The RANK-RANKL-OPG axis in dermatological malignancies: A systematic review.

BACKGROUND Prolonged immobility during intensive care unit (ICU) admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times. Prior research has demonstrated that mobilization within a week of ICU admission potentially benefits physical function in critically ill patients. AIM To evaluate the effects of initiating mobilization within 72 hours of ICU admission in critically ill patients through an updated systematic review and meta-analysis. METHODS A systematic search was performed through MEDLINE, Scopus, and Cochrane Library from inception until September 2024 for randomized controlled trials (RCTs) comparing early mobilization (EM) with usual or conventional care in critically ill adult patients. Primary outcomes included length of ICU (days) and ventilation duration (days). Secondary outcomes included muscle strength, functional status, adverse events, all-cause mortality, and quality of life (QOL). A random effects meta-analysis was performed for pooled effect estimates and to derive risk ratios (RR) and corresponding 95% confidence intervals (CI). RESULTS Out of 3487 results, 16 RCTs were included with a population of 2385 patients (1195 receiving EM and 1190 with usual care.) A significant reduction in the length of ICU stays [mean difference (MD) = -1.02, 95%CI: -1.96 to -0.09; P = 0.03; I 2 = 60%] and ventilation duration (MD = -1.07, 95%CI: -1.91 to -0.23, P = 0.01; I 2 = 57%) was observed in the EM group compared to usual care. EM significantly improved muscle strength [standard MD (SMD) = 0.47, 95%CI: 0.18-0.75, P = 0.001; I 2 = 79%] and functional status (SMD = 0.70, 95%CI: 0.40-1.00, P < 0.00001; I 2 = 81%) in ICU patients. No statistically significant difference was observed in adverse events (RR = 1.72, 95%CI: 1.01-2.94, P = 0.05; I 2 = 31%), all-cause mortality (RR = 1.10, 95%CI: 0.79-1.53, P = 0.57; I 2 = 30%), and QOL (SMD = 0.04, 95%CI: -0.07-0.15, P = 0.50; I 2 = 9%) between the two groups. CONCLUSION Initiating mobilization within 72 hours of ICU admission is associated with improved functional outcomes and reduced ICU length of stay and ventilation duration. These findings indicate that EM may be a safe option for ICU patients, contributing to lower recovery times and healthcare costs. Further extensive research is required to validate the long-term effects on survival and QOL.

Parental presence in neonatal units (NUs) is essential for infant development and family well-being. A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care, thereby improving outcomes for infants and their families. To identify and analyze primary factors influencing parental involvement in their child's care in a neonatal intensive care unit (NICU). A literature search was conducted using the PubMed, MEDLINE, and Cochrane Library for systematic reviews databases, with the following search terms: "parental presence neonatology", "couplet care", "zero separation neonatal care", "family integrated care", "couplet care intervention", "mother-child separation", "parents newborn togetherness", "mother-baby care", "closeness and separation NICU", "mother-infant interaction NICU", "kangaroo care", "dyad mother-infant", and "newborn integrated care". The database search for this literature review began on December 10, 2024, with the final search conducted on April 10, 2025. The literature search yielded 281 articles, out of which 23 were selected for a detailed review. The factors associated with parental presence in NUs were grouped into five main categories: Parents' socio-demographic and cultural traits; the physical layout and care model of the NUs; the quality of parents' relationships with the healthcare staff; their active involvement in neonatal care; and the newborn's health status. The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.

Silodosin in treating men With BPH-associated lower urinary tract Symptoms: A systematic review and network meta-analysis.

