Search Results for: Il dolore neuropatico: review

Introduction
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally. Early diagnosis and intervention are crucial for preventing disease progression. The concept of early COPD is considered to represent the initial phase of the disease course. However, different terms are used, and a standardised definition is lacking. This has hindered research and clinical utility. This systematic review aims first to examine current early COPD research and outline the definitions and terms used to help reach consensus and direct future clinical research. Second, it will identify currently proposed markers and tools for predicting the progression of early COPD and the quality of evidence to help direct future research and facilitate the development of novel management strategies.

Methods and analysis
This study will search for all clinical studies on early COPD, using a standardised search strategy, searching CENTRAL (the Cochrane Library), MEDLINE (Ovid), PubMed, Scopus, Web of Science and Google Scholar. Titles and abstracts will be reviewed and compared against inclusion and exclusion criteria. Stage 1 of this review will assess the terms and definitions used for early COPD. Stage 2 will assess studies presenting additional markers or tools for predicting the progression of early COPD. Study quality will be assessed using a modified Downs and Black checklist for observational studies and the risk of bias (RoB) 2 tool for randomised controlled trials. This protocol has been registered in PROSPERO (CRD42025645320).

Ethics and dissemination
This systematic review will use freely available data within the literature and will not directly involve human participants; therefore, ethical approval is not required. The results of this systematic review will be prepared and submitted for presentation as conference presentation(s) and for publication as a peer-reviewed article.

PROSPERO registration number
CRD42025645320.

Objectives
To identify and assess the social support interventions provided to caregivers of older adults with dementia. By synthesising the findings, it seeks to provide insights into effective strategies that can enhance caregivers’ support.

Design
A scoping review.

Data sources
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was strictly followed in this study. Searches were systematically conducted across five databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL) from their inception up to February 2025.

Eligibility criteria for selecting studies
We included original intervention studies published in English that examined social support interventions for caregivers of older adults with dementia, focusing on outcomes reporting social support.

Data extraction and synthesis
Data extraction was conducted using a standardised Microsoft Excel chart based on Arksey and O’Malley’s method. Two reviewers independently collected information on study characteristics (authors, country, publication year, design, sample size, assessment tools, interventions and outcomes). Disagreements were resolved by a third independent reviewer.

Results
A total of 31 studies were selected for this review, revealing six distinct categories of social support interventions for caregivers of older adults with dementia. These categories included peer support (n=7), counselling group intervention (n=2), health education (n=2), mindfulness-based stress reduction intervention (n=1), individual therapy (n=1) and multicomponent interventions (n=18). The findings indicate that these interventions significantly enhanced the social support available to caregivers, leading to positive outcomes such as reduced caregivers burden, anxiety, depression and improved coping skills.

Conclusion
This review underscores the variety of interventions designed to enhance social support for caregivers of older adults with dementia. The findings provide valuable insights for caregivers, administrators and other stakeholders, emphasising the critical need to adopt and promote effective social support strategies for this population.

Trial registration details
A review protocol was registered on the OSF(Open Science Framework) registries, with the following registration doi: https://doi.org/10.17605/OSF.IO/D9C53.

Introduction
Physiotherapy is a recommended treatment for a wide range of conditions. However, waitlists can delay access to care, leading to poorer patient outcomes and added strain on healthcare systems. Group-based physiotherapy treatments have shown comparable clinical effectiveness to individual care and may help address these challenges. Despite this potential, their implementation in practice remains limited. Therefore, this systematic review aims to: (1) identify the determinants of use, intention to use, satisfaction, attitudes and experience with group-based treatments of patients and physiotherapy professionals, such as physiotherapists or physiotherapy technologists and (2) assess the factors that may influence patients’ and professionals’ preferences for group-based treatments over individual treatments.

Methods and analysis
Systematic searches were conducted on 6 September 2024 in the Medline, Embase, Web of Science, EBSCO CINAHL and Cochrane databases to identify studies published in French or English, in line with the language proficiency of the review team. Eligible studies will use quantitative, qualitative or mixed-method designs and report original data on the use or intention to use, satisfaction with, attitudes toward and experiences with group-based physiotherapy treatments, from either patients or physiotherapy professionals. Studies will be screened by two independent reviewers, with any discrepancy resolved through consensus or by involving a third reviewer. Data will be extracted from the included studies by two independent reviewers using a predefined data extraction form, with any discrepancy similarly resolved. For quantitative findings, the direction of the relationship between the outcomes and their determinants will be reported, along with the magnitude and significance of the coefficients, where available. For qualitative findings, relevant quotes will be provided to illustrate the relationship between the outcomes and their determinants. All included studies will be assessed by two independent reviewers using the Mixed Methods Appraisal Tool, with any discrepancy resolved again through consensus or by involving a third reviewer.

