Risultati per: Progressi nel trattamento della psoriasi: review

Circulation, Volume 151, Issue 12, Page 863-877, March 25, 2025. Hypertension is the leading modifiable risk factor for atrial fibrillation (AF) and is estimated to be present in >70% of AF patients. This Frontiers Review was prepared by 29 expert members of the AF-SCREEN International Collaboration to summarize existing evidence and knowledge gaps on links between hypertension, AF, and their cardiovascular sequelae; simultaneous screening for hypertension and AF; and the prevention of AF through antihypertensive therapy. Hypertension and AF are inextricably connected. Both are easily diagnosed, often silent, and frequently treated inadequately. Together, they additively increase the risk of ischemic stroke, heart failure, and many types of dementia, resulting in greater all-cause mortality, considerable disease burden, and increased health care expenditures. Automated upper arm cuff blood pressure devices with implemented technology can be used to simultaneously detect both hypertension and AF. However, positive screening for AF with an oscillometric blood pressure monitor still requires ECG confirmation. The current evidence suggests that high-risk individuals aged ≥65 years or with treatment-resistant hypertension could benefit from AF screening. Since antihypertensive therapy effectively lowers AF risk, particularly in individuals with left ventricular dysfunction, hypertension should be the key target for AF prediction and prevention rather than merely a comorbidity of AF. Nevertheless, several important gaps in knowledge need to be filled over the next years, including the ideal method and selection of patients for simultaneous screening of hypertension and AF and the optimal antihypertensive drug class and blood pressure targets for AF prevention.

Background
The transition to higher education represents a demanding adaptation process with several socioeconomic factors involved. Mental health problems among university students have been worsening since the beginning of the COVID-19 pandemic. Our objective is to create scientific evidence about the models of mental health-promoting interventions among higher education students applied in academic environments, as well as their effectiveness. We aim to synthesise the scientific evidence on the models of an intervention promoting mental health among university students applied in academic environments as well as their results.

Methods and analysis
A systematic review of the literature will be conducted. The research will be carried out using the EBSCO databases (CINAHL Complete, MEDLINE Complete, Psychology and Behavioral Sciences Collection), PubMed and Scopus. The research strategy includes the following MeSH or similar terms: Universities [Mesh], Students [Mesh], Education [Mesh], Undergraduate, “Higher Education”, Universit*, College, Student*; “Psychosocial intervention” [Mesh], “Non-pharmacological”, “Intervention model*”, “Mental health promotion program*”, Intervention*; “Randomized Controlled Trial”, RCT; “Mental health” [Mesh], Depression [Mesh], Anxiety [Mesh], “Stress, psychological” [Mesh], “Quality of life” [Mesh], and “Psychological well-being” [Mesh]. All experimental studies with mental health-promoting interventions for university students that were published between January 2017 and November 2024 in English will be eligible. Two independent reviewers will apply the inclusion and exclusion criteria, analyse the quality of the data and extract it for synthesis. Disagreements will be resolved by a third reviewer. All randomised controlled trial studies with interventions in university students and their efficacy (with means and SD) will be included in the systematic review of the literature. The standardised mean difference will be used as the effect size to standardise individual results. Sensitivity analysis, subgroup analysis and meta-regression will be conducted to explore the causes of heterogeneity and the robustness of the results.

Ethics and dissemination
Ethical approval is not required for this study as it is based on the review of previously published data. The results will be disseminated through publication in peer-reviewed journals and presentations at academic conferences, as well as in events organised by student associations.

PROSPERO registration number
CRD42022359608.

Introduction
Domestic violence (DV) is a major public health problem for women around the world, and more commonly for women in Latin American countries (LACs). DV poses a threat to women’s health and can have more severe effects in women at midlife and older (aged 50 and above), including a decline in physical and mental abilities leading to a reduced independence. Low- and middle-income countries, including LACs, are projected to experience the greatest population growth in women at midlife and older worldwide over the next few decades. Current LAC literature about DV in relation to women at midlife and older is predominantly prevalence focused. The objective of this review is to identify what is known about DV among women at midlife and older in LACs.

