Risultati per: Il dolore neuropatico: review

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…

Despite common approaches to defining SMM, there are opportunities to improve comparability. No two definitions for use with administrative data in different settings involved a similar incidence and set of components and involved a similar distribution of components among cases. Harmonization of the purpose, constituent codes, and sources of data would facilitate comparisons between maternity systems.

Women who underwent child marriage are vulnerable to and disproportionally affected by IPV, emphasising the need for international efforts on targeted IPV interventions and ending child marriage globally to prevent more victims.

Introduction
Nonagenarians and centenarians, compared with other age groups, often exhibit distinct physiological characteristics and a higher prevalence of comorbidities, thus further complicating their care in intensive care unit (ICU) settings. Despite the increasing number of such patients being admitted to ICUs, comprehensive research and studies on their characteristics, outcomes and complications during their ICU stays remain lacking. This scoping review will comprehensively address the following question: What are the characteristics, outcomes, complications and mortality rates among nonagenarians and centenarians admitted to ICUs, including their preadmission health status, reasons for admission, duration of hospital/ICU stays, and factors associated with adverse outcomes? The key objectives are to map the breadth and depth of the available evidence and identify key concepts, gaps and variations in research focus. Finally, we aim to highlight well-studied areas suitable for systematic synthesis, point to underexplored topics warranting further investigation and propose standardised approaches to research design and reporting in this domain.

Methods and analysis
We will conduct a systematic search of MEDLINE, Embase and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. All studies and publications reporting data on patients aged ≥90 years will be included, from an unlimited timeline to 31 August 2024. Studies reporting the characteristics, outcomes and complications of nonagenarians and centenarians admitted to ICUs will be included. The data will be analysed and summarised descriptively through a narrative approach. Qualitative data related to quality-of-life outcomes will be analysed thematically, as applicable.

Ethics and dissemination
Ethics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.

Weight gain in outpatient programmes was markedly slower than in inpatient treatment. Clearer reporting of weight gain and a better understanding of the sequelae of faster/slower recovery is important to set future weight gain targets. Our results set an important baseline for current programmes to benchmark against.

Even after successful tuberculosis treatment, children and adolescents can experience respiratory impairments and disability that may reduce their quality of life, ability to participate in activities, and growth potential. The epidemiology and clinical manifestations of these impairments vary by age, reflecting distinct biological and behavioural differences. Future research should prioritize these younger populations to ensure their unique needs and challenges are adequately represented.

This CPG provides the first evidence-based recommendations on use of food restrictions to prevent infections in children and adolescents undergoing chemotherapy and paediatric haematopoietic cell transplant recipients.

Introduction
Stand-alone HIV clinics in sub-Saharan Africa (SSA) have effectively expanded antiretroviral therapy since the 2000s, transforming HIV from a deadly infection into a chronic condition. However, over the past decade, there has been a significant rise in the prevalence of non-communicable diseases (NCDs) globally and in SSA. People living with HIV are at higher risk for some NCDs, including hypertension, diabetes and different cancers. The region’s current healthcare infrastructure is not equipped to address this growing burden. Integrating health services for HIV and NCDs (ie, combining services for HIV with services for hypertension, diabetes, depression and mental health, substance use disorder or cancer) could be one strategy for responding to these challenges. In this scoping review, we aim to identify randomised controlled trials on HIV-NCD integration, assess implemented integration models and measured outcomes and highlight evidence gaps.

Methods and analysis
This scoping review will follow the Arksey and O’Malley (2005) methodological framework. Reporting will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. We will conduct a systematic search of the databases OVID Medline, Embase, Web of Science, Global, Africa Index Medicus, including terms related to HIV, NCDs and healthcare integration. Included trials must have been conducted within SSA and have been published in English or French after 1 January 2010. We will not select based on sample size or number of clusters. Both the title and abstract screening and full-text screening will be done in Covidence by at least two reviewers working independently. Data extraction will focus on key variables, including study design, geographical location, integration intervention, measured outcomes and reported findings.

