Data Extraction Research Articles

Human and animal brucellosis and risk factors for human infection in Ethiopia: a systematic review and meta-analysis (2015–2024)

Background and objectiveBrucellosis is a neglected zoonotic disease caused by Brucella species. Unlike most developed nations, the problem of brucellosis in Ethiopia remains a public and animal health concern. This study was conducted to determine the magnitude of brucellosis in animals (mainly cattle, sheep, goats, dogs and camels) and humans, and to identify the risk factors for human brucellosis.MethodologyThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this systematic review and meta-analysis, which was performed from May 2024 to July 2024. Academic databases such as PubMed, ScienceDirect, Scopus, PubMed Central, Web of Science, and Google Scholar were searched to identify articles focusing on brucellosis in humans and animals in Ethiopia. Data extraction was performed according to predefined inclusion and exclusion criteria. The included articles were appraised using the appraisal tool for cross-sectional studies to assess study quality. Publication bias and small study effects were examined using funnel plot observation and Egger’s test, respectively. Statistical analysis was conducted using R software version 4.4.1.ResultsThirty-nine articles published between 2015 and 2024 were included in the final analysis from a total of 1,427 identified articles. The overall pooled seroprevalence of brucellosis was 5.0% (95% CI: 3.0, 6.0). The seroprevalence of brucellosis was higher in humans at 6.9% (95% CI: 4.9, 8.8) and lower in cattle at 3.5% (95% CI: 2.2, 4.7). There was high heterogeneity in the reports of brucellosis seroprevalence between studies (τ² = 0.0038, H² = 255.9, I² = 99.61%, Q-test = 1954.99, df = 56, p ≤ 0.001). Laboratory tests and study location were identified as factors contributing to potential sources of variation in the pooled seroprevalence. Drinking raw milk from aborted animals, touching aborted materials or fetuses, and occupation were among the risk factors for human brucellosis. No publication bias or small study effects were detected.ConclusionThe findings indicate that brucellosis continues to pose a significant zoonotic threat, particularly to humans, where the seroprevalence is notably higher than in animals. These results highlight the need for targeted public health interventions and greater awareness to reduce the incidence of brucellosis, especially among high-risk populations.

Barriers and facilitators of HIV partner status notification in low- and lower-middle-income countries: A mixed-methods systematic review

BackgroundThe uptake of HIV partner status notification remains limited in low- and lower-middle-income countries. This mixed-methods systematic review aims to summarize the barriers and facilitators of HIV partner status notification in these settings.MethodsWe searched PubMed, Embase, CINAHL, PsychINFO, Scopus, and Web of Science from January 01, 2000, to August 31, 2023, for empirical qualitative and quantitative studies. Two independent reviewers completed the title, abstract, full-text screening, and data extraction. The risk of bias was assessed using a mixed-methods appraisal tool (MMAT), and the study findings were summarized narratively.ResultsOut of the 2094 studies identified, 59 relevant studies were included. Common barriers included fear of stigma and discrimination, violence, abandonment, breach of confidentiality and trust, low HIV-risk perception, and limited knowledge of HIV and HIV testing. Facilitators of HIV partner status notification were feelings of love and closeness in marital relationships, feelings of protecting self and partners, and HIV counseling services.ConclusionEfforts to improve HIV partner status notification in low- and lower-middle-income countries should consider barriers and facilitators across all its components, including notification, testing, and linkage to treatment. In addition, HIV partner services must be adapted to the unique needs of key populations.

Strategies to improve research participation by older people with cognitive impairment: a systematic review.