Methods and analysis
This review will be conducted in accordance with JBI scoping review methodology. This includes a three-step search strategy: first, a search to identify articles from databases in MEDLINE, Scopus and LILACS; then, a second search using all key words and index terms identified from the articles in step one across select databases; and third, screening the reference lists of included studies and reports for additional studies. All studies which focus on DV in LACs among women at midlife and older will be eligible for inclusion, including those related to definitions, frameworks, cultural norms, risk factors, interventions, evaluations, measurement tools, and health and social consequences. Titles, abstracts and full texts will be assessed by two independent reviewers. A data extraction tool will be used, and findings will be presented in a narrative accompanied by diagrams and tables that address the review questions.

Ethics and dissemination
Ethics approval is not required for this review. Findings will be disseminated through a range of traditional approaches, including publication in a peer-reviewed publication and conference presentations.

Trial registration
This review has been registered with Open Science Framework https://doi.org/10.17605/OSF.IO/SZMF7.

Objectives
This study aimed to investigate the safety and effectiveness of opioid-free anaesthesia (OFA) versus conventional opioid anaesthesia (OA) for postoperative pain management and recovery in patients undergoing laparoscopic surgery.

Design
Systematic review and meta-analysis.

Data sources
The databases of PubMed, Embase, Cochrane Library and Web of Science were searched from inception to August 2023.

Eligibility criteria for selecting studies
We included any randomised controlled trial comparing OFA (at least two drugs or two more alternatives to opioids) with OA for laparoscopic surgery. The primary outcomes included postoperative pain scores, measured on a Numerical Rating Scale or Visual Analogue Scale ranging from 0 to 10, at 0–2 hours and 24 hours postoperatively; postoperative analgesic consumption, measured in morphine equivalent doses (mg); and quality of recovery, assessed using the QoR-40 score (ranging from 40 to 200). The secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), antiemetic use, extubation time (measured in minutes), post-anaesthesia care unit discharge time (measured in minutes), shivering, bradycardia, hypotension and pruritus.

Data extraction and synthesis
Meta-analyses were performed using Stata16 software, using the DerSimonian and Laird’s method and inverse variance to summarise effect sizes for each outcome under a random effects model for all outcomes. Outcomes were reported as OR for binary outcome indicators and mean difference (MD) for continuous outcome indicators, with corresponding 95% CIs. I² coefficients were used to assess high, medium and low heterogeneity. RoB was used to assess the risk of bias of the included studies. GRADE assessed the certainty of the evidence using a systematic framework for rating the quality of evidence and strength of recommendations.

Results
Ultimately, 12 studies involving 983 patients undergoing laparoscopic surgery were included in this systematic evaluation and meta-analysis. The results of the meta-analysis showed an association of OFA with reduced early postoperative 0–2-hour pain response (MD –1.29; 95% CI –2.23 to –0.36; I²=92%; p

Introduction
Research suggests that adverse childhood experiences can have a lasting influence on children’s development that result in poorer health outcomes in adulthood. Like other exposure-outcome relationships, however, there is uncertainty about the extent to which the relationship between adverse childhood experiences and health is causal or attributable to other factors. The aim of this systematic review is to better understand the nature and extent of the evidence available to infer a causal relationship between adverse childhood experiences and health outcomes in adulthood.

Methods and analysis
A systematic review of evidence from cross-sectional and longitudinal studies will be conducted to examine the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood. A comprehensive search for articles will be conducted in four databases (Medline, CINAHL, PsycInfo and Web of Science) and Google Scholar. We will include studies published since 2014: (1) of adults aged 16 years or over with exposure to adverse childhood experiences before age 16 years from general population samples; (2) that report measures across multiple categories of childhood adversity, including both direct and indirect types and (3) report outcomes related to disease morbidity and mortality. Two reviewers will independently screen all titles and abstracts and full texts of potentially relevant studies. Included studies will be evaluated for risk of bias with the Risk Of Bias In Non-randomised Studies of Exposures tool. Data extraction will include extraction of study characteristics; measurement of adverse childhood experiences, outcome assessment and measurement of outcomes; details about confounding variables and contextual variables; methods of statistical analysis; and methods for assessing causal inference. We will carry out a meta-analysis and incorporate causal assessment with reference to the Bradford Hill criteria and the Grading of Recommendations Assessment, Development and Evaluation framework.