Ethics and dissemination
This scoping review aims to generate new insights from publicly available research. Therefore, ethical approval is not required. Study findings will be shared through discussion with policymakers, implementation science researchers and healthcare providers. The results of this study are intended to be published in a peer-reviewed journal.

Trial registration
This protocol has been registered with Center for Open Science OSF Registry (DOI: 10.17605/OSF.IO/RGQSN). The search was conducted on 25 March 2024 and updated on 21 October 2024. The review is expected to be completed by March 2025.

Objectives
Providing adequate access to mental health services is a global challenge. Smartphone apps offer a potentially cost-effective, available and accessible solution for monitoring, supporting and treating mental health conditions. This systematic review describes and evaluates the usage of smartphone apps across a wide range of mental health disorders in terms of clinical effectiveness, feasibility and acceptability.

Design
This is a systematic review of studies examining treatment, self-monitoring and multipurpose smartphone apps for mental health disorders.

Data sources
Studies were identified through a comprehensive search of the Ovid and PubMed databases. Articles published up to 14 January 2024 were included based on predefined criteria.

Eligibility criteria
We included randomised controlled trials that compared mental health apps (single- or multipurpose) with treatment-as-usual or no treatment for clinical populations with mental health disorders. Studies were excluded if they focused on web-based interventions, combined apps with non-TAU treatments or targeted physical health apps.

Data extraction and synthesis
Two independent reviewers screened and selected studies, with a third reviewer resolving inconsistencies. Extracted data included study details, participant characteristics, app information and outcome measures related to effectiveness, feasibility and acceptability. A risk-of-bias assessment for each study was conducted.

Results
Out of 4153 non-duplicate articles screened, 31 studies met full-text eligibility criteria. These included 6 studies on treatment apps, 4 on self-monitoring apps and 21 on multipurpose apps for a range of mental health disorders. Fifteen were identified as having between some and high concern on the risk-of-bias assessment. While smartphone apps were generally effective and acceptable, their feasibility appeared to decline over time.

Conclusions
Smartphone apps are promising tools for mental healthcare, demonstrating effectiveness and acceptability. However, challenges such as reduced feasibility over time, potential biases and underrepresented demographics require further research. This review proposes five recommendations for improving clinical translation in future studies.

Objectives
People living with HIV (PLWH) were previously shown to have a higher prevalence of non-calcified coronary plaque with discrepant results for coronary stenosis and any plaque prevalence. This systematic review and meta-analysis summarise and estimate pooled effect sizes for observational studies among PLWH using comprehensive coronary CT angiography (CTA).

Design
Preferred Reporting Items for Systematic Review and Meta-analysis reporting guidelines were used.

Data sources
PubMed, Embase, Web of Science, CINAHL, Cochrane Clinical Trials and EBM were searched from inception to 23 February 2024.

Eligibility criteria
We included studies evaluating coronary atherosclerosis in adult PLWH with controls and CTA results for plaque prevalence, extent, severity and high-degree stenosis.

Data extraction and synthesis
Two independent reviewers used standardised methods to screen for relevance by title, abstract and full-text review. Two unblinded independent reviewers manually extracted data and rated study quality using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. A sensitivity analysis was performed with a fixed effects model. Publication bias was assessed by visual inspection of funnel plots and formal testing by Egger’s and Begg’s tests. Segment scores were evaluated using the difference of medians.

Results
PLWH showed a significantly higher prevalence of non-calcified plaque (34% (95% CI: 15% to 53%)) compared with controls (22% (95% CI: 6% to 38%)) with an OR of 1.61 (1.13–2.30, p=0.009). There was no significant difference in partially calcified plaque prevalence (OR=1.20, 0.96–1.49), stenosis prevalence (OR=1.34, 0.92–1.96) and median difference in Segment Involvement Score (SIS; 0.39, –0.01 to 0.79) in PLWH compared with controls who have a non-significant difference in calcified plaque (OR=0.80, 0.61–1.04). The prevalence of any plaque (OR=1.22, 0.93–1.61) and difference in median Segment Stenosis Score (–0.12, –0.60 to 0.35) did not differ between groups.

