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European Journal of Medicinal Chemistry Jan 2024Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it... (Review)
Review
Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it is considered an excellent molecular target for both PCa imaging (both for staging and follow-up), by means of PET/CT and for radioligand therapy. Its interesting molecular features have enabled the development of a new diagnostic and therapeutic approach for PCa, called "theranostics." Considering the abundance of PSMA-based probes that have appeared so far in the literature, the present work focuses the attention on radiopharmaceuticals with increasing clinical application, highlighting advantages and disadvantages in terms of different metabolization and excretion processes, pharmacokinetic, binding affinity and variable internalization rate, tumor-to-background ratio, residence times and toxicity profile.
Topics: Male; Humans; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Precision Medicine; Gallium Radioisotopes
PubMed: 37992520
DOI: 10.1016/j.ejmech.2023.115966 -
Journal of Medical Internet Research Dec 2023Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position ECAs as innovative tools for delivering interventions for promoting health-related behavior adoption. This includes motivational interviewing (MI), a therapeutic approach that combines brief interventions with motivational techniques to encourage the adoption of healthier behaviors.
OBJECTIVE
This study aims to identify the health issues addressed by ECAs delivering MI interventions, explore the key characteristics of these ECAs (eg, appearance, dialogue mechanism, emotional model), analyze the implementation of MI principles and techniques within ECAs, and examine the evaluation methods and primary outcomes of studies that use ECAs providing MI interventions.
METHODS
We conducted a scoping review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology. Our systematic search covered the PubMed, Scopus, IEEE Xplore, ACM Digital, and PsycINFO databases for papers published between January 2008 and December 2022. We included papers describing ECAs developed for delivering MI interventions targeting health-related behaviors and excluded articles that did not describe ECAs with human appearances and without the necessary evaluation or MI explanation. In a multistage process, 3 independent reviewers performed screening and data extraction, and the collected data were synthesized using a narrative approach.
RESULTS
The initial search identified 404 articles, of which 3.5% (n=14) were included in the review. ECAs primarily focused on reducing alcohol use (n=5, 36%), took on female representations (n=9, 64%), and gave limited consideration to user ethnicity (n=9, 64%). Most of them used rules-driven dialogue mechanisms (n=13, 93%), include emotional behavior to convey empathy (n=8, 57%) but without an automatic recognition of user emotions (n=12, 86%). Regarding MI implementation, of 14 studies, 3 (21%) covered all MI principles, 4 (29%) included all processes, and none covered all techniques. Most studies (8/14, 57%) conducted acceptability, usability, and user experience assessments, whereas a smaller proportion (4/14, 29%) used randomized controlled trials to evaluate behavior changes. Overall, the studies reported positive results regarding acceptability, usability, and user experience and showed promising outcomes in changes in attitudes, beliefs, motivation, and behavior.
CONCLUSIONS
This study revealed significant advancements in the use of ECAs for delivering MI interventions aimed at promoting healthier behaviors over the past 15 years. However, this review emphasizes the need for a more in-depth exploration of ECA characteristics. In addition, there is a need for the enhanced integration of MI principles, processes, and techniques into ECAs. Although acceptability and usability have received considerable attention, there is a compelling argument for placing a stronger emphasis on assessing changes in attitudes, beliefs, motivation, and behavior. Consequently, inclusion of more randomized controlled trials is essential for comprehensive intervention evaluations.
Topics: Humans; Female; Motivational Interviewing; Health Behavior; Communication; Motivation; Emotions
PubMed: 38064707
DOI: 10.2196/52097 -
International Journal of Nursing Studies Oct 2023Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In... (Review)
Review
BACKGROUND
Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In community settings, self-management behaviours are central to their prevention. However, adherence with pressure ulcer prevention guidelines remains low, with little evidence guiding the relationship between patients and healthcare professionals to establish a concordant partnership.
OBJECTIVE
To synthesise evidence on factors contributing to community-based pressure ulcer prevention using the Theoretical Domains Framework and the Capability, Opportunity, Motivation, Behaviour (COM-B) model of behaviour.
DESIGN
Mixed methods systematic review and narrative synthesis.
