Use of computed tomography for shoulder arthroplasty: A systematic review.

Introduction: The prevalence of total shoulder arthroplasties is on the rise annually. Improvements in implant quality, construct stability, and surgical techniques have notably enhanced post-operative results, prompting an expansion of indications for shoulder arthroplasty. Despite its high success rate, opportunities for enhancement remain, especially in preoperative planning and intraoperative execution. Advanced imaging technologies offer significant potential in optimizing implant placement, thus improving the longevity of the procedure. To our knowledge, a comprehensive review examining the impact of advanced imaging on shoulder arthroplasty has yet to be conducted. This systematic review aims to investigate the benefits of advanced imaging technologies in this context, focusing on their application in preoperative planning, osteoarthritis assessment, intraoperative adjustments, patient-specific instrumentation, and navigational aids. Methods: This review utilized a comprehensive search of PubMed to identify relevant studies published from 2000 to 2024, focusing on the application of various imaging techniques in shoulder arthroplasty. The search was conducted by two authors and centered on plain radiography, CT scans, and MRI. The selection criteria included availability of full-text articles, English language, direct comparison of imaging techniques, and a focus on patient outcomes, including discussions on broader applications such as intraoperative navigation and patient-specific instrumentation development. Results: Enhanced imaging techniques, particularly CT scans and MRIs, have been shown to significantly improve outcomes in shoulder arthroplasty. While plain radiographs remain standard, CT scans provide superior bony detail, crucial for evaluating glenoid wear and determining augmentation needs. Preoperative CT imaging has been demonstrated to enhance implant placement accuracy. Moreover, intraoperative technologies based on CT imaging, such as patient-specific instrumentation and navigation systems, contribute to better surgical results. Conclusion: The benefits of CT imaging in shoulder arthroplasty significantly outweigh the associated costs. Current literature strongly supports the adoption of CT imaging in these procedures, particularly when used alongside modern operative technologies.

Outcomes of arthroscopic coracoclavicular management for acromioclavicular joint injuries: A systematic review.

Introduction: Various surgical procedures for coracoclavicular (CC) ligament repair have been described for symptomatic acromioclavicular joint dislocations, with none emerging as a clear gold standard. There has been increased interest in arthroscopic approaches. This systematic review evaluates clinical outcomes after arthroscopic surgeries used to treat chronic and acute AC joint dislocations. Methods: We searched three databases (PubMed, EMBASE, and OVID [MEDLINE]) from database inception to December 20, 2022. Studies were included if they met the following criteria: studies evaluating humans, English language studies, level of evidence I to IV, and studies investigating clinical outcomes in patients following arthroscopic surgery for coracoclavicular ligament reconstruction. Studies on open reconstruction techniques only were excluded. Primary outcomes included function/pain scores, coracoclavicular distances, complications, and revision rates. Results: Fifty-two studies were included. In 33 studies, postoperative Constant-Murley scores ranged from 82.8 to 99 points. Postoperative VAS scores ranged from 0.3 to 4.1 in 16 studies. In 46 studies, revision rates ranged from 0 % to 44.4 %. We did not observe a difference in revision rates between chronic and acute cases (P = 0.268). Complications were more common in chronic than acute cases (25.5 % vs. 16.4 %; P < 0.001). Conclusions: Arthroscopic surgery for chronic and acute CC ligament injuries exceeds the MCID and PASS for several outcomes, with low failure rates. Arthroscopic CC reconstruction is a safe and effective alternative for chronic AC joint dislocations. Level of evidence: IV (Systematic Review of Level I-IV Studies).

Evaluating the Efficacy of Immune Checkpoint Inhibitors in Elderly Patients: A Systematic Review and Meta-analysis.

In this chapter, we outline the steps for designing and conducting a rigorous systematic review and meta-analysis, focusing on the efficacy of immune checkpoint inhibitors (ICIs) in elderly patients. ICIs have improved survival rates in advanced cancers, yet their effectiveness in older populations remains unclear. We detail the essential processes involved in both systematic reviews and meta-analyses. We can evaluate the efficacy of ICIs in elderly patients with advanced cancer, examining outcomes such as overall survival and progression-free survival.

Gerontological educational interventions for student nurses: a systematic review of qualitative findings.

OBJECTIVES: This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS: Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS: Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.