Conclusion
This study demonstrates a greater prevalence of non-calcified plaque in PLWH than controls. Additional research is needed to assess quantitative CTA measurements. Increased power may reveal a difference in the prevalence of high-degree stenosis and median SIS score in PWLH, while controls may have a greater prevalence of calcified plaque.

Introduction
Intensive care unit (ICU) delirium is an acute brain dysfunction that affects up to 7 out of 10 patients admitted to ICUs. Patients who develop ICU delirium cannot think clearly, have trouble paying attention, do not understand what is happening around them and may see or hear things that are not there. ICU delirium increases the time patients spend in ICUs and hospitals and therefore healthcare costs. ICU delirium is also associated with increased mortality and dementia in the longer term. ICU delirium prevention and management strategies are likely to include both pharmacological and non-pharmacological components as part of a complex intervention, but it is unclear which components should be included. The objective of this meta-review is to systematically map the quantity and certainty of the available evidence from reviews and meta-analyses of randomised controlled trials (RCTs) of pharmacological and non-pharmacological interventions, which will be used to design a multicomponent intervention to prevent and manage ICU delirium.

Methods and analysis
A systematic search strategy was performed in MEDLINE (Ovid), Embase (Elsevier), Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and Web of Science (from inception to 26 September 2023), as well as Epistemonikos (from inception to 19 July 2023). We will include all critically ill adults (aged≥18 years) and any ICU delirium prevention or management intervention (pharmacological or non-pharmacological). For pharmacological interventions, we will include reviews of RCTs. For non-pharmacological interventions, we will consider reviews of RCTs, quasi-experimental and cohort studies. We will use the International Consensus Study (Del-COrS) core outcome set for research evaluating interventions to prevent or manage ICU delirium and synthesise our findings using quantitative data description methods. We will involve our Patient and Public Involvement group of people who experienced ICU delirium to develop and comment on such aspects as the research question, methodology and which outcomes are most important.

Ethics and dissemination
No ethical approval is required for this study. The results of this meta-review will be disseminated through peer-reviewed publications and conferences. They will also form part of an evidence map and logic model for the prevention and management of ICU delirium.

PROSPERO registration number
CRD42023473260

Objectives
Improving the quality of care requires specific, comprehensive and continuous attention from the administration of a health system. However, information on evaluations of national and subnational policies and strategies for quality is lacking. This study aims to map studies evaluating policies and strategies for quality in health systems around the world.

Design
This is a scoping review based on the guidelines of the Joanna Briggs Institute (JBI), guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

Data sources
The search for articles was carried out in the Embase, Medline/Pubmed, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature databases and in the grey literature in July 2024.

Eligibility criteria
Publications describing a tool for evaluating interventions for quality in the health system and studies containing at least one conceptual framework related to the evaluation of policies and strategies for quality in the health system, in any language, were included.

Data extraction and synthesis
Data selection was carried out independently by two reviewers, whose conflicts were resolved by consensus and the decision of a third reviewer. The findings were synthesised using a data extraction protocol adapted from two theoretical frameworks on National Quality Policies and Strategies proposed by the WHO.

Results
The data search resulted in 133 potentially eligible studies, of which 14 studies were included in the review. We found 27 countries that had evaluated their policies or strategies, most of them in Asia (11) and Africa (9). Six studies used instruments to evaluate interventions for quality at the health system level. An instrument used in Afghanistan, Armenia, Guatemala and Mexico proved to be potentially useful for dissemination in other countries. Among the elements recommended by the WHO for the implementation of strategic policies for quality, the most present were governance and organisational structure.

