Risultati per: Infezione da Helicobacter pylori: review

Introduction
Pulmonary complications frequently occur as comorbidities in individuals with transfusion-dependent thalassaemia (TDT). Despite their clinical significance, the existing literature lacks a systematic review and meta-analysis examining the prevalence and risk factors for pulmonary dysfunction in this patient cohort. Therefore, we propose to conduct a systematic review and meta-analysis to report the prevalence and associated risk factors of pulmonary dysfunction in TDT patients.

Methods and analysis
This systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We will search PubMed, EMBASE, the Cochrane Library, Scopus and Web of Science to identify English-language literature from the inception of each database up to 31 May 2024. We will include studies that involve TDT patients and report on the method of pulmonary function assessment, the proportion of pulmonary dysfunction and the analysis of risk factors for pulmonary dysfunction. The study designs included will be cohort, case-control and cross-sectional studies. Exclusions will apply to studies on non-TDT or patients with other diseases, reviews, case reports and animal experiments, as well as duplicated published studies, studies without full-text availability or studies from which raw data cannot be extracted. The screening process, including title, abstract and full texts, will be conducted independently by two reviewers. Data extraction will be performed following standardised protocols. The quality of the included studies will be assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality criteria. The meta-analysis will be conducted using Stata 14.0 and Review Manager (RevMan) 5.4 software, incorporating subgroup analyses, heterogeneity assessments and publication bias evaluations to ensure the robustness and reliability of the findings.

Ethics and dissemination
As the data for this systematic review and meta-analysis are sourced exclusively from previously published literature, there is no requirement for ethical approval. The dissemination of the results will occur through publication in a peer-reviewed scholarly journal and presentations at relevant scientific conferences.

PROSPERO registration number
CRD42024504353.

Introduction
Reversal treatment is commonly used for managing oral anticoagulant (OAC)-associated intracranial haemorrhages. Its effects on mortality are still understudied, particularly in various subtypes of intracranial haemorrhages. This systematic review and meta-analysis aims to synthesise the available data to study the impact of reversal therapies on mortality following various OAC-associated acute intracranial haemorrhages.

Methods and analysis
This protocol follows the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Protocols, and the final review will be reported in accordance with the PRISMA reporting guidelines. This systematic review and meta-analysis will include studies that assess contemporary reversal treatment in comparison to no reversal treatment, in cases of OAC-associated intracranial haemorrhage. Stratification will be performed for the types of bleeding as well as OAC at bleeding onset. Preliminary searches to determine search term inclusions were conducted in May–August 2024 in the electronic databases Embase, PubMed, Scopus and Web of Science without language and publication date restrictions. Randomised controlled studies, non-randomised controlled trials, and observational studies will be considered for the final meta-analysis. Three reviewers (MT, JOS and AB) will screen titles and abstracts, and one reviewer (MT) will subsequently conduct full-text screening.
Risks of bias will be assessed by MT using tools such as Risk of Bias 2, Risk Of Bias In Non-randomised Studies – of Interventions and the Newcastle-Ottawa Scale. Heterogeneity among the study results will be assessed using the I² statistic. If appropriate, a random-effects meta-analysis model will be performed. Subgroup analyses and meta-regression (if applicable) will be performed to assess sources of heterogeneity among (1) intracranial haemorrhage types, (2) OAC drugs and (3) study types, with randomised controlled trials being the primary focus.

Ethics and dissemination
Ethical approval is not needed as this project involves previously published data. We intend to publish the results in a peer-reviewed journal.

PROSPERO registration number
CRD42024556420.

Introduction
Cancer remains a major global health challenge, affecting millions annually and ranking as the second leading cause of death worldwide. The complexity of cancer treatment requires an interdisciplinary approach, connecting professionals from various fields to deliver personalised and integrated care. However, structural issues and insufficient interdisciplinary training can impede effective collaboration, which is why effective interprofessional education (IPE) is needed. This protocol depicts the planned procedures for a scoping review that aims to explore the role of IPE in enhancing interdisciplinary collaboration within oncology by mapping and synthesising the implementation, impact and evaluation strategies of patient-centred IPE programmes.

