Risultati per: Il dolore neuropatico: review

To the Editor We read with great interest the recent review on community-acquired pneumonia (CAP) by Dr Vaughn and colleagues. Although the thoroughness of the article is commendable, it is necessary to address the brief and somewhat dismissive mention of lung ultrasonography in diagnosing CAP. The assertion that “the utility of ultrasonography for diagnosing CAP is unclear” does not adequately reflect the advancements and growing body of evidence supporting the clinical value of this tool.

In Reply We appreciate the questions raised by Dr Di Bella and colleagues in their Letter to the Editor regarding the use of lung ultrasonography for diagnosing CAP.

Objectives
Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals want for coping with PSIs, what support interventions/approaches are currently available and which have evidence for effectiveness.

Design
Systematic research review with narrative synthesis.

Data sources
Medline, Scopus, PubMed and Web of Science databases (from 2010 to mid-2021; updated December 2022), reference lists of eligible articles and Connected Papers software.

Eligibility criteria for selecting studies
Empirical studies (1) containing information about support frontline healthcare staff want before/after a PSI, OR addressing (2) support currently available, OR (3) the effectiveness of support to help prevent/alleviate consequences of a PSI. Study quality was appraised using the Quality Assessment for Diverse Studies tool.

Results
Ninety-nine studies were identified. Staff most wanted: peer support (n=28), practical support and guidance (n=27) and professional mental health support (n=21). They mostly received: peer support (n=46), managerial support (n=23) and some form of debrief (n=15). Reports of poor PSI support were common. Eleven studies examined intervention effectiveness. Evidence was positive for the effectiveness of preventive/preparatory interventions (n=3), but mixed for peer support programmes designed to alleviate harmful consequences after PSIs (n=8). Study quality varied.

Conclusions
Beyond peer support, organisational support for PSIs appears to be misaligned with staff desires. Gaps exist in providing preparatory/preventive interventions and practical support and guidance. Reliable effectiveness data are lacking. Very few studies incorporated comparison groups or randomisation; most used self-report measures. Despite inconclusive evidence, formal peer support programmes dominate. This review illustrates a critical need to fund robust PSI-related intervention effectiveness studies to provide organisations with the evidence they need to make informed decisions when building PSI support programmes.

PROSPERO registration number
CRD42022325796.

Objective
To investigate the antecedents to episodes of aggression and the use of coercive measures in inpatient mental health settings, organize and explore their relationships and patterns through thematic analysis, identify gaps in the literature and provide insights for future research.

Introduction
The use of coercive measures in inpatient mental health settings remains controversial and ethically challenging. Despite an international consensus on the need to reduce their use, the antecedents to aggression and episodes involving coercive measures remain insufficiently explored. This review seeks to address this gap by systematically mapping the evidence of these antecedents and exploring their relationship, providing a foundation for future research.

Inclusion criteria
Studies included were those published from 2014 to the present in the English language, focusing on either adult mental health inpatients or mental healthcare professionals aged 18 years or older involved in episodes of aggression or exposure to coercive measures in both acute and long-term inpatient mental health settings. Included studies must address antecedents to aggression or the use of coercive measures. Exclusions apply to studies focusing exclusively on behaviours unrelated to aggression or coercive measures, studies conducted in non-inpatient settings and those involving child, adolescent, geriatric or forensic populations.

Methods
The review will follow the Joanna Briggs Institute methodology for scoping reviews. The search strategy will cover key databases, including Ovid Medline, APA PsycINFO and Scopus, with reference list screening to ensure comprehensive coverage. Initial exploratory searches were conducted in June 2024, with the formal searches updated in January 2025. Studies will be screened against the inclusion criteria, and data will be extracted using a standardised form adapted to the review objectives. Grey literature will be excluded, focusing on peer-reviewed evidence. The analysis will include descriptive mapping of the antecedents to aggression and the use of coercive measures, supplemented by thematic analysis to organize and explore patterns and relationships between them. Results will be presented in a descriptive summary, supported by thematic analysis and descriptive statistics.

Ethics and dissemination
Ethical approval is not required since this study uses existing published literature. The results will be disseminated through a peer-reviewed journal and presented at relevant international conferences.

Introduction
Low back pain (LBP) is a global health concern. Approximately two-thirds of those who recover from LBP experience a relapse within a year, with many chronic cases encountering acute flare-ups (exacerbation). This systematic review will synthesise and analyse whether physical and/or psychological features can predict recurrent episodes of LBP or exacerbation of pain.