Older people with cognitive impairment are unrepresented in clinical research. Our objective was to review evidence for strategies to support their research inclusion and participation. Systematic review of published reports of inclusion and participation strategies for older people with cognitive impairment in clinical research (PROSPERO CRD42020212092). Five databases were searched September 2020, March 2023 and April 2024. Screening, full text review and data extraction were independently performed. Risk of bias was assessed using Scottish Intercollegiate Guidelines Network Methodology Checklists. Outcomes were participant characteristics, recruitment and consent processes, retention, experience, involvement of others, adverse events, and other reported outcomes. Of 4564 identified sources, 12 studies were included. Nine compared recruitment strategies; three examined consent processes. Of 4,208 participants (mean age 78.3 years), 61% were female. Median (interquartile range) monthly recruitment rate was 10.3 (5.6-14.8). Participants had mild cognitive impairment, dementia and/or delirium and two-thirds of studies involved proxies or study partners. Community outreach or population screening had higher recruitment compared to primary care referral and/or screening. Formal capacity and consent methods achieved lower rates of consent compared to informal. A memory and organisational aid increased participants' ability to provide informed consent compared to standard assessment. Few studies reported participants' or recruiters' subjective experience, and no studies reported participant retention or adverse events. Targeted, tailored and multi-pronged recruitment and consent strategies to support inclusion of older people with cognitive impairment appear promising. Higher quality studies are needed to confirm this finding.

Exploring the impact of professional development about family-centred service for health professionals working in paediatric disability: a scoping review

Purpose To explore the impact of family-centred service education on the knowledge, attitudes, self-efficacy, and practice of service providers working in paediatric disability. Materials and Methods The review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The search strategy was completed in seven electronic databases. Screening and data extraction was undertaken by two reviewers. Data extraction included content, delivery methods and impact of professional development programs. A narrative synthesis was conducted. Results Twenty-two studies reported on twenty programs. Participants were from multiple disciplines in 13 programs and families were involved in development, delivery, or as participants, in nine. Program content typically related to participatory caregiving. Synthesis of findings suggested the ‘active ingredients’ were dynamic interactions among the participants and facilitators, and the program content and delivery methods, that promoted reflection and shifting perspectives among participants. Studies reported positive impacts on service provider attributes, but few studies evaluated behaviours in practice and broader influences on family-centred services. Conclusions While all programs involved active participation and relevant content, programs promoting reflection, sharing perspectives as part of a diverse group, and lived experience through family involvement, supported learning about family-centred services as both a philosophy and a process.

Effectiveness of Acceptance and Commitment Therapy on Mental Health Issues: A Systematic Review

Background Mental health disorders rank among the most common psychiatric conditions, with lifetime prevalence rates that have a significant effect on the global population. Although CBT is still the most generally recommended psychosocial intervention for mental health problems, a significant number of patients do not fully react to therapy, which results in persistent symptoms. Acceptance and Commitment Therapy (ACT) has gained worldwide attention as a promising intervention with a growing body of empirical support across a variety of mental health conditions. Summary A systematic review was conducted to evaluate ACT’s impact on mental health. Comprehensive searches of Scopus, PubMed, Google Scholar, and Shodganga, along with reference and citation checks, yielded 15 studies meeting the inclusion criteria. Four independent reviewers assessed the studies for eligibility, methodological rigor, and data extraction. The findings revealed that ACT consistently reduces symptom severity, improves emotional regulation, enhances life satisfaction, and increases psychological flexibility. However, common methodological limitations include small sample sizes, lack of long-term follow-ups, and limited control group comparisons. Key Message ACT demonstrates significant promise as a trans-diagnostic intervention adaptable to various mental health issues. Despite its evident benefits in symptom reduction and psychological well-being, further research addressing methodological constraints is crucial to optimize its clinical applications and establish its long-term efficacy.

Systemic sclerosis-related fecal incontinence: a scoping review focusing on a neglected manifestation.

This scoping-review sought to summarize the current knowledge on the epidemiology, pathogenesis, clinical presentation, and the investigations that may help characterize faecal incontinence (FI) in patients with systemic sclerosis (SSc). The planned scoping review was based on the methodological framework proposed by Arksey & O'Malley.Two databases were screened: PubMed (Medline), (webofSciences), data extraction was performed using a predefined template. 454 abstracts were screened and 61 articles were finally included, comprising 32 original articles. The prevalence of FI was 0,4% to 77% in original articles that did not use FI among the mandatory inclusion criteria. Internal anal sphincter was reported as more impacted than external sphincter and vasculopathy of arterioles and extra-cellular matrix deposition with fibrous replacement of the internal sphincter were the key underlaying pathogenic events. The most represented PRO in original articles was the Wexner FI score (22% of original articles) followed by the UCLA SCTC-GIT 2.0 (16% of original articles). Although there is no validated diagnostic approach for FI in SSc, 47% of original articles used anorectal manometry to assess rectal physiology in SSc patients. Conservative measures to treat either liquid or hard stool including anti-diarrheal medications and dietary adjustments were the first step of proposed FI management in included narrative reviews and guidelines. This is the first scoping review exploring FI in SSc. We propose a new research agenda which may help improve treatment strategies and foster research focusing on a neglected manifestation of SSc.