Methods and analysis
This scoping review will be conducted in line with the Joanna Briggs Institute guidelines for scoping reviews. The research team will develop a comprehensive search strategy and apply it to the following databases: CENTRAL, CINAHL, Embase, MEDLINE, PsycInfo, Scopus and Web of Science . Additionally, we will search for grey literature (eg, using OpenDOAR) and contact relevant organisations for pertinent reports. Each database will be searched without date restrictions on 11 September 2024. In the first stage, eligibility criteria will be assessed through a blinded title and abstract screening, followed by a full-text review. The research team will then extract and synthesise data related to the scoping review questions, focusing on implementation, impact and evaluation strategies employed in the included studies.

Ethics and dissemination
As this protocol does not involve collecting primary data, ethical approval is not required. The results of this review will be published in a peer-reviewed journal and disseminated through institutional websites and conferences.

Introduction
As educators and health professionals, school nurses are in an optimal position to improve and advocate for adolescent reproductive and sexual health. This report outlines a protocol for a systematic review to synthesize evidence on the effects of school nurse-led education interventions and barriers and facilitators to implementing the interventions to improve students’ knowledge, attitudes and behaviours related to sexual and reproductive health in high-income countries.

Methods and analysis
We will develop a protocol to systematically review school nurse-led education interventions aimed at promoting adolescent sexual and reproductive health. This protocol will be based on the methodology of the Cochrane Handbook for Systematic Reviews of Interventions. The search will be conducted in Ovid-MEDLINE, CINAHL, Cochrane Library, Ovid-Embase, PsycINFO, Koreamed and ScienceON using relevant Medical Subject Headings and text words to identify the literature on different types of studies examining school nurse-led sexual and reproductive health education interventions in April 2024. Two independent reviewers will select relevant studies and extract data using a predefined template. We will assess methodological quality using the risk-of-bias tools appropriate for study designs and will resolve discrepancies through discussion with the review team. Where appropriate, we will conduct meta-analyses to estimate the effectiveness of school nurse-led sexual and reproductive health education interventions. Additionally, a qualitative evidence synthesis will be performed for the qualitative research included in the review. Finally, both a quantitative synthesis and a qualitative synthesis will be combined into a secondary synthesis addressing the facilitators and barriers of sexual and reproductive health educational interventions provided by school nurses to adolescents.

Ethics and dissemination
This review will synthesise publicly available resources and does not require ethical approval. The findings will provide insights into how school nurses can improve students’ sexual and reproductive health. The results will be disseminated through peer-reviewed publications, reports and academic conferences.

PROSPERO registration number
CRD42022347625.

Introduction
Empirical data on the barriers limiting artificial intelligence (AI)’s impact on healthcare are scarce, particularly within the Canadian context. This study aims to address this gap by conducting a scoping review to identify and evaluate AI algorithms developed by researchers affiliated with Canadian institutions for patient triage, diagnosis and care management. The goal is to identify characteristics in the developed AI algorithms that can be leveraged for a better impact.

Methods and analysis
A scoping review will be conducted following the JBI Methodology for Scoping Reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Relevant literature will be identified through comprehensive searches of MEDLINE (PubMed), CINAHL (EBSCO) and Web of Science (Clarivate) databases, combining keywords related to AI, clinical management and the Canadian context. Studies published after 2014, in English or French, that discuss AI algorithms developed for patient triage, diagnosis or care management by researchers affiliated with Canadian institutions will be included. Data from the selected articles will be extracted and analysed descriptively, and findings will be presented in tabular form accompanied by a narrative summary.

Ethics and dissemination
Ethical approval is not required for this study as it involves the review of publicly available literature. The scoping review is expected to be completed by November 2025. The findings will be disseminated through publications in peer-reviewed journals and presentations at conferences focused on AI and healthcare practice.

Our review highlights the potential for the use of AI algorithms applied to retina images, particularly CFP, to screen, predict, or diagnose the various microvascular and macrovascular complications of diabetes. However, we identified few studies with longitudinal data and a paucity of randomized control trials, reflecting a gap between the development of AI algorithms and real-world implementation and translational studies.

Objective
We assessed whether Penthrox (methoxyflurane) can provide better pain relief for elective, outpatient interventional procedures compared with other methods of pain control.

Design
Systematic review.