Neutralizing antibodies in milk and blood of lactating women vaccinated for SARS-CoV-2: a systematic review / Anticorpos neutralizantes no leite e no sangue de lactantes vacinadas para SARS-CoV-2: uma revisão sistemática

ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.

RESUMO Objetivo: Comparar a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite materno e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Fontes de dados: Foi efetuado registro no International Prospective Register of Systematic Reviews — PROSPERO (CRD42021287554) e foram seguidas as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foram elegíveis estudos de coorte, caso-controle e transversais que avaliaram anticorpos contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e tiveram como grupo controle lactantes não vacinadas. Utilizaram-se os Descritores em Ciências da Saúde (DeCs), Medical Subject Heading (MeSH) e Emtree para as bases Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Medline/PubMed) e Embase, respectivamente. Na Web of Science e Scopus foi feita adaptação da estratégia. Não foram estabelecid as restrições quanto ao período de publicação e idioma. Síntese dos dados: As buscas identificaram 233 registros. Foram excluídos 128 duplicados e 101 fora dos critérios de inclusão, e quatro estudos de coorte foram elegíveis. As lactantes vacinadas com Pfizer-BioNTech e Moderna apresentaram anticorpos contra SARS-CoV-2 no sangue e no leite materno. Conclusões: As mulheres lactantes vacinadas apresentaram níveis mais elevados de imunoglobulina G (IgG) e A (IgA) no soro e no leite materno em comparação com as mulheres não vacinadas.

Efectos de la terapia manual en personas con fibromialgia: Revisión sistemática y metaanálisis / Effects of Manual Therapy in People with Fibromyalgia: Systematic Review and Meta-Analysis

Resumen Objetivo: El objetivo de esta revisión sistemática con metaanálisis es sintetizar la evidencia científica disponible sobre los efectos de la terapia manual aplicada de forma aislada en comparación a otras intervenciones en el dolor, la capacidad funcional, la impresión global de mejoría y severidad de síntomas autopercibida en personas con fibromialgia. Metodología: Se realizó una revisión sistemática y metaanálisis con búsqueda electrónica en MEDLINE, WoS, SCOPUS, PEDro, CENTRAL y LILACS. Resultados: Once estudios cumplieron con los criterios de selección y seis fueron incluidos en una síntesis cuantitativa. El dolor al terminar el tratamiento tuvo una diferencia de medias de -0.42 (IC al 95% -1.14, 0.30, p = 0.25), el estado funcional al terminar el tratamiento tuvo una diferencia de medias de -0.15 (IC al 95% -0.69, 0.40, p = 0.60), la impresión global de salud al terminar el tratamiento tuvo una diferencia de media de -1.13 (IC al 95% -1.68, -0.57 p = <0.00) y posterior a doce meses una diferencia de media de -0.48 (IC al 95% -0.78, -0.19 p = <0.00), la impresión global de severidad después de la intervención tuvo una diferencia de medias de -0.62 (IC al 95% -1.22, -0.03, p = 0.04) y posterior a doce meses una diferencia de medias de -0.43 (IC al 95% -1.18, 0.32, p = 0.26). Conclusiones: La terapia manual aislada es una intervención que podría mejorar significativamente la autopercepción del estado global de mejoría y severidad de síntomas a corto plazo en comparación a agentes físicos placebo. Sin embargo, no es mejor que otras intervenciones para disminuir el dolor y mejorar la capacidad funcional.

Abstract Objective: The aim of this systematic review with meta-analysis is to synthesize the available scientific evidence on the effects of manual therapy applied in isolation in comparison to other interventions on pain, functional capacity, global impression of improvement, and self-perceived severity of symptoms in people with fibromyalgia. Methodology: A systematic review with meta-analysis was conducted with electronic search of MEDLINE, WoS, SCOPUS, PEDro, CENTRAL, and LILACS. Results: Eleven studies met the selection criteria and six were included in a quantitative synthesis. Pain at the end of treatment had a mean difference of -0.42 (95% CI -1.14, 0.30, p = 0.25), functional status at the end of treatment had a mean difference of -0.15 (95% CI - 0.69, 0.40, p = 0.60), the global impression of health at the end of treatment had a mean difference of -1.13 (95% CI -1.68, -0.57 p = <0.00) and a mean difference of -0.48 after twelve months (95% CI -0.78, -0.19 p = <0.00), the global impression of severity after the intervention had a mean difference of -0.62 (95% CI -1.22, -0.03, p = 0.04 ) and a mean difference of -0.43 after twelve months (95% CI -1.18, 0.32, p = 0.26). Conclusions: Isolated manual therapy is an intervention that could significantly improve the self-perception of the global state of improvement and severity of symptoms in the short term compared to sham physical agents. However, it is not better than other interventions to reduce pain and improve functional capacity.