Methods and analysis
This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Comprehensive literature searches will be conducted in MEDLINE, EMBASE, APA PsycInfo, PubMed, CINAHL Plus, Web of Science, Scopus and ZETOC, spanning from each database’s inception through to January 2025. Google Scholar and grey literature sources, including OpenGrey, will also be searched to ensure comprehensive coverage. Two independent reviewers will screen titles, abstracts and full texts, assessing the risk of bias with a modified Quality in Prognosis Studies tool. The overall certainty of evidence will be evaluated using an adapted Grading of Recommendations Assessment, Development and Evaluation approach. If sufficient data homogeneity is present, a meta-analysis will be performed; otherwise, findings will be synthesised narratively. The results will identify the ability of physical and/or psychological factors to predict pain recurrence or acute exacerbation in case of persistent non-specific LBP.

Ethics and dissemination
This study protocol does not present any ethical concerns. The findings from the systematic review will be submitted for publication in a peer-reviewed journal and will also be presented at relevant conferences.

PROSPERO registration number
CRD42024599514.

Introduction
Sub-Saharan Africa bears a disproportionate burden of cancer-related morbidity and mortality compared with high-resource settings. Although pathology services are essential to providing optimal oncological care, diagnostic capacity in sub-Saharan Africa is insufficient for the cancer burden. This scoping review will be conducted to summarise the current state of practices and evidence for interventions and implementation strategies to improve anatomic pathology services for cancer in the region. The objective of this scoping review is to describe efforts to strengthen capacity for anatomic pathology services in sub-Saharan Africa. The information gathered will be used to inform the design of future pathology capacity-building interventions. The primary aim of the scoping review is to comprehensively map the existing evidence on initiatives aimed at enhancing the capacity for pathology services.

Methods and analysis
This study will follow Joanna Briggs Institute methodology for scoping reviews. MEDLINE, Embase, Cochrane Central and African Index Medicus will be searched for articles published in English and Portuguese with no limitations placed on date or publication type. A limited search for grey literature will be conducted using the WHO Institutional Repository for Information Sharing. Two independent reviewers will screen all articles, extract data and complete the descriptive analysis. All discrepancies will be resolved using a third reviewer. The results will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will consider scientific literature from published primary studies as well as scoping and systematic reviews related to capacity-building efforts to strengthen anatomic pathology services in any sub-Saharan African country. All study designs will be considered, including quantitative, qualitative and/or mixed-methods studies.

Ethics and dissemination
Ethical approval is not required for this study. Dissemination of findings from this work will include the publication of the results in a peer-reviewed journal and presentations at conferences.

Protocol registration number
Open Science Framework, https://osf.io/6cmhg.

Introduction
Research indicates that older hospitalised individuals are more susceptible to hospital adverse events (AEs). Frailty is a syndrome marked by increased vulnerability, sudden and severe health changes and the risk of adverse outcomes. The majority of the available research puts a limited emphasis on those who live with frailty and examines the relationship between age alone and the occurrence of AEs. This review investigates the association between frailty and the likelihood of hospital AE occurrences in hospitalised older patients.

Methods and analysis
The proposed systematic review will search Ovid MEDLINE, CINAHL, Scopus and Web of Science databases. Studies that published original data in English using any methodology will be included. A manual search of the final included studies reference list will be made to identify studies that meet the inclusion criteria. If feasible, a meta-analysis will be conducted using the R statistical programme, and results will be visually presented using a forest plot. If there is high heterogeneity and a meta-analysis is not feasible, a narrative synthesis and analysis guided by Cochrane criteria will be conducted, and results will be presented in appropriate tables and figures.

Ethics and dissemination
No ethical approval will be obtained for this review since it will use secondary published data. The systematic review’s results will be published in a peer-reviewed frailty and geriatrics care-related journal and disseminated in conferences, congresses and scientific meetings.

Introduction
Human ocular trematode infections, caused by parasitic flatworms, are a significant public health concern worldwide. It can lead to mild-to-severe consequences if untreated. This protocol outlines a scoping review methodology, which aims to explore the knowledge on the aetiopathogenesis, clinico-epidemiological and diagnostic aspects, and patient perspectives related to ocular trematode infections in humans.

