Risultati per: Il dolore neuropatico: review

Introduction
Health systems are facing increasingly complex healthcare challenges, including system fragmentation, silos culture, lack of accountability, budgetary constraints and epidemiological transitions. Many governments adopted healthcare networks as a new strategy to address the complex healthcare challenges (eg, multidisciplinary care) by fostering effective clinical and interprofessional collaboration (IPC) across clinical pathways. Yet, limited evidence exists on how IPC is fostered within healthcare networks (ie, happening inside the structure of the network—including processes, systems, communication and practices).

Objectives
This review aims to identify the underlying processes and drivers for effective IPC within healthcare networks, as well as facilitators and barriers.

Design
We followed the scoping review guidance developed by the Joanna Briggs Institute and Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews reporting guidelines.

Data sources
We searched five databases (PubMed (Medline), Scopus, Web of Science, Research4Life and BDSP).

Eligibility criteria
We included peer-reviewed articles published between 2010–2024 in French or English that addressed IPC within healthcare networks.

Data extractions and synthesis
Data charting included the general characteristics of included studies, IPC characteristics, barriers and facilitators and implications for policy and practice. Thematic analysis was guided by the levels of IPC at individual, professional, interactional and organisational levels.

Results
29 studies were included in this review. Most scholars from the included studies indicated that IPC is a complex, socially stratified process that includes four levels: individual, interactional, professional role and organisational characteristics. The main barriers were poor communication, lack of shared knowledge and decision-making, hierarchy and power imbalances. Key facilitators included clarifying roles, building formal structures for IPC, enhancing communication and promoting interprofessional education and training.

Conclusion
Promoting IPC necessitates systemic interventions that target multiple levels, including the individual, interactional, professional and organisational dimensions. Additional research is needed to understand how to foster effective IPC and develop strategies to ensure high-quality patient care.

Introduction
Teenage pregnancy remains a critical global health issue, particularly in low- and middle-income countries. The intergenerational transmission of teenage pregnancy underscores the need for targeted interventions. Existing research on intergenerational approaches is fragmented, with varying methodologies and outcomes. This scoping review seeks to address this gap by answering the following research questions: What are the available intergenerational interventions for teenage pregnancy, and what are the associated risks and protective factors for early and late teenage pregnancy?

Methods and analysis
This study does not involve primary data collection and therefore does not require ethical approval. The review will be conducted in five stages: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting the results. A comprehensive search of electronic databases, grey literature and relevant organisational websites will be conducted for literature published between 2014 and 2024. Data will be extracted using a standardised form and synthesised narratively. Stakeholder consultation will be conducted to refine findings and ensure relevance. The findings will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) extension for Scoping Reviews guidelines. The results will be presented through narrative synthesis, with tables and charts used to summarise key information.

Ethics and dissemination
As the review is based on publicly available data, ethical approval is not required. Ethical clearance will be sought for stakeholder consultations, if necessary. Findings will be disseminated through peer-reviewed publications, conferences, policy briefs and shared openly on the Open Science Framework (OSF). This protocol is registered in the OSF (https://doi.org/10.17605/OSF.IO/CM9WK).

Objectives
Ensuring equity in clinical trials has been declared a global priority. Australia is competitive in the international clinical trial sphere. We aimed to explore factors that influence oncology clinical trial participation in Australia.

Design
Scoping review.

Data sources
On 27 May 2024, a systematic search using a predefined strategy was conducted across four electronic databases (Medline, CINAHL, EMBASE and Scopus), grey literature and hand searches.

Eligibility criteria
All cancer (haematological and non-haematological) clinical trials that discussed factors influencing participation in Australia were included. There were no language or age restrictions.

Data extraction and synthesis
Data were extracted using a predesigned extraction tool. Quantitative results were analysed using descriptive statistics. Qualitative data were synthesised using a framework method into four domains (1) patients, (2) healthcare professionals, (3) clinical trials and (4) health services.

Results
Of 1084 citations identified, 393 duplicates were removed. Of the 691 titles and abstracts screened, 54 articles underwent full-text review, and 42 articles were included in the final analysis. Key factors that influence clinical trial participation were identified across all domains, many consistent with the international literature. For example, while self-reported willingness emerged as a key facilitator across diverse patient groups, cohort studies revealed lower participation rates for migrant populations, older patients and those residing in regional areas. Importantly, we were also able to identify the foundations of an evidence base of interventions that directly support increased clinical trial participation.