To conduct a meta-analysis of the literature to summarize the risk factors for pulmonary infection in patients with cervical spinal cord injury. Computer-based searches were performed in CNKI, CBM, Wanfang Database, VIP Series Databases, The Cochrane Library, WOS, PubMed, Springer Link, EBSCO, MEDLINE and other databases. The time frame was from January 1, 2000 to April 1, 2025. Case-control studies and cohort studies related publications were searched according to subject terms and free words. According to inclusion and exclusion criteria, 7 publications were identified, and finally meta-analysis was performed on them by Review Manager 5.3 software. Seven publications met the inclusion criteria, with a total of 912 cases and 742 controls. The results of meta-analysis showed that the risk factors for pulmonary infection in patients with cervical spinal cord injury were: American Spinal Injury Association (ASIA) Impairment Scale (AIS) - AIS A and AIS B (OR: 3.90, 95% CI: 2.74-5.53), high-level injury (OR: 2.73, 95% CI: 1.69-4.40), hormone shock therapy (OR: 4.14, 95% CI: 2.58-6.62), smoking history (OR = 2.34, 95% CI: 1.54-3.55), operation time (P < 0.00001, I2 = 96%), hypoalbuminemia (P < 0.00001, I2 = 96%), and age (P < 0.00001, I2 = 95%). AIS A and B, high-level injury, hormone shock therapy and smoking history are risk factors for pulmonary infection in patients with cervical spinal cord injury. Controlling the above factors can effectively reduce the incidence of pulmonary infection in patients with cervical spinal cord injury.

Tonsillectomy, with or without adenoidectomy, is the most common major surgical procedure performed in children. The risk and incidence of primary and secondary post-tonsillectomy hemorrhage (PTH) have been well described. The goal of this scoping review is to analyze the incidence and risk factors for recurrent PTH, and to map existing evidence to identify knowledge gaps. CINAHL, Cochrane Library, Embase, Google Scholar, and Ovid Medline. The study followed PRISMA-ScR guidelines. Three reviewers independently screened studies, including those reporting the incidence of PTH and recurrent PTH in children. There were 229 recurrent PTH episodes described in the 11 manuscripts included in this analysis, with 7.1% of initial PTH cases re-bleeding (0.33% of total tonsillectomy cases). Management of recurrent PTH involved surgical intervention and observation. Oropharyngeal findings at the time of the initial PTH and management strategy for the initial PTH were not associated with increased recurrence rates. The indication for tonsillectomy, NSAID usage, and surgical technique were not associated with recurrent PTH when reported. Across studies, there was wide heterogeneity in how recurrent bleeding was defined, and inconsistent reporting of timing and outcomes. The predictive value of laboratory screening for occult coagulopathies in children with multiple bleeds was unclear. No clear risk factors for recurrent PTH were identified from the pooled analysis. This scoping review highlights major research gaps, including the need for standardized definitions and severity grading, prospective multicenter data to clarify predictors of recurrence, and systematic evaluation of hematologic screening protocols.

Background: Adhering to tuberculosis (TB) treatment is vital for preventing the spread of the disease and the rise of drug-resistant strains. However, low adherence rates remain challenging, reflecting the public's limited understanding of the importance of completing treatment, underscoring the need for better health education. Objective: This scoping review aims to explore and synthesize existing health education strategies designed to enhance adherence to tuberculosis treatment. Methods: A scoping review using Arksey and O'Malley was conducted. Relevant articles published within the last 10 years, from 2014 to 2024, were selected for this review. The research literature was gathered from six databases: PubMed, Science Direct, Sage, Cochrane Library, ProQuest, and Google Scholar. The Joanna Briggs Institute guidelines were used for data extraction. Results: Out of 1,213 studies reviewed, 14 articles were included in this analysis. This review identifies five key themes related to health education strategies: the purpose of health education, the media of intervention, the methods of intervention, the duration of intervention, and the outcomes of education. Conclusion: Effective health education strategies to promote treatment adherence among tuberculosis patients can significantly improve patient compliance. A wider adoption of these strategies will help control tuberculosis and achieve global elimination goals. In the future, telemedicine and tele-nursing will be vital for enhancing adherence in areas with limited healthcare access.