[Utilizing ChatGPT in Systematic Reviews and Meta-Analyses].

The current uses, potential risks, and practical recommendations for using chat generative pre-trained transformers (ChatGPT) in systematic reviews (SRs) and meta-analyses (MAs) are reviewed in this article. The findings of prior research suggest that, for tasks such as literature screening and information extraction, ChatGPT can match or exceed the performance of human experts. However, for complex tasks such as risk of bias assessment, its performance remains significantly limited, underscoring the critical role of human expertise. The use of ChatGPT as an adjunct tool in SRs and MAs requires careful planning and the implementation of strict quality control and validation mechanisms to mitigate potential errors such as those arising from artificial intelligence (AI) 'hallucinations'. This paper also provides specific recommendations for optimizing human-AI collaboration in SRs and MAs. Assessing the specific context of each task and implementing the most appropriate strategies are critical when using ChatGPT in support of research goals. Furthermore, transparency regarding the use of ChatGPT in research reports is essential to maintaining research integrity. Close attention to ethical norms, including issues of privacy, bias, and fairness, is also imperative. Finally, from a human-centered perspective, this paper emphasizes the importance of researchers cultivating continuous self-iteration, prompt engineering skills, critical thinking, cross-disciplinary collaboration, and ethical awareness skills with the goals of: continuously optimizing human-AI collaboration models within reasonable and compliant norms, enhancing the complex-task performance of AI tools such as ChatGPT, and, ultimately, achieving greater efficiency through technological innovative while upholding scientific rigor.

How to Cope With Stress in the Desert-The Date Palm Approach.

Increasing desertification constitutes a global environmental problem, mainly driven by climate change and inappropriate land-use that limits agriculture, forestry and human colonization. The selection of suitable plant species to mitigate desertification is particularly challenging, as it usually requires simultaneous counteraction against a whole set of unfavourable environmental conditions, including heat, drought, high tropospheric ozone and salinity. It therefore seems useful to identify the survival strategies of plants native in desert environments. Date palm constitutes a plant species native in desert environments and cultivated worldwide in arid regions that have been studied intensively for stress defence during the last decade. The present review summarizes the current state of biochemical stress defence mechanisms including avoidance, osmotic and metabolic adjustments and reactive oxygen species scavenging, addresses whole-plant regulations and trade-off between stress compensation/defence and growth of date palms. The review advances our knowledge about how this typical desert species copes with both individual and multiple environmental stresses at the cellular to the whole-plant level, and identifies areas of future research required to fully understand the strategies of this plant species to survive in the desert, thereby contributing to efforts for the mitigation of climate change and desertification.

Short- versus standard-course antibiotic therapy for urinary tract infection in children: a systematic review and meta-analysis.