A Systematic Review and Meta-Analysis of Autologous vs Irradiated Homologous Costal Cartilage Grafts for Dorsal Augmentation Rhinoplasty

Abstract Background Autologous costal cartilage (ACC) is commonly used for dorsal augmentation rhinoplasty due to its availability and strength, despite risks like hypertrophic scarring and pneumothorax for the patient. Irradiated homologous costal cartilage (IHCC) offers an alternative, potentially mitigating these complications. Previous reviews comparing these materials have been methodologically weak. Objectives Our aim was to perform a robust systematic review and meta-analysis comparing the outcomes of ACC and IHCC in dorsal augmentation rhinoplasty to guide clinical decision-making in nasal reconstruction. Methods MEDLINE, EMBASE, Google Scholar, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched. Data extraction and quality assessment were performed by two independent authors. The primary outcomes of interest were warping, revision rates, infection rates, and displacement. Methodological quality and risk of bias were assessed using GRADE and Cochrane’s ROBINS I tool, respectively. Results Thirty-six articles were reviewed, including one comparative and thirty-five single-arm studies (ACC: 29, IHCC: 8), encompassing 2,526 patients from 13 countries. Adverse events included warping (ACC: 6%, p<0.0001; IHCC: 6%, p<0.0001). Resorption rates were 1% for ACC (p = 0.06) and 3% for IHCC (p < 0.0001). Revision surgery rates were similar (ACC: 4%, p<0.001; IHCC: 4%, p<0.001), as were infection rates (ACC: 1.8%, p=0.03; IHCC: 1.3%, p=0.03). Conclusions Current evidence does not demonstrate the superiority of ACC or IHCC for dorsal augmentation rhinoplasty. Both grafts are viable, with the choice guided by patient and surgeon preferences. Prospective, high-quality data with standardized outcomes are needed to improve clinical decision-making.

Use of Implementation Science Concepts in the Study of Misinformation: A Scoping Review.

Misinformation hinders the impact of public health initiatives. Efforts to counter misinformation likely do not consider the full range of factors known to affect how individuals make decisions and act on them. Implementation science tools and concepts can facilitate the development of more effective interventions against health misinformation by leveraging advances in behavior specification, uptake of evidence, and theory-guided development and evaluation of complex interventions. We conducted a scoping review of misinformation literature reviews to document whether and how important concepts from implementation science have already informed the study of misinformation. Of 90 included reviews, the most frequently identified implementation science concepts were consideration of mechanisms driving misinformation (78%) and ways to intervene on, reduce, avoid, or circumvent it (71%). Other implementation science concepts were discussed much less frequently, such as tailoring strategies to the relevant context (9%) or public involvement in intervention development (9%). Less than half of reviews (47%) were guided by any theory, model, or framework. Among the 26 reviews that cited existing theories, most used theory narratively (62%) or only mentioned/cited the theory (19%), rather than using theory explicitly to interpret results (15%) or to inform data extraction (12%). Despite considerable research and many summaries of how to intervene against health misinformation, there has been relatively little consideration of many important advances in the science of health care implementation. This review identifies key areas from implementation science that might be useful to support future research into designing effective misinformation interventions.

