Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia. The accurate and continuous monitoring of these symptoms is essential for optimizing treatment strategies and improving patient outcomes. Traditionally, clinical assessments have relied on scales and methods that often lack the ability for continuous, real-time monitoring and can be subject to interpretation bias. Recent advancements in wearable technologies, such as smartphones, smartwatches, and activity trackers (ATs), present a promising alternative for more consistent and objective monitoring. This review aims to evaluate the use of smartphones and smart wrist devices, like smartwatches and activity trackers, in the management of PD, assessing their effectiveness in symptom evaluation and monitoring and physical performance improvement. Studies were identified by searching in PubMed, Scopus, Web of Science, and Cochrane Library. Only 13 studies of 1027 were included in our review. Smartphones, smartwatches, and activity trackers showed a growing potential in the assessment, monitoring, and improvement of motor symptoms in people with PD, compared to clinical scales and research-grade sensors. Their relatively low cost, accessibility, and usability support their integration into real-world clinical practice and exhibit validity to support PD management.

With the development of rapid rehabilitation surgery, the hospitalization time for patients undergoing total hip replacement has been shortened, resulting in a reduction in their direct medical care. Postoperatively, they need long-term rehabilitation exercises to restore joint function, which poses additional challenges for health professionals.

This study aims to construct a rehabilitation management plan for the entire nursing path of hip replacement patients using the continuous care model, solve the problem of interrupted rehabilitation, and thereby improve the rehabilitation effect of patients.

40 patients from September 2023 to February 2024 were selected as the control group and received routine care. From March to August 2024, 40 patients were selected as the experimental group and received the intervention plan. The differences in rehabilitation exercise compliance, rehabilitation self-efficacy, pain condition, postoperative complications, and patient satisfaction between the two groups were compared.

The compliance rate of rehabilitation exercises and self-efficacy in rehabilitation were significantly higher in the experimental group than in the control group. The joint stiffness, joint dislocation, deep vein thrombosis, and pain scores of the experimental group were lower than those of the control group (P < 0.05), while there was no significant difference in joint infection.

By implementing the rehabilitation management plan based on the continuous care model, it can promote the rehabilitation exercise effect of patients, alleviate their pain, reduce postoperative complications, and improve patient satisfaction.

Intracranial meningiomas are the most common primary tumors of the central nervous system. Although generally benign, some genetic alterations can induce aggressive behavior characterized by higher recurrence rates and reduced survival.

A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, using PubMed, EMBASE, Web of Science, and Scopus databases to identify studies published until November 2024. Studies investigating genetic alterations in meningiomas with prognostic data (recurrence or survival) and a minimum sample size of five patients were included. Data were extracted and analyzed independently by two reviewers.

Of 3032 studies identified, 20 met the inclusion criteria. The most frequently studied pathogenic variants were telomerase reverse transcriptase promoter (TERTp) and neurofibromatosis type 2 (NF2), both associated with shorter recurrence-free survival (RFS) and overall survival (OS), respectively TERTp RFS (hazard ratio [HR] 4.35, 95% confidence interval [CI] 2.87-6.60) and OS (HR 2.55, 95%CI 1.25-5.22), and NF2 RFS (HR 1.49, 95%CI 1.04-2.14) and OS (HR 2.98, 95% CI 1.37-6.49). Subgroup analysis suggested that the TERTp variant may be more predictive of lower survival for overall meningiomas (instead of World Health Organization III only), similar to NF2 variants. Additionally, Krüppel-like factor 4 was identified as a protective factor, while cyclin-dependent kinase inhibitor 2A/B was identified as a risk factor.

This systematic review highlights the importance of pathogenic variants, particularly TERTp and NF2, as prognostic markers in intracranial meningiomas. These findings underscore the potential of integrating genetic profiling into clinical practice to refine risk stratification and guide personalized therapeutic strategies, ultimately improving patient outcomes and quality of life.

Multiple Sclerosis (MS), a chronic and demyelinating disorder of the central nervous system, is often associated with challenges in decision-making (DM). This systematic review aims to evaluate the performance of patients with different subtypes of MS in DM tasks, focusing on connections with cognitive impairments, emotional changes, and brain structural alterations.

We conducted a systematic search, following PRISMA guidelines, for all peer-reviewed articles. We searched the following databases: Scopus, PubMed, and Web of Science. This review has been registered in the Prospective Register of Systematic Reviews (PROSPERO 2024) with the number CRD42024503190.

Our electronic searches identified 443 papers. After reading the full text of the selected publications and applying predefined inclusion criteria, we included 18 studies based on their pertinence and relevance to the topic.

This review highlights the multifaceted nature of DM deficits in individuals with MS. These difficulties result from cognitive impairments such as working memory, brain structural changes, and emotional processing challenges including depression. Our findings present a comprehensive synthesis of the complexities surrounding DM in MS, emphasizing the need for future research to better understand these relationships and their implications for enhancing patient quality of life and autonomy in DM processes.

Background: Osteosarcopenic obesity (OSO) syndrome, also defined as osteosarcopenic adiposity (OSA), is characterized by the concurrent loss of bone and muscle mass, accompanied by excess fat, leading to reduced functionality and metabolic imbalances. Recent studies have highlighted the role of microRNAs (miRNAs) in the pathophysiology of OSO/OSA, showing differential expression in individuals with osteosarcopenia and obesity. However, a thorough investigation in this area has been limited. Methods: A comprehensive search of international bibliographic databases, including Embase, PubMed and Scopus, was conducted. Results: From an initial search yielding 1311 records, 19 studies met the eligibility criteria for final evaluation. These findings highlight how physical exercise and nutritional factors can influence miRNA expression, emphasizing their role in promoting better health outcomes in aging populations. Furthermore, the critical role of miRNAs as indicators of muscle atrophy and the biological processes associated with aging and sarcopenia have been documented in various animal studies. Conclusions: Despite the limitations of this review, the findings indicate that miRNAs could serve as promising biomarkers and therapeutic targets for managing OSO/OSA. These results suggest that targeted interventions, such as resistance training and lifelong exercise, may effectively influence miRNA expression, potentially alleviating the impacts of OSO/OSA.

Atrial fibrillation significantly increases the risk of ischemic stroke, with thrombi primarily originating in the left atrial appendage (LAA). While direct oral anticoagulants (DOACs) are the standard for stroke prevention, LAA occlusion (LAAO) has emerged as a nonpharmacologic alternative, particularly for patients at high bleeding risk. A systematic review and meta-analysis included 15 studies (1 randomized control trial and 14 observational studies) encompassing 22,420 patients (10,704 LAAO, 11,716 DOAC). LAAO and DOACs demonstrated comparable thromboembolic event rates. LAAO was associated with significantly lower risks of stroke/transient ischemic attack (risk ratio: 0.86, P = 0.0004), major bleeding [hazard ratio (HR): 0.74, P = 0.03], cardiovascular mortality (HR: 0.57, P < 0.00001), and all-cause mortality (risk ratio 0.66, P = 0.006). The composite outcome significantly favored LAAO (HR: 0.67, P = 0.0008). No significant difference was found in intracranial bleeding rates.