Conclusion
This scoping review contributes new findings to a body of international literature, while contributing a unique Australian perspective. These findings establish the foundations of an evidence base that supports inclusive clinical trial participation.

Objectives
Sympathetic crashing acute pulmonary oedema (SCAPE) is a menacing medical emergency and a severe form of acute heart failure that requires urgent intervention. Nitroglycerin (NTG) is commonly used in SCAPE management, but the optimal dosing remains uncertain. This meta-analysis compared the efficacy and safety of high-dose vs low-dose NTG in SCAPE patients, assessing mechanical ventilation need, symptom resolution, hospital stay and major adverse cardiovascular events (MACE).

Design
Systematic review and meta-analysis conducted per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, registered in Prospective Register of Systematic Reviews (CRD42024527486).

Data sources
A comprehensive search in PubMed, Europe PMC and ScienceDirect up to November 2024. Reference lists of included studies were also reviewed.

Eligibility criteria
Randomised controlled trials (RCTs) and observational studies comparing high-dose NTG (≥100 mcg/min) with low-dose NTG (

Antibiotic exposure during pregnancy or early childhood enhances AD risk, with childhood exposure posing a higher risk than prenatal exposure. Exposure time (during pregnancy and childhood) and the age at outcome measurement are important influencing factors for this association. Diagnostic criteria, race, frequency of antibiotic exposure, and type of antibiotics may also affect this relationship. While the observed statistical significance may be associated with the increased statistical power afforded by the large sample size, the clinical implications of these findings warrant cautious interpretation.

Objective
Cognitive stimulation (CS) is a non-pharmacological intervention aimed at enhancing cognitive function. However, the effectiveness of CS in individuals diagnosed with mild cognitive impairment (MCI) remains inconclusive. Therefore, this study aimed to assess the effectiveness of CS in improving cognitive function, psychological well-being, instrumental activities of daily living (IADL) and quality of life (QoL) in individuals with MCI, based on randomised controlled trials (RCTs).

Design
Systematic review and meta-analysis.

Data sources
Six English databases were systematically searched, including PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, American Psychological Association PsycInfo and Academic Search Premier.

Eligibility criteria
RCTs about CS for individuals with MCI, published between January 2003 and December 2024.

Data extraction and synthesis
Data were extracted and assessed using the revised Cochrane risk of bias tool for randomised trials by independent researchers. The meta-analysis was conducted using the standardised mean difference (SMD) and 95% CIs of the included studies.

Results
The meta-analysis included five eligible studies for the primary outcomes of cognitive function and three eligible studies for the secondary outcomes of psychological wellness. In the pooled samples, the CS intervention had a significant effect on cognitive function (SMD=0.63, 95% CI 0.25 to 1.01; p=0.001) and depression symptoms (SMD=–0.29, 95% CI –0.55 to –0.03; p=0.03) in individuals with MCI. However, no significant improvements in anxiety symptoms were identified after the CS intervention (SMD=–0.05; 95% CI –0.31 to 0.21; p=0.71).

Conclusion
The CS intervention can effectively improve cognitive function and alleviate depression symptoms. Although a meta-analysis was not conducted for IADL and QoL due to the limited number of included studies, positive trends in enhancing IADL performance and augmenting QoL were observed in individuals with MCI. However, due to the scarcity of relevant studies in this research field, more comprehensive RCTs are warranted to provide a better understanding of the potential benefits of CS and to guide its clinical application in the future.

PROSPERO registration number
CRD42023494685.

Introduction
People living alone with neurodegenerative conditions face unique difficulties in maintaining independence and accessing appropriate health and social care support. Consolidating current understanding regarding these unique difficulties would better inform health and social care services and enable more tailored and appropriate service delivery. The proposed scoping review will summarise evidence from studies that provide evidence about people with dementia, Parkinson’s disease, Huntington’s disease or motor neurone disease who live alone. This protocol sets out the processes that will be followed in the subsequent scoping review to ensure that a transparent, rigorous and reproducible approach is used to identify, select and synthesise relevant evidence.

Methods and analysis
This scoping review protocol uses well-established methodology outlined by the Preferred Reporting Items for Systematic review and Meta-Analysis and the Joanna Briggs Institute. Relevant publications will be searched using PubMed, Web of Science Core Collection, CINAHL and AgeLine via EBSCOhost and EMBASE, PsycInfo and Social Policy and Practice via Ovid. Grey literature will be searched via Google looking specifically for pdf documents. As there was no previous review on the topic, no date restrictions will be applied to the searches. Piloting of the search strategy provided an estimate of the number of titles likely to require title and abstract screening, which, along with prior experience from a similar review approach, informed the feasibility of the proposed strategy. For research publications, a two-stage screening approach will be undertaken. The first stage will involve screening titles and abstracts for relevant literature on people with neurodegenerative conditions living alone in the community. The second stage will involve full text screening of selected articles. For grey literature, the first 20 PDFs per website identified in Google will be downloaded and screened. Summary data will be extracted from publications selected for inclusion. Data synthesis will involve tabulating study characteristics and findings and preparing narrative summaries to identify commonalities, gaps and areas for future research.