Ethics and dissemination
This study is a systematic review protocol collecting data from published literature and does not require approval from an institutional review board. The findings from this systematic review will be disseminated via a peer-reviewed journal publication, professional networks and social media.

PROSPERO registration number
CRD42024554563.

Background
Delayed graft function (DGF) continues to represent one of the most frequently encountered early complications following kidney transplantation. Despite notable progress in donor and recipient pretreatment protocols, diagnostic techniques and therapeutic approaches, the incidence of DGF, along with its associated short- and long-term sequelae, has not demonstrated a significant reduction. DGF is influenced by a multitude of factors, and individuals with exposure to these risk factors exhibit a markedly increased probability of developing DGF.

Objectives
To systematically identify and evaluate risk factors associated with DGF in kidney transplant recipients.

Design
A systematic review and meta-analysis

Data sources
A comprehensive search was performed across multiple databases, including PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, VIP and SinoMed, from the inception of each database until 1 March 2024.

Primary outcome measures
OR and OR 95% CI of risk factors for DGF.

Results
The meta-analysis included 19 studies involving a total of 153 008 patients, of whom 96 596 (63.1%) developed DGF. The following risk factors for DGF were identified: prolonged cold ischaemia time (CIT) (OR=1.05, 95% CI=1.03 to 1.07, p

Introduction
Eating disorders (EDs) are complex psychological and physiological disorders that often co-occur in the presence of other mental health difficulties. Mentalisation-based therapy (MBT) offers a promising therapeutic approach for treating comorbid difficulties by fostering individuals’ capacity to understand their own and others’ mental states. More specifically, MBT is a novel approach for treating EDs that recognises the intricate interplay between psychological factors and disordered eating behaviours, targeting the underlying cognitive and emotional processes implicated in ED pathology. The possible value of MBT in treating EDs has been proposed, but the existing research on the topic has not yet been synthesised. This review aims to examine the effectiveness of MBT across diverse ED presentations through analysis of the peer-reviewed literature.

Methods and analysis
This systematic review protocol adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols checklist. The review will include peer-reviewed studies on MBT for EDs without geographical restrictions. A systematic search for the published literature will be conducted using the following databases: Medline, Embase, PsycInfo and Cochrane Central Register of Controlled Trials. For articles to be included, documents must describe and evaluate MBT for EDs and be a quantitative study. There will be no restrictions on publication date. The two authors will independently screen titles, abstracts and full-text articles. A meta-analysis will be conducted for data synthesis if at least three studies with comparable designs, populations and outcomes are identified. If studies are too heterogeneous, a narrative synthesis will summarise the results. The findings may contribute to a more nuanced understanding of MBT’s role in ED treatment, with potential implications for clinical practice, policy development and future research endeavours.

Ethics and dissemination
Ethical approval is not required as all data are available from public sources. The results of this systematic review will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number
CRD42024421136.

Objectives
To examine the effectiveness of exercise interventions to improve long COVID symptoms and the tolerance of exercise interventions among people with long COVID.

Design
Systematic review.

Data sources
Medline via EBSCOhost, Embase via OVID and CENTRAL via the Cochrane Library up to 28 February 2023.

Eligibility criteria for selecting studies
Inclusion criteria were: (1) participants with long COVID, as defined by study authors; (2) random assignment to either an exercise intervention or a comparison group and (3) a quantitative measure of at least 1 of the 12 core long COVID outcomes. Exclusion criteria were: (1) signs or symptoms not reasonably attributable to prior SARS-CoV-2 infection; (2) pre-exposure or postexposure prophylaxis for COVID-19 or the prevention of long COVID symptoms and (3) interventions where the primary exercise component is breathing or respiratory muscle training.

Data extraction and synthesis
Two reviewers independently extracted data, and studies were narratively synthesised.

Results
Eight studies were included. Follow-up periods ranged from 2 to 28 weeks (mean=8.5 weeks). Sample sizes ranged from 39 to 119 (mean=56). All studies were in adults (mean age=49.9 years) and both sexes (mean female proportion=53.9%). Four studies were at low risk of bias, two were unclear and two were high. The evidence suggests that exercise interventions lead to short-term improvements in dyspnoea, fatigue, physical function and the physical domain of quality of life among people with long COVID. Of the five studies that reported adverse events, rates were low and, when reported, mild. Of the seven studies that reported sufficient relevant information, 1 of 252 participants who received exercise discontinued the intervention due to tolerance-related issues.