Paediatric Graves' disease (PGD) is an autoimmune condition, which if left untreated, can result in cardiac complications. National Institute for Health and Care Excellence (NICE) Guidance (NG145) advocates the use of antithyroid drugs (ATD) as first-line therapy for PGD, with a consultation to consider a move to definitive therapy in the form of radioactive iodine (RAI) or thyroidectomy if the initial 2-year course failed to achieve normal thyroid function. We aim to evaluate the effectiveness, adverse events, and potential predictors of remission for ATD and RAI in treating PGD.

A thorough guideline search of NICE Evidence and Royal College of Physicians (RCP) guidelines and policy was conducted to yield a guideline relevant to our review question. A literature search of the Cochrane Library, MEDLINE, EMBASE and PubMed, alongside a clear inclusion and exclusion criteria was utilised to generate systematic reviews and primary literature exploring the efficacy and adverse effects (AEs) of ATD and RAI. Our guideline, systematic reviews and primary literature were appraised using AGREE-II, AMSTAR 2 and CASP respectively.

The search strategy yielded one NICE guideline (NG145) published in November 2019, two systematic reviews published after November 2019 and four primary studies, published after the most recent systematic review (August 2020). All studies concluded that ATD and RAI are effective treatment options for PGD. With regards to AEs, RAI and ATD were safe treatment options, with the latter having the least severity of complications.

In patients who have been identified to have predictors of remission, we agree with NG145 and ATD should be offered as first-line treatment. However, for those who do not have characteristics aligning with the predictors of remission, RAI should be offered as first-line therapy. Future studies should investigate the effect of biochemical parameters to identify predictors of remission, to aid the choice of treatment in paediatric Graves' disease treatment.

Malnutrition is a critical complication among cancer patients, affecting ≤80% of individuals depending on cancer type, stage, and treatment. Artificial intelligence (AI) has emerged as a promising tool in healthcare, with potential applications in nutritional management to improve early detection, risk stratification, and personalized interventions. This systematic review evaluated the role of AI in identifying and managing malnutrition in cancer patients, focusing on its effectiveness in nutritional status assessment, prediction, clinical outcomes, and body composition monitoring. A systematic search was conducted across PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medica Database from June to July 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quantitative primary studies investigating AI-based interventions for malnutrition detection, body composition analysis, and nutritional optimization in oncology were included. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools, and evidence certainty was evaluated with the Oxford Centre for Evidence-Based Medicine framework. Eleven studies (n = 52,228 patients) met the inclusion criteria and were categorized into 3 overarching domains: nutritional status assessment and prediction, clinical and functional outcomes, and body composition and cachexia monitoring. AI-based models demonstrated high predictive accuracy in malnutrition detection (area under the curve >0.80). Machine learning algorithms, including decision trees, random forests, and support vector machines, outperformed conventional screening tools. Deep learning models applied to medical imaging achieved high segmentation accuracy (Dice similarity coefficient: 0.92-0.94), enabling early cachexia detection. AI-driven virtual dietitian systems improved dietary adherence (84%) and reduced unplanned hospitalizations. AI-enhanced workflows streamlined dietitian referrals, reducing referral times by 2.4 d. AI demonstrates significant potential in optimizing malnutrition screening, body composition monitoring, and personalized nutritional interventions for cancer patients. Its integration into oncology nutrition care could enhance patient outcomes and optimize healthcare resource allocation. Further research is necessary to standardize AI models and ensure clinical applicability. This systematic review followed a protocol registered prospectively on Open Science Framework (https://doi.org/10.17605/OSF.IO/A259M).

This systematic review evaluates the efficacy of low-dose aspirin (LDA) in preventing preeclampsia in high-risk pregnancies. A comprehensive search of recent randomized controlled trials was conducted, focusing on studies published within the last five years. The review included five studies that investigated LDA at doses ranging from 60 mg to 150 mg, with outcomes measured in diverse populations. Findings indicate that LDA can reduce preeclampsia risk, particularly in specific subgroups such as non-Hispanic white women, but its efficacy is influenced by factors such as aspirin resistance, ethnicity, and biomarker levels. The review also highlights the importance of anti-inflammatory biomarkers like 15-epi-lipoxin A4 and IL-2 in understanding aspirin's mechanism of action. However, significant variability was observed across studies, suggesting that a personalized approach to aspirin prophylaxis may be necessary. This review underscores the need for future research to address gaps in aspirin efficacy across different populations and to explore biomarker-driven strategies for preeclampsia prevention.

This systematic review explores the comparative efficacy of metformin, combined oral contraceptives (COCs), and their combination in the management of polycystic ovary syndrome (PCOS) among adolescent females. A comprehensive literature search was conducted across PubMed, Scopus, and Cochrane CENTRAL in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, yielding 645 records, of which seven randomized controlled trials (RCTs) met the inclusion criteria. The included studies varied in design, population size, and outcome focus but consistently evaluated metabolic, hormonal, and reproductive endpoints. Results indicated that, while COCs were effective in reducing hyperandrogenic symptoms and regulating menstrual cycles, they were often associated with adverse metabolic effects, such as increased hepatic enzymes and insulin resistance. In contrast, insulin-sensitizing agents, particularly in combination regimens such as SPIOMET (spironolactone, pioglitazone, and metformin combination), showed superior outcomes in improving ovulation rates, insulin sensitivity, and body composition, with fewer metabolic side effects. Combination therapy with metformin and COCs also demonstrated a balanced improvement in both reproductive and metabolic profiles. The overall quality of included studies was rated as having some concerns due to variability in study design and reporting. Despite these limitations, the evidence supports a more individualized and metabolically focused approach to managing adolescent PCOS, emphasizing the benefits of early intervention with insulin-sensitizing therapies.

Post-stroke depression (PSD) is a common neuropsychiatric complication that adversely affects rehabilitation outcomes, cognitive recovery, and quality of life in stroke survivors. While selective serotonin reuptake inhibitors (SSRIs) are widely used as first-line treatment, serotonin-norepinephrine reuptake inhibitors (SNRIs) have emerged as potential alternatives with broader neurochemical targets. This systematic review aimed to compare the efficacy of SSRIs and SNRIs in the treatment and prevention of PSD. A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Google Scholar in accordance with PRISMA guidelines, applying filters for English-language clinical trials. Five randomized controlled trials met the inclusion criteria and were analyzed. The findings revealed that both SSRIs and SNRIs significantly improved depressive symptoms, with escitalopram showing early and superior antidepressant effects compared to sertraline. SNRIs like duloxetine and reboxetine demonstrated added benefits in cognitive outcomes, prevention of PSD, and symptom subtype-specific efficacy, particularly in retarded depression. While the overall risk of bias was low in most studies, limitations such as small sample sizes and limited direct head-to-head comparisons were noted. These results support the clinical utility of both drug classes and emphasize the need for individualized pharmacologic strategies based on patient characteristics and symptom profiles.