Dietary diversity and its associated factors among adolescent girls in Ethiopia: a systematic review and meta-analysis

BackgroundEven though fragmented and inconsistent findings have been reported in Ethiopia, adolescence is a period of rapid growth following infancy and is severely affected by micronutrient deficiencies, food insecurity, and poor-quality diets. Therefore, the aim of this meta-analysis was to estimate the pooled prevalence of dietary diversity and its associated factors among adolescent girls in Ethiopia.MethodsInternational databases such as EMBASE, Hinari, Scopus, PubMed, Google Scholar, and direct Google searches were systematically used to search for articles and reports. The Newcastle-Ottawa Scale, modified as appropriate, was used for cross-sectional studies to assess the quality of the included articles and reports. A Microsoft Excel sheet was used for data extraction and then exported into STATA version 17 for further analysis. The pooled prevalence of dietary diversity was estimated using a random effects meta-analysis approach. Egger’s and Begg’s tests were employed to evaluate publication bias.ResultsThe pooled prevalence of minimum dietary diversity among adolescent girls in Ethiopia was 43% (95% CI: 30, 56) with significant heterogeneity (I2 = 99.2%, p = 0.00). Urban residence (OR: 2.46), mother being a government employee (OR: 2.31), attending a private school (OR: 6.24), adolescent having formal maternal education (OR: 4.49), adolescent having formal paternal education (OR: 3.26), father being a government employee (OR: 3.50), father being a merchant employee (OR: 2.51), middle family wealth index (OR: 1.76), household food security (OR: 3.96), receiving nutrition counseling (OR: 2.46), and higher meal frequency (OR: 7.35) were significantly associated with minimum dietary diversity.ConclusionThe pooled prevalence of dietary diversity among adolescent girls was low. Factors significantly associated with achieving minimum dietary diversity included urban residence, higher parental education and employment in government, private school attendance, household wealth, food security, receiving nutrition counseling, and higher meal frequency. These findings emphasize the need to improve dietary diversity among rural adolescent girls and food insecure households. Establishing nutrition counseling services could enhance understanding and skills related to a varied diet.

Genital bleeding in prepubertal girls: a systematic review

IntroductionThis systematic review aims to collate evidence of the causes of genital bleeding, other than child sexual abuse and accidental injuries, presenting in prepubertal girls. It provides an update to...

The impact of using simulation-based learning to further develop communication skills of pharmacy students and pharmacists: a systematic review

BackgroundEffective communication in healthcare, among professionals and between professionals and patients is crucial for delivering high-quality care. While simulation effectively translates technical skills to clinical practice, its impact on communication, particularly in pharmacies, is less well documented.AimThis systematic review examined the impact of simulation-based education on communication skills among pharmacy students and pharmacists. It aims to identify the types of simulations used, the outcomes obtained, and the effectiveness of these simulations in enhancing communication skills, perception and confidence.MethodWe conducted searches in MEDLINE, LISSA, EMBASE, and PsycINFO for articles on communication training through simulation for pharmacy students and pharmacists. The search covered the period from inception to August 31, 2022. To be included, studies had to meet the following criteria: (i) target pharmacy student or graduate pharmacists; (ii) use simulation in the field of clinical pharmacy; (iii) provide a complete description of the outcome measure. Studies for which it was impossible to extract data specific to pharmacy students or simulation were excluded. Three investigators independently evaluated each title and abstract. If each investigator considered the citation eligible, six authors progressed to full-text review. The outcomes related to communication were categorized into three groups: perception of the importance of communication in delivering high-quality patient care, confidence in communication skills, and assessed communication proficiency. The quality of studies included in this review was assessed using the Mixed Methods Appraisal Tool (MMAT).ResultsThe total number of participants was 3337. Among the 20 articles reviewed, which were primarily published in the United States over the last decade, only one focused on community pharmacists. Quasi experimental designs were predominant, and studies often relied on learners' self-assessments with non-validated questionnaires. Simulation-based learning aimed to enhance communication skills and attitudes across interprofessional contexts (involving nursing and medical students), patients, and families, frequently utilizing simulated patients. Studies evaluating outcomes have emphasized communication skills with patients and families, while those involving healthcare professionals often focused on perception of the importance of communication in delivering high-quality patient care.ConclusionDespite study heterogeneity, this systematic review concluded that simulation-based training significantly enhances perception, confidence, and communication skills. The development of clear guidelines and standardized assessment tools to evaluate communication would significantly improve the validity and reliability of future research efforts (PROSPERO registration: n°CRD42022371915).