Data sources
Cochrane Central Register of Controlled Trial, MEDLINE, Emcare, Embase, ClinicalTrials.gov and the Cumulative Index to Nursing and Allied Health Literature were searched from inception to 6 November 2023.

Eligibility criteria
All published studies including randomised controlled trials (RCTs), cohort studies and case–control studies investigating Penthrox for pain relief, during and/or after an interventional procedure, were included.

Data extraction and synthesis
Two independent reviewers identified eligible studies and retrieved data. Risk of bias was assessed using Cochrane Collaboration Risk of Bias V.2.0 and Risk of Bias in Non-randomised Studies of Interventions (ROBINS I) tools. A meta-analysis was not possible due to heterogeneity.

Results
The literature search yielded 1189 records. 12 studies were eligible for inclusion: 5 RCTs and seven non-randomised studies of interventions (NRSIs). Penthrox was used for a range of procedures across five medical specialities: gastroenterology, gynaecology, haematology, orthopaedics and urology. Two RCTs showed a significant reduction in intraprocedural pain when Penthrox was compared with placebo. However, three RCTs where Penthrox was compared with either placebo or intravenous sedation showed no significant differences in pain or comfort level. Similarly, the NRSIs showed variable results. Most patients were satisfied (63% to >98%; seven studies) with Penthrox, and seven out of eight studies reported that the majority of participants would use it again (46.8%–95%; eight studies). No serious adverse events were reported.

Conclusion
Penthrox (methoxyflurane) shows promise as an analgesic for invasive, elective interventional procedures in the outpatient setting, although the relative benefits appear to vary depending on intervention and comparator pain control measures. There is a pressing need for robustly conducted, large, generalisable multicentre RCTs to evaluate the effectiveness of Penthrox.

PROSPERO registration number
CRD42023404574.

Introduction
Mental health issues among women in Sub-Saharan Africa (SSA), especially those living with HIV, pose a major public health challenge. Despite the established connections between HIV status and mental health outcomes, there is a noticeable absence of targeted interventions for this group within the literature. Many studies tend to focus on broad mental health concerns without addressing the specific needs of women with HIV, or they neglect to incorporate mental health elements into current HIV-related programmes. This scoping review aims to gather and analyse the existing research on interventions designed to improve the mental health of women in SSA, both with and without HIV. It will identify barriers preventing this population from accessing mental healthcare, highlight important gaps in the current literature and suggest directions for future research.

Methods and analysis
To conduct this scoping review, the researcher will adhere to the methodological framework proposed by Arksey and O’Malley. The literature search will span several databases, including PubMed, MEDLINE, Web of Science and PsychInfo, to ensure a comprehensive collection of relevant studies. The selection process will involve two stages: two independent reviewers will initially screen titles for eligibility and a full-text review of the selected articles. A specially designed tool will be used for data extraction, focusing on minimising bias and accurately capturing study details. The final selection of studies will be analysed using a standardised tool to comprehensively assess all bibliographic information and study characteristics. The planned study dates for the review will be January to March 2025.

Ethics and dissemination
No ethical approval is required as the review will draw on publicly available publications and materials. The study’s conclusions will be subject to peer review and published in a scientific journal, with the abstract shared at local and international conferences. Key findings will be disseminated to health ministries, community-based organisations focused on women’s mental health and HIV, and policymakers to inform policy decisions regarding mental health interventions for women in SSA.

Introduction
Social media has an impact on the reach and speed with which information is disseminated, benefiting patients and healthcare professionals by sharing knowledge, even from a distance. However, these channels can pose risks when used irresponsibly by these actors. Thus, e-professionalism emerges as a modulator of professionals’ behaviours and attitudes, and its evaluation is fundamental given the demand for quality in services, including in these settings. Thus, this study aims to identify instruments used to assess the e-professionalism of healthcare professionals.

Methods and analysis
A systematic review will be developed to answer the question: ‘How is e-professionalism in healthcare professionals evaluated in the literature?’. The searches will take place in the following databases: PUBMED/Medline, EMBASE, Web of Science, ERIC and Scopus using descriptors such as ‘professionalism’, ‘e-professionalism’, ‘social media’ and synonyms. Studies will be selected after evaluating titles and abstracts, followed by an analysis of full texts using the Rayyan tool. Studies that present the development and validation of e-professionalism assessment instruments for nursing, pharmacy, medicine and dentistry will be included. The quality of the instruments will be assessed based on evidence of content and construct validity reported by the developers.