Background: Pneumonia remains a major cause of morbidity and mortality among critically ill children. Lung ultrasound has emerged as a promising bedside diagnostic tool. Methods: A systematic review and meta-analysis across PubMed, Embase, The Cochrane Library, Scopus, World Health Organization Libraries, Epistemonikos, and MedRxiv was conducted to evaluate the diagnostic accuracy of lung ultrasound for pneumonia in paediatric patients. Publication bias was evaluated using the generalised Egger’s test. Diagnostic performance metrics, including sensitivity, specificity, and the area under the receiver operating characteristic curve were pooled using a bivariate random-effects model. Results: Thirty studies comprising a total of 4356 children were included. The studies were of high methodological quality, with minimal heterogeneity. Lung ultrasound pooled sensitivity was 91% (95% CI: 87–94%), and specificity was 90% (95% CI: 83–94%). The ROC curve was 0.95 (95% CI: 0.90–0.95), indicating excellent diagnostic performance. Conclusions: LUS is a reliable and accurate imaging modality for diagnosing pneumonia in critically ill children. The findings support its use as a first-line diagnostic tool in emergency and intensive care settings.

Although Magnetic Resonance Imaging (MRI) is gaining momentum in forensic and post-mortem settings, its exact role in forensic investigations is yet to be determined. The current review aims to chart current and potential roles of MRI in forensic investigations, providing an overview of existing pertinent scientific literature. A mapping review was conducted in accordance with the PRISMA guidelines. Medline, Web of Science, Embase and the Cochrane Library were searched using database-specific syntaxes. Eligible articles included reviews, original research, case reports, letters, laboratory studies, and dissertations written in English. Articles not mentioning MRI, involving only functional MRI, and non-forensic clinical post-mortem examinations were excluded. Articles were categorised using thematic analysis. Data extraction included first-author country of origin, year of publication, level of evidence, and mention of MRI-protocol. The initial search yielded 16,184 papers, 525 of which were included. Main focus of forensic MRI research is in medicolegal examination (n = 285), identification (n = 158), and process optimisation (n = 155); 73 articles were multi-categorical, and myriad subcategories were identified (foetus/child/adult, living/postmortem, anatomical regions, practice/guidelines/infrastructure, etc.). Articles were published over a 34-year period, originating from 34 countries. There were 235 level C-, 289 level B-, and 2 level A-evidence articles. 268 articles mentioned MRI protocols. The extensive amount of research across myriad subcategories highlights vast potential of MRI in forensic investigation. However, the overall level of evidence at this time is low, lacking standardisation. Further organization, standardization, and high-quality research are needed to clarify how best to apply MRI in forensic settings.

levated levels of cancer antigen-125 (CA-125) are strongly associated with the likelihood of ovarian cancer recurrence, making it a significant concern in clinical practice. [18F]FDG PET/CT has emerged as a valuable tool for detecting recurrent ovarian cancer. This study aims to evaluate the diagnostic performance of [18F]FDG PET/CT in identifying ovarian cancer relapse among patients exhibiting rising CA-125 levels, through a systematic review and meta-analysis. A comprehensive search was carried out across PubMed, Embase, and the Cochrane Library, encompassing all records up to July 2024. Studies were eligible for inclusion if they provided data on true positives (TP), false positives (FP), true negatives (TN), and false negatives (FN) regarding the detection of ovarian cancer recurrence in patients with elevated CA-125 levels. Studies were excluded if they were duplicates, lacked full-text availability, contained incomplete information or were unable to be included in data extraction, involved animal studies, or were reviews or systematic reviews. The data were analyzed using STATA version 15.1. Across all included studies, the pooled sensitivity and specificity were 0.94 (95% confidence interval (CI): 0.89-0.97) and 0.89 (95% CI: 0.71-0.96), respectively. The positive likelihood ratio (LR+) was 7.11 (95% CI: 2.75-18.38), while the negative likelihood ratio (LR-) was 0.07 (95% CI: 0.03-0.15). The overall diagnostic odds ratio (DOR) amounted to 99.20 (95% CI: 26.66-369.14). Additionally, the area under the receiver operating characteristic curve (AUC) reached 0.97 (95% CI: 0.95-0.98). With its high sensitivity and specificity, [18F]FDG PET/CT serves as an effective tool for detecting ovarian cancer recurrence in patients exhibiting elevated CA-125 levels. These results endorse its effectiveness as a dependable diagnostic method in clinical settings. This meta-analysis provides updated pooled evidence that [18F]FDG PET/CT demonstrates excellent diagnostic accuracy (AUC 0.97) in detecting ovarian cancer recurrence in patients with elevated CA-125. Compared with earlier meta-analyses limited to PET alone, our findings highlight the added value of integrated PET/CT systems in improving specificity and reducing false positives, thereby supporting its recommendation in international guidelines and strengthening its role in clinical decision-making for recurrent ovarian cancer.

