco
- Clinical Science Laboratory, Department of Health Sciences, Los Valles Campus, University of Guadalajara, 46600 Ameca, Jalisco Mexico
| | - Sandra Margarita Ramírez-Meza
- Laboratory for the Evaluation of Nutritional Status and Dietetics, Department of Health Sciences, Los Valles Campus, University of Guadalajara, 46600 Ameca, Jalisco Mexico
| | - Omar Íñiguez-Mosqueda
- Internal Medicine Service, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, 44340 Guadalajara, Jalisco Mexico
| | - José Javier Morales-Núñez
- Clinical Science Laboratory, Department of Health Sciences, Los Valles Campus, University of Guadalajara, 46600 Ameca, Jalisco Mexico
| | - Mayra Leticia Ramírez-Evangelista
- Clinical Science Laboratory, Department of Health Sciences, Los Valles Campus, University of Guadalajara, 46600 Ameca, Jalisco Mexico
| | - Itzel Viridiana Reyes-Pérez
- Department of Molecular Biology and Genomics, University Center for Health Science, University of Guadalajara, 44340 Guadalajara, Jalisco Mexico
| | - Omar Graciano-Machuca
- Laboratory of Biological Systems, University of Guadalajara, Los Valles Campus, 46600 Ameca, Jalisco Mexico
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Vera-Ponce VJ, Loayza-Castro JA, Zuzunaga-Montoya FE, Sanchez-Tamay NM, Bustamante-Rodríguez JC, Valladolid-Sandoval LAM, Vásquez-Romero LEM, Gutiérrez de Carrillo CI. Prevalence and incidence of prediabetes in Latin America. A systematic review and meta-analysis. J Diabetes Metab Disord 2025; 24:25. [PMID: 39735173 PMCID: PMC11680525 DOI: 10.1007/s40200-024-01549-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 12/10/2024] [Indexed: 12/31/2024]
Abstract
Introduction Prediabetes represents a significant public health challenge in Latin America. Its prevalence varies considerably depending on the diagnostic criteria used, which hinders a precise understanding of its magnitude in the region. Objective To estimate the prevalence and incidence of prediabetes in Latin America through a systematic review (SR). Methods A SR and meta-analysis was conducted searching through October 25, 2024 in SCOPUS, EMBASE, Web of Science, and PubMed. Studies were included if they: (1) used probabilistic sampling methods, (2) included adult participants (≥ 18 years), (3) assessed prediabetes using WHO criteria, fasting glucose, postprandial glucose, or HbA1c, and (4) were published in English, Spanish, or Portuguese. Studies using non-probabilistic sampling, focusing on specific medical conditions, or lacking sufficient data to calculate prevalence or incidence were excluded. Random-effect models were used to estimate pooled prevalence, with heterogeneity assessed using I² statistics and publication bias through funnel plots. Results Twenty-five studies from 9 countries published between 1992 and 2023 were analyzed. The pooled prevalence of prediabetes was 24% (95% CI: 18-30%). According to specific criteria, the prevalences were: WHO 11% (95% CI: 5-18%), FG 18% (95% CI: 10-27%), PPG 20% (95% CI: 3-46%), and HbA1c 32% (95% CI: 21-52%). High heterogeneity was observed among studies (I² = 99-100%, p < 0.001). Only one study analyzed the incidence, which was 12.8%. Conclusions Prediabetes prevalence in Latin America is high, with significant variations by diagnostic criteria. The limited number of incidence studies and high heterogeneity highlight the need for standardized approaches in future research. Implementation of preventive strategies and strengthening of epidemiological surveillance systems are crucial for addressing this public health challenge. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01549-6.
