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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 -
Archives of Dermatological Research Dec 2023Limited data is present that characterizes dermatological conditions and their risk factors in people experiencing homelessness (PEH).We conducted a systematic review to... (Review)
Review
Limited data is present that characterizes dermatological conditions and their risk factors in people experiencing homelessness (PEH).We conducted a systematic review to investigate the types of dermatological conditions in PEH, their risk factors, and provide solutions when providing dermatological care to this patient population. We searched PubMed, EMBASE and Cochrane for articles written in English from 2012 to 2022. The last search was performed on December 27, 2022. Twelve studies met the inclusion criteria. Fifty-eight percent of the studies took place in the USA (n = 7) and 42% of studies took place in Canada (n = 5). Prevalent dermatological conditions included, skin cancer, cutaneous manifestations of malnutrition, cutaneous diphtheria, Group A Streptococcus infection (iGAS), lice, atopic dermatitis, acne, sexually transmitted infections (STIs), and Staphylococcus aureus infections. Risk factors included substance use disorder, skin trauma, not having access to sunscreen or hats, unstable housing, higher exposure to extreme weather, and higher mobility. Due to studies being conducted in the USA or Canada, results may not be generalizable. This systematic review strongly suggests that many dermatological conditions prevalent in PEH can be contributed to poor skin integrity. Better measures can significantly reduce certain dermatological conditions by improving access to dermatological care.
Topics: Humans; Ill-Housed Persons; Skin Diseases; Risk Factors; Skin; Dermatitis, Atopic
PubMed: 37833427
DOI: 10.1007/s00403-023-02722-2 -
Critical Reviews in Therapeutic Drug... 2024Cosmeceuticals have gained great importance and are among the top-selling products used for skin care. Because of changing lifestyles, climate, and increasing pollution,...
Cosmeceuticals have gained great importance and are among the top-selling products used for skin care. Because of changing lifestyles, climate, and increasing pollution, cosmeceuticals are utilized by every individual, thereby making cosmeceuticals a fruitful field for research and the economy. Cosmeceuticals provide incredibly pleasing aesthetic results by fusing the qualities of both cosmetics and medicinal substances. Cosmeceuticals are primarily utilized to improve the appearance of skin by making it smoother, moisturized, and wrinkle-free, in addition to treating dermatological conditions, including photoaging, burns, dandruff, acne, eczema, and erythema. Nanocosmeceuticals are cosmetic products that combine therapeutic effects utilizing nanotechnology, allowing for more precise and effective target-specific delivery of active ingredients, and improving bioavailability.
Topics: Humans; Cosmeceuticals; Skin Care; Skin; Acne Vulgaris; Nanotechnology
PubMed: 38608133
DOI: 10.1615/CritRevTherDrugCarrierSyst.v41.i5.20 -
Advances in Wound Care Feb 2024With the increasing diabetic population worldwide, diabetic foot ulcers (DFUs) are a significant concern. This study aimed to compare the efficacy of skin substitutes,... (Meta-Analysis)
Meta-Analysis
With the increasing diabetic population worldwide, diabetic foot ulcers (DFUs) are a significant concern. This study aimed to compare the efficacy of skin substitutes, biomaterials, and topical agents with standard care. A meta-analysis was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, EMBASE, and Web of Science were searched using the following keywords: diabetes mellitus AND skin graft OR tissue replacement OR dressing OR drug. Two independent reviewers performed data collection and quality assessment of the eligible studies. The primary outcome was the 12- to 16-week healing rates and the secondary outcome was recurrence rates. Thirty-eight randomized controlled trials, including 3,862 patients, were analyzed. The studies exhibited low heterogeneity (τ = 0.10) without significant asymmetry (Egger's test, = 0.8852). After pooling direct and indirect estimates, placenta-based tissue products exhibited the best wound healing probability (-score = 0.90), followed by skin substitutes with living cells (-score = 0.70), acellular skin substitutes (-score = 0.56), and advanced topical dressings (-score = 0.34) compared with standard of care. The recurrence analysis showed significant improvement in the intervention group compared with the control group (11.21% vs. 15.15%). This network meta-analysis provides the relative effectiveness and rank of biomaterials and topical dressings in DFU healing. The results could help clinical decision making.
Topics: Humans; Diabetic Foot; Biocompatible Materials; Network Meta-Analysis; Bandages; Wound Healing; Diabetes Mellitus
PubMed: 37395488
DOI: 10.1089/wound.2023.0024 -
PharmacoEconomics Nov 2023Numerous therapies have recently emerged for treatment of patients with atopic dermatitis (AD), a common skin disease, and understanding their cost-effectiveness is of...