Background Post-stroke motor dysfunction is common, with diverse intervention strategies; however, their efficacy across recovery phases remains unclear. Objective To systematically review and compare the effects of different exercise interventions on motor function in patients at different post-stroke recovery phases. Methods Web of Science, PubMed, Embase, and the Cochrane Library were searched from inception to October 2025. Randomized controlled trials (RCTs) in adults with stroke assessing exercise effects on motor function were included. A Bayesian Network Meta-analysis (NMA) was applied for measures with enough studies and comparisons. Risk of bias was assessed using the Cochrane tool. Results A total of 35 RCTs involving 1,540 stroke patients. In the acute phase, aerobic exercise (AE) was potentially superior to conventional therapy (CT) in improving 6-min walk distance (6MWD), Barthel Index (BI), and Fugl-Meyer Assessment (FMA). In the subacute phase, AE also showed a certain advantage in enhancing 6MWD. According to the surface under the cumulative ranking curve (SUCRA), core stability exercise combined with resistance exercise (CSE + RE, 99.99%) ranked best for improving the 10-meter walk test (10MWT); CSE (80.84%) was most effective for BI; and AE (78.73%) was optimal for improving FMA. In the chronic phase, AE + RE ranked first for improving 6MWD (83.33%) and FMA (99.90%); CSE (98.62%) was the most effective for 10MWT; and AE (87.85%) remained the best intervention for enhancing BI. Conclusion Exercise interventions exert phase-specific effects on motor recovery post-stroke. These findings underscore the importance of tailored, phase-specific rehabilitation programs. Long-term efficacy and individualized optimization require further investigation. Systematic review registration PROSPERO CRD42024607395.

Risdiplam has broadened therapeutic options for spinal muscular atrophy (SMA). While its efficacy and safety are well established in children, data in adults remain limited. This review summarizes current evidence on risdiplam use in the adult SMA population. Following PRISMA 2020 guidelines, we systematically reviewed PubMed, Scopus, and the Cochrane Library up to September 2025 for studies including risdiplam-treated adults (≥ 18years). Outcomes were summarized across motor, bulbar, respiratory, patient-reported, safety, and adherence domains. Fourteen studies (> 200 adults, mainly SMA types 2 and 3) were included. Most participants were non-ambulant and treatment naïve. Motor function was generally stable, with modest yet significant improvements on RULM, HFMSE, or MFM-32, particularly among younger/less severely affected adults. Swallowing, speech, and fatigue often improved even in advanced disease. Patient-reported outcomes consistently indicated perceived gains in quality of life across all phenotypes. Adverse events were mostly mild and transient-mainly gastrointestinal symptoms, photosensitivity, or liver enzyme elevations-with very few temporary discontinuations. Risdiplam shows a favorable safety profile and provides both disease stabilization and multidimensional benefits across all functional phenotypes in adults with SMA, although further longitudinal studies using standardized outcome measures are needed to clarify its long-term impact.