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Affiliation(s)
- Víctor Juan Vera-Ponce
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
| | - Joan A. Loayza-Castro
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
| | | | - Nataly Mayely Sanchez-Tamay
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
| | - Juan Carlos Bustamante-Rodríguez
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
| | - Lupita Ana Maria Valladolid-Sandoval
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
| | - Luisa Erika Milagros Vásquez-Romero
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
| | - Carmen Inés Gutiérrez de Carrillo
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Perú
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Xin C, Gai Y, Wei L, Wang Y, Luo Y, Han B. Potential diagnostic tools for intensive care unit acquired weakness: A systematic review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2025; 8:100301. [PMID: 39995749 PMCID: PMC11849193 DOI: 10.1016/j.ijnsa.2025.100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 12/30/2024] [Accepted: 01/26/2025] [Indexed: 02/26/2025] Open
Abstract
Background Intensive care unit-acquired weakness is a prevalent complication among critically ill patients, associated with heightened mortality rates, extended durations of mechanical ventilation and hospital stays, as well as diminished mobility and unfavorable prognoses. Early diagnosis of intensive care unit-acquired weakness and identification of its subcategories are essential for early implementation of targeted interventions and care strategies. Nevertheless, there remains a significant gap in the availability of widely accepted, accurate, and user-friendly diagnostic tools for intensive care unit-acquired weakness. Objective The aim of this research was to conduct a comprehensive review of pertinent studies on diagnostic tools for intensive care unit-acquired weakness in critically ill patients, summarizing their diagnostic efficacy and constraints to aid healthcare professionals in choosing suitable diagnostic tools for intensive care unit-acquired weakness. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement were utilized to direct the literature search, bias risk assessment and data extraction. The search databases included PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL. The search period was from the inception of the database to 1 July 2024. Different types of risk bias assessment tools were used for different types of studies. Due to the heterogeneity of the data, solely a narrative synthesis of the intensive care unit-acquired weakness diagnostic tool was performed in this study. Results A total of 38 observational studies were included in the study. In the included studies, the gold standard for intensive care unit-acquired weakness diagnosis include the Medical Research Council score, muscle biopsy and electrophysiologic testing, potential diagnostic tools include the manual muscle test, electrophysiologic testing, imaging, serum inflammatory markers, neuromuscular ultrasound, and other parameters. In various studies, the diagnostic accuracy of intensive care unit-acquired weakness diagnostic tools has been inconsistent, with each tool possessing its own set of advantages and disadvantages. At present, no single tool is available for the definitive diagnosis of intensive care unit-acquired weakness, necessitating the combined use of multiple methods, each with inherent limitations. Manual muscle test is inexpensive and straightforward to perform, but it requires the patient to be conscious and cooperative. Muscle biopsy is invasive and rarely utilized. Electrophysiological testing can help differentiate whether intensive care unit-acquired weakness is caused by neural or muscular alterations, thereby aiding in the classification of its subtypes. However, it is moderately invasive, costly, and operator-dependent. Other diagnostic modalities, such as imaging and respiratory parameters, are under ongoing investigation. Conclusions The diagnostic tools available in intensive care unit-acquired weakness are varied, each with its own strengths and limitations. This study summarizes the current evidence on potential diagnostic tools for intensive care unit-acquired weakness and identifies possible future directions for these diagnostic tools. Registration PROSPERO Registration Number CRD42024573139.
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Affiliation(s)
- Chen Xin
- Xuanwu Hospital, Capital Medical University, Beijing, China
- School of Nursing, Capital Medical University, Beijing, China
| | - Yubiao Gai
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Wei
- Nursing Department, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yanqiu Wang
- Xuanwu Hospital, Capital Medical University, Beijing, China
- School of Nursing, Capital Medical University, Beijing, China
| | - Yuhong Luo
- Xuanwu Hospital, Capital Medical University, Beijing, China
- School of Nursing, Capital Medical University, Beijing, China
| | - Binru Han
- Xuanwu Hospital, Capital Medical University, Beijing, China
- School of Nursing, Capital Medical University, Beijing, China
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Bird SB. Antipsychotic-induced hyperprolactinemia: Toxicologic mechanism and the increased breast cancer risk. Toxicol Rep 2025; 14:101927. [PMID: 39989981 PMCID: PMC11846583 DOI: 10.1016/j.toxrep.2025.101927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2024] [Revised: 01/02/2025] [Accepted: 01/23/2025] [Indexed: 02/25/2025] Open
Abstract
Antipsychotic drugs are effective at improving both the positive and negative symptoms of schizophrenia as well as the manic phase of bipolar disorder. Whether an antipsychotic is termed typical or atypical is related to the xenobiotic's propensity to cause extrapyramidal side effects. However, with a few exceptions, drugs of both classes of antipsychotics are known to cause hyperprolactinemia. As many breast cancers are responsive to prolactin concentrations, the persistent increase in prolactin of the antipsychotics has implications for public health and carcinogenesis. The objective of this study was to review the extant literature on hyperprolactinemia due to antipsychotics, and to determine the risk imposed by those drugs on human breast cancer. A summary risk of breast cancer with use of any antipsychotic was found to be 1.19 (95 % confidence interval 1.10-1.30). When limiting usage of antipsychotics to 5 or more years, the summary risk increased to 1.26 (95 % confidence interval 1.12-1.43). And when limited to those studies who evaluated only those medications with the greatest increase in prolactin, the risk increased to 1.59 (95 % confidence interval 1.37-1.85). Given this increased risk of breast cancer, stronger warnings about this increased risk are warranted, and regular monitoring of prolactin levels and breast cancer screening should be part of the management plan for these patients.
