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JAMA Dermatology Jul 2024Seborrheic dermatitis is a prevalent chronic inflammatory skin disease, yet its global prevalence, pathogenesis, and epidemiology remain inadequately defined.
IMPORTANCE
Seborrheic dermatitis is a prevalent chronic inflammatory skin disease, yet its global prevalence, pathogenesis, and epidemiology remain inadequately defined.
OBJECTIVE
To provide a detailed estimation of the global prevalence of seborrheic dermatitis, analyze demographic variations, and explore differences in various settings.
DATA SOURCES
Embase, PubMed, Scopus, and Cochrane Database of Systematic Reviews were searched from inception through October 2023.
STUDY SELECTION
Original investigations on seborrheic dermatitis prevalence were included after duplicate screening of titles, abstracts, and full articles, including only studies with clinician-diagnosed cases.
DATA EXTRACTION AND SYNTHESIS
Following PRISMA guidelines, data were extracted and quality was assessed independently by multiple reviewers. A random-effects model using restricted maximum likelihood was used for meta-analysis and subgroup analyses.
MAIN OUTCOME AND MEASURE
The primary outcome was the pooled estimate of global seborrheic dermatitis prevalence.
RESULTS
From 1574 identified articles, 121 studies were included, encompassing 1 260 163 individuals and revealing a pooled global seborrheic dermatitis prevalence of 4.38% (95% CI, 3.58%-5.17%), with significant heterogeneity (I2 = 99.94%). Subgroup analyses showed variations by age, with a higher prevalence in adults (5.64% [95% CI, 4.01%-7.27%]) compared to children (3.70% [95% CI, 2.69%-4.80%]) and neonates (0.23% [95% CI, 0.04%-0.43%]). Geographic analyses indicated variability, with the highest prevalence in South Africa (8.82% [95% CI, 3.00%-14.64%]) and the lowest in India (2.62% [95% CI, 1.33%-3.92%]).
CONCLUSIONS AND RELEVANCE
This comprehensive meta-analysis provides a detailed estimation of the global prevalence of seborrheic dermatitis, highlighting significant variability across different demographics and settings.
PubMed: 38958996
DOI: 10.1001/jamadermatol.2024.1987 -
JAMA Network Open Jul 2024Termination of resuscitation (TOR) rules may help guide prehospital decisions to stop resuscitation, with potential effects on patient outcomes and health resource use.... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Termination of resuscitation (TOR) rules may help guide prehospital decisions to stop resuscitation, with potential effects on patient outcomes and health resource use. Rules with high sensitivity risk increasing inappropriate transport of nonsurvivors, while rules without excellent specificity risk missed survivors. Further examination of the performance of TOR rules in estimating survival of out-of-hospital cardiac arrest (OHCA) is needed.
OBJECTIVE
To determine whether TOR rules can accurately identify patients who will not survive an OHCA.
DATA SOURCES
For this systematic review and meta-analysis, the MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science databases were searched from database inception up to January 11, 2024. There were no restrictions on language, publication date, or time frame of the study.
STUDY SELECTION
Two reviewers independently screened records, first by title and abstract and then by full text. Randomized clinical trials, case-control studies, cohort studies, cross-sectional studies, retrospective analyses, and modeling studies were included. Systematic reviews and meta-analyses were reviewed to identify primary studies. Studies predicting outcomes other than death, in-hospital studies, animal studies, and non-peer-reviewed studies were excluded.
DATA EXTRACTION AND SYNTHESIS
Data were extracted by one reviewer and checked by a second. Two reviewers assessed risk of bias using the Revised Quality Assessment Tool for Diagnostic Accuracy Studies. Cochrane Screening and Diagnostic Tests Methods Group recommendations were followed when conducting a bivariate random-effects meta-analysis. This review followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) statement and is registered with the International Prospective Register of Systematic Reviews (CRD42019131010).
MAIN OUTCOMES AND MEASURES
Sensitivity and specificity tables with 95% CIs and bivariate summary receiver operating characteristic (SROC) curves were produced. Estimates of effects at different prevalence levels were calculated. These estimates were used to evaluate the practical implications of TOR rule use at different prevalence levels.
RESULTS
This review included 43 nonrandomized studies published between 1993 and 2023, addressing 29 TOR rules and involving 1 125 587 cases. Fifteen studies reported the derivation of 20 TOR rules. Thirty-three studies reported external data validations of 17 TOR rules. Seven TOR rules had data to facilitate meta-analysis. One clinical study was identified. The universal termination of resuscitation rule had the best performance, with pooled sensitivity of 0.62 (95% CI, 0.54-0.71), pooled specificity of 0.88 (95% CI, 0.82-0.94), and a diagnostic odds ratio of 20.45 (95% CI, 13.15-31.83).