BACKGROUND: Urinary tract infections are prevalent among children and are responsible for a significant healthcare burden. Antibiotic therapy is the cornerstone of treatment, but the optimal treatment duration remains elusive. OBJECTIVES: This systematic review and meta-analysis aimed to explore the optimal duration of antibiotic therapy for urinary tract infection (UTI) in pediatric patients. DATA SOURCES: A comprehensive search was performed, including MEDLINE, Embase, and Cochrane Library databases. STUDY ELIGIBILITY CRITERIA: We included only randomized controlled trials (RCTs) comparing short-course (2 to 5 days) and standard-course (≥ 7 days) antibiotic treatment in patients < 18 years of age. STUDY APPRAISAL AND SYNTHESIS METHODS: We performed this systematic review and meta-analysis following Cochrane Collaboration recommendations using a random-effects model. Effect estimate was calculated using the risk ratio (RR) with 95% confidence interval (95% CI) for dichotomous and mean difference (MD) with 95% CI for continuous endpoints. Significance was regarded at p-value < 0.05. Statistical analysis was performed using Review Manager 5.4.1. RESULTS: Data from 12 RCTs, encompassing 1442 children, were included. Follow-up ranged from 1 to 12 months. The mean age was 5.9 years, with approximately 87% female patients. E. coli was the most common pathogen isolated from urine cultures. There was a significant difference in cure rates (RR 0.97; 95% CI 0.95-0.99; p = 0.01) between the groups when only studies that included febrile UTI were analyzed together, favoring 7 days or more of treatment, but with high heterogeneity. Otherwise, there was no significant difference in cure rates (RR 0.99; 95% CI 0.91-1.08; p = 0.80) in children with afebrile UTI or recurrence of UTI at any time in children with afebrile (RR 0.98; 95% CI 0.84-1.15; p = 0.80) or febrile UTI (RR 0.52; 95% CI 0.10-2.83; p = 0.45). Also, there was no significant difference in failure rates in children with urinary tract abnormalities and afebrile UTI (RR 0.79; 95% CI 0.47-1.32; p = 0.36), between the short- and the standard-course treatment groups. LIMITATIONS: This analysis was limited by the moderate heterogeneity and the small subgroup of children with urinary tract abnormalities, which could have underpowered our results. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: The primary outcome of this analysis suggests that a short course of antibiotic therapy is feasible in children with afebrile UTI, but more studies are warranted to safely establish an optimal treatment duration for children with febrile UTI. SYSTEMATIC REVIEW REGISTRATION NUMBER: The study protocol was registered in the PROSPERO platform under the number CRD42023489094.

Effects of dyadic interventions on psychological outcomes among cancer patients with non-active treatment: a systematic review and meta-analysis.

OBJECTIVE: Cancer and its treatment can generate substantial psychological distress (depression and anxiety). The objective of this systematic review and meta-analysis is to explore the effectiveness of dyadic interventions on psychological outcomes in cancer patients with non-active treatment and to test subgroup analyses to explore the source of heterogeneity affecting effect sizes. DESIGN: Systematic searching across eight databases identified studies related to dyadic interventions for psychological outcomes of cancer patients published between 2007 and 2022. Rigorous inclusion and exclusion criteria were utilized. Random-effects models were used to compute effect sizes with Hedge's g, forest plot, and Q and I2 statistics to measure heterogeneity. Moderator analyses were examined. RESULTS: Eleven primary studies were identified (938 patients with cancer, 56.14 ± 7.29 years old). Overall, dyadic interventions significantly improved depression (g = .36, 95% confidence interval .026 to .68, I2 = 76%) and anxiety (g = .29, 95% confidence interval 0.14 to .45, I2 = 0%) compared to controls. With subgroup analyses, fidelity of dyadic interventions, number of weeks across intervention, and number of days after intervention measured were moderators affecting effect sizes. CONCLUSION: Dyadic interventions appear to be effective among adults with cancer with non-active treatment. Additional research is needed to explore the efficacy of dyadic interventions among more diverse samples and to examine routes for integrating dyadic interventions into practice. IMPLICATIONS FOR CANCER SURVIVORS: Adult with cancer might participate in the dyadic intervention for improving psychological outcomes.

Impact of COVID-19 on Depression, Anxiety and Stress of Dental Students: A Systematic Review.

AIM: To determine the impact of the COVID-19 pandemic on depression, anxiety and stress of dental students by way of a systematic review. MATERIALS AND METHODS: This review was conducted following the Cochrane Handbook for Systematic Reviews. An electronic search was conducted for the period January 2020 to February 2023. Quality assessment was evaluated in accordance with the Newcastle-Ottawa Scale. Frequency distribution was calculated for stress, anxiety and depression associated with students' gender, year of study and living circumstances. RESULTS: Twenty-three studies were eligible for inclusion in the final review. Variables contributing to stress, anxiety and depression of dental students include gender, year of study and living circumstances. Being female is the most significant factor impacting on mental health. CONCLUSIONS: Results emphasise the need for dental institutions to develop targeted intervention programmes for more vulnerable students. Failure to act in a future pandemic event could result in ongoing psychological issues that persist following graduation, resulting in unfit dentists who may potentially affect the quality of the dental workforce.