The role of vaginal dysbiosis in the progression of human papilloma virus (HPV) associated cervical lesions has gained attention in recent years. While many studies use 16S rRNA gene sequencing for microbiota analysis, shotgun metagenomic sequencing offers higher taxonomic resolution and insights into microbial gene functions and pathways. This systematic review evaluates the relationship between compositional and functional changes in the vaginal microbiome during HPV infection and cervical lesion progression. A literature search was performed according to PRISMA guidelines in PubMed, Web of Science, Scopus, and ScienceDirect databases. Seven studies utilizing metagenomic sequencing in patients with HPV infection or HPV-associated cervical lesions were included. Progression from HPV infection to cervical lesions and cancer was associated with a reduction in Lactobacillus species (particularly Lactobacillus crispatus) and an enrichment of anaerobic and pathogenic species, especially Gardnerella vaginalis. Heterogeneous enriched metabolic pathways were also identified, indicating functional shifts during lesion progression. As most studies were conducted in Asia, further research in diverse regions is needed to improve the generalizability of findings. Future studies employing metagenomic sequencing may help identify biomarkers for early pre-cancerous lesions and clarify the role of vaginal microbiota in persistent HPV infection and cervical dysplasia.

Early detection of post-surgical infections is crucial for improving patient outcomes and reducing healthcare burdens. This systematic review evaluates the diagnostic accuracy of C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), and neutrophil-lymphocyte ratio (NLR) in identifying early post-surgical infections across various surgical specialties. A comprehensive search was conducted in PubMed, MEDLINE, Embase, and Cochrane Library following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, yielding eight high-quality studies, including meta-analyses, randomized controlled trials, and cohort studies. The findings indicate that CRP is the most extensively studied biomarker, with postoperative day (POD) 3-7 levels demonstrating moderate to high predictive value in abdominal, colorectal, spinal, and pancreatic surgeries. PCT was effective in guiding the management of adhesion-related small bowel obstruction, while NLR showed moderate diagnostic performance in orthopedic infections. Sensitivity and specificity varied across biomarkers and surgical types, with CRP showing the highest accuracy in spinal surgery (100% sensitivity and 96.8% specificity). Quality assessment using AMSTAR 2, ROB 2, QUADAS-2, and NOS tools revealed a moderate risk of bias in most studies due to heterogeneity in methodologies and biomarker cutoffs. The results support the integration of biomarker-based infection monitoring into perioperative protocols to optimize patient management, facilitate early discharge, and reduce unnecessary antibiotic use. Future research should focus on large-scale multicenter trials to establish standardized biomarker thresholds and explore the potential of combining multiple biomarkers with artificial intelligence-driven predictive models.

Psoriasis is a chronic inflammatory skin disease characterized by red lesions and skin patches with silvery scales. Overall, 2 - 3 % of the worldwide population is affected by psoriasis. Recent treatment strategies for psoriasis involve Mesenchymal stromal/stem cell (MSC) transplantation instead of conventional treatment with monoclonal antibodies and small molecule drugs. However, studies systematically determining the efficacy of MSC therapy to treat psoriasis are lacking. Three electronic databases, including Cochrane, PubMed, and Web of Science Library, were searched for related studies from 2013 to 2023 using a widespread list of key terms. Among the collected records, duplicates and non-relevant articles were removed by screening the title, abstract, and full text based on the inclusion and exclusion criteria. Data were extracted from the eligible full-text articles to perform the meta-analysis, determining MSC therapy's efficacy in treating psoriasis. In the screening process, five clinical and sixteen preclinical studies, including 1 study with both preclinical and clinical data, showing the efficacy of MSC transplantation therapy to mitigate psoriasis were eligible for the systematic review. The meta-analysis was based on the data extracted from 10 eligible preclinical studies involving 343 animals. Pooled results demonstrated that the Psoriasis Area and Severity Index (PASI) score and the epidermal thickness of the psoriatic plaques in the animals post-MSC transplantation were significantly reduced. Our meta-analysis showed the efficacy of MSC transplantation therapies in mitigating psoriasis in preclinical animal models. Thus, further clinical research is warranted to translate these findings from bench to bedside.

Heart failure with reduced ejection fraction (HFrEF) remains a major cause of morbidity and mortality worldwide, despite advancements in pharmacotherapy. Among the most significant recent developments are sodium-glucose co-transporter 2 (SGLT2) inhibitors and angiotensin receptor-neprilysin inhibitors (ARNIs), both of which have demonstrated substantial improvements in clinical outcomes. This systematic review aimed to compare the efficacy, clinical outcomes, and therapeutic value of SGLT2 inhibitors versus ARNIs while also exploring their potential synergistic effects in the treatment of HFrEF. A comprehensive literature search was conducted across PubMed, Scopus, Embase, and Cochrane Central, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included randomized controlled trials published within the last 10 years. Five high-quality studies met the strict inclusion criteria, reflecting the limited but robust available evidence. The results suggest that both drug classes are effective in reducing cardiovascular death and heart failure hospitalizations, with emerging evidence indicating that their combined use may further enhance clinical outcomes. SGLT2 inhibitors have shown consistent benefits across key endpoints, even when used alongside ARNI therapy. The review highlights favorable safety profiles for both drug classes and supports early combination therapy in suitable patient populations. Observations regarding potential synergistic effects emerged from consistent trends across studies rather than being predefined primary outcomes. These findings reinforce current guideline recommendations advocating for multidrug strategies and emphasize the need for future direct comparative trials to optimize treatment sequencing in HFrEF.

Transperineal prostate biopsy (TPPB) under local anaesthesia is a widely employed biopsy method, and is currently endorsed by the European Association of Urology (EAU). This review aimed to assess the pooled detection rates of clinically significant prostate cancer using TPPB under local anaesthetic. Additionally, pain scores and complications were also reported.

Our search was conducted in line with the most recent Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations up to August 2024. The study was registered on PROSPERO under the ID: CRD42024588824. An electronic search was conducted of the PubMed, Embase and Cochrane Central Register of Controlled Trials databases along with grey literature using the Google search engine.

In total, there were 2881 patients included in this review. Biopsy histology results were reported in 11 studies comprising 2781 cases. We observed a clinically significant prostate cancer rate of 52% (95% CI 44%-60%) for studies that employed both a mix of systematic and targeted biopsies and 26% (95% CI 23%-30%) when systematic biopsies alone were taken. The pooled rate was 48% (95% CI 37%-59%), overall. Complications after prostate biopsies were reported by 9 studies with a combined 2688 patients. There were 61 patients (2.3%) who had Clavien-Dindo (CD) 1-2 complications and three patients (0.1%) who had CD 3-5 complications. The pooled rate of CD 1 and 2 complications was 2% (95% CI 1%-4%).