CONCLUSIONS AND RELEVANCE
In this review, there was insufficient robust evidence to support widespread implementation of TOR rules in clinical practice. These findings suggest that adoption of TOR rules may lead to missed survivors and increased resource utilization.
Topics: Out-of-Hospital Cardiac Arrest; Humans; Cardiopulmonary Resuscitation; Emergency Medical Services; Clinical Decision Rules; Resuscitation Orders
PubMed: 38958975
DOI: 10.1001/jamanetworkopen.2024.20040 -
Journal of Strength and Conditioning... Jul 2024Pairwise comparison of heavy dynamic strength and fast dynamic strength interventions on sprint performance: a systematic review and meta-analysis. J Strength Cond Res...
Pairwise comparison of heavy dynamic strength and fast dynamic strength interventions on sprint performance: a systematic review and meta-analysis. J Strength Cond Res 38(8): 1509-1520, 2024-Previous studies have shown that both heavy dynamic strength (HDS) and fast dynamic strength (FDS) training can be used to improve sprint performance; however, a review and meta-analysis investigating pairwise studies that compare these two training interventions have not been performed. The aims of the study were to systematically review and analyze HDS and FDS training methodologies and evaluate their effect size difference, in pairwise comparison studies to determine and compare their effects on sprint performance. Databases were systematically searched using Boolean phrasing to identify eligible articles, and meta-analyses were performed on the extracted data. Seven studies met the inclusion criteria, which resulted in data from 138 subjects across 24 separate sprint assessments. Overall, there was a small effect in favor of FDS (standardized mean difference = 0.27, 95% confidence intervals [-0.07; 0.60], 95% prediction intervals [-1.01; 1.55]), but this was deemed not significant because of the wide-ranging prediction intervals. There is no distinguishable difference between HDS and FDS training on sprint performance. The wide-ranging prediction intervals suggest the variability is too great to determine whether one training type is more effective than the other. Practitioners should consider the individual needs of their athletes when deciding which training type to use for long-term sprint development.
PubMed: 38958937
DOI: 10.1519/JSC.0000000000004839 -
Chinese Journal of Integrative Medicine Jul 2024Resveratrol is a non-flavonoid polyphenol that shows promise in reducing pro-inflammatory factors and maintaining endothelial function, which hints at its potential role... (Review)
Review
BACKGROUND
Resveratrol is a non-flavonoid polyphenol that shows promise in reducing pro-inflammatory factors and maintaining endothelial function, which hints at its potential role in slowing atherosclerosis and preventing acute coronary events.
OBJECTIVE
To study the cardioprotective effects of resveratrol on inflammatory mediators and endothelial function in patients with coronary artery disease (CAD).
METHODS
A thorough search was conducted in databases (Cochrane Library, ProQuest, PubMed, LILACS, ScienceDirect, Springer, Taylor&Francis, CNKI, Wanfang, and Weipu) until September 24, 2023. The vasopro-inflammatory mediators, endothelial function and outcomes related to cardiovascular events were observed. Titles and abstracts were assessed, and bias was evaluated with Cochrane RoB 2.0. Heterogeneity of results was explored by meta-regression, certainty of evidence was assessed by the GRADE system, and conclusive evidence was enhanced by trial sequence analysis.
RESULTS
Ten randomized controlled trials and 3 animal studies investigated resveratrol's impact on inflammatory mediators and endothelial function. In primary prevention studies, meta-analysis showed a significant reduction (95% CI: -0.73 to -0.20; P=0.0005) in tumor necrosis factor-α (TNF-α) expression with resveratrol, demonstrating a dose-dependent relationship. No significant difference was observed in interleukin-6 (IL-6) expression with P=0.58 for primary prevention and P=0.57 for secondary prevention. Vascular endothelial nitric oxide synthase (eNOS) expression was significantly increased after resveratrol pre-treatment following CAD events. Secondary prevention studies yielded no significant results; however, meta-regression identified associations between age, hypertension, and lower doses with the extent of TNF-α alterations. High certainty of evidence supported TNF-α reduction, while evidence for IL-6 reduction and eNOS elevation was deemed low.