Conclusions
Although the evidence provides an indication of how countries have implemented their quality policies and strategies, we identified the need for tools to assess their impact on health systems.

Introduction
Appropriate use of pesticides minimises harm to human health and the environment. Despite regulations and restrictions on use, however, many farmers still use highly toxic pesticides in ways that endanger their health and the environment. Many pesticide users know little about the health effects of these chemicals or how to handle them safely. A systematic review will collate evidence of the effectiveness of educational interventions among farmers regarding health hazards and the safe handling of pesticides. The review aims to summarise the impact of educational interventions on knowledge and reported behaviour of pesticide users and to identify characteristics of more effective interventions.

Methods and analysis
We will search MEDLINE, LILACS, AGRICOLA, IMBIOMED, SciELO, Web of Science, Scopus, Embase databases and from the grey literature, Open Grey and WHO to identify potentially eligible studies. We will consider randomised and non-randomised controlled trials that evaluated the impact of educational interventions among farmers about the safe use of pesticides. We will include studies published between 2000 and 2024 in English, Spanish and Portuguese and consider outcomes of knowledge about pesticide health effects, knowledge about safe handling of pesticides and reported behaviour when handling pesticides. A meta-analysis of eligible studies, using a random-effects model, will estimate the impact of educational interventions on the outcomes as the difference between the intervention group and the control group at the last point of measurement. We will assess heterogeneity using the 2 test and I2 statistic, conduct a sensitivity analysis by removing each study from the meta-analysis and evaluate publication bias with a funnel plot and Begg and Egger tests. Subgroup analyses will examine the impact of different kinds of educational interventions.

Ethics and dissemination
Ethics approval is not required as no information from individuals are collected. The results will be published in a peer-reviewed journal or disseminated at relevant conferences.

PROSPERO registration number
CRD42023413028.

Introduction
Breastfeeding is the biological norm for infant nutrition. In certain scenarios, feeding at the breast is not possible, because of either maternal or neonatal reasons. In those cases, infants can still receive expressed mother’s own milk (MOM) and its beneficial properties. Mothers can express their milk using a variety of methods, while applying different hygiene practices, in different settings; moreover, expressed milk might receive processing before it is fed to the infant, particularly to reduce transmission of viruses such as cytomegalovirus to premature infants. The present protocol was designed to gather the evidence on the effect that the expression method, the hygiene regimen and setting and any processing used on expressed MOM can have on the clinical outcomes of recipient infants.

Methods
This systematic review will follow the methodological recommendations of the Cochrane Collaboration, in accordance with WHO recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will apply a hybrid search strategy, by combining structured database search with predefined snowballing searches. We will include primary research studies only, without restrictions on the type and including observational studies; no publication time, setting or language restriction will be applied, provided the abstract is available in English. Studies evaluating different methods of MOM expression, hygiene practices or settings during expression, processing of MOM and reporting clinical outcomes on recipient infants will be eligible. The searches have been planned to be performed in April–May 2024. Two reviewers will independently perform the reference screening, data extraction and risk of bias analysis of eligible studies, by using standardised tools specific for each study design. Quantitative and thematic narrative data synthesis will be performed and statistical heterogeneity between studies tested. Meta-analyses of extracted data will be performed where applicable. For relevant outcomes, certainty of the evidence will be tested by using the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination
Ethical approval is not required for this study since no original data will be collected. There is patient and public involvement throughout this research process. The results of this review will be disseminated through publication in a peer-reviewed journal and through conference presentations. Moreover, this systematic review will inform recommendations on milk banking of the WHO Department of Nutrition and Food Safety.

PROSPERO registration number
CRD42024523299.

This systematic review to support a 2025 US Preventive Services Task Force Recommendation Statement summarizes published evidence on the benefits and harms of screening for, and treatment of, osteoporosis to prevent fractures in adults.

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.