TPPB under local anaesthetic is a safe, efficacious and well-tolerated method of prostate biopsy when compared with other methods. Undertaking the procedure under local anaesthesia does not seem to lower cancer detection rates.

Negative pressure wound therapy (NPWT) has emerged as a promising intervention for reducing surgical site infections (SSIs) across various surgical disciplines, particularly in high-risk abdominal and gastrointestinal surgeries. This systematic review aimed to evaluate the efficacy of NPWT in preventing SSIs and improving postoperative outcomes in such procedures. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library, identifying 641 studies, of which 10 high-quality randomized controlled trials (RCTs) met the inclusion criteria. Studies included a range of abdominal procedures, including emergency laparotomies, colorectal cancer surgeries, and hepatopancreatobiliary interventions. Findings indicated that NPWT significantly reduced SSI rates in high-risk populations, particularly in contaminated and emergency abdominal surgeries, with reductions in seroma formation and wound dehiscence also observed. However, some studies reported no significant benefits in lower-risk procedures, highlighting the importance of appropriate patient selection. Quality assessment revealed moderate-to-high methodological quality, though common limitations included open-label designs and sample size variability. The results support the targeted use of NPWT in high-risk abdominal surgeries, though further large-scale, multicenter trials are needed to refine patient selection criteria and optimize clinical application.

The introduction of systematic reviews in medicine has prompted a paradigm shift in employing evidence for decision-making across various fields. Its methodology involves structured comparisons, critical appraisals, and pooled data analysis to inform decision-making. The process itself is resource-intensive and time-consuming which can impede the timely incorporation of the latest evidence into clinical practice.

This article introduces digital tools designed to enhance systematic review processes, emphasizing their functionality, availability, and independent validation in peer-reviewed literature.

We discuss digital evidence synthesis tools for systematic reviews, identifying tools for all review processes, tools for search strategy development, reference management, study selection, data extraction, and critical appraisal. Emphasis is on validated, functional tools with independently published method evaluations.

Tools like EPPI-Reviewer, Covidence, DistillerSR, and JBI-SUMARI provide comprehensive support for systematic reviews. Additional tools cater to evidence search (e.g., PubMed PICO, Trialstreamer), reference management (e.g., Mendeley), prioritization in study selection (e.g., Abstrackr, EPPI-Reviewer, SWIFT-ActiveScreener), and risk bias assessment (e.g., RobotReviewer). Machine learning and AI integration facilitate workflow efficiency but require end-user informed evaluation for their adoption.

The development of digital tools, particularly those incorporating AI, represents a significant advancement in systematic review methodology. These tools not only support the systematic review process but also have the potential to improve the timeliness and quality of evidence available for decision-making. The findings are relevant to clinicians, researchers, and those involved in the production or support of systematic reviews, with broader applicability to other research methods.

Innovative surgical approaches are crucial in pediatric oncology to enhance treatment outcomes and minimize morbidity. Robotic-assisted surgery (RAS) has shown promise in both surgical precision and recovery in pediatric patients. This systematic review aims to address this gap by examining the current role and impact of RAS in managing pediatric genitourinary tumors, focusing on its feasibility, safety, and patient outcomes. This review was registered with PROSPERO (CRD42023464820). We included studies involving pediatric patients undergoing RAS for genitourinary tumors, focusing on outcomes like conversion rates, resection completeness, and complications. Studies were identified through searches in PubMed, EMBASE, and Scopus until October 2023. Study quality and bias were assessed using ROBINS-I for cohort studies and Joanna Briggs Institute tools for case reports and series. Of 2119 citations, 42 studies were included, comprising 29 case reports, five case series, and eight retrospective cohort studies. Robotic-assisted renal surgeries were most common, with favorable outcomes in terms of resection completeness and low recurrence rates. Adrenal, bladder, and retroperitoneal surgeries also showed promising results, although rare instances required conversion to open surgery. Collaborative efforts and perioperative aids like intraoperative ultrasound and three-dimensional modeling were crucial for success. This work is limited by the lack of large cohort studies and addressing the learning curve associated with these procedures. RAS shows promise in treating pediatric genitourinary tumors, offering precise resections and favorable outcomes, warranting further research and refinement.

The role of toll-like receptor 4 (TLR4) in schizophrenia remains unclear, with studies reporting conflicting results on its expression and activation in persons with schizophrenia (PwSCZ). This systematic review/meta-analysis compared basal monocytic TLR4 expression, as well as its activation pattern between PwSCZ and healthy controls (HCs).

This study was registered with PROSPERO (CRD42021273858) and adhered to the PRISMA guidelines. A systematic search was conducted through MEDLINE (via PubMed), Web of Science, and Scopus from inception to December 12, 2023. Quantitative syntheses were conducted for (a) basal monocytic TLR4 density, (b) basal percentage of TLR4+ monocytes, and (c) basal TLR4 gene expression. Effect sizes were computed using Hedges' g for mean differences. Random-effect models with restricted maximum-likelihood estimation were used, and subgrouping was conducted based on antipsychotic status. The studies' risk of bias was assessed using the Joanna Briggs Institute (JBI) tool.

Eleven studies (473 PwSCZ, 416 HCs) were included. Pooled analysis revealed a nonsignificant trend toward increased basal monocytic TLR4 density in PwSCZ (Hedges' g = 0.317 [95% CI: -0.060, 0.694], τ2 = 0.127, I2 = 68.91%). The difference became significant after sensitivity analysis and excluding one study (Hedges' g = 0.469 [0.195,0.742], p = 0.001). No significant difference was found between the groups in terms of TLR4+ monocytes percentage (Hedges' g = 0.235 [-0.245, 0.715], τ2 = 0.31, I2 = 87.30%) or TLR4 gene expression (Hedges' g = 0.179 [-0.502, 0.861], τ2 = 0.29, I2 = 79.04%). According to qualitative synthesis, TLR4 stimulation resulted in reduced monocytic activation in PwSCZ compared to HCs.

This study suggested a trend toward an increased basal monocytic TLR4 density in PwSCZ, with no difference in the basal percentage of TLR4+ monocytes or TLR4 gene expression. However, the limited available data underscores the need for future studies.

Background/Objectives: Bruxism and temporomandibular disorders (TMDs) are common conditions of the stomatognathic system. Some studies suggest a potential link with traumatic brain injury (TBI), which is gaining increasing interest among researchers. The aim of this scoping review is to map the available evidence on the association between TBI and bruxism or TBI and TMDs. Methods: The review was conducted by analyzing four databases: PubMed, Web of Science, Scopus, and the Cochrane Collaboration database. A total of 340 studies were reviewed in this work, and 4 studies examining the connections between TBI were included in the analysis (with n = 3 focusing on the association between bruxism and TBI, and n = 1 on the association between TMDs and TBI). Results: Analyzing the publications on bruxism and TMDs in relation to TBI, at this stage it can be concluded that there is no solid evidence confirming the impact of TBI on the studied conditions. This is due to the quantity and quality of the collected evidence. Conclusions: In light of the presented review, it must be concluded that the quantity and quality of the evidence are insufficient to assert that TBI is a factor in the onset of bruxism or TMDs. Further research on this phenomenon is recommended, particularly focusing on the effects of different severities of TBI and various regions of brain injury.

