Do urinary tract infections affect the rate of periprosthetic joint infections in patients who underwent arthroplasty surgery? A systematic review and meta-analysis.

Periprosthetic joint infection (PJI) is a significant issue in orthopedic surgery. Urinary tract infections (UTIs) and asymptomatic bacteriuria (ASB) have been identified as potential causes of PJI; however, evidence is inconclusive. Understanding these relationships is critical for improving therapy and patient outcomes. A systematic review was performed by conducting searches from PubMed, EBSCO, ProQuest, and manual searching with adherence to the Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 guideline. Studies that reported UTI/ASB and PJI were included. Meta-analysis was conducted using a random-effects model using RevMan 5.4 software. A total of 14 studies were included with UTIs and ASB showed an overall association with increased risk of PJI (odds ratio [OR]: 1.84, 95% confidence interval [CI]: 1.14-2.99, P = 0.01). However, subgroup analysis for UTIs and ASB was not significant. Further analysis of UTIs in total hip arthroplasty (THA) surgery showed a significant association (OR: 1.76, 95% CI: 1.57-1.96) with PJI. Preoperative UTIs timing between 0 and 2 weeks before surgery showed an increased risk of PJI (OR: 1.45, 95% CI: 1.35-1.55). Antibiotic treatment in ASB did not significantly impact PJI rates. Urine and PJI sample cultures in four studies showed no correlation of microorganisms between the two sites. According to recent evidence, a statistically significant association was found between UTIs and PJI in patients who underwent THA surgery. However, ASB did not yield significant results in relation to PJI. These results should be supported by larger and well-designed studies to make proper clinical suggestion in future. For further research, it is recommended to adopt standardized criteria for outcome measurement and to involve larger sample sizes to enhance the reliability and generalizability of findings.

Conservative management in high-grade renal trauma: a systematic review and meta-analysis.

OBJECTIVE: To systematically investigate and analyse the aggregated data from recent studies to provide a quantitative synthesis for a conservative approach to the management of high-grade kidney trauma, as accumulating evidence supports the favourable outcomes of a conservative approach. METHODS: A comprehensive search was performed using databases, including PubMed, EBSCO, ProQuest, Google Scholar, and Cochrane Library, to identify studies relevant to high-grade renal trauma in both adult and paediatric populations. The compare review focused on comparing conservative management interventions, such as observation, rest, resuscitation, transfusion, symptomatic management, and angioembolisation, with operative management interventions. Search strategies incorporated specific medical subject headings and keywords related to conservative management, kidney trauma, mortality, and renal preservation. Random and fixed-effect meta-analyses were conducted to estimate the rates of nephrectomy and mortality, respectively. RESULTS: A total of 36 and 29 studies were included for qualitative and quantitative synthesis, respectively. The aggregated data showed a cumulative risk difference of 0.52 (95% confidence interval [CI] 0.38-0.66, P < 0.001), indicating a higher likelihood of nephrectomy in cases where operative management was used instead of conservative management. In terms of mortality, conservative management demonstrated a lower risk difference of 0.09 (95% CI 0.05-0.13, P < 0.001). CONCLUSION: The results indicate that opting for conservative management in cases of high-grade renal trauma, particularly for haemodynamically stable patients, presents a lower risk of mortality and reduced probability of requiring nephrectomy when compared to operative management. These findings provide strong evidence in favour of considering conservative management as a viable and effective treatment option for high-grade renal trauma.

Probiotics supplementation or probiotic-fortified products on sarcopenic indices in older adults: systematic review and meta-analysis from recent randomized controlled trials.

Introduction: A noteworthy correlation was seen between changes in the gut microbiome and sarcopenia in older adults. Along with increasing research on probiotic supplementation for various medical problems, we aimed to obtain evidence and summarize the effect of probiotic supplementation on sarcopenic indices among older adults. Methods: We utilized PubMed, EBSCO, and Proquest, in addition to manual search using synonyms and variation for 'probiotic,' 'sarcopenia,' and 'older adults.' Randomized controlled trials investigated the utilization of probiotics or probiotic-containing products in older adults with sarcopenic indices including muscle mass and strength. The random-effects model was applied to the meta-analysis process. Results: Seven studies were obtained with 733 pooled older adults. Probiotic supplementation resulted in a significant increase of muscle mass with adjusted SMD (Standardized Mean Difference) of 0.962 (95% CI: 0.288 to 1.635, p = 0.049) using till and trim analysis and muscle strength with SMD of 1.037 (95% CI: 0.077 to 1.996, p = 0.03). However, both outcomes were associated with significantly high heterogeneity (I2 = 89.5% and I2 = 89.9%, respectively). Conclusion: When opposed to a placebo, the probiotic treatment improved the amount of muscle and its endurance based on recent evidence, however, further studies should be done with larger samples and targeted populations.

Lactoferrin as treatment for iron-deficiency anemia in children: a systematic review.