METHOD
Systematic searches were conducted in the CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases on 14th December 2022. Studies were eligible if they contained data on the factors associated with adherence and concordance with pressure ulcer prevention guidelines in the community for patients, caregivers, and healthcare professionals. Methodological quality was assessed using the Hawker tool. Findings were synthesised using the Theoretical Domains Framework. The resulting themes were mapped onto the Capability, Opportunity, Motivation, Behaviour (COM-B) model.
RESULTS
Thirty studies were included in the review, including quantitative, qualitative, and mixed methods research. The synthesis identified 12 of the 14 Theoretical Domains Framework domains, with knowledge, social influences, beliefs about consequences, and beliefs about capabilities the most prevalent. Although knowledge appears to be an important contributor to adherence with prevention guidelines, knowledge alone does not appear sufficient to achieve concordance. A concordant relationship was facilitated by healthcare professionals' knowledge, motivation to work alongside patients and their priorities, and interpersonal skills to build rapport and trust, whilst barriers included lack of healthcare professional skills to navigate sensitive issues, paternalistic views of patient compliance and organisational processes that impact building rapport.
CONCLUSIONS
Several psychosocial factors may affect the ability to achieve concordance between individuals, caregivers and healthcare professionals with pressure ulcer prevention guidelines in the community. However, data regarding the efficacy of behaviour change interventions targeting these constructs is limited, with further research required to guide intervention development in this area.
Topics: Humans; Pressure Ulcer; Quality of Life; Motivation; Health Personnel; Patient Compliance; Qualitative Research
PubMed: 37542960
DOI: 10.1016/j.ijnurstu.2023.104561 -
Heliyon Dec 2023Oxymel is a functional beverage with a rich historical background of use in multiple societies. Various simple and compound oxymels are prescribed in certain... (Review)
Review
BACKGROUND
Oxymel is a functional beverage with a rich historical background of use in multiple societies. Various simple and compound oxymels are prescribed in certain complementary and traditional medical systems, including traditional Persian Medicine. In recent years, numerous clinical and preclinical studies have been conducted in the pharmacy and food industry to investigate the efficacy of various oxymel formulations. This article aims to systematically review and summarize interventional studies on oxymel in both clinical research and animal models.
METHODS
Relevant articles were searched in Embase, MEDLINE, Web of Science Core Collection, Scopus, and Google Scholar from inception to July 2023 using the keyword "Oxymel" and its equivalents in other languages. Animal and human interventional studies were selected from the search results for review.
RESULTS
This review includes twenty studies, comprising twelve clinical trials, two case studies, and six animal studies. The most commonly reported actions of oxymel include positive effects on the cardiovascular system, as well as antioxidant and anti-inflammatory properties. Furthermore, compound oxymel formulations have demonstrated additional benefits depending on the inclusion of specific medicinal herbs.
CONCLUSION
Based on our findings, oxymel appears to be a valuable functional food for healthy individuals and a potentially effective and safe treatment option for managing certain diseases such as asthma, obesity, and type 2 diabetes. However, further clinical trials with larger sample sizes and longer durations are needed to fully elucidate the potential side effects and benefits of both simple and compound oxymels in various disease states.
PubMed: 38125478
DOI: 10.1016/j.heliyon.2023.e22649 -
Journal of Affective Disorders Apr 2024Ketamine and esketamine has been suggested to have potential efficacy in preventing postpartum depression (PPD) recent years. The aim of this meta-analysis was to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ketamine and esketamine has been suggested to have potential efficacy in preventing postpartum depression (PPD) recent years. The aim of this meta-analysis was to evaluate the effectiveness of ketamine and esketamine on PPD after cesarean delivery.
METHODS
We systematically searched PubMed, Embase, and the Cochrane Library for studies investigating the efficacy of ketamine and esketamine in preventing PPD. The primary outcomes of this study were risk ratios (RRs) and EPDS scores (Edinburgh Postnatal Depression Scale) in relation to PPD after ketamine and esketamine. The second outcomes were the postoperative adverse events.