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Affiliation(s)
- Steven B. Bird
- UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01545, USA
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Han M, Huang J, Yang J, Chen J, Qi H. Barriers and facilitators to the implementation of guidelines for venous thromboembolism prevention and management: A mixed-methods systematic review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2025; 8:100273. [PMID: 39717799 PMCID: PMC11664414 DOI: 10.1016/j.ijnsa.2024.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 11/19/2024] [Accepted: 11/25/2024] [Indexed: 12/25/2024] Open
Abstract
Background Evidence-based venous thromboembolism prevention and management is a priority for global health services. Low adoption of venous thromboembolism guidelines can result in compromised patient outcomes. Understanding clinicians' and patients' perceptions of barriers to and facilitators for guideline implementation and mapping identified barriers and facilitators to the Consolidated Framework for Implementation Research may inform theoretical interventions to improve guideline adoption rates. Objective To synthesize quantitative and qualitative evidence on both 1) perceptions and experiences of hospital clinicians and patients regarding venous thromboembolism practices and 2) barriers to and facilitators for guideline implementation. Data source English-language studies from MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane published between 2012 and 2023. Methods The included studies primarily focused on two aspects: firstly, elucidating the perceptions and experiences of healthcare providers and patients concerning venous thromboembolism management practices, and secondly, identifying the barriers and facilitators that influence the implementation of venous thromboembolism guidelines. The Mixed Methods Appraisal Tool was used for critical appraisal. Quantitative data were transformed into qualitized data and then thematically synthesized with qualitative data to compare the perspectives of clinicians and patients. Barriers and facilitators related to each topic were mapped to the Consolidated Framework for Implementation Research, and the barriers were entered into its implementation strategy matching tool to obtain implementation strategies. Results Of 8262 studies of varying quality, 26 (20 quantitative, five qualitative, and one mixed-methods) met the inclusion criteria. Four themes represented factors influencing guideline implementation: 1) healthcare-led multidisciplinary prevention and management, 2) feasibility of guideline implementation, 3) patient involvement in prevention and management, and 4) government and hospital environments and related systems. The majority of barriers identified by healthcare providers were related to the second and fourth themes, while for patients, there were multiple barriers under the third theme. Barriers were mainly mapped into four domains: intervention characteristics, outer setting, inner setting, and characteristics of individuals. Most facilitators mentioned by healthcare providers and patients were related to themes 1, 3, and 4 and mapped to three domains: outer setting, inner setting, and characteristics of individuals. Seven optimal implementation strategies were obtained through the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change matching tool. Conclusions We highlighted the most influential factors associated with implementing venous thromboembolism guidelines from the perspectives of both clinicians and patients, and mapping these factors to the Consolidated Framework for Implementation Research can help to develop stakeholder-appropriate implementation interventions. Registration This study's protocol has been registered at PROSPERO under the registration number CRD42024518184.