CONCLUSION
Resveratrol reduces TNF-α in individuals at risk for CAD, specifically 15 mg per day. However, its usefulness in patients with confirmed CAD is limited due to factors such as age, high blood pressure, and insufficient dosage. Due to the small sample size, the reduction of IL-6 is inconclusive. Animal studies suggest that resveratrol enhances endothelial function by increasing eNOS. (PROSPERO registration No. CRD42023465234).
PubMed: 38958883
DOI: 10.1007/s11655-024-3665-0 -
Sleep & Breathing = Schlaf & Atmung Jul 2024To systematically review the literature regarding the concordance of sleep bruxism (SB) between monozygotic (MZ) and dizygotic (DZ) twins. (Review)
Review
OBJECTIVE
To systematically review the literature regarding the concordance of sleep bruxism (SB) between monozygotic (MZ) and dizygotic (DZ) twins.
METHODS
The registration for this systematic review was accomplished in the International Prospective Register of Systematic Reviews (PROSPERO, No. CRD42021251751). As of July 2022, four databases were searched, including PubMed, Scopus, Embase, and Web of Science, as well as the grey literature in Google Scholar and OpenGrey. Observational studies evaluating SB in MZ and DZ twins of any age and sex were included. For the evaluation of the risk of bias, the Joanna Briggs checklist was utilized. The certainty of evidence was assessed via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Pooled and subgroup meta-analyses were performed to estimate concordance of SB between twins (p < 0.05).
RESULTS
In total, 3,155 records were identified. In the qualitative analysis, eleven studies were included; of these, seven were included in the meta-analysis. The majority of the articles exhibited a low risk of bias (63.6%). Greater SB concordance was observed between MZ twins than between DZ twins in the analysis of general concordance (OR = 1.47; 95% CI = 1.07-2.02) and also positive concordance (OR = 1.53; 95% CI = 1.29-1.81). Within the subgroup analyses, the significance of the findings remained only for the reported/self-reported SB regarding general concordance (OR = 1.44; 95% CI = 1.07-1.95) and positive concordance (OR = 1.55; 95% CI = 1.28-1.88). Low certainty of the evidence was observed for the general concordance analysis, while moderate certainty was observed for the positive concordance.
CONCLUSION
There was a higher concordance of SB in MZ twins compared to DZ twins, indicating a possible genetic influence on the condition's occurrence.
PubMed: 38958854
DOI: 10.1007/s11325-024-03090-5 -
Neurological Sciences : Official... Jul 2024Parkinson's disease (PD) patients often experience non-motor symptoms like depression and anxiety, significantly impacting their quality of life. With the limited...
BACKGROUND
Parkinson's disease (PD) patients often experience non-motor symptoms like depression and anxiety, significantly impacting their quality of life. With the limited effectiveness of pharmacological treatments, effective non-pharmacological interventions are needed. This systematic review and meta-analysis aimed to evaluate the efficacy of cognitive-behavioral therapy (CBT) in reducing depression and anxiety symptoms in PD patients.
METHODS
Randomized controlled trials (RCTs) exploring CBT's effectiveness for depression and anxiety in PD patients were included. Studies published until April 2023 were identified from PubMed, Web of Science, and Scopus. Methodological quality was assessed using the Risk of Bias-2 (ROB-2) tool. Statistical analysis involved calculating the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) using Review Manager 5.4.1.
RESULTS
The systematic review included 12 studies involving 241 PD patients. CBT led to a substantial reduction in anxiety (SMD -0.95, 95% CI [-1.15 to -0.74], P < 0.00001) and depression (SMD -1.02, 95% CI [-1.39 to -0.65], P < 0.0001). Both traditional CBT and tele-CBT (administered over the phone or internet) were effective in treating depression and anxiety. Traditional CBT improved depression (SMD -1.16, 95% CI [-1.83 to -0.49], P < 0.00001), while tele-CBT showed comparable results (SMD -0.90, 95% CI [-1.31 to -0.48], P < 0.00001). For anxiety, both traditional CBT (SMD -0.94, 95% CI [-1.25 to -0.63], P < 0.00001) and tele-CBT (SMD -0.95, 95% CI [-1.22 to -0.67], P < 0.00001) significantly reduced symptoms. In conclusion, this systematic review and meta-analysis demonstrated the efficacy of CBT in reducing depression and anxiety in PD patients. Healthcare providers are encouraged to integrate CBT into their treatment protocols. However, additional high-quality studies with longer-term follow-up assessments are needed to further enhance understanding in this area.
PROSPERO REGISTRATION
CRD42023424758.
PubMed: 38958793
DOI: 10.1007/s10072-024-07659-6 -
Clinical Research in Cardiology :... Jul 2024Drug-coated balloon (DCB) is an established treatment option for in-stent restenosis and small vessel, de novo, coronary artery disease (CAD). Although the use of this...