RESULTS
Thirteen randomized controlled trials (RCTs) and one retrospective study including 2916 patients were analyzed, including six on the use of ketamine and eight on the use of esketamine. The risk ratios and EPDS scores of PPD were significantly decreased in the ketamine/esketamine group compared to those in the control group in one week and four weeks postoperative periods. Subgroup analyses showed that high dosage, administrated in patient controlled intravenous analgesia (PCIA) method and only esketamine exhibited a significant reduction in the incidence and EPDS scores of PPD in one week and four week postoperative. However, the incidences of postoperative adverse events, such as dizziness, diplopia, hallucination, and headache were significantly higher in the ketamine/esketamine group than that in the control group.
CONCLUSION
Ketamine and esketamine appear to be effective in preventing PPD in the one week and four week postoperative periods after cesarean delivery with moderate certainty of evidence. But they can also lead to some short-term complications too. Future high-quality studies are needed to confirm the efficacy of ketamine and esketamine in different countries.
Topics: Female; Pregnancy; Humans; Ketamine; Depression, Postpartum; Cesarean Section; Headache; Randomized Controlled Trials as Topic
PubMed: 38286233
DOI: 10.1016/j.jad.2024.01.202 -
Journal of Drugs in Dermatology : JDD Sep 2023A rise in market demand for anti-aging skin care products has resulted in a proliferation of cosmeceuticals, including products that contain vitamin C. Many topicals...
PURPOSE
A rise in market demand for anti-aging skin care products has resulted in a proliferation of cosmeceuticals, including products that contain vitamin C. Many topicals containing vitamin C claim to reduce the appearance of wrinkles. However, these claims have not been systematically evaluated.
METHODS
A systematic review of literature published between January 2015 and September 2022 was performed per PRISMA guidelines. Scopus, Web of Science, and PubMed were queried for records relevant using the following Medical Subject Heading (MeSH) terms: “Topical Vitamin C OR Ascorbic acid”, “Vitamin C efficacy”, “dermatology”, “cosmetology”, and “skin anti-aging”. Variables of interest included: study type, study location, study duration, sample size, patient description, type and ingredients of the topical formulation, outcome measurement, results, and adverse events.
RESULTS
After deduplication, consideration of inclusion and exclusion criteria, and title/abstract screening, 5,428 initial records were reduced to 7 articles, including 4 meeting Level IB criteria, one meeting Level IIA criteria, and 2 meeting Level IIB criteria. Methods for assessing clinical improvements included global photodamage score, skin topography assessment, reflectance confocal microscopy (RCM) skin analysis, Dynamical Atlas, and participant self-assessment. Conclusions: While 4 of the 7 studies met Level IB evidence, further high-quality, prospective, and comparative studies are indicated to better elucidate the role of topical vitamin C in wrinkle reduction. All the studies used vitamin C in combination with other ingredients or therapeutic mechanisms, thereby complicating any specific conclusions regarding the efficacy of vitamin C. Citation: Sanabria B, Berger LE, Mohd H, et al. Clinical efficacy of topical vitamin C on the appearance of wrinkles: a systematic literature review. J Drugs Dermatol. 2023;22(9):898-904. doi:10.36849/JDD.7332.
Topics: Humans; Ascorbic Acid; Prospective Studies; Vitamins; Treatment Outcome; Aging; Pharmaceutical Vehicles
PubMed: 37683066
DOI: 10.36849/JDD.7332 -
Communications Medicine Oct 2023Monogenic insulin resistance (IR) includes lipodystrophy and disorders of insulin signalling. We sought to assess the effects of interventions in monogenic IR,...
BACKGROUND
Monogenic insulin resistance (IR) includes lipodystrophy and disorders of insulin signalling. We sought to assess the effects of interventions in monogenic IR, stratified by genetic aetiology.
METHODS
Systematic review using PubMed, MEDLINE and Embase (1 January 1987 to 23 June 2021). Studies reporting individual-level effects of pharmacologic and/or surgical interventions in monogenic IR were eligible. Individual data were extracted and duplicates were removed. Outcomes were analysed for each gene and intervention, and in aggregate for partial, generalised and all lipodystrophy.