Ethics and dissemination
Ethical approval is not required for this review, as the information included is in the public domain and people with lived experience are consultees rather than research participants. Consultation with people with lived experience, stakeholders and experts linked with the National Institute for Health and Care Research Policy Research Unit in Dementia and Neurodegeneration University of Exeter will help to ensure the relevance and applicability of findings. Dissemination will include a policy report and peer-reviewed publications aimed at informing policy, practice and improving support services for people living alone with neurodegenerative conditions.

Introduction
Chronic diseases, such as diabetes, hypertension and cardiovascular diseases, represent a significant burden on global health systems. Health information technology (HIT) offers innovative solutions to improve disease management, patient outcomes and healthcare efficiency. However, the diverse applications and impacts of HIT in chronic disease management are not well understood. The objective of this scoping review is to assess the extent and type of evidence on the role of HIT in enhancing chronic disease management.

Methods and analysis
This protocol outlines a scoping review to assess the extent and nature of the evidence on the role of HIT in managing chronic diseases. The review will be conducted in accordance with the JBI methodology for scoping reviews. This review will include studies involving adult patients with chronic diseases. The focus will be on various HIT interventions, including electronic health records (EHRs), telehealth services, mobile health (mHealth) applications, remote monitoring devices and health information exchanges (HIEs). Studies conducted in primary care, hospital and community health settings will be considered. Exclusions will include studies focused on paediatric populations or non-digital health interventions. We will include quantitative, qualitative and mixed-methods studies published from January 2013 to December 2024. A comprehensive search will be conducted across PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus and Google Scholar. Reference lists of included studies will be screened for additional sources. Two independent reviewers will screen titles, abstracts and full texts, extract data and resolve discrepancies through discussion or consultation with a third reviewer. The study is scheduled to begin in May 2025 and conclude by November 2025, and the process will be documented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The data will be presented as tables, charts and a narrative summary.

Ethics and dissemination
As this review involves the analysis of publicly available literature, ethical approval is not required. The results will be disseminated via peer-reviewed publications, conference presentations and engagements with stakeholders involved in chronic disease care and digital health policy. The authors will also explore opportunities to share supplementary materials in open-access repositories to promote transparency and reproducibility.

Introduction
Point-of-care ultrasound (POCUS) is considered an essential component of intensive care practice, enabling rapid assessment and diagnosis of various medical conditions. Critical care nurses (CCNs) have increasingly adopted this bedside technology, which has demonstrated to improve patient care and streamline workflows. This scoping review aims to map and present the contexts in which CCNs use POCUS, the content and structure of the training programmes undertaken and any reported impacts on patient outcomes.

Methods and analysis
This scoping review will be conducted in accordance with the Joanna Briggs Institute guidelines and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklists. We will search Medline, EBSCOhost CINAHL and Google Scholar for relevant studies published from 2015 to the present. Additionally, the reference lists of included studies will be manually checked for further relevant articles. All review steps will be carried out by at least two reviewers to ensure accuracy and reliability. Data charting will be performed narratively, detailing the study characteristics and findings pertinent to the review questions.

Ethics and dissemination
There is no ethics disclosure required for this review protocol, as the data will be sourced from previously published primary studies. The findings of this review will be published in a peer-reviewed journal and disseminated through presentations at both national and international conferences.

Introduction
Identifying difficult airways and avoiding unanticipated difficult airways through difficult airway assessment are crucial for patient safety prior to airway management. Therefore, accurately predicting difficult airways through airway assessment is a fundamental and significant technique in airway management by clinicians. Artificial intelligence (AI) is a rapidly evolving science with greater data processing ability than humans. AI, given its ever-expanding applications in medical diagnosis and disease prediction, has been employed to predict cases with difficult airways. Nevertheless, the diagnostic performance of AI algorithms for difficult airway assessment remains unclear due to the small sample sizes, insufficient image acquisition standards and poor predictive accuracies. Consequently, this study aims to formulate a protocol for a systematic review and meta-analysis to ascertain the diagnostic value of AI in assessing difficult airways.