Drug-coated balloon versus drug-eluting stent for treating de novo large vessel coronary artery disease: a systematic review and meta-analysis of 13 studies involving 2888 patients.
INTRODUCTION
Drug-coated balloon (DCB) is an established treatment option for in-stent restenosis and small vessel, de novo, coronary artery disease (CAD). Although the use of this tool is increasing in everyday practice, data regarding performance in the treatment of de novo, large vessel CAD (LV-CAD) is still lacking. A systematic review and meta-analysis were conducted to evaluate the efficacy and safety of DCB versus drug-eluting stent (DES) in this setting.
METHODS
A comprehensive literature search was performed including Medline, Embase, and Cochrane electronic databases up to January 24, 2024, for studies which compared the efficacy and safety of DCB versus DES in the treatment of de novo lesions in large vessels (≥ 2.5 mm), reporting at least one clinical outcome of interest (PROSPERO ID: CRD42023470417). The analyzed outcomes were cardiovascular death (CVD), myocardial infarction (MI), target lesion revascularization (TLR), all-cause death (ACD), and late lumen loss (LLL) at follow-up. The effect size was estimated using a random effects model as risk ratio (RR) and mean difference (MD) and relative 95% confidence interval (CI).
RESULTS
A total of 13 studies (6 randomized controlled trials and 7 observational studies) involving 2888 patients (DCB n = 1334; DES n = 1533) with de novo LV-CAD were included in this meta-analysis following our inclusion criteria. No differences were observed between DCB and DES in terms of CVD (RR 0.49; 95% CI [0.23-1.03]; p = 0.06), MI (RR 0.48; 95% CI [0.16-1.45]; p = 0.89), TLR (RR 0.73; 95% CI [0.40-1.34]; p = 0.32), ACD (RR 0.78; 95% CI [0.57-1.07]; p = 0.12), and LLL (MD - 0.14; 95% CI [- 0.30 to 0.02]; p = 0.10) at follow-up. DES proved a higher mean acute gain versus DCB [1.94 (1.73, 2.14) vs 1.31 (1.02, 1.60); p = 0.0006].
CONCLUSION
Our meta-analysis showed that DCB PCI might provide a promising option for the management of selected, de novo LV-CAD compared to DES. However, more focused RCTs are needed to further prove the benefits of a "metal-free" strategy in this subset of CAD.
PubMed: 38958753
DOI: 10.1007/s00392-024-02481-8 -
European Journal of Physical and... Jul 2024Injections of botulinum toxin type A (BoNT-A) are the first-line treatment for spastic muscle overactivity (MO). Some authors observed that BoNT-A injections lead to...
INTRODUCTION
Injections of botulinum toxin type A (BoNT-A) are the first-line treatment for spastic muscle overactivity (MO). Some authors observed that BoNT-A injections lead to changes in muscle structure and muscle elasticity that are probably not completely reversible. This possible effect is critical, as it could lead to negative impacts on the effectiveness of BoNT-A interventions. Our study aimed to evaluate the current literature regarding changes in muscle elasticity and structure after BoNT-A injection, by diagnostic imaging, in neurological populations with MO. Our second objective was to pool all articles published on this topic in order to provide a quantitative synthesis of the data.
EVIDENCE ACQUISITION
A systematic search was conducted between October 2021 and April 2023 using different databases in accordance with PRISMA guidelines. Two independent reviewers screened articles for inclusion, extracted data, and evaluated methodological quality of the studies. A meta-analysis was performed to compare muscle elasticity and structure before and after BoNT-A injections.
EVIDENCE SYNTHESIS
A sample of 34 studies was selected for qualitative review and 19 studies for quantitative review. Meta-analysis of pre-post studies demonstrated significant improvement with a medium effect size (standardized mean difference=0.74; 95% CI 0.46-1.02; P<0.001) of muscle elasticity assessed by ultrasound elastography (USE) 4 weeks after BoNT-A injection. No statistically significant difference was found for muscle thickness, pennation angle, and muscle echo-intensity assessed by magnetic resonance imaging and/or ultrasonography at short-term. On the other hand, normalized muscle volume decreased with a small effect size (standardized mean difference = -0.17; 95% CI -0.25 - -0.09; P<0.001) 6 months after BoNT-A injection.