BACKGROUND: Anemia is a common nutritional problem in children, especially those under five. Lactoferrin (Lf) as a supplement in treating iron deficiency anemia (IDA) has been studied, but its results in children have not been reviewed. This review aims to evaluate the effect of lactoferrin on children with IDA. METHODS: PubMed, ProQuest, EBSCO and Ovid databases were searched using a variation of keywords: lactoferrin, anemia, and children. The literature selected must be clinical trial-based in design. The years of the studies published were limited to 2012 and 2022. RESULTS: Eleven studies were included in the final systematic review, consisting of 10 randomized controlled trials (RCTs) and 1 non-randomized trial. Serum ferritin (SF) and hemoglobin (Hb) were found to be increased in groups treated with Lf or a combination of Lf and elemental iron compared to iron only or placebo supplementation. Adverse events such as constipation, vomiting, anorexia, and abdominal pain were found; particularly, a significant decrease in constipation is seen in Lf-treated groups. CONCLUSIONS: This study supports Lf as a superior treatment for IDA in children regarding the improvement in hematological and iron indices and fewer adverse effects.

Demographic and cardiovascular risk factors associated with pre-frailty and frailty among community-dwelling older adults in Jakarta, Indonesia: Active Aging Study.

Introduction: This study aimed to evaluate the prevalence of frailty and its determinants, especially in relation to chronic disease and lifestyle among elderly individuals. Method: A cross-sectional study was conducted among 278 individuals aged 60 years and over living in Jakarta. All participants underwent assessment, including medical history-taking, physical examination and blood tests for the sugar level and lipid profile. Frailty was assessed using the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe. All data were analysed using the chi-square test and multinomial logistic regression analysis. Results: The prevalence of pre-frailty and frailty among the older adults was 40.6% and 28.8%, respectively. Female sex, lack of exercise, presence of cardiovascular diseases and high low-density lipoprotein cholesterol (LDL-C) level were associated with pre-frailty and frailty. Education for <9 years was associated only with frailty. After adjustments for all covariates, female sex (adjusted odds ratio [AOR] = 1.96, 95% confidence interval [CI]=1.07-3.60; AOR=3.93, 95% CI=1.87-8.24), lack of exercise (AOR=l4.81, 95% CI=5.07-43.26; AOR=49.48, 95% CI=16.20-151.09) and presence of cardiovascular diseases (AOR=5.32, 95% CI= 1.40-19.20; AOR=6.06, 95% CI= 1.63-22.56) were associated with pre-frailty and frailty. Meanwhile, education for <9 years (AO R= 1.97, 95% CI=1.05-3.69) and high LDL-C level (AOR=3.52, 95% CI=1.14-10.88) were associated with frailty. Conclusion: Exercise, early screening and intervention for cardiovascular diseases and maintenance of lower LDL-C levels may prevent and slow the progression of frailty.

Sarcopenia and impairment in global cognitive, delayed memory, and olfactory function, among community-dwelling adults, in Jakarta, Indonesia: Active aging study.

Objectives: This study aimed to investigate the association of sarcopenia among community-dwelling older adults with chronic conditions, lipid profiles, and cognitive ability measured by multiple assessment tools. Materials and Methods: This cross-sectional study involved 398 older adults aged 60 years and older who resided in Jakarta, Indonesia. The study participants were visited and interviewed by trained interviewers in the subdistrict office. Participants were clinically examined using a standardized protocol, which included the participants' medical history, general physical examination, cognitive assessment, and blood test for lipid profile. Sarcopenia was measured using three components that were muscle strength (measured by handgrip strength), physical performance (measured by 6-m walk speed), and appendicular skeletal mass (measured using bioelectrical impedance analysis). Association was tested using multivariate logistic regression and reported as an odds ratio. Results: Sarcopenia was significantly associated with older age (adjusted odd ratio [AOR]: 2.91, 95% confidence interval [CI]: 1.22-3.95) and smoking (AOR: 6.53, 95% CI: 2.89-14.73). Global cognitive impairment, word list recall impairment, and olfactory dysfunction have 191% (95% CI: 1.28-6.66), 141% (95% CI: 1.12-5.2), and 100% (95% CI: 1.11-3.61) increase of odds of having sarcopenia, respectively. Conclusion: Global cognitive impairment, word list recall impairment, and olfactory dysfunction could be the predictors of sarcopenia. Strategies and implementations directed more toward the improvement of cognitive impairment might improve or prevent sarcopenia. However, the exact causality between both variables still needs to be explored further.

Memory impairment and its associated risk and protective factors among older adults in Indonesia.