Lysyl oxidase-like 2 (LOXL2) is a key enzyme involved in extracellular matrix remodeling, and its high expression is associated with cancer progression. This study aims to assess the relationship between LOXL2 expression and clinical prognosis in cancer patients through meta-analysis and bioinformatics. A comprehensive literature search was conducted in PubMed, Cochrane Library, Web of Science, and Embase databases until December 2023. Studies reporting the relationship between LOXL2 expression and overall survival (OS) or disease-free survival (DFS) were included. Hazard ratios (HR) and odds ratios (OR) with 95% confidence intervals (CIs) were calculated. Subgroup analyses and meta-regression were performed to evaluate sources of heterogeneity. A total of 30 studies with 5021 patients were included. High LOXL2 expression was significantly associated with poor OS (HR = 1.92, 95% CI: 1.65-2.23, P < 0.001) and DFS (HR = 1.81, 95% CI: 1.39-2.36, P < 0.001). LOXL2 expression correlated with several clinicopathological features, including tumor size (OR = 1.53, P = 0.006), lymph node metastasis (OR = 1.71, P = 0.016), and distant metastasis (OR = 2.63, P < 0.001). Sensitivity analysis confirmed the robustness of these results. High LOXL2 expression is a reliable prognostic biomarker for various cancers, correlating with poor survival outcomes and advanced clinical features. LOXL2 may serve as a therapeutic target to improve cancer prognosis and treatment.

To assess patient outcomes with regard to swallowing, feeding tube dependence, tracheostomy use, pain levels, and recovery metrics between transoral robotic surgery and (chemo)radiotherapy. Medline, EMBASE, Web of Science Core Collection, and the Cochrane Library. A meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines through a literature search of data sources (CRD42023464144). Sixteen studies comprising 2185 patients were included. There were no significant differences in sex and age distribution between the transoral robotic surgery and (chemo)radiotherapy groups. Most patient demographics and disease status at baseline were comparable between the two groups. Meta-analysis of the studies found reduced gastrostomy tube usage in the transoral robotic surgery group at 6 and 12 months albeit poorer swallowing outcomes at 12 months according to the MD Anderson Dysphagia Index. Pain levels were generally lower in the transoral robotic surgery group in the long term. This review presents the most extensive examination to date of swallowing performance and recovery metrics in controlled trials of transoral robotic surgery versus (chemo)radiotherapy. Our findings show that transoral robotic surgery shows promise in managing difficult anatomical areas and low-grade tumors. However, methodological inconsistencies were noted between included studies, particularly in eligibility criteria and human papillomavirus p16 status. Consensus statements and/or guidelines on stratification and reporting of patients may aid in reducing this heterogeneity, while further randomized controlled trials may improve our understanding and guide the development of clinical guidelines on treatment choice.

Introduction: Cognitive impairment is a major complication of cerebrovascular diseases (CVDs), significantly affecting patients’ quality of life. With limited approved pharmacological interventions, non-pharmacological approaches, such as remote ischemic conditioning (RIC), have emerged as potential therapeutic strategies. This systematic review and meta-analysis aimed to evaluate the efficacy of RIC in improving cognitive function in patients with CVDs. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted comprehensive searches across PubMed, Embase, the Cochrane Library (CENTRAL), and Web of Science for relevant studies published up to April 30, 2025. Study quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Pooled estimates were calculated using random-effects models, accounting for heterogeneity. Results: Seven studies, involving 302 participants, met the inclusion criteria. Meta-analysis demonstrated that RIC significantly improved global cognitive performance (SMD 0.65, 95% CI 0.41-0.90, P&lt;0.00001). Notable improvements were observed in visuospatial and executive functions (SMD 0.61, 95% CI 0.33-0.89, P&lt;0.0001). However, no significant effects were found in other cognitive domains, including naming, attention, language, abstract reasoning, delayed recall, and immediate memory. Heterogeneity across studies varied by outcome. Conclusion: RIC shows promise for improving visuospatial/executive functions in cerebrovascular disease (SMD=0.47, p&lt;0.001), though effects in other cognitive domains remain inconclusive. Large-scale trials with comprehensive assessments, mechanistic neuroimaging, and extended follow-up are needed to establish sustained clinical benefits.