Conclusion
Available evidence suggests that exercise interventions may be beneficial and tolerable among some people with long COVID. However, the evidence base consists of a limited number of studies with small sample sizes and short follow-up periods.

The network meta-analysis reveals that saturation SB+TB and SB+saturation TB have no significant difference in csPCa detection between them and SB+TB. Meanwhile, ips-SB+TB and saturation TB are effective biopsy strategies for MRI-positive PCa patients, offering a more targeted approach for detecting csPCa.

TPT decreased the risk of TBD in patients with RD, especially in TB high burden countries/regions. When using isoniazid monotherapy, extending the treatment course might have better protection. TST combined with IGRA might be optimal when screening the TBI. More types of RDs, short-course regimens containing rifamycins and high-quality randomized controlled trials (RCT) should be the focus of future research.

Nel 2019 il marito tentò di ucciderla dandole fuoco

Objective
A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings.

Design
A systematic qualitative review and meta-synthesis was conducted following the five-step methodology proposed by Sandelowski et al.

Data source
Three databases (Medline, Embase and Scopus) were systematically searched without time restrictions up to 25 May 2024.

Eligibility criteria for selecting studies
Qualitative studies exploring perspectives, experiences and other similar factors were included. These studies were assessed for methodological quality using the Critical Appraisal Skills Programme.

Data extraction and synthesis
The reviewers independently searched, screened and coded the results of the included studies. Data were synthesised using the method proposed by Thomas and Harden.

Results
Seventeen studies were included in the meta-synthesis. Four key dimensions emerged, reflecting both the barriers and the facilitators of multidisciplinary team performances: (1) organisational variables, (2) individual variables, (3) collaborative variables and (4) role variables. A total of 36 variables were identified, which could function as barriers (n=6; eg, high staff turnover), facilitators (n=6; eg, strong listening skills) or both (n=24; eg, team climate), depending on the context.

Conclusions
This meta-synthesis identifies specific barriers and facilitators and variables that can act as both. Understanding these factors enables targeted interventions to enhance the performance of multidisciplinary teams in clinical practice, particularly in acute care settings.

PROSPERO registration number
CRD42022297395.

Introduction
Cancer affects not only patients but also their families, increasing the risk of stress-related illnesses among family members. Despite the development of various support interventions, family members continue to report unmet support needs, largely due to the limited implementation of these interventions into routine care or their lack of relevance to family needs. Co-design approaches, which involve stakeholders in the development process, are recommended to enhance both implementation and relevance. This scoping review aims to map the available evidence on co-design approaches in family interventions within oncology, examining key themes, methodologies and outcomes of interventions.

Methods and analysis
This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews checklist and the Joanna Briggs Institute framework. The review will follow five stages: identifying the research questions, retrieving relevant studies, selecting studies, charting data and collating, summarising and reporting the results. The research will focus on co-design approaches in family interventions in oncology, exploring activities involved, barriers encountered and their impact on outcomes. A comprehensive search was conducted in EMBASE, MEDLINE, Scopus, CINAHL and PsycINFO databases in August 2024, with no date restrictions, and articles will be selected based on predefined inclusion criteria. Study selection will be performed independently by two reviewers, with disagreements resolved by a third. All reviewers will carry out the data extraction. Data will be analysed using descriptive content analysis and presented through narrative summaries, tables and diagrams to highlight study characteristics and research aims. The findings will inform future research and practice, offering insights into co-design strategies in family interventions in oncology.

Ethics and dissemination
Ethical approval is not needed as this scoping review does not involve collecting data from human participants. The results produced from this review will be submitted to a scientific peer-reviewed journal for publication and will be presented at scientific meetings.

Trial registration details
https://doi.org/10.17605/OSF.IO/2RWB9.

Introduction
This scoping review synthesises the existing literature on racial and ethnic disparities in the utilisation of continuous glucose monitors (CGMs) among adults and children with diabetes in the USA. The primary objective is to describe the extent and nature of these disparities, with the broader goal of informing future research and interventions to address health inequities.