Ethics and dissemination
This review is exempt from ethical approval because it does not include patient data. The results of the systematic review will be disseminated through a peer-reviewed journal and presented at a relevant conference.

PROSPERO registration number
CRD42023454825.

L’organismo viene colpito da più agenti. Effetti delle cure dopo qualche giorno

Andreoni, ‘sovrainfezioni da più batteri a causa del prolungarsi del suo stato’

Introduction
Cancer and its treatments can lead to a wide range of side-effects that can persist long after treatments have ended. Across Europe, survivorship care is traditionally hospital-based specialist-led follow-up, leading to gaps in supportive care. Improved screening, diagnosis and treatment increase survival rates. With more individuals living with, through and beyond cancer, the predominance of the hospital-based specialist model is unsustainable, costly and resource-intensive. An understanding of what alternative Models of Care are available and the barriers and facilitators to their implementation is a first step towards enhancing supportive care across the cancer journey. The aim of this scoping review is to source and synthesise information from studies evaluating patient-oriented models of cancer survivorship supportive care for adults in Europe.

Methods and analysis
The scoping review will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses—Scoping Review Extension guidelines and will be guided by a six-stage methodological framework. A search strategy has been developed according to the Population, Concept and Context structure and will be applied to seven databases. A targeted search of grey literature will be completed. All identified records will be screened using predefined eligibility criteria by at least two researchers and undergo full-text review for inclusion. Data pertaining to the conceptualisation, evaluation and implementation of sourced Models of Care will be extracted.

Ethics and dissemination
As there is no primary data, ethical approval is not required. This review will be conducted as part of the EU COST Action CA21152—Implementation Network Europe for Cancer Survivorship Care. The protocol and subsequent scoping review will be published in a peer-reviewed journal. The Action involves representatives from most countries across Europe which will assist with the dissemination of the work to key stakeholders.

Introduction
Urinary incontinence (UI) is a common condition among older adults with adverse consequences to health and well-being. Shame, stigma and cultural perspectives can prevent treatment-seeking behaviour. Although there is an abundance of studies in the health research literature that explore the physiological basis of UI, there is limited evidence on the role culture plays in shaping knowledge of, attitudes to and beliefs about UI. This review aims to answer what is known about the role of culture in shaping the attitudes and beliefs on UI to identify gaps in the literature and direct future research.

Methods and analysis
The Joanna Briggs Institute method for scoping reviews will be used to conduct the review, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The MEDLINE, Embase, PsycINFO, Cumulated Index in Nursing and Allied Health Literature, EBSCOhost, Scopus databases and WHO Index Medicus databases will be searched, without any restriction on language and publication date, enhancing the comprehensiveness and inclusivity of the review. A preliminary search of MEDLINE was conducted (09 February 2024) to identify articles. The screening and analysis of the search results from the databases will be managed using Covidence software. Two authors will screen articles, with a third involved as needed to resolve any differences. Findings will be organised using tables and key themes will be identified.

Ethics and dissemination
Formal ethics approval is not required for this review as it does not involve any human or animal participants. Findings will be disseminated in a high-impact peer-reviewed journal with a focus on open-access publication at conferences and used to inform studies on the development of culturally sensitive management programmes for UI with the full involvement of patients.

Trial registration
Open Science Framework https://osf.io/3d97f

Objectives
Sepsis-associated hypotension or shock is a critical stage of sepsis, and a current clinical emergency that has high mortality and multiple complications. A new restrictive fluid resuscitation therapy has been applied, and its influence on patients’ renal function remains unclear. The purpose of this study is to evaluate the influence of restrictive fluid resuscitation on incidence of severe acute kidney injury (AKI) in adult patients with sepsis hypotension and shock compared with usual care.

Design
Systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach.

Data sources
PubMed, Embase, Web of Science and Cochrane Library were searched through 1 November 2024.