Cerebral small vessel disease (CSVD) plays a significant role in the development of lacunar strokes and is closely associated with cognitive decline, gait disturbances, and vascular dementia. This systematic review explores the pathophysiology and management of CSVD, with a focus on its contribution to stroke recurrence and patient outcomes. Key findings indicate that structural cardiac abnormalities, inflammatory markers, and metabolic disorders are critical predictors of stroke risk in individuals with CSVD. Structural changes in the heart, such as altered left ventricular geometry, are linked to higher stroke recurrence rates, while elevated inflammatory markers, like high-sensitivity C-reactive protein, are associated with increased vascular events. Metabolic conditions, particularly diabetes, correlate with more severe vascular abnormalities and a heightened risk of recurrent strokes and mortality. Notably, some treatment strategies, such as dual antiplatelet therapy, may inadvertently increase mortality in specific patient groups, underscoring the importance of individualized therapeutic approaches. These insights emphasize the multifactorial nature of CSVD and highlight the need for comprehensive risk assessments and targeted management strategies to improve clinical outcomes.

This systematic review evaluates the cardiovascular and renal outcomes associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in patients with type 2 diabetes, focusing on findings from randomized controlled trials. A comprehensive search was conducted across PubMed, Embase, and the Cochrane Library, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seven high-quality trials met the inclusion criteria, with a combined focus on major adverse cardiovascular events (MACE), heart failure hospitalizations, all-cause and cardiovascular mortality, and renal function decline. SGLT2 inhibitors demonstrated superior efficacy in reducing heart failure and renal outcomes, while GLP-1 receptor agonists were more effective in preventing MACE and improving glycemic control. Combination therapy showed potential additive benefits, particularly in improving myocardial and arterial function. The findings highlight the complementary roles of these drug classes, underscoring the importance of personalized therapy based on individual patient profiles. Further research, including long-term head-to-head trials, is warranted to validate these results and optimize treatment strategies.

Trauma-specific care denotes best practice when working with individuals with histories of childhood abuse, maltreatment, or experiences of intimate partner violence. However, youth with autism spectrum disorder and exposure to intimate partner violence characterize a specific subpopulation of trauma-impacted individuals who present unique challenges for practitioners and researchers alike. The comorbidity of trauma and autism spectrum disorder raises a specific practice problem requiring an in-depth understanding of the complex interrelationship of childhood experiences of intimate partner violence, the associated traumatic sequelae, and the neurobiological characteristics of autism spectrum disorder. The current research on the intersectionality of intimate partner violence, trauma, and autism is limited. This paper draws attention to the practice implications of working with adolescent clients with both a history of trauma from childhood exposure to intimate partner violence and a diagnosis of autism spectrum disorder. The author utilizes a case study to contextualize presenting concerns, prioritize needs, and identify treatment outcomes. A systematized review is used to methodically review the literature on clinical interventions for youth with autism spectrum disorder and trauma. The aim is to draw attention to the gap in the literature as well as provide clinicians with a structured review of the literature on interventions for this unique population. Recommendations include research and tailored interventions to meet the developmental and concrete needs of the client in the present case study and perhaps others who are similarly situated. Clinical and research implications highlight the need for specialized care and further research to meet this underserved population.

Background/Objectives: In recent years, the popularity of non-verbal cognitive training for aphasia has increased. Building on evidence that language abilities engage brain areas involved in executive functions (EFs) processing, this review aims to analyze the utility of EFs training alone or combined with traditional rehabilitation approaches to improve language abilities in aphasia. Methods: Systematic searches were performed in four databases evaluating studies focusing on the effects of EFs training in language rehabilitation, yielding 185 studies. After reading the full text of the selected studies and applying predefined inclusion criteria, nine studies were included based on pertinence and relevance to the topic. This systematic review has been registered in the Prospective Register of Systematic Reviews (PROSPERO 2024) with the number CRD42024519087. Results: The results of the analyzed studies indicate that various EFs training methods, such as computer-assisted executive control training, Cognitive Flexibility in Aphasia Therapy (CFAT), and the Dr. Neuronowski® program, as well as the combination of transcranial direct current stimulation (tDCS) with EFs training, can lead to improvements in language abilities in people with aphasia. Additionally, EFs training often results in specific effects on treated functions like working memory (near transfer effects) and untreated ones such as spoken sentence comprehension (far transfer effects). Conclusions: Despite the heterogeneity of the treatments and the small simple size of the studies analyzed, preliminary results are promising. Future research should further explore the effectiveness and specific contribution of EFs training to improving language functions in aphasia.

Leadership and management is one of the four pillars of advanced practice, which implies that advanced clinical practitioners (ACPs) would be well positioned to take on these roles.

This study aimed to explore whether ACPs' management responsibilities would support their transition into a clinical management role.

This mixed-method narrative literature review uses reflective thematic analysis and a deductive approach to generate themes based on the six critical tasks of a manager mapped to the four pillars of advanced clinical practice. The Mixed Methods Appraisal Tool was used to assess research quality.

Eleven articles of varying quality were identified. Research suggests that, although ACPs can demonstrate they already have the skills to fulfil management roles, there is limited evidence that they take on these positions.

ACPs have the clinical background and training to transition into management roles more easily than staff without these prerequisites. Nevertheless, there remains insufficient evidence that this is happening in practice. By promoting and encouraging this role transition, ACPs could use their breadth of skills to become future managers.

This systematic review evaluates the comparative efficacy and safety of antihypertensive therapies, including angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs), in managing hypertension among chronic kidney disease (CKD) patients. A comprehensive search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted across five databases, identifying eight randomized controlled trials (RCTs) published in the last five years. The included studies examined diverse populations, ranging from pediatric to elderly CKD patients, with interventions tailored to specific subgroups, including those with proteinuria or diabetic kidney disease. Key outcomes assessed included changes in estimated glomerular filtration rate (eGFR), proteinuria reduction, cardiovascular events, and treatment-related adverse effects. Findings highlighted the superiority of ACEis and ARBs in reducing proteinuria and slowing CKD progression, particularly in proteinuric patients, while CCBs were effective in blood pressure control and improving cardiovascular parameters. However, no head-to-head trials directly comparing renin-angiotensin-aldosterone system (RAAS) inhibitors (ACEis/ARBs) and CCBs were identified, limiting definitive conclusions regarding their relative efficacy. Limitations such as small sample sizes and short follow-up durations were also noted in some studies. This review underscores the importance of individualized therapy based on patient-specific factors to optimize renal and cardiovascular outcomes. Further research is recommended to explore long-term outcomes and combination therapies in this population.