Corticosteroids in Pediatric Septic Shock: A Narrative Review

Objective: A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Data Sources: Review of literature from January 2013 to December 2023 from online libraries Pubmed, Medline, Cochrane Library, and Scopus. Study Selection: The keywords “septic shock”, “steroids” and “children” were used. Data Extraction: Of 399 articles, 63 were selected. Data Synthesis: Regarding mortality, although the 2019 Cochrane review supports reduced mortality, benefits on long-term mortality and in patients with CIRCI (critical illness-related corticosteroid insufficiency) are not clear. Yang’s metanalysis and retrospective studies of Nichols and Atkinson show no difference or even an increase in mortality. Regarding severity, the Cochrane review claims that hydrocortisone seems to reduce the length of intensive care hospitalization but influences the duration of ventilatory and inotropic support, and the degree of multi-organ failure appears limited. Further controversies exist on adrenal function evaluation: according to literature, including the Surviving Sepsis Campaign guidelines, basal or stimulated hormonal dosages do not allow the identification of patients who could benefit from hydrocortisone therapy (poor reproducibility). Regarding side effects, muscle weakness, hypernatremia, and hyperglycemia are the most observed. Conclusions: The literature does not give certainties about the efficacy of corticosteroids in pediatric septic shock, as their influence on primary outcomes (mortality and severity) is controversial. A subgroup of patients suffering from secondary adrenal insufficiency could benefit from it, but it remains to be defined how to identify and what protocol to use to treat them.

Beyond Infection: The Role of Stunting in Tuberculosis Susceptibility and Treatment Outcomes

Background: Tuberculosis (TB) remains a major global health concern, particularly in developing countries. Stunting, a manifestation of chronic malnutrition, is prevalent in these regions and is increasingly recognized as a significant risk factor for TB. This systematic review aims to comprehensively analyze the impact of stunting on TB susceptibility and treatment outcomes. Methods: A systematic search of PubMed and ScienceDirect databases was conducted for studies published in the last 10 years, focusing on the relationship between stunting and TB. The PRISMA guidelines were followed for article selection and data extraction. Results: The review identified a significant association between stunting and increased TB risk. Stunted individuals exhibit impaired immune responses, making them more susceptible to TB infection. Moreover, stunting negatively affects TB treatment outcomes, including increased treatment duration, higher relapse rates, and greater mortality risk. Conclusion: Stunting is a critical determinant of TB susceptibility and treatment outcomes. Addressing stunting through comprehensive nutritional interventions is crucial not only for reducing the burden of malnutrition but also for enhancing TB prevention and control efforts.

Efficacy and safety of salvianolate injection in treating acute myocardial infarction: a meta-analysis and systematic literature review

PurposeSalvianolate for injection (SFI) is a widely used treatment for acute myocardial infarction (AMI). This study aims to assess the efficacy and safety of SFI in treating AMI by synthesizing evidence from published randomized controlled trials (RCTs).MethodsSeven databases were searched for relevant RCTs published up to 1 July 2024. Two investigators independently conducted the literature searches, data extraction, and quality assessment. Subgroup and sensitivity analyses were performed to address potential heterogeneity. Data analyses were conducted using RevMan 5.4 software.ResultThirty RCTs with a total of 3,931 participants were included in the study and analyzed. The results revealed that SFI significantly reduced major adverse cardiac events (MACEs) (RR = 0.34, 95% CI: 0.24 to 0.49, p < 0.05). In addition, SFI lowered creatine kinase-MB (CK-MB) (MD = −5.65, 95% CI: −9.55 to −1.76, p < 0.05) and improved left ventricular ejection fraction (LVEF) (MD = 6.2, 95% CI: 4.82 to 7.57, p < 0.05). Further reductions were observed in C-reactive protein (CRP) (MD = −6.17, 95% CI: −8.11 to −4.23, p < 0.05), malondialdehyde (MDA) (MD = −1.95, 95% CI: −2.08 to −1.83, p < 0.05), and endothelin-1 (ET-1) (MD = −12.27, 95% CI: −17.13 to −7.40, p < 0.05). The incidence of adverse events did not significantly differ between the EG and CG [RR = 0.74, 95% CI: 0.42 to 1.33, p = 0.32].ConclusionThis study suggests that SFI may be a promising alternative therapy for treating AMI without increasing the risk of adverse events. However, our findings may be limited by the quality of the existing studies. High-quality RCTs are needed to provide more robust evidence.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024567279.