Eligibility criteria
We included randomised controlled trials that compared restrictive fluid resuscitation with liberal fluid therapy on patients with sepsis-associated hypotension and shock, to find out their effect on the incidence of severe AKI. Severe AKI was defined as the AKI network score 2–3 or Kidney Disease Improving Global Outcomes stages 2 and 3.

Data extraction and synthesis
Two independent reviewers used standardised methods to search, screen and code included trials. Risk of bias was assessed using the Cochrane Systematic Review Handbook for randomised clinical trials. Meta-analysis was conducted using random effects models. Sensitivity and subgroup analyses, trial sequential analysis (TSA), Egger’s test and the trim-and-fill method were performed. Findings were summarised in GRADE evidence profiles and synthesised qualitatively.

Results
Nine trials (3718 participants) were included in this research and the analysis was conducted in random effects model. There was a significant difference in the incidence of severe AKI (risk ratio 0.87, 95% CI 0.79 to 0.96, p=0.006; I2=0%) and the duration of mechanical ventilation (mean difference –41.14, 95% CI –68.80 to –13.48; p=0.004; I2=74%) between patients receiving restrictive fluid resuscitation and patients receiving liberal fluid resuscitation. TSA showed that the cumulative amount of participants met the required information size, the positive conclusion had been confirmed. The GRADE assessment results demonstrated moderate confidence in the incidence of severe AKI, as well as the results of all second outcomes except the Intensive Care Unit length of stay (ICU LOS), which received limited confidence. The result of incidence of worse AKI was rated as of high certainty.

Conclusions
It is conclusive that fluid restriction strategy is superior to usual care when it comes to reducing the incidence of severe AKI in sepsis-associated hypotension and shock. Shorter duration of ventilation is concerned with fluid restriction as well, but the heterogeneity is substantial. GRADE assessments confirmed moderate and above certainty. Traditional fluid resuscitation therapy has the potential to be further explored for improvements to be more precise and appropriate for a better prognosis.

PROSPERO registration number
CRD42023449239.

Kruisbrink M, Robertson W, Ji C, et al. Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies. BMJ Open 2017;7:e018585. doi: 10.1136/bmjopen-2017-018585 This article was previously published with an error. The conclusions of the article are not affected. The article was adjusted on the following points: Table 1 contained a few small inaccuracies regarding the study of Meneton et al. These have been corrected. A few typographical errors were adjusted and the following piece of text has been removed: “Only Haaramo et al34 reported significant associations…those without insomnia symptoms.” The studies by Kuula et al and Byrne et al have been removed from the tables, figures and text. Kuula et al assessed lipids at one point in time only and Byrne concerned a cohort of an intervention programme, thereby not meeting the inclusion criteria. They were not included…

Objectives
To examine the authorship and content of systematic reviews (SRs) of biases experienced by medical professionals through a gender lens.

Design
Review of SRs.

Data sources
We searched PubMed, Embase, PsycINFO and CINAHL from inception. Searches were conducted in May 2022 and updated in October 2023.

Eligibility criteria
Reviews of studies reporting biases experienced by hospital physicians at any stage of their careers and in any country. Reviews were included if they used systematic methods to search the literature and synthesise the data. Non-English language publications were excluded.

Data extraction and synthesis
The main theme of each eligible review was identified through qualitative thematic analysis. We used NamSor to determine the first/last authors’ gender and computed the proportion of female authors for each review theme.

Results
56 articles were included in the review. These covered 12 themes related to gender, race and ethnicity bias experienced by physicians at any stage of their careers. The overall proportion of female authors was 70% for first authors and 51% for last authors. However, the gender of authors by theme varied widely. Female authors dominated reviews of research on discrimination and motherhood, while male authors dominated reviews on burnout, mental health and earnings. Only six reviews were identified that included race and ethnicity; 9 out of the 12 first and last authors were female.

Conclusions
Understanding the potential for a gendered evidence base on biases experienced by hospital physicians is important. Our findings highlight apparent differences in the issues being prioritised internationally by male and female authors, and a lack of evidence on interventions to tackle biases. Going forward, a more collaborative and comprehensive framework is required to develop an evidence base that is fit for purpose. By providing a point of reference, the present study can help this future development.

PROSPERO registration number
CRD42021259409; Pre-results.