Compared with the general population, Black African and Black Caribbean women, living in the UK, are less likely to participate in breast cancer screening.

The aims of this review were to: (1) systematically describe the barriers to breast cancer screening, experienced by women of Black African and Black Caribbean descent, living in the UK and (2) identify which barriers interventions attempting to reduce inequalities have targeted, and whether they have been effective at increasing participation in breast cancer screening, among women of Black African and Black Caribbean descent.

We conducted a mixed-methods systematic review of primary research published in peer-reviewed journals. Seven databases were searched, yielding eight articles for inclusion in the review.

Barriers to breast cancer screening participation were categorised into six analytical themes: 'Understanding of, and concerns about, breast screening, the procedure and the reliability of test results', 'Misconceptions about, and lack of understanding of, the causes of breast cancer and personal risk', 'Emotional responses to cancer and screening', 'General barriers to accessing healthcare services (including breast screening)', 'Beliefs about cancer as a treatable disease' and 'Religious beliefs, cultural taboos and stigma'. These findings derive largely from studies with women who were not eligible for screening. Four studies testing interventions to promote uptake among ethnic minority groups were identified. None of them targeted Black African or Black Caribbean women, specifically; however, it was possible to extract data, for these groups, from the studies.

Further research with women who are eligible for screening (but do not attend) is needed to verify the findings of this review. Studies targeting barriers experienced by Black women, particularly, are needed to reduce inequalities.

Nordic walking (NW) has been reported to be beneficial in various chronic diseases.

To determine whether NW improves function in patients with heart failure (HF) with low left ventricular ejection fraction more than conventional cardiac rehabilitation or usual care.

Systematic literature searches in PubMed, ScienceDirect, and Web of Science were conducted. According to patient, intervention, comparison, and outcome (PICO) principles, a stepwise selection process was completed to identify eligible studies. Only randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. Pooled effects were determined using a random effect analysis model for the meta-analysis.

A total of 282 participants from four RCTs were included. The improvement of peak oxygen consumption (peak VO2) was greater in the NW group than in the control group (mean difference [MD] = 2.18 mL/kg/min; 95% confidence interval [CI] = 1.35-3.01; p < .01). The improvement of the 6-minute walk test (6MWT) distance was also greater in the NW group than in the control group (MD = 16.51 meters; 95% CI = 3.23-29.80; p = .01).

This systematic review highlights the benefits of NW training in patients with chronic HF, particularly those with systolic dysfunction. Specifically, NW walking was associated with increased peak VO2 and 6MWT improvement compared to conventional cardiac rehabilitation or usual care. These results suggest that NW may be a useful component of cardiac rehabilitation. However, additional larger studies with a wider range of patients are needed.

This systematic review explores the impact of dietary fiber interventions on glycemic control and weight management in individuals with diabetes or at risk for diabetes. A comprehensive search was conducted across PubMed, Embase, and Cochrane Library following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, identifying randomized controlled trials published in the last five years. Ten studies met the inclusion criteria, evaluating various types of dietary fiber, including soluble, insoluble, viscous fiber, and resistant starch. The findings demonstrated significant improvements in key glycemic markers such as fasting plasma glucose, glycated hemoglobin (HbA1c), and postprandial glucose levels, as well as weight management outcomes such as reductions in body weight and waist circumference. Secondary benefits included improvements in lipid profiles, insulin sensitivity, and gut microbiota composition. The quality assessment revealed a low risk of bias in most studies, ensuring robust evidence. Despite these promising results, gaps in long-term effects and variations in intervention efficacy warrant further research. These findings emphasize the potential of dietary fiber as a practical and accessible intervention in diabetes management and prevention.

Background/Objectives: Tinnitus, often described as a ringing in the ears, affects a significant portion of the population, varying in perception and severity. Methods: This systematic review investigates the correlation between tinnitus and temporomandibular joint disorders (TMDs) within a PRISMA-compliant framework, ensuring methodological transparency and rigor. Using databases, such as PubMed, Scopus, and Web of Science, we analyzed studies from the past decade to evaluate clinical and observational evidence. Results: A significant association between TMD and tinnitus was found, with somatosensory and neuroplastic mechanisms contributing to this relationship. Key therapeutic approaches identified include manual therapy and multidisciplinary treatments, demonstrating potential clinical efficacy. Conclusions: However, the available evidence remains inconsistent, emphasizing the need for further research with standardized methodologies to improve understanding and refine therapeutic strategies. This review provides a foundation for future studies aiming to enhance tinnitus management by addressing underlying TMD-related mechanisms.

Background: Evidence-based practice must be promoted in nursing education to provide quality care. For this, teaching practices that promote its development must be considered. Aim: The aim of this study was to explore a learning experience centered on evidence-based practice through cooperative learning in an online discussion forum with nursing students. Methods: We employed a descriptive qualitative study with the participation of 137 nursing students. A teaching intervention based on cooperative teamwork through an online forum is proposed. The students, through a question, must manage information to provide a reasoned answer. The interactions in the forums were analyzed through qualitative content analysis. Results: Two themes and eight categories emerged: Critical Analysis of the Literature (Computer Literacy, Reliability of the data sources, Level of evidence according to the article design, and Relevance of the research) and Clinical Practice (Patient's perspective, Professional experience, Quality of care, and Usefulness of EBP). Conclusions: The use of interactive teaching methodologies (cooperative learning and online discussion forums) facilitates the construction of knowledge applied to clinical practice. Students perceive EBP as necessary and useful for optimal care management, and the forums allow for the development of key competencies, such as autonomous learning, teamwork, and critical thinking.

Background and Objectives: Pain in the TMJ is the second most common in the orofacial region. The objective of this systematic review was to assess whether a decrease in estrogen levels increases the risk of idiopathic condylar resorption by reviewing relevant literature and evidence. Material and Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search was performed in the PubMed (Medline), Science Direct (Elsevier), and Web of Science electronic databases. Results: The initial database search identified a total number of 453 studies. After applying the selection criteria, 36 articles were selected for a full-text analysis, and nine studies involving 1105 patients were included in the systematic review. According to the Newcastle-Ottawa Scale (NOS), two of the included articles were graded as being of "Moderate" quality and one was of "Fair" quality. After evaluating the rest of the articles according to the AXIS tool for cross-sectional studies, we generally found that the reliability is moderate. The results show that the decrease in estrogen promotes the occurrence of inflammation in the temporomandibular joint, and some sources mention that it increases the occurrence of idiopathic joint resorption, but we did not establish a complete correlation between the level of estrogen and idiopathic joint resorption. Conclusions: This systematic review indicates that there is no evidence suggesting that fluctuations in estrogen levels contribute to idiopathic mandibular condylar resorption, but reduced estrogen levels can be associated with chronic pain in the temporomandibular joint.