Methods and analysis
English-language databases (Cochrane Library, Web of Science, PubMed, Ovid Medline and Embase), Chinese electronic databases (China National Knowledge Infrastructure, VIP and Wanfang ] and clinical trial registry databases will be searched from their inception until January 2025 to identify clinical trials of AI for difficult airway assessment. Sensitivities, specificities, areas under the receiver operating characteristic curve, diagnostic likelihood ratios and diagnostic ORs with 95% CIs will be presented as indicators of AI’s diagnostic accuracy in assessing difficult airways. Depending on the level of statistical heterogeneity evaluated by the I-square test, the fixed-effects or random-effects model will be employed. The risk of bias will be evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Furthermore, the quality of evidence concerning the outcomes will be assessed based on the Grading of Recommendations Assessment, Development and Evaluation criteria for diagnostic tests. Heterogeneity will be investigated through sensitivity, meta-regression and subgroup analyses. Additionally, Deeks’ funnel plot asymmetry test will be used to detect publication bias.

Ethics and dissemination
Ethical approval is not required for this systematic review protocol. The results will be disseminated through peer-reviewed publications.

PROSPERO registration number
CRD42023462926.

Global HPV vaccination coverage remains significantly below the target of 90%. Strategies to effectively enhance HPV vaccination coverage must be identified, developed, and implemented to address this gap.

This systematic review to support a 2025 US Preventive Services Task Force Recommendation Statement summarizes published evidence on the benefits and harms of screening and harms of treatment of syphilis during pregnancy.

Introduction
In countries with access to the electronic health record (EHR), both patients and healthcare professionals have reported finding errors in the EHR, so-called EHRrors. These can range from simple typos to more serious cases of missing or incorrect health information. Despite their potential detrimental effect, the evidence on EHRrors has not been systematically analysed. It is unknown how common EHRrors are or how they impact patients and healthcare professionals.

Methods and analysis
A mixed systematic review will be carried out to address the research gap. We will search PubMed, Web of Science and CINAHL for studies published since 2000, which report original research data on patient-identified and healthcare professional-identified EHRrors. We will analyse (1) the prevalence of EHRrors, (2) the types of EHRrors and (3) their impact on care. Quantitative and qualitative findings will be synthesised following the Joanna Briggs Institute Framework for Mixed Systematic Reviews. Identified studies will be critically appraised for meta-biases and risk of bias in individual studies. The confidence in the emerging evidence will be further assessed through the Grading of Recommendations Assessment, Development and Evaluation approach. Findings will be contextualised and interpreted involving an international team of patient representatives and practising healthcare professionals.

Ethics and dissemination
The study will not involve collection or analysis of individual patient data; thus, ethical approval is not required. Results will be published in a peer-reviewed publication and further disseminated through scientific events and educational materials.

PROSPERO registration number
CRD42024622849.

Objectives
The incidence of cancer diagnosed during pregnancy is increasing, but data relating to perinatal outcomes for infants exposed to systemic cancer treatment in utero remain limited. This systematic review and meta-analysis aimed to synthesise evidence from the available literature to investigate whether perinatal outcomes for babies born to women with gestational cancer differ based on whether they are exposed to systemic cancer treatment in utero.

Design
A systematic review was conducted according to PRISMA-P guidelines. We extracted raw data from the eligible studies to calculate ORs and 95% CIs for perinatal outcomes reported in the included studies.

Data sources
A comprehensive search of Medline, Embase, Cochrane Library and CINAHL databases identified studies published between January 2001 and May 2025.

Eligibility criteria
Studies were eligible for inclusion in the review that reported on both a study group (women with gestational cancer who received systemic therapy during pregnancy) and a comparison group (women with gestational cancer who did not receive systemic therapy during pregnancy).

Data extraction and synthesis
Two independent reviewers extracted data. Perinatal outcomes included spontaneous abortion, pregnancy termination, intrauterine growth restrictions (IUGR), stillbirth, intrauterine foetal death, neonatal mortality, preterm birth (

The findings suggest that music therapy, particularly receptive methods or combinations of receptive and active approaches, offer effective, flexible, and scalable interventions for reducing anxiety symptoms, offering psychological benefits that enhance patient autonomy and quality of life, though its impact on physiological outcomes and long-term effects requires further research.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for glycemic control or weight management in patients with type 2 diabetes mellitus (T2DM) or overweight/obesity. However, there are concerns regarding their association with serious gastrointestinal adverse events though findings have been inconsistent.