Methods and analysis
The review, including the development of the review protocol, will be conducted over 2 years from January 2024. The Joanna Briggs Institute Reviewers’ Manual and the framework developed by Arksey and O’Malley will be used as the guidelines for the scoping review that is suggested in this protocol. Accordingly, the PCC (Population, Concept, Context) framework and three-stage search strategy will be used to develop the research question and to conduct the search respectively. Publications up to December 2024 will be searched across multiple databases, including MEDLINE/PubMed, Scopus, Science Direct, CINAHL and Google Scholar.

Ethics and dissemination
Since the study will make use of secondary data, ethical approval will not be required. The scoping review’s findings will be published in a scientific journal and presented at relevant conferences, aiming to improve the disease outcomes through guiding future research in ocular trematode infections and informing potential strategies to uplift the disease control and prevention measures and patient care.

Objective
The objective of this review was to map the available evidence on oral health surveys of traditional peoples and communities (TPC) in Brazil, addressing the question, ‘What evidence is available on oral health surveys of traditional peoples and communities in Brazil?’.

Design
Scoping review according to the Scoping Review extension for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Data sources
MEDLINE/PubMed, Scopus, Web of Science, Embase and Latin American and Caribbean Literature in Health Sciences were searched up until June 2023.

Eligibility criteria
Studies involving individuals from indigenous groups, quilombolas, riverside communities and Romani communities, all included in TPC in Brazil, were included without any age restrictions.

Data extraction and synthesis
Data were extracted by two independent reviewers, and studies were categorised considering the author and year of publication, the traditional group, study type, geographical location, age group, sample size, data collection method and the main oral health condition assessed.

Results
After the searches, 39 studies were included in the review, and 2 studies were manually added. The studies included in the review were published between the years 1968 and 2023. Of the total, 31 studies investigated the oral health condition of indigenous peoples, 7 were studies on quilombola communities and 3 studies focused on riverside communities. No studies on Romani people were found in the search. The majority of studies were located in the Northeast region (n=12) of the country, with dental caries being the main oral health issue assessed (n=13) through clinical examinations (n=25), with a high prevalence observed among TPC (n=11).

Conclusion
This review reveals that in Brazil, studies on the oral health of TPC are ongoing, although they occur in an isolated and independent manner, indicating a considerably high prevalence of oral health problems in these communities.

Thomas B, Pattinson R, Edwards D, et al. Defining and measuring long COVID fatigue: a scoping review. BMJ Open 2024;14:e088530. doi: 10.1136/bmjopen-2024–0 88 530 The authors have identified several copyediting errors in their paper since it was published online. Results In the third paragraph, the eligibility criteria were met by 57 studies; however, the country-wise breakdown was not clearly provided. Additionally, the count for Italy was previously incorrect and has been revised from 8 to 7. The corrected text now reads: ‘Studies spanned 22 countries: Italy (n=7),27 44 54 60 67 71 72 Spain (n=6),30 39 43 57 59 65 UK (n=7),31 48 53 56 61 73 74 USA (n=6),32 35 36 52 75 76 Germany (n=5),28 38 50 63 77 Ireland (n=3),8 47 62 the Netherlands (n=3),51 68 78 Denmark (n=2),26 41 Egypt (n=2),66 79 Brazil (n=2),45 55 Hungary (n=2),40 80 France (n=1),64 India (n=2),37 81 Canada (n=1),9 Poland…

Introduction
Microsimulation models are computer-based models, which can be employed to simulate the behaviour of microagents, such as children and adolescents, to understand the potential behavioural and economic effects of health interventions or policies. As a result, these models can be useful tools to help guide decision-making. A comprehensive review of the literature on child and adolescent microsimulation models has yet to be undertaken. Moreover, an evaluation of the quality of the existing models can be useful to understand their strengths and limitations and thus inform the development of future models. The aim of this scoping review will be to retrieve, synthesise and critically appraise the literature on existing microsimulation models focused on child and adolescent health.

Methods and analysis
We will conduct a scoping review using established methods. We will search PubMed (until 23 September 2024), Embase (until 18 September 2024), CINAHL (until 9 September 2024), PsyclNFO (11 September 2024), EconLit (until 9 September 2024) and Scopus (until 10 September 2024), with an update closer to the time of manuscript submission. We will also undertake snowballing, Google searches and searches on specific journal (eg, International Journal of Microsimulation) and websites (eg, https://www.microsimulation.ac.uk/) to complement database searches. We will extract relevant data on all studies retrieved and use the Quality Assessment Reporting for Microsimulation Models checklist to assess the reporting quality of each model. We will use a narrative synthesis with summary tables to describe our findings. Findings will be synthesised by type of health condition, if/where possible.