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, highlighting the critical need for effective preventive therapies. Statins, or HMG-CoA reductase inhibitors, are widely prescribed for their ability to lower low-density lipoprotein (LDL) cholesterol and reduce CV risk. This systematic review evaluates the long-term impact of statins on CV and all-cause mortality across diverse populations, including those with chronic kidney disease, chronic heart failure, and other comorbid conditions. A comprehensive search of major databases identified randomized controlled trials and large observational cohort studies with follow-up periods exceeding one year. Findings demonstrated significant reductions in CV mortality (hazard ratio (HR) range: 0.38-0.76) and all-cause mortality (HR range: 0.55-0.80) with statin therapy, particularly among high-risk groups, such as individuals with elevated LDL-C and moderate chronic kidney disease. Additional benefits were observed in preventing major adverse cardiovascular events (MACEs). Subgroup analyses revealed variations in efficacy based on age, sex, comorbidities, and statin type or dosage, with some populations, such as those with chronic heart failure and chronic obstructive pulmonary disease, showing limited benefit. Geographic and ethnic diversity were underrepresented in the included studies, and data on long-term effects in populations with advanced renal impairment or inflammatory conditions remain insufficient. These gaps underscore the need for methodologically robust studies and tailored approaches to statin therapy that account for individual patient profiles, including comorbidities and demographic factors. Practical steps include integrating statins with newer lipid-lowering agents and developing personalized treatment protocols to maximize their benefits and minimize risks. This review reinforces the critical role of statins in reducing the global burden of CVDs while emphasizing areas for future research.

Edentulism can be treated with conventional complete dentures or implant-assisted prostheses. While two-implant assisted overdentures are superior to conventional mandibular dentures, the effectiveness of maxillary options remains unclear. This systematic review aims to assess whether conventional or implant-assisted maxillary prostheses provide better satisfaction and quality of life for patients with edentulous maxilla.

An electronic search was conducted across Medline (PubMed), Scopus, Embase, and the Cochrane Library up to May 23, 2024, to find studies comparing satisfaction and oral health-related quality of life in patients using conventional maxillary dentures versus implant-assisted maxillary prostheses.

Out of 1119 retrieved articles, 1085 were deemed irrelevant after screening, and 34 studies were evaluated for inclusion. Only six studies met the criteria, with the main reason for exclusion being the lack of comparison between new implant prostheses and new conventional dentures, as opposed to old unsatisfactory conventional maxillary dentures. Due to limited sample sizes and high heterogeneity, a meta-analysis was not feasible. The literature did not show significant differences in quality of life or satisfaction between conventional and implant-assisted complete maxillary prostheses, except for patients with pre-treatment preference toward implants.

There is no evidence supporting the superiority of either conventional or implant-assisted prosthetic options for restoring the edentulous maxilla. Further well-designed clinical studies are needed to compare new conventional and new implant-assisted complete maxillary prostheses with different designs.

Conventional and implant-assisted complete maxillary prostheses appear equally successful in restoring the quality of life and satisfaction of patients with an edentulous maxilla. The cost and morbidity associated with implant-assisted prostheses may be greater. A properly made conventional denture can serve as a diagnostic tool to assist treatment planning.

Prehabilitation, involving physical, nutritional, and psychological interventions before surgery, has emerged as a promising strategy to improve postoperative outcomes. This systematic review evaluated the impact of prehabilitation programs across various surgical systems, including cardiac, abdominal, colorectal, and thoracic surgeries. Data were synthesized from meta-analyses and systematic reviews to assess the effectiveness of uni- and multimodal prehabilitation interventions. Findings demonstrate that multimodal prehabilitation, particularly combining exercise and nutrition, significantly reduces postoperative complications, enhances functional recovery, and shortens hospital length of stay (LoS). While benefits were observed across surgical systems, variability in outcomes was noted due to differences in intervention design and patient populations. The review highlights the adaptability of prehabilitation and underscores its potential as a cost-effective and scalable approach to optimize surgical outcomes. However, gaps remain in standardizing protocols and evaluating long-term benefits, particularly for underrepresented surgeries such as spine and thoracic procedures. These findings support the integration of tailored prehabilitation programs into perioperative care and emphasize the need for further high-quality research.

This systematic review evaluates the comparative efficacy of low-carbohydrate diets (LCDs) versus low-fat diets (LFDs) in improving glycemic control, weight management, and lipid profiles in individuals with type 2 diabetes mellitus (T2DM) or prediabetes. Seven randomized controlled trials involving diverse populations were included, with dietary interventions ranging from very low-carbohydrate ketogenic (LCK) diets (typically <10% of total caloric intake from carbohydrates, with higher fat and moderate protein) to moderate carbohydrate regimens (30-45% of total calories). LFDs, in contrast, prioritized carbohydrate intake (50-60% of total calories), with reduced fat (<20-30%) and moderate protein (15-20%). Across studies, LCDs consistently demonstrated greater reductions in HbA1c, fasting glucose, and triglycerides, alongside superior weight loss and increased high-density lipoprotein cholesterol compared to LFDs. Additionally, LCDs were associated with significant reductions in diabetes medication use, highlighting their potential to decrease pharmacological dependency and improve metabolic outcomes, including enhanced insulin sensitivity and reduced inflammation. Despite variability in long-term outcomes and adherence, LCDs emerged as a promising alternative to traditional dietary approaches for managing T2DM. Further research is warranted to explore strategies to improve dietary adherence, such as behavioral interventions and technological support, and to evaluate long-term sustainability, including their effects on cardiovascular health and quality of life. These findings underscore the transformative potential of LCDs in diabetes management and highlight the need for personalized dietary approaches.

Patellofemoral joint (PFJ) diseases are chronic degenerative conditions that contribute to knee joint symptoms. Unicompartmental knee arthroplasty (UKA) is widely regarded as an effective treatment for knee osteoarthritis (KOA); however, its specific indications remain a subject of debate.

Patients with PFJ disease are expected to experience outcomes post-UKA comparable to those of patients without PFJ disease.

We conducted this meta-analysis following the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A comprehensive search of PubMed, Embase, and Web of Science databases was conducted for studies examining the association between PFJ disease and UKA, including publications up to September 2024. Extracted data encompassed author, publication year, country, disease type, prosthesis type, sample size, mean patient age, gender distribution, follow-up duration, PFJ disease prevalence at surgery, diagnostic methods, and whether PFJ disease was considered a contraindication for UKA. To maintain objectivity, only studies in which PFJ diseases were visually identifiable were included in the meta-analysis. Statistical analyses were performed using Stata 15.0 and Review Manager 5.4.1. A random-effects meta-analysis was conducted to evaluate the Oxford Knee Score (OKS), Knee Society Score (KSS), flexion range of motion (ROM), Forgotten Joint Score (FJS), Tegner activity score, and prosthesis survival rate, with outcomes stratified by PFJ disease type (PFJ degeneration or patella cartilage injury). Mean differences, confidence intervals, and P values were calculated for comparisons between the PFJ disease and non-PFJ disease groups. The Methodological Index for Non-Randomized Studies (MINORS) criteria and the Newcastle-Ottawa Scale (NOS) were applied to evaluate the risk of bias. To address heterogeneity, sensitivity analyses were performed, and publication bias was assessed using funnel plots and Egger's test.