The Use of Telehealth for People With Disabilities: A Systematic Literature Review and Narrative Synthesis.

AIMS: To identify the use of telehealth for people with disabilities in community or primary care settings and to explore effective telehealth interventions for this group. DESIGN: Systematic literature review and narrative synthesis. DATA SOURCES: The literature search was conducted in January 2024 using five electronic databases including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO. METHODS: The review followed the Tawfik's guideline and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines for reporting. Out of 7363 retrieved articles, 1871 duplicates were removed, 5389 were excluded after title and abstract review, and 4 were excluded due to unavailable full text. One additional article was obtained through citation and hand searching. Thirteen studies were quality assessed using the Mixed Methods Appraisal Tool. Quantitative data were narratively synthesised. RESULTS: Thirteen quantitative studies were selected including three quasi-experimental studies and ten randomised controlled trials. The types of telehealth included telemonitoring, computerised intervention, virtual reality, telephone care, mHealth tools, decision support tools, digital storytelling and technology-assisted language interventions. The most common type of disability was intellectual disability, and the most common telehealth provider was the digital device itself. Most studies used surveys as the data collection method and the interventions were mostly conducted individually. Computer-based telehealth interventions demonstrated significant improvement in attention, health knowledge and psychological well-being. Telephone, virtual reality and tablet interventions also had positive impacts on body weight, motor coordination and pragmatic language skills. Telemonitoring was also beneficial. CONCLUSIONS: This systematic review examined the current state and effectiveness of telehealth interventions for people with disabilities. However, few intervention studies were found, and some studies were of poor quality. Continued interest and efforts from the government and researchers are needed targeting people with disabilities. IMPACT: Results provide valuable insights for healthcare providers, policymakers and researchers. They raise awareness about the potential of telehealth to address healthcare disparities and improve access to care for people with disabilities. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution: Systematic review.

Predicting the resolution of hypertension following adrenalectomy in primary aldosteronism: Controversies and unresolved issues a narrative review.

BACKGROUND: Hypertension resolution following adrenalectomy in patients with primary aldosteronism (PA) remains a critical clinical challenge. Identifying preoperatively which patients will become normotensive is both a priority and a point of contention. In this narrative review, we explore the controversies and unresolved issues surrounding the prediction of hypertension resolution after adrenalectomy in PA. METHODS: A comprehensive literature review was conducted, focusing on studies published between 1954 and 2024 that evaluated all studies that discussed predictive models for hypertension resolution post-adrenalectomy in PA patients. Databases searched included MEDLINE®, Ovid Embase, and Web of Science databases. RESULTS: The review identified several predictors and predictive models of hypertension resolution, including female sex, duration of hypertension, antihypertensive medication, and BMI. However, inconsistencies in study designs and patient populations led to varied conclusions. CONCLUSIONS: Although certain predictors and predictive models of hypertension resolution post-adrenalectomy in PA patients are supported by evidence, significant controversies and unresolved issues remain. While the current predictive models provide valuable insights, there is a clear need for further research in this area. Future studies should focus on validating and refining these models.

Impact of psilocybin on cognitive function: A systematic review.

Psilocybin is a classic psychedelic with demonstrated preliminary clinical efficacy in a range of psychiatric disorders. Evaluating the impact of psilocybin on cognitive function is essential to unravel its potential benefits and risks. In this systematic review, we assessed psilocybin's effect on cognitive function through a comprehensive search of electronic databases from inception to January 2024, identifying 20 articles involving 2,959 participants. While 85% of studies were conducted in healthy volunteers, most of these studies (85%) used macrodoses, ranging from 45 µg/kg to 30 mg/70 kg. Various cognitive aspects were evaluated and yielded mixed results. Global cognitive function, and processing speed remained mostly unchanged in healthy individuals; However, a limited number of studies reported improvements in certain areas such as sustained attention, working memory, and executive function especially in patients with treatment-resistant depression (TRD). Emotional processing was positively modified, particularly in TRD patients. Psilocybin was observed to enhance emotional empathy without significantly altering cognitive empathy and social cognition. Cognitive flexibility and creative cognition were noted to initially decline but could potentially improve over time. Additionally, with respect to learning and memory skills, psilocybin showed promise in improving specific memory types such as semantic associations and associative learning, while its effects on episodic and verbal memory have been less pronounced compared to other cognitive enhancers. The observed mixed findings underscore the complexity of psilocybin's cognitive influence. Further research is essential to provide a clearer understanding of psilocybin's impact on cognitive domains and to guide the development of safe and effective interventions.