BACKGROUND
Numerous therapies have recently emerged for treatment of patients with atopic dermatitis (AD), a common skin disease, and understanding their cost-effectiveness is of high importance for policy makers. This systematic literature review (SLR) aimed to provide an overview of full economic evaluations that assessed cost-effectiveness of emerging AD treatments.
METHODS
The SLR was conducted in Medline, Embase, UK National Health Service Economic Evaluation Database and EconLit. Reports published by the National Institute for Health and Care Excellence, the Institute for Clinical and Economic Review and the Canadian Agency for Drugs and Technologies in Health were manually searched. Economic evaluations published from 2017 to September 2022 that compared emerging AD treatments with any comparator were included. Quality assessment was conducted by using the Consensus on Health Economic Criteria list.
RESULTS
A total of 1333 references were screened after removing duplicates. Among those references, 15 that conducted a total of 24 comparisons were included. Most studies were from the USA, UK or Canada. Seven different emerging treatments were compared, mostly with usual care. In 15 comparisons (63%), the emerging treatment was cost-effective, and 11 out of 14 dupilumab comparisons (79%) reported that dupilumab was cost-effective. Upadacitinib was the only emerging therapy that was never classified as cost-effective. On average, 13 out of 19 quality criteria (68%) per reference were rated as fulfilled while manuscripts and health technology reports received generally higher quality assessment scores than published abstracts.
DISCUSSION
This study revealed some discrepancies in the cost-effectiveness of emerging therapies for AD. A variety of designs and guidelines made comparison difficult. Therefore, we recommend that future economic evaluations use more similar modelling approaches to improve comparability of results.
OTHERS
The protocol was published in PROSPERO (ID: CRD42022343993).
PubMed: 37392363
DOI: 10.1007/s40273-023-01293-4 -
Disability and Rehabilitation Nov 2023A systematic review and meta-analysis investigating the duration and frequency of lower extremity prosthesis use and what factors were associated with changes in their... (Review)
Review
PURPOSE
A systematic review and meta-analysis investigating the duration and frequency of lower extremity prosthesis use and what factors were associated with changes in their use.
MATERIALS AND METHODS
A search of PubMed, CINAHL, and Scopus over 20 years revealed 2409 articles. After review, 29 studies remained, representing 4814 participants with lower limb loss. Quality, funding, publication, and quantitative analyses were addressed.
RESULTS
The mean prosthesis use was 9.6 (5.3) hours/day and 6.4 (1.9) days/week. Distal amputation sites averaged more hours/day of prostheses use than proximal amputations (13.2 [3.2] vs. 10.8 [5.0], < .001). After hemipelvectomy or hip dislocations, average prostheses use was less hours/day (6.0 [4.7]) than after transfemoral (12.9 [4.8]) or transtibial amputations (14.0 [4.5]) ( < .05). Pooled effects revealed an association between comorbidities and abandonment (OR 0.35, = .03). The data supported six empirical evidence statements concerning age, sex, social support, amputation proximity, balance, skin condition, comorbidities, pain, falls, and fitness in association with changes in prosthesis utilization.
CONCLUSIONS
The study provided systematic data on lower-extremity prosthesis use, thus helping to inform clinical decision-making and patient education. It also elucidated a path for future studies focused on modifiable factors related to prosthesis use and related outcomes.Implications for rehabilitationLower limb loss can trigger costly and debilitating sequela, which could be mitigated by increased prosthesis use and functionality, but there is no consensus on how often prostheses are being used and what affects changes in their use.When counseling patients on what they can expect after a lower extremity amputation and to set goals, the aggregated means of 9.6 (5.3) hours per day and 6.4 (1.9) days per week can be informative.Individuals who use a lower extremity prosthesis or may have to use one in the future can increase their prosthesis use and mobility by limiting further health deterioration.Rehabilitative care involving the multidisciplinary prioritization of proper socket fit, fitness training, gait training, and social support is associated with increased prosthetic device usage.
PubMed: 37927090
DOI: 10.1080/09638288.2023.2276838 -
Journal of Clinical Nursing Oct 2023Burnout is a significant occupational problem among oncology nurses, affecting their physical and mental health and the quality of medical care. Besides, there is a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Burnout is a significant occupational problem among oncology nurses, affecting their physical and mental health and the quality of medical care. Besides, there is a gradually increasing trend that we should pay more attention to.
OBJECTIVES
To investigate the prevalence, influencing factors and interventions of oncology nurses' burnout among different continents.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
English literature in PubMed, EMBASE, MEDLINE/EBSCOhost, CINAHL Complete and Web and of Science were searched before 1 March 2022.