The recognition of poor sleep quality is a significant health issue since there is a paucity of comprehensive data on sleep quality in women and the previous studies that have no providing a holistic understanding of the issue across different stages of women's lives. Therefore, conducting a systematic review and meta-analysis of poor sleep quality and associated factors among women in Ethiopia is an essential to provide actionable insights for healthcare providers and policymakers. A systematic review and meta-analysis of 11 studies among 6038 women of the exact heterogeneity of (I² = 99%) with a comprehensive search using electronic databases (PubMed, Cochrane Library, Google Scholar, and African Journal Online) was performed covering articles indexed through June 2000 to 1,August 2025. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Epidemiological Data Research Institute Critical Appraisal Checklist which studies scoring above 75% were considered for inclusion in the meta-analysis. The inter-rater reliability between the two reviewers for the JBI quality assessment was substantial (Cohen's κ = 0.82; 95% CI: 0.73-0.91), indicating good consistency in scoring across studies. The I2 test statistics were used to examine the heterogeneity of the studies. A random-effects meta-analysis was performed to estimate the prevalence of the poor sleep quality, and the results are reported in a forest plot. The pooled prevalence of poor sleep quality among 6038 women was 42.25% (95 CI: 30.80, 53.7). In this review, having depressed (AOR = 3.7, 95%CI: 2.82, 4.8), substance use (AOR = 2.00, 95%CI: 1.6, 2.6), Intimate Partners Violence (IPV) (AOR = 3.20, 95%CI: 1.95, 5.3), stress 2.50, 95%CI: 1.82, 3.43), and low social support (AOR = 4.2, 95%CI: 2.700, 6.60) were significantly associated with poor sleep quality. Poor sleep quality is affecting over 40% of women in Ethiopia. Depression, substance use, intimate partner violence, stress, and low social support are statistically associated with poor sleep quality. Therefore, targeting mental health and social support, alongside public education and policy integration, are essential to improve sleep quality.

The objective of this systematic review was to establish an overview of changes in body composition as a result of early breast cancer treatment. Patient/material and methods: Five databases (PubMed, CINAHL, Embase, Web of Science and Cochrane Library) were used for identifying studies and papers. Selection criteria included: > 18 years, early breast cancer stage 0-III and measurement of body composition with either dual X-ray absorptiometry (DXA), magnetic resonance imaging (MRI) or computed tomography (CT). Studies using only bioelectrical impedance were excluded. A total of 734 studies were screened; 29 studies were full-text reviewed, and 10 studies were included in this systematic review, with a total of n = 1,062. Included studies were published from 2018 to 2024. This review found consistent increases in fat mass between 3.3 and 9.2% across the studies. Results for lean body mass were less consistent. Two studies examined visceral fat mass, yet both found statistically significant increases. This systematic review identified consistent increases in total fat mass and visceral fat across the included studies, regardless of whether the treatment involved chemotherapy, endocrine therapy or a combination of both. In contrast, findings related to lean body mass were considerably less consistent. The results highlight the potential implications following breast cancer treatment and emphasise the importance of metabolic monitoring, diet and exercise to increase quality of life and prevent recurrence. This review also highlights the need for more research on the topic, as the included studies exhibit substantial heterogeneity, making it difficult to draw definitive conclusions.

Abstract Background CAR T cells still face numerous obstacles in treating hematologic and solid malignancies. Although gene editing technologies have improved CAR T cell therapy, there are currently no systematic reviews to broadly address preclinical and clinical outcomes of gene-edited CAR T cells. Therefore, we aimed to systematically review the preclinical and clinical studies that evaluate the outcomes of knocked-out/knocked-down (KO/KD) CAR T cells. Methods This study was submitted to international Prospective Register of Systematic Reviews (PROSPERO) with the ID CRD42022320541 and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. We searched Five databases (PubMed, EMBASE, Cochrane Library, Web of Science, and Clinicaltrials.gov) up to March 19th, 2022 for the keywords of “CAR T cell” and “knock-out/knock-down”. The retrieved records then underwent a two-step screening process based on the inclusion criteria, first title/abstract and then full-text screenings, and their data were used for qualitative synthesis. Results Our search results yielded 3780 records. Finally, a total of 241 records, including 193 animal and 52 human studies (four concurrent in both groups) that reported KO/KD genes for 105 proteins were included. The positive effects of these 105 KO/KD were categorized into five groups: (1) enabling allogeneic CAR production while limiting GVHD, (2) increasing the efficacy of CAR T cells, (3) Decreasing their side effects, (4) limiting CAR T cell fratricide, and (5) enabling the use of concurrent therapies. In the human section, solid tumors had fewer studies with less favorable outcomes compared to hematologic malignancies. Conclusions This systematic review emphasized the various mechanisms by which CAR T cell effects could be boosted. Future researchers can choose their desired genes out of the 105 mentioned candidates. We also encourage the researchers to increase their efforts on solid tumors to compensate for the lack of increased efficacy in this group.