Nebulized tranexamic acid for treatment of post-tonsillectomy bleeding: a systematic review and meta-analysis.

PURPOSE: Post-tonsillectomy bleeding (PTB) is a significant complication and common reason for emergency department (ED) visits. Limited literature has investigated the clinical efficacy of nebulized tranexamic acid (TXA) for treating PTB; however, the results were conflicting and not comprehensively summarized. This study aimed to provide the first-ever systematic review encompassing all literature exploring the efficacy and safety of nebulized TXA in treating PTB. METHODS: We screened six databases until 01-July-2024, for relevant studies and assessed their quality using validated tools. We provided a qualitative summary of baseline characteristics and clinical data. The primary endpoint was the reoperation rate to manage PTB, and its effect size was aggregated as a proportion or risk ratio (RR) with a 95% confidence interval (CI) using a random-effects model. RESULTS: We analyzed nine studies (2 case reports, 4 case series, and 3 retrospective comparative studies), all of which demonstrated good quality and low risk-of-bias. In studies using nebulized TXA for treating PTB (n = 9 studies), the pooled proportion of reoperation to control bleeding was 0.27 (95% CI: 0.08-0.5). The rate of reoperation to control bleeding was significantly lower in the nebulized TXA arm compared to the no-TXA arm (n = 3 studies, RR = 0.55, 95% CI [0.39-0.77], p < 0.001). CONCLUSION: Nebulized TXA is safe and promising for treating PTB. This is evidenced by its high efficacy in achieving hemostasis in acute settings during ED visits and reducing the rate of reoperations needed to control PTB. Further high-quality investigations are warranted to corroborate these findings.

Differences in the reporting of conflicts of interest and sponsorships in systematic reviews with meta-analyses in dentistry: an examination of factors associated with their reporting.

BACKGROUND: Reporting conflicts of interest (COI) and sources of sponsorship are of paramount importance in adequately interpreting the results of systematic reviews. Some evidence suggests that there is an influence of COI and sponsorship on the study results. The objectives of this meta-research study were twofold: (a) to assess the reporting of COI and sponsorship statements in systematic reviews published in dentistry in three sources (abstract, journal's website and article's full text) and (b) to assess the associations between the characteristics of the systematic reviews and reporting of COI. METHODS: We searched the PubMed database for dental systematic reviews published from database inception to June 2023. We assessed how COI and sponsorship statements were reported in the three sources. We performed a logistic regression analysis to assess the associations between the characteristics of the systematic reviews and the reporting of COI. RESULTS: We assessed 924 abstracts published in PubMed and on the corresponding journals´ websites. Similarly, full texts associated with the 924 abstracts were also assessed. A total of 639 (69%) and 795 (88%) studies had no statement of COI in the abstracts on PubMed and the journal's website, respectively. In contrast, a COI statement was reported in 801 (87%) full texts. Sponsorship statements were not reported in 911 (99%) and 847 (93%) abstracts published in PubMed and a journal´s website, respectively. Nearly two-thirds of the full-text articles (N = 607) included sponsorship statements. Journal access was significantly associated with COI statement reporting in all three sources. Open-access journals have significantly higher odds to report COI in PubMed and full-texts, while have significantly lower odds to report COI in the websites, compared with subscription or hybrid journals. Abstract type was significantly associated with COI statement reporting on the journal's website and in the full text. Review registration based on the full text and the number of authors were significantly associated with COI statement reporting in PubMed and in the full texts. Several other variables were found to be significantly associated with COI statement reporting in one of the three sources. CONCLUSIONS: COI and sponsorship statements seem to be underreported in the abstracts and homepage of the journals, compared to the full-texts. These results were particularly more pronounced in abstracts published in both the PubMed database and the journals' websites. Several characteristics of systematic reviews were associated with COI statement reporting.

Diagnostic Accuracy of USG and MRI for the Detection of Rotator Cuff Injury.