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Affiliation(s)
- Mengbo Han
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingying Huang
- Postanesthesia Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Yang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaojiao Chen
- Orthopedics Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiou Qi
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Li Z, Cai H, Xu B, Dong Q, Jia K, Lin Z, Wang X, Liu Y, Qin X. Prevalence, antibiotic resistance, resistance and virulence determinants of Campylobacter jejuni in China: A systematic review and meta-analysis. One Health 2025; 20:100990. [PMID: 40027923 PMCID: PMC11871471 DOI: 10.1016/j.onehlt.2025.100990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 02/02/2025] [Accepted: 02/05/2025] [Indexed: 03/05/2025] Open
Abstract
Campylobacter jejuni (C. jejuni) is recognized as a serious food contaminant that extensively results in foodborne diseases. Numerous studies have been conducted on the prevalence and antibiotic resistance of C. jejuni, but there is a lack of comprehensive analysis of published data. This study provides a comprehensive overview of the epidemiology, antibiotic resistance, and virulence determinants of C. jejuni in China through a systematic review and meta-analysis. The prevalence levels of C. jejuni from low to high were the humans (5.2 %, 95 % CI: 4.2-6.4 %), foods (12.5 %, 95 % CI: 9.7-15.6 %), animals (15.4 %, 95 % CI: 13.2-17.6 %), and environment (17.8 %, 95 % CI: 9.7-27.7 %), respectively. Furthermore, C. jejuni exhibits high resistance rates to antibiotics such as cefoperazone, nalidixic acid, ciprofloxacin, cefradine, and tetracycline. The overall multi-drug resistance rate (MDR) of C. jejuni was 72.8 % (95 % CI: 62.4-82.2 %), indicating a serious problem with MDR. The resistance of C. jejuni to most antibiotics has increased in the last 20 years. Among the main resistance determinants of C. jejuni, gyrA_T86I and tet(O) had a higher pooled prevalence of 94.8 % (95 % CI: 88.7-99.0 %) and 79.0 % (95 % CI: 66.9-89.2 %), respectively. Furthermore, the high prevalence of virulence-related genes was shown in C. jejuni, such as adhesion (cadF, racR), invasion (ciaB, iamA, ceuE), and toxin (cdtB, cdtC). In summary, C. jejuni has a high prevalence with regional characteristics, and antibiotic resistance of this bacterium especially animal sources remains a serious problem in China. Comprehensive monitoring and control measures for this pathogen are urgently needed to ensure food safety and public health.
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Affiliation(s)
- Zhao Li
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Hua Cai
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Biyao Xu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Qingli Dong
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Kai Jia
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Zijie Lin
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Xiang Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Yangtai Liu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Xiaojie Qin
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
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Ruiz-Ranz E, Asín-Izquierdo I. Physical activity, exercise, and mental health of healthy adolescents: A review of the last 5 years. SPORTS MEDICINE AND HEALTH SCIENCE 2025; 7:161-172. [PMID: 39991129 PMCID: PMC11846438 DOI: 10.1016/j.smhs.2024.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 10/07/2024] [Accepted: 10/11/2024] [Indexed: 02/25/2025] Open
Abstract
The mental health of adolescents is a priority for successful development. Physical activity (PA) and exercise can have effects on the mental health of adolescents. This review analysed the effect that physical exercise interventions can have on the mental health of healthy adolescents between 10 and 19 years of age. The search was carried out in four databases. PubMed, Web of Science, Scopus and SportDiscuss, were searched up to December 31, 2022, following the general model. Eleven studies were selected, with a total sample of 23 681 participants in 2 435 studies published in the last 5 years involving healthy adolescents. The search process and review of the articles was performed by independent expert investigators. The risk-of-bias and the methodological quality were analysed using the Cochrane scale. The limited and heterogeneous studies conducted so far do not clearly establish the benefits of PA on adolescents' mental health. However, some PA interventions seem to improve subjective well-being, self-esteem, physical and mental well-being, anxiety, lifestyle, emotional intelligence, depressive mood, and perceived benefit and confidence in healthy adolescents. It is important to design an effective and appropriate physical exercise programme that can be implemented for adolescents to achieve significant effects on their mental health. Studies that did not implement an appropriate exercise program with improvements in adolescent physical fitness showed no changes in psychological variables. Further research is needed to clearly establish that exercise programmes have positive effects on mental health in healthy adolescents.
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Affiliation(s)
- Eva Ruiz-Ranz
- Department of Education Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Iván Asín-Izquierdo
- Department of Musical, Plastic and Corporal Expression, Faculty of Social and Human Sciences, University of Zaragoza, Teruel, Spain
- Physical Performance and Sports Research Center, Department of Sports and Computer Sciences, Faculty of Sport Sciences, Pablo de Olavide University, Seville, Spain
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
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Shao X, He L, Liu Y. The effects of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents: a meta-analysis. Neural Regen Res 2025; 20:1513-1520. [PMID: 39075917 PMCID: PMC11624860 DOI: 10.4103/nrr.nrr-d-23-01296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/01/2023] [Accepted: 01/27/2024] [Indexed: 07/31/2024] Open
Abstract
Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the PubMed, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using ReviewManager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference (MD; before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants (60 children and 471 adolescents, 10.9-16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I2 test provided by ReviewManager software. The meta-analysis showed that there was no heterogeneity among the studies (P = 0.67, I2 = 0.00%). The combined effect of the interventions was significant (MD = 2.88, 95% CI: 1.53-4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This meta-analysis was registered at PROSPERO (registration ID: CRD42023439408).