This scoping review systematically mapped the evidence on the association between tooth loss and serum cholesterol levels in adults, addressing a significant gap in understanding the direct link beyond broader systemic conditions such as cardiovascular disease. In accordance with the PRISMA-ScR guidelines, a comprehensive search of four electronic databases (PubMed, MEDLINE, EMBASE, and Cochrane Library) was conducted from July 1968 to September 2025. Studies involving adults (≥ 18 years) that quantified tooth loss and reported serum lipid profiles specifically high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and/or triglycerides levels - were included. Among the 23 studies synthesized, a majority demonstrated a significant association between greater tooth loss and adverse lipid profiles, characterized by lower high-density lipoprotein cholesterol levels, higher low-density lipoprotein cholesterol levels, and elevated triglyceride levels. A dose-response relationship was evident, with more extensive tooth loss correlated with progressively worsening cholesterol levels. Analysis of edentulous populations suggested that the primary mechanism in this population may be nutritional maladaptation from impaired masticatory function rather than systemic inflammation. Some evidence indicates a bidirectional relationship, where dyslipidemia may also be a risk factor for tooth loss. Notably, prosthetic rehabilitation for partial tooth loss was associated with improved cholesterol levels, an effect not consistently observed with complete dentures. This scoping review suggests an association between tooth loss and dyslipidemia, which may be mediated through dietary changes due to reduced masticatory function and systemic inflammatory pathways. However, as a scoping review that included studies of heterogeneous designs and did not perform a formal risk of bias assessment, these results are indicative of an association and cannot establish causality. Despite these limitations, the gathered evidence underscores the importance of considering oral health when developing strategies to maintain metabolic health.

Rosai-Dorfman disease (RDD) is a rare non-Langerhans histiocytosis that involves the central nervous system (CNS) in approximately 5% of cases, most often presenting intracranially. While pediatric cases have been reported more frequently, adult intracranial RDD (IC-RDD) remains poorly characterized. We conducted a systematic review and individual patient data meta-analysis in accordance with PRISMA guidelines to define the epidemiology, clinical presentation, pathology, management strategies, and outcomes of adult IC-RDD. PubMed, Scopus, and the Cochrane Library were searched for histologically confirmed cases in adults over 18years, and case reports, case series, and observational studies were included. Data were extracted on demographics, symptoms, imaging, histopathology, treatment, and outcomes. Primary endpoints were recovery and recurrence-free survival (RFS), with risk ratios (RRs) and 95% confidence intervals (CIs) calculated using random-effects models. A total of 327 patients from 186 studies met inclusion criteria. The median age was 43.6years (range 18-83), with a male predominance (70.9%). The most common symptoms were headache (35.2%), seizures or loss of consciousness (28.7%), and visual disturbance (26.9%). Lesions were typically supratentorial intra-axial (52.9%) or extra-axial (20.5%). Surgical intervention was performed in 93.6% of patients, with gross total resection (GTR) achieved in 45.3%. At a median follow-up of 18.8months, 37.9% achieved full recovery, 46.8% partial recovery, and 15.3% experienced recurrence, with a median RFS of 12months. GTR was strongly associated with improved recovery (RR 0.26, 95% CI 0.19-0.37), whereas supratentorial intra-axial location (RR 0.56, 95% CI 0.41-0.75) and perilesional edema (RR 0.65, 95% CI 0.47-0.89) predicted poorer outcomes. These findings indicate that adult IC-RDD predominantly affects middle-aged men, presents with mass-effect symptoms, and has a location-dependent prognosis, with GTR conferring the best chance of recovery but recurrence remaining common and underscoring the need for long-term surveillance.