A total of 14,866 knees from 48 relevant studies were included in this systematic review. Methodological quality was assessed using the MINORS criteria, with case series scoring 11.0/16 and cohort studies scoring 18.2/24. PFJ degeneration emerged as the most studied condition, followed by patella cartilage injury. Clinical outcomes assessments indicated that medial PFJ degeneration, anterior knee pain, patella cartilage damage, and patella baja did not significantly impact UKA outcomes or prosthesis survival. However, severe lateral PFJ degeneration, lateral patellar subluxation, lateral trochlear osteophytes, and patellar bone marrow edema did influence results. Fifteen high-quality studies were included in the meta-analysis, involving 6080 patients-1338 in the PFJ disease group and 4,742 in the non-PFJ disease group. With an average NOS score of 7.2, the studies were generally of high quality. Meta-analysis results showed no significant differences between groups in final follow-up OKS, FJS, Tegner activity score, or prosthesis survival rate. However, the PFJ disease group had lower KSS and reduced flexion ROM compared to the non-PFJ disease group. Subgroup analysis further revealed that the PFJ degeneration group scored lower than the patella cartilage injury group on OKS, KSS, and flexion ROM following UKA.

In summary, PFJ disease was found to have limited impact on UKA outcomes; however, caution is recommended for cases involving severe lateral PFJ degeneration due to potential restrictions in postoperative knee function, particularly affecting flexion ROM in UKA patients.

Loneliness can occur at any age, but it is more prevalent among older adults due to the associated risk factors. Various interventions exist to improve this situation, but little is known about their long-term effects. Our aims were to determine if these interventions have long-lasting effects and for how long they can be sustained. Additionally, we aimed to analyze if the interventions carried out by volunteers affected the outcomes regarding loneliness and psychological impact.

A systematic review was performed by searching the literature in the MEDLINE PubMed, SCOPUS, Web of Science, PsycINFO, and Web of Science databases for interventions focused on the lonely population. The inclusion criteria for this review were the assessment of loneliness using a validated tool, and loneliness being the primary or secondary outcome. The CASPe checklist was used to assess the risk of bias in the selected studies, and the PRISMA-ScR recommendations were followed to present and synthesize the results.

Thirty articles were included. The interventions identified were classified into five categories: psychosocial, technological, health promotion, physical exercise, and multicomponent interventions. Loneliness improved in 24 studies during the post-intervention analysis. Social connectivity and depressive symptoms also improved in most interventions. Long-term follow-ups were conducted with positive results in a total of 16 interventions. Depressive symptoms and social connectivity were also improved. Eight of the interventions were carried out by volunteers and showed good results regarding loneliness.

The results obtained in this work suggested that multidisciplinary interventions can reduce loneliness, but more controlled clinical studies are needed.

Acute lymphoblastic leukaemia (ALL) is the most prevalent cancer in childhood and is one of the leading causes of death annually. Antineoplastic treatments are associated with a high risk of malnutrition, which is important for continuous growth and development.

This systematic review aimed to evaluate the effect of these treatments on the nutritional status of paediatric patients with ALL. Data were collected from the PubMed, Scopus, and Web of Science databases following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. All the studies in which nutritional status was assessed in human beings diagnosed with ALL up to 18 years and published in English or Spanish between January 1900 and December 2023 were included.

A total of 18 articles and 1692 participants were analysed in this review. Article quality was evaluated using the ROBINS-I tool. This systematic review has been registered on PROSPERO (CRD42024505111). ALL treatment has a negative impact on the nutritional status of these patients and played an important role in their growth and global development. ALL treatments can modify hunger perception and the palatability of food.

Nutritional status is important for patient prognosis and survival. Nutritional evaluation, a specific nutritional assessment, and follow-up should be recommended for these patients to decrease the nutritional impact on global health. More homogeneous studies must be conducted to reach robust conclusions regarding the best type of nutritional intervention for these patients.

Cardiac surgery procedures are among the main treatments for people with cardiovascular disease, with physiotherapy playing a vital part. Respiratory complications are common and associated with prolonged Intensive Care Unit (ICU) and hospital stay, as well as increased mortality. Inspiratory muscle training has been found to be beneficial in improving respiratory muscle function in critically ill patients and patients with heart failure. The purpose of this review is to present the results of implementing inspiratory muscle training (IMT) programs in patients before and/or after cardiac surgery. The PubMed, Embase and Science Direct databases were searched from January 2012 to August 2023. In the present review, randomized controlled clinical trials (RCTs), clinical trials and quasi-experimental studies conducted in adult patients pre and/or post cardiac surgery were included. Fifteen studies were considered eligible for inclusion in the review. The results revealed that the IMT programs varied in intensity, repetitions, and duration in all included studies. Most studies implemented the IMT after the surgery. Statistical significance between groups was noted in Maximal Inspiratory Pressure and the 6-Minute Walk Distance Test. Preoperative and postoperative programs could improve inspiratory muscle strength, pulmonary function, and functional capacity as well as decrease the length of hospital stay in patients undergoing cardiac surgery. No clear evidence emerged favoring low or higher IMT intensities. The combination of IMT with other forms of exercise might be beneficial in patients undergoing cardiac surgery. However, further RCTs are required to provide confirming evidence.

Acupuncture has been demonstrated to be a safe and effective treatment for insomnia in patients without cancer. A lack of evidence, however, supports its application in the treatment of cancer-related insomnia (CRI).

To conduct a systematic review and meta-analysis to assess the efficacy as well as safety of acupuncture for alleviating insomnia in patients with cancer.

A systematic search was conducted using four electronic databases (PubMed, EMBASE, Scopus and the Cochrane Library) to select publications published in peer-reviewed journals written in English. The OR was calculated, along with their 95% CIs. We assessed heterogeneity using Cochrane Q, I2 statistics and the appropriate p value. The analysis used RevMan V.5.3.

The present meta-analysis comprised 561 individuals from 10 randomised controlled trials (RCTs) across age cohorts. Acupuncture intervention improves Pittsburgh Sleep Quality Index (PSQI) scores and CRI more than control, with a pooled OR of 1.66 (95% CI 1.12 to 2.46), OR of 5.90 (95% CI 2.64 to 13.23) for electroacupuncture, OR of 2.30 (95% CI 1.48 to 3.58) for auricular-acupuncture and 2.72. Acupuncture improved the Insomnia Severity Index (ISI) and CRI more than control approaches, with ORs of 1.31 (95% CI 0.69 to 2.48), 5.29 (95% CI 2.18 to 12.84), 3.17 (95% CI 1.35 to 7.44) and 1.64 (95% CI 1.00 to 2.68).

The change in PSQI and ISI scores showed that acupuncture moderately improved insomnia in patients with cancer. Acupuncture is safe and effective, enabling subsequent clinical treatments.