RESULTS
10 non-randomised experimental studies, 8 case series, and 23 case reports meet inclusion criteria, all rated as having moderate or serious risk of bias. Metreleptin use is associated with the lowering of triglycerides and haemoglobin A1c (HbA1c) in all lipodystrophy (n = 111), partial (n = 71) and generalised lipodystrophy (n = 41), and in LMNA, PPARG, AGPAT2 or BSCL2 subgroups (n = 72,13,21 and 21 respectively). Body Mass Index (BMI) is lowered in partial and generalised lipodystrophy, and in LMNA or BSCL2, but not PPARG or AGPAT2 subgroups. Thiazolidinediones are associated with improved HbA1c and triglycerides in all lipodystrophy (n = 13), improved HbA1c in PPARG (n = 5), and improved triglycerides in LMNA (n = 7). In INSR-related IR, rhIGF-1, alone or with IGFBP3, is associated with improved HbA1c (n = 17). The small size or absence of other genotype-treatment combinations preclude firm conclusions.
CONCLUSIONS
The evidence guiding genotype-specific treatment of monogenic IR is of low to very low quality. Metreleptin and Thiazolidinediones appear to improve metabolic markers in lipodystrophy, and rhIGF-1 appears to lower HbA1c in INSR-related IR. For other interventions, there is insufficient evidence to assess efficacy and risks in aggregated lipodystrophy or genetic subgroups.
PubMed: 37794082
DOI: 10.1038/s43856-023-00368-9 -
Journal of Cachexia, Sarcopenia and... Apr 2024Half of osteoporotic fractures occur in patients with normal/osteopenic bone density or at intermediate or low estimated risk. Muscle measures have been shown to... (Review)
Review
Half of osteoporotic fractures occur in patients with normal/osteopenic bone density or at intermediate or low estimated risk. Muscle measures have been shown to contribute to fracture risk independently of bone mineral density. The objectives were to review the measurements of muscle health (muscle mass/quantity/quality, strength and function) and their association with incident fragility fractures and to summarize their use in clinical practice. This scoping review follows the PRISMA-ScR guidelines for reporting. Our search strategy covered the three overreaching concepts of 'fragility fractures', 'muscle health assessment' and 'risk'. We retrieved 14 745 references from Medline Ovid SP, EMBASE, Web of Science Core Collection and Google Scholar. We included original and prospective studies on community-dwelling adults aged over 50 years that analysed an association between at least one muscle parameter and incident fragility fractures. We systematically extracted 17 items from each study, including methodology, general characteristics and results. Data were summarized in tables and graphically presented in adjusted forest plots. Sixty-seven articles fulfilled the inclusion criteria. In total, we studied 60 muscle parameters or indexes and 322 fracture risk ratios over 2.8 million person-years (MPY). The median (interquartile range) sample size was 1642 (921-5756), age 69.2 (63.5-73.6) years, follow-up 10.0 (4.4-12.0) years and number of incident fragility fractures 166 (88-277). A lower muscle mass was positively/not/negatively associated with incident fragility fracture in 28 (2.0), 64 (2.5) and 10 (0.2 MPY) analyses. A lower muscle strength was positively/not/negatively associated with fractures in 53 (1.3), 57 (1.7 MPY) and 0 analyses. A lower muscle function was positively/not/negatively associated in 63 (1.9), 45 (1.0 MPY) and 0 analyses. An in-depth analysis shows how each single muscle parameter was associated with each fragility fractures subtype. This review summarizes markers of muscle health and their association with fragility fractures. Measures of muscle strength and function appeared to perform better for fracture risk prediction. Of these, hand grip strength and gait speed are likely to be the most practical measures for inclusion in clinical practice, as in the evaluation of sarcopenia or in further fracture risk assessment scores. Measures of muscle mass did not appear to predict fragility fractures and might benefit from further research, on D3-creatine dilution test, lean mass indexes and artificial intelligence methods.