RESULTS
Twenty studies included 5904 oncology nurses in this review. Meta-analysis was performed in 19 of the studies. First, the pooled mean scores estimate for emotional exhaustion (EE) was 22.13 (95% CI: 19.69-24.58), depersonalization (DP) was 6.89 (95% CI: 5.67-8.10) and personal accomplishment (PA) was 32.86 (95% CI: 29.34-36.37). A high level of burnout was defined as a high level of EE (score ≥ 27), a high level of DP (score ≥ 10), and a low level of PA (score ≤ 33). Of these, 36.40% of nurses reported high EE, 28.26% reported high DP and 28.68% reported low levels of PA. Furthermore, there are differences in the prevalence, influencing factors and intervention measures of burnout among oncology nurses in different regions. The highest pooled mean scores for EE and DP were found in Asia. And the highest pooled mean scores for PA were found in the Americas. The factors that influence burnout among Asian oncology nurses are mostly personal-related factors such as empathy and personality traits, while the factors that influence burnout among European oncology nurses are work-related factors. This review included three intervention studies from Europe and the Americas, with fewer intervention studies on burnout in oncology nurses in Asia.
CONCLUSION
Oncology nurses in Asia had the highest pooled mean scores for EE and DP, and the highest mean scores for the PA pool in the Americas. There are regional differences in the prevalence and factors influencing burnout among oncology nurses, but there are few interventions for it. Therefore, future interventions should be developed to address the differences that exist in different regions.
RELEVANCE TO CLINICAL PRACTICE
Burnout among oncology nurses in different regions is a concern, and this review may provide a reference for managers to target interventions to alleviate burnout among oncology nurses.
Topics: Humans; Prevalence; Burnout, Professional; Emotions; Europe; Nurses; Surveys and Questionnaires
PubMed: 37492975
DOI: 10.1111/jocn.16838 -
Supportive Care in Cancer : Official... Aug 2023This systematic review and meta-analysis evaluates the efficacy of Mepitel Film in preventing acute radiation dermatitis (RD) in patients with head and neck cancer (HNC)... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This systematic review and meta-analysis evaluates the efficacy of Mepitel Film in preventing acute radiation dermatitis (RD) in patients with head and neck cancer (HNC) across randomized controlled trials (RCTs).
METHODS
Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched on 5 March 2023 to identify relevant RCTs. RD assessment tools and outcomes were compared across studies. Pooled effect sizes and 95% confidence intervals (CI) were estimated based on random-effects analysis using RevMan 5.4.
RESULTS
Three RCTs conducted between 2018 and 2020 were included. Mepitel Film decreased RD severity when compared to Sorbolene or Biafine but not when compared to mometasone. A per-protocol analysis of two of the trials revealed that, overall, Mepitel Film significantly reduced the incidence of grade 2-3 RD (odds ratio (OR), 0.24; 95% CI, 0.09-0.65; p = 0.005) and moist desquamation (OR, 0.21; 95% CI, 0.10-0.46; p < 0.0001) and decreased average patient, researcher, and combined components of the Radiation-Induced Skin Reaction Assessment Scale (the standardized mean difference (SMD) for patient ratings, - 2.56; 95% CI, - 3.15 to - 1.96, p < 0.00001; SMD for researcher ratings, - 3.47; 95% CI, - 6.63 to - 0.31, p = 0.03; SMD for combined scores, - 3.68; 95% CI, - 6.43 to - 0.92, p = 0.009). Noted issues with Mepitel Film included itchiness and poor adherence.
CONCLUSION
While there were discrepancies across studies, Mepitel Film demonstrated a decrease in the incidence of grade 2-3 RD and moist desquamation. These findings emphasize the need for further examining Mepitel Film's efficacy across diverse patient groups and the importance of standardizing RD severity assessment methodologies and control arms.