Ethics and dissemination
Ethical approval is not required for this review as it involves the collection of data from existing publications only. The findings will be disseminated through publication in a peer-reviewed scientific journal and presentations at relevant conferences.

Trial registration number
CRD42024574513.

Introduction
Pharmacomechanical thrombectomy (PMT) can be a useful treatment for restoring vein patency quickly, especially for extensive acute deep vein thrombosis (DVT). However, previous evidence failed to validate the effectiveness of PMT in reducing the incidence of post-thrombotic syndrome (PTS). To address this controversy, the reformation study aims to improve rheolytic thrombectomy for acute DVT of the lower limb through primary popliteal vein thrombosis clearance.

Method and analysis
Reformation is a prospective randomised multicentre trial. It has 160 patients in two groups: the modified access group (80 patients) and the traditional access group (80 patients). The purpose of this study is to assess whether the modified access approach for removing inflow thrombus in a one-stage procedure is more effective in enhancing the success rate of the procedure and reducing the incidence of PTS during a 24-month follow-up period, for patients with acute whole limb DVT.

Ethics and dissemination
The reformation study has been registered at www.clinicaltrials.gov. The study protocol has been approved by the Institutional Review Board and Human Research Ethics Committee of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (approved number: KY2021-067-A). The results will be disseminated by publication in a peer-reviewed journal.

Trial registration number
NCT05286710.

Protocol version and date
V.1.2, 20 August 2022.

Our findings suggest that monthly IPTp-SP has superior effect on GWG compared to weekly chloroquine or IPTp-DHA + PPQ in malaria-endemic areas. The result provides further evidence indicating that IPTp-SP improves maternal weight gain, an important determinant of fetal growth beyond its antimalarial effects. Due to the limited number of trials with weight and height measures available for the IPD meta-analysis we were likely underpowered to detect any significant difference between 2-dose SP and monthly IPTp-SP.

Uptake of nirsevimab varied substantially between the countries that have implemented infant RSV immunisation programmes. Despite the limited number of studies and the lack of more accurate data at national level the low uptake estimates for RSV maternal vaccine and RSV vaccines for older adults are concerning. National, clinical, and public health initiatives are needed to increase uptake of RSV immunisation products and ensure maximum benefit to people currently at risk of severe RSV outcomes.

This narrative review summarizes the epidemiology, molecular characteristics, clinical presentation, and management of small cell lung cancer.

Circulation, Volume 151, Issue 22, Page 1606-1619, June 3, 2025. The win ratio is a method for analyzing a hierarchical composite outcome. It has been most widely used in randomized clinical trials (RCTs) in cardiovascular disease. We performed a review of cardiovascular RCTs using the win ratio published between January 2022 and July 2024. The aims were to summarize current use and to provide examples to illustrate effective use and communication. We identified 36 eligible RCTs, mainly in heart failure and ischemic heart disease. Intervention was pharmaceutical in 26, a procedure in 7, and treatment strategy in 3 trials. When outcomes were analyzed with both conventional composite end points or hierarchical analysis, the conclusions tended to be similar. The win ratio was often used to combine evidence from event outcomes and quantitative measures together in a hierarchical composite, as was done in 23 RCTs. It was also used to create a clinically more relevant measure in RCTs by recognizing the clinical priorities among event outcomes. Selected example RCTs illustrate how the clarity of win ratio findings can be improved by (1) complementing the win ratio (a relative measure) with the win difference, (2) identifying which components of a hierarchical composite drive the overall results, and (3) clearly prespecifying the outcomes and win ratio analysis to be used. We conclude with a set of recommendations for future use of hierarchical composite outcomes and the win ratio. When used wisely, the win ratio is a valuable tool in the analysis of RCTs.

To the Editor We read with great interest the recent study by Na et al on social determinants of health (SDOH) and suicide-related outcomes. This comprehensive review provides valuable insights into the role of SDOH in suicide risk, highlighting key factors that merit public health and policy attention. However, we believe that further discussion on methodological and theoretical aspects could strengthen the study’s implications.

Mission Statement: To advance the equitable, person-centered, and evidence-based practice of internal medicine through publication of scientifically rigorous, innovative, and inclusive research, review, and commentary that informs dialogue and action with clinical, public health, and policy impact.