AIMS: This study aimed to evaluate the association between memory impairment and its risk and protective factors, focusing on demographic and health-related variables among older adults in Indonesia. METHOD: The data analyzed were the Indonesian Family Life Survey-5 (IFLS-5) using cross-sectional variables of 4236 older adults aged 60 years and over included in the 2015 round. Memory impairment was assessed by immediate word list recall from the Telephone Interview for Cognitive Status (TICS). Sociodemographic factors and multiple health variables were included as predictors. Data were analyzed using frequency analyses bivariate and stepwise logistic regression tests. RESULT: Among 4236 older adults, 49.7% were male and 50.3% were female. Stepwise backward analyses showed that memory impairment was independently associated with older age, being female, or not in a union (unmarried, separated, divorced, or widowed), having obtained low levels of education, living in a rural area, reporting low life satisfaction, low social capital, higher dependency, and having clinical depression. Only moderate (but not high or low) physical activity levels were associated with a lower risk. Being underweight increased the risk, but being overweight/obese (as assessed by BMI) protective factors for a lower immediate recall score. CONCLUSION: Increasing education and continued engagement of older adults in psychosocial activities, including moderate physical activity, improving mental health, preventing weight loss, and maintaining functional ability to decrease dependency, are associated with increased episodic memory, especially in non-married and older women in rural areas of Indonesia.

Probiotic supplementation improved cognitive function in cognitively impaired and healthy older adults: a systematic review of recent trials.

INTRODUCTION: Recent evidence suggests that there is clear association between microbiota and cognitive functioning, which is known as microbiome-gut-brain axis. Probiotic bacteria consumption can alter human microbiota; therefore, probiotic supplementation might affect the gut microbiota dynamics and influence cognitive function. METHODS: Three electronic databases including PubMed, ProQuest, and EBSCOHost databases were utilized. Manual hand search of article was also done. We selected randomized controlled trial articles that measure cognitive function (as the primary outcome) after intervention with probiotic supplementation on older adult population with AD, MCI, or healthy condition. The following terms and its variant were used: "probiotic," "cognitive function," "mild cognitive impairment," "dementia," and "Alzheimer's disease." RESULT: Nine of 10 included studies (AD, MCI, or healthy cognition population) showed cognitive function was improved significantly after probiotic supplementation, compared to control group. One study that included severe AD did not show significant changes. CONCLUSION: Most studies involving AD, MCI, or healthy older adults showed cognitive improvement in subjects treated with probiotics for 12-24 weeks.

New-Onset and Exacerbation of Psoriasis following COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series.

Introduction: Although uncommon, several cases of new-onset and exacerbation of psoriasis have been reported after coronavirus disease 2019 (COVID-19) vaccination. This study aims to systematically review reports regarding new-onset and exacerbation of psoriasis to identify features related to that condition following COVID-19 vaccination. Materials and Methods: Three databases were utilised, namely, PubMed, Google Scholar, and EBSCOHost to search for literature published until June 2022. We used the following MeSH terms: "psoriasis," "exacerbation," "induced psoriasis," and "COVID-19 vaccination." The included literature must report the case/(s) of psoriasis exacerbation in previously-in-remission or induced psoriasis in individuals receiving any dose of COVID-19 vaccines regardless of the type. Results: Among 33 selected studies, an overall mean age was 57.52 ± 15.92 years. Female (n = 40; 54.8%) was more frequently reported than male (n = 33; 45.2%). In terms of vaccine types, Pfizer is the most commonly reported (49 cases; 67.1%), followed by Astra-Zeneca (13 cases; 17.8%), Moderna (10 cases; 13.7%), and CoronaVac (1 case; 1.4%). The onset of psoriasis after receiving the COVID-19 Vaccines was varied, ranging from 1 to 90 days (Mean ± SD: 15.75 ± 18.22). Plaque psoriasis was most commonly reported, followed by pustular, guttate and other types of psoriasis. Reported cases were frequently treated with topical steroids and monoclonal antibodies monotherapy. Conclusions: Although the cases of new-onset and exacerbation of psoriasis after COVID-19 vaccination is quite scarce, the possibility of occurrence should be acknowledged and managed properly; and patients should be informed, particularly ones with history of psoriasis without discouraging patients to take vaccine.

Depression among Older Adults in Indonesia: Prevalence, Role of Chronic Conditions and Other Associated Factors.

Background: Depression is one of the most common illnesses worldwide, with a prevalence of 5.7% among older adults aged over 60. Depression is a severe health condition that can significantly affect the quality of life. Objective: The objective of this study is to investigate the determinant factors of depression among older adults in Indonesia. Methods: Data of 4236 adults of 60 years old and over were taken from the fifth wave of the Indonesian Family Life Survey (IFLS-5). Sociodemographic and multiple health-related variables collected through interviews and measurements were analyzed. Multivariate logistic regression was used to evaluate depression and its associated factors. Results: The prevalence of depression assessed using ten questions from the Center for Epidemiologic Studies Depression Scale (CES-D 10) was 16.3%. Significant associated factors for depression were moderate and low subjective economic status, living in Java or other regions outside Sumatra and Java, no life satisfaction, self-perceived as having poor health, having dependency (IADL scores), and experienced falls and insomnia. Among chronic conditions, stroke, arthritis, and hearing impairment were also more common in depressed older adults. Conclusion: Predictors of depression identified in this study may be used to help prevent and improve depression in Indonesian older adults, especially those who live on Java. Improvement in healthcare, especially in the prevention and rehabilitation of stroke, arthritis, possible frailty (falls and dependency), hearing impairment, and insomnia, concurrent with early detection of depression in these chronic conditions, may help create a better quality of life among Indonesian older adults.