Topics: Humans; Randomized Controlled Trials as Topic; Head and Neck Neoplasms; Motion Pictures; Dermatitis
PubMed: 37594538
DOI: 10.1007/s00520-023-07988-w -
Archives of Dermatological Research Aug 2023Many patient-reported outcome measures (PROMs) have been used to study quality of life (QOL) in the skin cancer population. Advanced melanoma and non-melanoma skin... (Review)
Review
Many patient-reported outcome measures (PROMs) have been used to study quality of life (QOL) in the skin cancer population. Advanced melanoma and non-melanoma skin cancer (NMSC) may be associated with increased morbidity, mortality, and treatment side effects; however, it is unclear which PROM is valid and appropriate to use in these populations for both clinical and research purposes. We aimed to identify the PROMs that have been used to measure QOL in advanced skin cancer patients and determine which of these PROMs have been validated to assess QOL outcomes in this population. A PubMed and EMBASE search was conducted from its inception to March 2021 according to PRISMA guidelines with a comprehensive list of search terms under three main topics: (1) PROM; (2) advanced skin cancer; and (3) staging and interventions. We included articles utilizing a PROM measuring QOL and having a patient population with advanced skin cancer defined as melanoma stage > T1a or non-melanoma AJCC stage T3 or greater. Advanced skin cancer patients were also defined as those with metastasis or requiring adjuvant therapy (systemic chemotherapy, radiation, and immunotherapy). Studies were excluded according to the following criteria: mix of low-risk and advanced skin cancer patients in the study population without stratification into low-risk and advanced groups, stage T1a melanoma or mix of stages without stratification, low-risk NMSC, no PROM (i.e., study specific questionnaires), non-English publication, review article or protocol paper, conference abstract, or populations including non-skin cancers. A total of 1,998 articles were identified. 82 met our inclusion criteria resulting in 22 PROMs: five generic health-related (QWB-SA, AQoL-8D, EQ-5D, SF-36, and PRISM), six general cancer (EORTC QLQ-C30, EORTC QLQ-C36, LASA, IOC, Rotterdam Symptom Checklist, and FACT-G), nine disease-focused or specialized (EORTC QLQ-H&N35, EORTC QLQ-MEL38, EORTC QLQ-BR23, Facial Disability Index, FACT-H&N, FACT-BRM, FACT-B, FACT-M, and scqolit), and two general dermatology (Skindex-16 and DLQI) PROMs. All PROMs have been generally validated except for EORTC QLQ-MEL38. Only two PROMs have been validated in the advanced melanoma population: FACT-M and EORTC QLQ-C36. No PROMS have been validated in the advanced NMSC population. The PROMs that were validated in the advanced melanoma population do not include QOL issues unique to advanced skin tumors such as odor, bleeding, itching, wound care burden, and public embarrassment. Breast cancer and head and neck cancer instruments were adapted but not validated for use in the advanced skin cancer population due to the lack of an adequate instrument for this population. This study highlights the need for PROM instrument validation or creation specifically geared toward the advanced skin cancer population. Future studies should aim to develop and validate a PROM to assess QOL in this population.
Topics: Humans; Quality of Life; Skin Neoplasms; Melanoma; Surveys and Questionnaires; Patient Reported Outcome Measures
PubMed: 36469125
DOI: 10.1007/s00403-022-02479-0 -
BMC Palliative Care Mar 2024Children with life-threatening and life-limiting conditions can experience high levels of suffering due to multiple distressing symptoms that result in poor quality of...
BACKGROUND
Children with life-threatening and life-limiting conditions can experience high levels of suffering due to multiple distressing symptoms that result in poor quality of life and increase risk of long-term distress in their family members. High quality symptom treatment is needed for all these children and their families, even more so at the end-of-life. In this paper, we provide evidence-based recommendations for symptom treatment in paediatric palliative patients to optimize care.
METHODS
A multidisciplinary panel of 56 experts in paediatric palliative care and nine (bereaved) parents was established to develop recommendations on symptom treatment in paediatric palliative care including anxiety and depression, delirium, dyspnoea, haematological symptoms, coughing, skin complaints, nausea and vomiting, neurological symptoms, pain, death rattle, fatigue, paediatric palliative sedation and forgoing hydration and nutrition. Recommendations were based on evidence from a systematic literature search, additional literature sources (such as guidelines), clinical expertise, and patient and family values. We used the GRADE methodology for appraisal of evidence. Parents were included in the guideline panel to ensure the representation of patient and family values.
RESULTS
We included a total of 18 studies that reported on the effects of specific (non) pharmacological interventions to treat symptoms in paediatric palliative care. A few of these interventions showed significant improvement in symptom relief. This evidence could only (partly) answer eight out of 27 clinical questions. We included 29 guidelines and two textbooks as additional literature to deal with lack of evidence. In total, we formulated 221 recommendations on symptom treatment in paediatric palliative care based on evidence, additional literature, clinical expertise, and patient and family values.
CONCLUSION
Even though available evidence on symptom-related paediatric palliative care interventions has increased, there still is a paucity of evidence in paediatric palliative care. We urge for international multidisciplinary multi-institutional collaboration to perform high-quality research and contribute to the optimization of symptom relief in palliative care for all children worldwide.
Topics: Humans; Child; Palliative Care; Quality of Life; Terminal Care; Pain; Family
PubMed: 38481215
DOI: 10.1186/s12904-024-01367-w