Ethics and dissemination
Given that primary data will not be collected in this study, research ethics approval is not required. We will present our findings at relevant conferences and publish our results in an appropriate peer-reviewed academic journal. In addition, we will use this information to guide the development of a microsimulation model on child and adolescent health for use in the Swedish context.

Registration details
https://osf.io/a8txn/

Background
Extreme weather and climate-related events are increasing in frequency and intensity, which pose substantial human casualties and economic losses. The healthcare and health-determining sectors require information about how extreme weather events affect the population’s health, healthcare and other sectors’ capacities to prepare for and manage these events and their aftermath. We aim to conduct a systematic review to identify the recent evidence on the costs and health outcomes of extreme weather events in humans.

Methods and analysis
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines were followed for reporting this protocol. A comprehensive search will be conducted using several search engines, for example, PubMed, Scopus and Institute for Scientific Information Web of Science. Peer-reviewed and grey literature published in English that evaluated the health outcomes and costs of extreme climate events will be retrieved without restriction on the publication year or geographical location. Two reviewers will independently assess each study for inclusion. Study quality will be evaluated with the recommended quality assessment tools. Data will be reported using descriptive statistics, graphical plots and a narrative synthesis.

Ethics and dissemination
An ethical assessment was not required. The data generated from the systematic review will be disseminated through peer-reviewed journal articles and international conferences and will inform our original research study.

PROSPERO registration number
This systematic review has been registered at the International Prospective Register of Systematic Reviews (registration ID: CRD42024582635).

Objective
This study aims to map the literature on screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip (DDH) in the Brazilian population aged 0–18 years, to describe regional variations in its presentation and management.

Design
Scoping review.

Data sources
PubMed/MEDLINE, Web of Science, Scopus, “Biblioteca Virtual em Saúde” and “Biblioteca Digital Brasileira de Teses e Dissertacões”. The journals, Revista Brasileira Ortopedia and Acta Ortopédica Brasileira, were manually searched for non-indexed issues. Databases were searched from their inception to February 2024.

Eligibility criteria
This scoping review included studies on Brazilian patients aged 0–18 years diagnosed with or being assessed for DDH. No language or date restrictions were applied.

Data extraction and synthesis
Studies were assessed based on title, authors, publication year, study design, sample size, level of evidence, region of Brazil and healthcare setting (public or private). The articles were then analysed across four categories: screening, diagnosis, treatment and outcomes.

Results
52 studies, published between 1951 and 2023, were included. Reported prevalence rates ranged from 0.75 to 56.4 cases per 1000 children. No study examined the effectiveness of specific screening programmes or compared their outcomes. The most common diagnostic methods were the Ortolani manoeuvre and ultrasonography using the Graf method. Of the 27 articles on treatment, 17 focused exclusively on surgical interventions, with the Salter osteotomy being the most frequent procedure.

Conclusions
There should be a greater focus on understanding the prevalence of DDH in Brazil, the availability of ultrasound devices and trained operators, and the follow-up of conservative treatments. More information on DDH in Brazil is essential for designing and implementing effective screening and treatment programmes. Future research should be done to understand the prevalence of the disease, optimal forms of screening and early treatment.

Objectives
To evaluate whether osteopathic and related manual interventions improve adult mental health (depression, anxiety, stress) and psychophysiological measures (eg, heart rate variability, skin conductance).

Design
Systematic review and meta-analysis of randomised controlled trials (RCTs).

Data sources
PubMed, MEDLINE (Ovid), Scopus, Cochrane, and AMED, searched through September 2024.

Eligibility criteria
English-language RCTs with ≥30 participants investigating osteopathic or related manual therapies (eg, myofascial release, high-velocity low-amplitude thrusts) delivered by qualified practitioners, compared with no treatment or sham, and reporting immediate postintervention mental health or psychophysiological outcomes.