CONCLUSIONS
Muscle elasticity measured by USE improves with a temporary effect at short-term following BoNT-A injections. Synthesis of studies that assesses muscle structure is hindered by methodological differences between studies. However, based on a small amount of data, normalized muscle volume seems to decrease at long-term after BoNT-A injections in children with CP suggesting that the timing of re-injection should be considered with caution in this population. Further work should focus on the long-term effect of repeated injections on muscle structure and elasticity in neurological populations.
PubMed: 38958691
DOI: 10.23736/S1973-9087.24.08029-8 -
Irish Journal of Medical Science Jul 2024Patients with diabetes mellitus (DM) are at higher risk of cardiovascular events, particularly acute myocardial infarction (MI). Sodium-glucose cotransporter 2... (Review)
Review
The effect of Empagliflozin on echocardiographic parameters in diabetic patients after acute myocardial infarction: A systematic review and meta-analysis with trial sequential analysis.
Patients with diabetes mellitus (DM) are at higher risk of cardiovascular events, particularly acute myocardial infarction (MI). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) can improve cardiac outcomes among heart failure individuals, however, the effects on acute myocardial infarction remain unclear. This meta-analysis investigates the impact of empagliflozin in diabetic patients following acute myocardial infarction. We comprehensively searched PubMed, Scopus, Cochrane, and Web of Science through August 10th, 2023. We included studies comparing empagliflozin versus placebo in diabetes patients with acute myocardial infarction. We used Revman to report the data as mean difference (MD) and 95% confidence interval (CI), and our effect size with a random effects model. Additionally, we performed Trial Sequential Analysis (TSA) to test the robustness of the results. The study protocol was published on PROSPERO with ID: CRD42023447733. Five studies with a total of 751 patients were included in our analysis. Empagliflozin was effective to improve LVEF% (MD: 1.80, 95% CI [0.50, 3.10], p = 0.007), left ventricular end-diastolic volume (LVEDV) (MD: -9.93, 95% CI [-16.07, -3.80], p = 0.002), and left ventricular end-systolic volume (LVESV) (MD: -7.91, 95% CI [-11.93, -3.88], p = 0.0001). However, there was no difference between empagliflozin and placebo groups in terms of NT-pro BNP (MD: - 136.59, 95% CI [-293.43, 20.25], p = 0.09), and HbA1c (MD: -0.72, 95% CI [-1.73, 0.29], p = 0.16). Additionally, empagliflozin did not prevent hospitalization due to heart failure (RR: 0.59, 95% CI [0.16, 2.24], p = 0.44, I-squared = 0%), and mortality (RR: 1.34, 95% CI [0.15,11.90], p = 0.79, I-squared = 25%). Empagliflozin initiation in diabetic patients following acute MI may improve echocardiographic parameters. However, empagliflozin might not be effective in heart failure prevention and optimal glycemic control in this patient population. Further large-scale trials are warranted to ascertain our findings.
PubMed: 38958683
DOI: 10.1007/s11845-024-03744-z -
Dental and Medical Problems 2024There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible adverse effects must also be evaluated.
OBJECTIVES
The aim of the present study was to compare the perception of pain and root resorption between orthodontic treatment with a surgical acceleration intervention vs. conventional orthodontic treatment.
MATERIAL AND METHODS
An electronic search was conducted in the MEDLINE, Scopus, Web of Science (WoS), ScienceDirect, Cochrane Library, and Virtual Health Library (VHL) databases up to September 12, 2022. Randomized or non-randomized, controlled, parallel-arm or split-mouth clinical trials were included. Fixed-and random-effects meta-analyses were performed with regard to heterogeneity. The risk of bias (RoB) was assessed using the RoB 2.0 and ROBINS-I tools.
RESULTS
A total of 1,395 articles were initially retrieved, 40 studies were finally included in the review and 15 studies were eligible for quantitative analysis. The meta-analysis showed a significant difference in pain perception between acceleration surgery vs. conventional orthodontics at 24 h (p = 0.040); however, this difference was not significant at 7 days (p = 0.080). Overall, the patients who underwent any acceleration procedure presented significantly less resorption as compared to those who were applied conventional treatment (p < 0.001). A similar significant difference was found in retraction movements (p < 0.001) and alignment movements (p = 0.030).
CONCLUSIONS
In the first 24 h, surgical interventions for the acceleration of tooth movement produce a greater perception of pain as compared to conventional orthodontic treatment, but the perception is similar after 7 days. Acceleration surgery results in less root resorption - in alignment movements, and especially in retraction movements.
Topics: Humans; Tooth Movement Techniques; Root Resorption; Orthodontics
PubMed: 38958635
DOI: 10.17219/dmp/161553