Are Pediatric Cancer Patients a Risk Group for Vitamin D Deficiency? A Systematic Review

Background: Vitamin D deficiency is increasingly recognized as a global health concern, with potential implications for cancer development and progression. This systematic review investigated the prevalence of vitamin D deficiency in pediatric cancer patients and its potential impact on clinical outcomes. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, and Cochrane Library, to identify the relevant studies published between 2009 and July 2024. Studies were included if they assessed vitamin D status in pediatric cancer patients and reported on the clinical outcomes. Data extraction and quality assessment were performed independently by two reviewers. Results: The review included 20 original articles encompassing a diverse pediatric population with various cancer types. A high prevalence of vitamin D deficiency was observed across the studies. Deficiency was associated with older age and lower socioeconomic status. Several studies reported associations between vitamin D deficiency and the increased risk of infection, poorer treatment response, and decreased survival. Conclusions: Vitamin D deficiency is highly prevalent in pediatric cancer patients and may negatively impact clinical outcomes. Routine screening for vitamin D deficiency and personalized supplementation strategies should be considered in this population. Further research is needed to establish optimal vitamin D management protocols and evaluate the long-term benefits of vitamin D repletion in pediatric oncology.

A systematic review and meta-analysis assessing the impact of pentoxifylline on the healing and recurrence of venous leg ulcers.

Venous leg ulcers (VLU) are the most severe manifestation of venous insufficiency and carry a poor prognosis because of delayed healing and recurrent ulceration. Pentoxifylline (PTX) is an example of a vasoactive medication that can be used alongside compression therapy to help improve ulcer healing rates. A previous review highlighted improved healing of VLU with PTX, although no analysis was made for complete ulcer healing and recurrence following treatment. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The EMBASE, MEDLINE and Cochrane databases were searched for all relevant English-language human studies between January 1980 and August 2023. Two independent authors screened and reviewed all articles for inclusion, performed data extraction and assessed methodological quality according to Cochrane's risk of bias tool. Primary outcomes included complete ulcer healing and recurrence rates in the ipsilateral limb. Ten studies were eligible for analysis, of which nine were randomised trials and one was an observational cohort study. There were a total of 1,025 participants, with 515 having received PTX. In those receiving 1200mg PTX, venous leg ulcers healed in 62% (315 participants). Compared to controls, PTX administration was associated with a significantly higher likelihood of complete ulcer healing (OR 2.56, 95% CI 1.97-3.32, p < .001). The rate and time of ulcer recurrence were not recorded in any of the studies included. The evidence demonstrates that PTX may have a significant beneficial impact on the rate of complete ulcer healing. Little evidence is currently present in the literature evaluating the recurrence rates of ulcers following PTX treatment. Large scale, high quality RCTs with an adequate follow-up period are needed to evaluate this and assess whether treatment with PTX shows a significant benefit in prevention of recurrence in venous ulcers.

The Impact of Ketamine on Outcomes in Acute Pain Management: An Umbrella Review

Background/Objectives: Ketamine offers effective pain relief with fewer side effects than traditional analgesics, making it a promising alternative for acute pain treatment. However, further research is needed to fully assess its role in perioperative care. This umbrella review aimed to compile the highest-quality evidence available regarding the application of ketamine in managing acute pain. Methods: A thorough search of the literature was carried out in PubMed, Scopus, and the Cochrane Library, including systematic reviews that focused on the application of ketamine in managing acute pain. The data extraction included the research type, analgesics used, number of studies and patients per review, pain types, scoring methods, ketamine doses, administration routes, and reporting guidelines. Results: Of the 807 records identified, 20 studies met the inclusion criteria. In accordance with the AMSTAR-2 evaluation, most of the systematic reviews were rated as critically low quality. Intravenous ketamine administered during the perioperative period was found to reduce the pain intensity of acute pain within 15–30 and 60 min following treatment, and decrease postoperative opioid consumption by 14–50% at both 24 and 48 h after surgery. Conclusions: Evidence shows that intravenous ketamine reduces the pain intensity, postoperative opioid use, and the risk of vomiting and nausea while improving analgesia, making it a valuable adjunct in perioperative pain management.