INTRODUCTION: Rotator cuff disease frequently causes shoulder pain and is diagnosed using various radiological methods alongside history and physical examination. Arthrography has traditionally been employed for this purpose, but newer non-invasive techniques such as ultrasonography (USG) and magnetic resonance imaging (MRI) are increasingly used. However, no single method is universally agreed upon as the best diagnostic tool, each having its own limitations. OBJECTIVES: To evaluate how effectively ultrasound and MRI can diagnose rotator cuff tears. MATERIALS AND METHODS: Seventy patients suspected of having a rotator cuff tear underwent investigations at the Radiology Department of Krishna Vishwa Vidyapeeth (Deemed to be University), Karad. USG and MRI examinations were done on the same day, along with a detailed history. USG was conducted using a GE LOGIQ P9 machine with a high-frequency 3-12 MHz transducer. MRI was conducted using a 1.5T Siemens Magnetom Avanto scanner. RESULTS: Pain and stiffness are the most common complaints in rotator cuff tears. The predisposing factors include male predominance, increasing age, dominant hand use, and trauma history. The supraspinatus tendon is the most frequently injured, with partial tears, especially articular surface tears, being more common than full-thickness tears. Clinical examinations, USG, and MRI are valuable in diagnosing rotator cuff tears. CONCLUSION: Our findings indicate that USG may not be as reliable in detecting rotator cuff tears as once believed. A positive ultrasound result is more trustworthy than a negative one. In contrast, MRI demonstrates greater sensitivity and overall diagnostic accuracy compared to both ultrasonography and clinical assessment for detecting rotator cuff tears.

Cupping Therapy for the Treatment of Migraine Headache: a systematic review and meta-analysis of clinical trials.

Objectives: Cupping therapy is a widely used complementary medicine for the treatment of migraine headaches globally. However, conflicting evidence exists on its effectiveness. To evaluate the safety and efficacy of cupping therapy in treating migraine headache disorder. Methods: Seven databases were systematically searched PubMed/MEDLINE, Clinicaltrials.gov, Cochrane CENTRAL, ScienceDirect, ProQuest, SinoMed, and the National Science and Technology Library. The primary endpoints are the treatment success and the pain intensity reduction. The secondary endpoints were adverse events (AEs) risk and improvement in quality of life (QoL), which was based on the Migraine Disability Scale (MIDAS). Subgroup analyses were performed based on the cupping techniques (wet and dry cupping) and adjunctive complementary treatments (i.e. acupuncture and/or collateral pricking). Results: Eighteen trials out of 348 records were included, pooling 1,446 participants (n = 797 received cupping therapy). Treatment success was significantly higher among those with cupping therapy (risk ratio [RR] [95% CI] = 1.83 [1.52-2.21]); with significant improvement observed only with wet cupping (RR [95% CI] = 1.88 [1.53-2.30]). The adjunctive complementary therapy did not achieve a greater amplitude of treatment success compared to cupping therapy alone. Furthermore, cupping therapy showed significant pain reduction compared to baseline (standardized mean difference [SMD] [95% CI] = 0.55 [0.39-0.70]) and achieved fewer risks of AEs (RR [95% CI] = 1.88 [1.53-2.30]). However, cupping did not improve the overall QoL (MIDAS SMD [95% CI] = -0.79 [-3.55-1.98]). Conclusion: Cupping therapy was an effective complementary modality to treat migraine headaches. However, it did not demonstrate improvement in QoL (PROSPERO CRD42024514509).

Applications of leech therapy in medicine: a systematic review.

Background: Leech therapy (LT) is one of the most widely used treatment methods in traditional medicine. The present study aimed to systematically review clinical trials regarding the effects of LT on the prevention and healing of different diseases. Methods: To identify all relevant published studies, we conducted a comprehensive search of PubMed, Scopus, and Web of Science databases without any temporal or geographical constraints until April 2023. To categorize the articles, five stages were considered. The PRISMA checklist and Cochran's bias analysis tool were used. Results: In total, 12 trials that met the inclusion criteria were studied. The results of the studies showed that LT has had successful outcomes in treating different conditions. These included hormonal and metabolic complications, cardiovascular problems, and inflammatory-based diseases. Conclusion: "Leech therapy" is a traditional medical treatment used successfully to control and treat various conditions. Although this method can have complications, it is possible to benefit from this low-cost and low-complication treatment by taking preventive measures.