This review explores the prognostic and predictive capabilities of 3 widely used genomic assays in breast cancer recurrence and outcomes across various racial and ethnic populations.

This systematic review and meta-analysis identifies reports of systematic reviews that included retracted studies in their meta-analyses, and assesses the impact of these retracted studies on the results.

The Review titled “A Person-Centered Approach to Supplemental Oxygen Therapy in the Outpatient Setting: A Review,” published online April 7, 2025, contained 3 instances of the same error in the section The Evidence. The correct threshold for severe resting desaturation is 88% or less. This article has been corrected online.

This Review proposes a person-centered framework to improve independence and quality of life for people using supplemental oxygen and summarizes supplemental oxygen evidence and landscape in the outpatient setting.

In Reply We thank Mermel for his thoughtful and careful review of our Teachable Moment article, “The Harm of Inappropriate Central Line Blood Cultures in Clinical Practice.” We agree that whether a positive central line culture reflects a bloodstream infection, colonization, or a false-positive result requires accounting for the outcome of each blood culture obtained. In our case, we reported that the initial central line blood culture grew coagulase-negative Staphylococcus, yet the initial and repeated peripheral cultures had negative results. As only 1 of the 2 initial blood cultures revealed infection, the positive result was limited to the central line culture, and subsequent cultures revealed negative results. This suggests colonization of the catheter hub or lumen or a false-positive result due to a skin contaminant. Coupled with an alternative explanation for the patient’s fever (ie, community-acquired pneumonia), the infectious diseases consultant did not disregard the possibility of a catheter-related bloodstream infection; rather, as stated in our initial report, they determined the risk to be low. Last, we agree that alcohol end caps are an important strategy to reduce false-positive results drawn from central lines, along with careful skin and catheter disinfection. Unfortunately, such strategies do not eliminate the risk of a false-positive result, supporting our conclusion to limit central line blood culture specimens in clinical practice to specific indications: inability to obtain peripheral blood cultures, suspected catheter-related bloodstream infection in the absence of another recognized source of infection, and neutropenic fever.

Objectives
The increased use of Community Health Services (CHS) is central to UK policy visions of moving more care out of hospital to reduce pressure across the healthcare system and, in particular, the demand on secondary care, hospital services. CHS are under-researched, and little is known about how they can best contribute towards this aim. The National Health Service (NHS) in England has recently undergone a significant reorganisation, with an increased emphasis on collaborative service delivery. In the aftermath of this reorganisation, the objective of this study was to explore how commissioners and providers of CHS think about the need for services and how decisions are made about the commissioning and allocation of resources in order to facilitate out-of-hospital care.

Design
A qualitative, semi-structured interview study with participants from four case study sites in England. Semi-structured interviews were conducted virtually and transcripts analysed using a reflexive thematic approach.

Setting
Adult CHS, which included two sites with CHS providers embedded in acute hospital Trusts, one standalone CHS Trust and a CHS provider collaborative. Sites were selected for both geographical (two sites in the north of England and two in the South) and organisational model diversity.

Participants
40 participants were interviewed across all four case study sites (site A, n=10; site B, n=17; site C, n=10; and site D, n=3). To be included in the study, participants were required to have a management role in providing or commissioning adult CHS and/or their understanding of this at strategic level within the Integrated Care Systems.

Results
Themes from current literature on commissioning (organisation, assessing needs, service design and development, contracting and funding, and performance management and support) were used to structure the data. Participants from all sites reported that the reorganisation of the NHS away from Clinical Commissioning Groups to Integrated Care Boards has resulted in confusion around the commissioning function, with a lack of clarity about current roles and responsibilities. All sites were undertaking some form of service review. However, participants highlighted the fact that current population health and CHS service data do not adequately support proactive planning of services to meet rising demand. CHS find it particularly difficult to evidence their contribution to hospital avoidance. Current block contract funding models also limit the extent to which CHS can provide the flexible services required if hospital admission is to be avoided. We also found some tension around the implementation of additional hospital avoidance services (eg, ‘virtual wards’) which did not necessarily integrate with or complement core CHS services.

Conclusions
Our focus on the commissioning of CHS has highlighted the fact that the new collaborative approach to service design and delivery embodied by the creation of Integrated Care Boards has led to some confusion around decision-making. In addition, the lack of appropriate data and the funding and contractual model used to procure CHS impacts their ability to contribute to the policy agenda of treating more people in the community. These factors should be addressed if CHS are to fulfil ambitions of preventing hospital admissions.