Safety and efficacy of glycopyrronium tosylate in patients with primary axillary hyperhidrosis: a systematic review and meta-analysis

Hyperhidrosis affects approximately 4.8% of the US population, impairing quality of life with excessive sweating. Glycopyrronium tosylate (GT), a topical anticholinergic, treats primary axillary hyperhidrosis in adults and pediatric patients. Despite its use, comprehensive evaluation of GT’s long-term safety and efficacy has been lacking. This systematic review and meta-analysis aimed to assess GT’s effectiveness and safety profiles. Following Cochrane and PRISMA guidelines, we conducted a thorough search of electronic databases for clinical trials on GT. Studies underwent quality assessment and data extraction based on predefined criteria. Primary outcomes included changes in the Dermatology Life Quality Index (DLQI), Hyperhidrosis Disease Severity Scale (HDSS), and Axillary Sweating Daily Diary (ASDD) or its change score (ASDD-C). Secondary outcomes evaluated safety concerns like mydriasis, dry mouth, urinary hesitation, and treatment-emergent adverse events. Our analysis, integrating data from three randomized controlled trials, highlights GT’s efficacy in improving quality of life and reducing sweating severity. Although minor adverse effects were reported, no significant increase in serious adverse events was observed. These findings suggest GT as a promising treatment for primary axillary hyperhidrosis, with benefits outweighing minimal side effects.

Effectiveness of Physical Activity in the Management of Nonspecific Low Back Pain: A Systematic Review

Background and Objectives: This systematic review evaluates the effectiveness of exercise interventions for managing nonspecific low back pain (NSLBP) and explores their impact on related biopsychosocial factors, physical health variables, and inflammatory biomarkers. Materials and Methods: A comprehensive search of five databases (PubMed, CINAHL, PEDro, SCOPUS, Cochrane Library) was conducted, covering studies from 2019 to 2024. Fifteen randomized controlled trials involving 1338 participants aged 18 to 65 years with NSLBP were included. Data extraction and quality assessment were performed independently by two reviewers using the PEDro scale, and risk of bias was evaluated using the Cochrane Risk-of-Bias tool (RoB 2.0). Results: Exercise significantly reduced pain intensity and improved biopsychosocial factors such as depression, disability, functionality, quality of life, and kinesiophobia. Additionally, it enhanced physical parameters like proprioception, muscle thickness, and physical performance. However, the review found insufficient evidence regarding the effects of exercise on inflammatory biomarkers in NSLBP patients. Conclusions: The findings suggest that physical exercise is an effective intervention for pain reduction and the improvement of overall health in NSLBP, though further research is needed to clarify its impact on inflammation.

Prevalence of Bacterial Pathogens Isolated from Canines with Pyoderma and Otitis Externa in Korea: A Systematic Review and Meta-Analysis

Bacterial skin infections, particularly pyoderma and otitis externa, are widespread in dogs, primarily caused by Staphylococcus and Pseudomonas species. This study evaluates the prevalence and types of bacterial pathogens in affected dogs in South Korea using a meta-analytical approach. Following the PRISMA guidelines, five electronic databases were searched for relevant studies published between 1990 and 2024. Three researchers independently performed data extraction and quality assessment. A subgroup analysis explored the variability in pathogen prevalence across studies based on bacterial genus, bacterial species, publication year, sampling year, sampling location, infection type, diagnostic method, and sample size. Publication bias was evaluated using funnel plots and Egger’s regression test, with all analyses conducted using the R program. Of the 944 articles, 29 met the eligibility criteria. The pooled bacterial prevalence among infected dogs was 99.95% (95%CI: 99.85–100). Staphylococcus was the most prevalent genus (95.93%), followed by Pseudomonas (48.43%), Enterococcus (20.32%), and Escherichia (17.63%). The most common species were Staphylococcus pseudintermedius (78.89%), Staphylococcus intermedius (71.43%), and Pseudomonas aeruginosa (46.13%). This study underscores the need for comprehensive treatment strategies targeting Gram-negative and Gram-positive bacteria, emphasizing further research on antimicrobial resistance patterns and treatment efficacy to enhance canine health outcomes in South Korea.