Data extraction and synthesis
Full-text screening, risk-of-bias assessment and data extraction were conducted independently by multiple reviewers using a standardised Joanna Briggs Institute (JBI) Extraction Form. Risk of bias was assessed using the JBI Critical Appraisal Checklist. For meta-analyses, Hedges’ g (with 95% CIs) was calculated from postintervention means and SD. Random-effects models accounted for heterogeneity, and prediction intervals were calculated to assess uncertainty in effect estimates.

Results
20 RCTs were included. Osteopathic interventions reduced depression (Hedges’ g=–0.47, 95% CI: –0.86 to –0.09, p=0.02) and increased skin conductance (Hedges’ g=0.67, 95% CI: 0.00 to 1.34, p=0.05). Depression improvements were greater in pain populations (Hedges’ g=–0.61, 95% CI: –1.06 to –0.17, p=0.01). However, wide prediction intervals and moderate heterogeneity indicate uncertainty in true effect sizes, and limited studies and sample sizes restrict assessment of publication bias.

Conclusions
Osteopathic and related manual therapies may reduce depression and influence certain psychophysiological markers, particularly in pain populations, but uncertainty and heterogeneity limit confidence. More rigorous, larger, and longitudinal RCTs are needed.

Trial registration number
This meta-analysis was not formally registered, though the protocol and search strategy can be found at Open Science Framework, registration identification: https://osf.io/jrtpx/.

Introduction
Sustaining evidence-based care is challenging in all clinical settings. Acute care settings have a unique set of contextual factors that may impact sustainability (eg, fast-paced, regular staff turnover). Much of the previous research explores sustainability across undifferentiated healthcare settings making it difficult to determine factors that influence sustainability in acute care settings. The aim of this review is to identify facilitators and barriers that influence the delivery of sustained healthcare interventions (eg, integration of clinical guidelines) within adult and paediatric hospital-based acute care settings.

Methods and analysis
A mixed methods systematic review updating Cowie et al’s (which included studies from 2008 to 2017) previously published systematic review will be conducted. The following databases will be searched: Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL and Allied and Complementary Medicine (AMED), from November 2017 to the present for studies published in English. Relevant reference lists of included studies will be manually searched. Empirical quantitative and qualitative studies that report the sustainability of an intervention or programme in acute care settings using a theoretical framework(s), model(s) or theory(ies) to explore facilitators and barriers, will be included. Studies will be exported into Covidence (Melbourne) and pairs of reviewers will independently screen abstracts and full-text studies. The discussion will be used to resolve any disagreements and a third coauthor enlisted should a consensus not be reached. Two independent coauthors will extract key study characteristics and assess each study’s quality. Data will be extracted using Covidence (Melbourne). Evidence tables will be used to present descriptive data. Facilitators and barriers will be mapped to the Consolidated Framework for Sustainability Constructs in Healthcare and a narrative approach will be used to present key findings.

Ethics and dissemination
No primary data will be collected so formal ethical approval is not required. Findings will be disseminated through peer-reviewed publications, presented at international conferences and on social media.

PROSPERO registration number
PROSPERO CRD42024547535.

Objectives
We aimed to provide an overview of the existing knowledge regarding the roles of physiotherapists in primary care teams.

Design
Scoping review based on the methodological framework provided by Arksey and O’Malley (2005) and updated by Levac et al (2010).

Data sources and study selection
A search strategy was carried out across the Medline, CINAHL, Academic Search Complete and AMED databases in June 2023. Selected articles, based on qualitative or mixed design studies, had to report on the roles of physiotherapists working in team-based primary care organisations and be published in the last 10 years.

Data extraction and analysis
Data were extracted by one team member and further validated by a second team member. A mixed thematic analysis based on the Competency Profile for Physiotherapists in Canada was used to identify all the roles undertaken by physiotherapists.

Results
The database search yielded 2324 articles. From the 13 included articles, 6 main themes emerged: conduct client assessment for musculoskeletal conditions, participate in health promotion and prevention, promote self-management support, communicate with patients, collaborate with other primary care providers and partners, and provide holistic care.

Conclusions
The review identified a wide variety of roles, primarily related to the treatment of musculoskeletal patients. In primary care settings, interprofessional collaboration can be hindered by a lack of knowledge regarding the roles of physiotherapists. Future studies should aim to develop effective strategies to ensure that all primary care team members have a comprehensive understanding of the roles of physiotherapists and to explore roles associated with non-traditional forms of physiotherapy practice.