Methods and analysis
Guided by the Joanna Briggs Institute methodological framework, this review will systematically search PubMed, Embase and Scopus for relevant studies. Included studies will focus on individuals diagnosed with type 1 or type 2 diabetes in the USA. Selection criteria will prioritise studies reporting demographic factors, CGM usage patterns and associated health outcomes. The primary outcome is the extent of racial and ethnic disparities in CGM utilisation. Data synthesis will use the National Institute on Minority Health and Health Disparities Framework (NIMHD) to uncover patterns of CGM utilisation among racial–ethnic groups. The NIMHD facilitates a multilevel examination of the factors influencing CGM initiation, continued use and attrition by integrating individual, interpersonal, community and societal level influences. This comprehensive approach provides a nuanced understanding of the barriers and facilitators shaping CGM usage across diverse populations. By applying the NIMHD framework, this review aims to identify existing disparities, uncover gaps in the literature and offer direction for future research and interventions.

Ethics and dissemination
As this study involves a review of previously published literature and does not involve human subjects research, institutional review board approval will not be pursued. Findings will be disseminated through peer-reviewed publications, conference presentations and lay summaries.

Literature review registration number
https://doi.org/10.17605/OSF.IO/RGW6M.

Objective
Previous research on interprofessional learning in primary healthcare has been focused on students’ learning in the encounter with the patient. However, the research is limited, and a review of the experiences of patients, students, and supervisors of interprofessional learning in primary healthcare is lacking. The focus of this scoping review is to describe the current knowledge and also to identify knowledge gaps.

Design
A scoping review in which blocks of keywords and synonyms were used for achieving a high level of subject precision together with a qualitative thematic analysis for the presentation of the results.

Data sources
Publications from 2012 to 2024 were searched for in the PubMed, CINAHL and ERIC databases.

Eligibility criteria for selecting studies
Peer-reviewed studies with a qualitative design describing the experiences of patients, students and supervisors of interprofessional learning in primary healthcare were included.

Data extraction and synthesis
The articles were retrieved, stored and reviewed in a shared online folder. All the authors participated in the scoping review. The decisions on inclusion/exclusion were made after a systematic, multidisciplinary team approach, which involved all the authors in the discussions to reach a consensus.

Results
The results showed that interprofessional learning helped the students to focus on the patient and that the students broadened their perspectives when working together. The results showed that supervisors planned for interprofessional learning by setting aside time for the students to get to know each other. The supervisors confirmed that interprofessional learning contributed to the primary healthcare employees remaining abreast with high professional standards, with updated knowledge, more resources and the implementation of several organisational changes.

Conclusions
Interprofessional learning contributed to a patient-centred approach that provided new insights and expanded knowledge for students in professional training. More research is needed to understand how interprofessional learning between different professions can be developed.

Objectives
Suicidal behaviours are common among medical students, and the prevalence might vary across various regions. Even though various systematic reviews have been conducted to assess the suicidal behaviours among medical students in general, no review has ever explored or carried out a sub-analysis to show the burden of suicidal behaviours among Bangladeshi medical students.

Design
This is a systematic review and meta-analysis of prevalence studies among Bangladeshi medical students. The review applied truncated and phrase-searched keywords and relevant subject headings for study identification using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines.

Data sources
PubMed (Medline), Scopus, PsycINFO and Google Scholar databases were searched between January 2000 and May 2024.

Eligibility criteria for selecting studies
The designed study included cross-sectional, case series, case reports and cohort studies of Bangladeshi medical students reporting suicidal behaviours (suicidal ideation, suicidal planning or suicidal attempts). Only freely accessible, full-text articles in English were included for analysis.

Data extraction and synthesis
Study screening, data extraction and methodological assessment were performed by two independent reviewers. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. A random-effects meta-analysis model was conducted to pool prevalence rates, complemented by narrative synthesis. Heterogeneity was assessed using the I 2 statistic.

Results
Data were obtained from 6 eligible studies, including 1625 medical students (691 male) of Bangladesh. The pooled prevalence of lifetime suicidal behaviours was 25%, for suicidal ideation (95% CI: 14% – 37%, I 2=91%; p