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Affiliation(s)
- Xueyun Shao
- Physical Education School, Shenzhen University, Shenzhen, Guangdong Province, China
- Shenzhen Institute of Neuroscience, Shenzhen, Guangdong Province, China
| | - Longfei He
- Shenzhen Institute of Neuroscience, Shenzhen, Guangdong Province, China
| | - Yangyang Liu
- Shenzhen Institute of Neuroscience, Shenzhen, Guangdong Province, China
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Giai Via R, Giachino M, Elzeiny A, Cipolla A, Marino A, D'Amelio A, Bosco F, Zoccola K, Aprato A, Massè A. Reconstruction of unfixable comminuted posterior wall acetabular fractures with autologous bone graft: A systematic review. J Orthop 2025; 63:21-26. [PMID: 39530045 PMCID: PMC11550724 DOI: 10.1016/j.jor.2024.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/20/2024] [Accepted: 10/23/2024] [Indexed: 11/16/2024] Open
Abstract
Background Posterior wall acetabular fractures, often caused by high-energy trauma, are complex injuries that pose significant surgical challenges, especially when comminuted. Traditional fixation techniques have shown variable outcomes, with severe comminution sometimes rendering fragment fixation impossible. The aim of this study was to evaluate the clinical and radiological outcomes of autologous bone grafting for reconstructing severely comminuted unfixable posterior wall acetabular fractures. Materials and methods A systematic review was conducted in accordance with the PRISMA guidelines. The search for clinical studies was carried out across four databases: Embase, PubMed, Medline, and Scopus. The included studies were evaluated using the Coleman Methodology Score. The present study protocol was registered in PROSPERO. Results The study involved 71 patients, with an average age of 37.12 years. Autologous iliac crest grafts were predominantly used, with the Kocher-Langenbeck approach in all cases. Clinical outcomes, assessed by Merle d'Aubigne and Harris Hip Scores, showed 78.9 % of patients reporting excellent to good results. Radiological outcomes indicated 66 % with excellent results per Matta's score. The overall success rate ranged from 57 % to 100 %, with a 5 % conversion to total hip arthroplasty. Complications were reported in 7 % of cases, including nonunion and avascular necrosis. Conclusion Autologous bone grafts for comminuted, non-fixable posterior wall acetabular fractures may be considered as a potential salvage option in young patients, potentially delaying the need for THA.
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Affiliation(s)
- Riccardo Giai Via
- University of Turin, Centro Traumatologico Ortopedico (CTO), Department of Orthopaedic Surgery, Turin, Italy
| | - Matteo Giachino
- University of Turin, Centro Traumatologico Ortopedico (CTO), Department of Orthopaedic Surgery, Turin, Italy
| | - Ahmed Elzeiny
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Kafr El Sheikh University, Egypt
| | - Alessandra Cipolla
- University of Turin, Centro Traumatologico Ortopedico (CTO), Department of Orthopaedic Surgery, Turin, Italy
| | - Andrea Marino
- University of Turin, Centro Traumatologico Ortopedico (CTO), Department of Orthopaedic Surgery, Turin, Italy
| | - Andrea D'Amelio
- University of Turin, Centro Traumatologico Ortopedico (CTO), Department of Orthopaedic Surgery, Turin, Italy
| | - Francesco Bosco
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy
- Department of Orthopaedics and Traumatology, G.F. Ingrassia Hospital Unit, ASP 6, Palermo, Italy
| | - Kristijan Zoccola
- Ortopedia e Traumatologia 2 – Ospedale San Giovanni Bosco, Azienda Sanitaria Locale Città di Torino, Turin, Italy
| | - Alessandro Aprato
- University of Turin, Ospedale Infantile Regina Margherita, Department of Pediatric Orthopaedic Surgery, Turin, Italy
| | - Alessandro Massè
- University of Turin, Centro Traumatologico Ortopedico (CTO), Department of Orthopaedic Surgery, Turin, Italy
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