Topics: Humans; Aged; Middle Aged; Hand Strength; Prospective Studies; Artificial Intelligence; Risk Factors; Osteoporotic Fractures; Muscle, Skeletal
PubMed: 38284511
DOI: 10.1002/jcsm.13418 -
Environmental Pollution (Barking, Essex... Nov 2023Accumulating number of epidemiological studies has recently proposed that improvement in the risk of autism spectrum disorders (ASD) is associated with persistent... (Review)
Review
Accumulating number of epidemiological studies has recently proposed that improvement in the risk of autism spectrum disorders (ASD) is associated with persistent organic pollutants (POPs) exposure. However, evidence from current researches is limited and inconsistent. Thus, we conducted a systematic review and meta-analysis to investigate the potential associations comprehensively. We systematically and extensively searched two electronic databases (PubMed and EMBASE) from inception to July 3, 2022 and an updated search was performed before submission. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were derived from stratified random-effects meta-analyses by type of exposure and outcome. We also tested the potential heterogeneity across studies, conducted sensitivity analysis and evaluated publication bias. A total of 20 studies were finally included in our study. Meta-analytical effect estimates indicated a positive association between prenatal exposure to PCB-138, PCB-153 and PCB-170 and an increased risk of ASD, with OR of 1.89 (95% CI = 1.21-2.95, I = 0%), 1.61 (95% CI = 1.05-2.47, I = 0%) and 1.46 (95% CI = 1.03-2.06, I = 0%) respectively. In contrast, PFDA was found inversely associated with the risk of ASD (OR = 0.70, 95% CI = 0.52-0.94, I = 0%). The level of evidence supporting a link between ASD risk and exposure to PCB-138, PCB-153, PCB-170, and PFDA was respectively categorized as low, low, moderate, and low. In summary, this systematic review and meta-analysis suggest that exposure to PCB-138, PCB-153, and PCB-170 correlates with a heightened risk of ASD, with evidence levels rated as "low", "low", and "moderate", respectively. In contrast, PFDA exposure appears to be inversely associated with ASD risk, with a "low" level of supporting evidence. However, due to the limited number of studies available for each exposure and outcome pairing, these results should be interpreted with caution. Sufficiently powered studies are needed to validate our findings.
PubMed: 37619697
DOI: 10.1016/j.envpol.2023.122439 -
Cureus Mar 2024Rosacea is a common cutaneous condition caused by persistent, recurring lesions in facial skin vessels. It is a chronic skin condition with a variety of clinical... (Review)
Review
Rosacea is a common cutaneous condition caused by persistent, recurring lesions in facial skin vessels. It is a chronic skin condition with a variety of clinical symptoms and an unknown cause. Rosacea begins with the widening of capillaries and a flushed appearance. Following that, telangiectasia appears, and reddened patches persist, particularly on the cheeks and nose. Erythema persists due to repeated vasodilation and telangiectasia. In addition, skin inflammation manifests as papules, pustules, lymphedema, and fibrosis. Despite recent advances in treatment, rosacea, a chronic inflammatory relapsing central facial dermatosis, can be extremely difficult to manage. The purpose of this meta-analysis and systematic review was to evaluate the effectiveness of low-dose isotretinoin in the treatment of rosacea. Following the guidelines set forth by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA), the researcher employed the following search terms in the EMBASE, Web of Science, PubMed, Cochrane Library, and Google Scholar databases to provide a therapeutic update relevant to clinical practice: "low dose isotretinoin," "isotretinoin and rosacea," "isotretinoin treatment of rosacea," and "effectiveness of isotretinoin in treating rosacea". The search was carried out by the researcher for articles published from February 2019 to February 2024. The articles included were all published in the English language. The overall frequency of patients with adverse events differed significantly between the groups treated with low-dose isotretinoin and the comparators (minocycline, pulsed dye laser, evening primrose oil, , doxycycline, combined dose or placebo) (0.80, 95% CI 0.73 to 0.88, p = 0.0001). Sub-group analysis indicated that there was a difference between the interventions used in the treatments all in favor of low-dose isotretinoin treatment. The results showed that the moderate group had RR: 0.76, 95% CI: 0.44-1.30, I2 = 0%; the mild group had RR: 0.94, 95% CI: 0.56-1.57, I2 = 0%; and the group with severe rosacea had RR: 0.73, 95% CI: 0.47-1.13, I2 = 0%. According to this study, rosacea can be treated effectively with low-dose isotretinoin even in patients at severe stages of the disease by using the recommended dose once a week. Further, the intervention has also been shown to have fewer side effects on the patients. Therefore, this study recommends randomized controlled trials to be done to fully investigate the best combination options for isotretinoin on mild to severe rosacea based on the fact that some of the treatments combined have shown to be effective on treatment.
PubMed: 38681262
DOI: 10.7759/cureus.57085