Systematic Review Of Primary Studies Research Articles

Accuracy and technical characteristics of CYP2C19 point of care tests: a systematic review.

Aim: To assess the accuracy and technical characteristics of CYP2C19 point of care tests (POCTs).Patients & methods: Systematic review of primary studies, in any population or setting, that evaluated POCTs for detecting CYP2C19 loss of function (LOF) alleles.Results: Eleven studies provided accuracy data (eight Spartan; one Genomadix Cube; one GMEX; one Genedrive). The POCTs had very high sensitivity and specificity for the alleles they tested for. Twenty-two studies reported technical characteristics: POCTs were easy to operate and provided results quickly. Limited data were reported for test failure rate and cost.Conclusion: CYP2C19 POCTs may be a useful alternative to laboratory-based testing to guide antiplatelet therapy. Further data are required on accuracy (GMEX; Genedrive), test failure and cost (all POCT).

Comparing the Effectiveness of Water Sponging Combined with Antipyretics Versus Antipyretics Alone in Lowering Fever in Children: A Systematic Review

Background: Fever occurs when the body temperature rises above normal due to external factors, such as exposure to high temperatures or heat sources. This study aims to assess the effectiveness of water sponging in combination with antipyretic versus antipyretic only on reducing body temperature in children with fever. Methods: This was a systematic review of primary studies using true experimental designs collected from online sources published between 1994 until 2024. Articles were screened using the PRISMA flow diagram with the following keywords: body temperature, children, fever, febrile, water sponging, antipyretic, randomized controlled trial. The data was reviewed accordingly. Results: The findings have revealed that three studies found no significant difference in temperature drops between tepid water sponging combined with antipyretics and antipyretics alone. Other studies, however, noted a faster initial drop with the combination, but temperatures equalized after two hours, with some children experiencing additional discomfort. Conclusion: The study concludes that while tepid water sponging combined with antipyretics initially reduces fever faster, both methods equalize within two hours, and the combination may cause additional discomfort.

Endoscopic vidian and vidian-branch neurectomy for refractory allergic rhinitis: A systematic review.

Endoscopic vidian neurectomy is expected to provide good therapeutic relief in patients with allergic rhinitis (AR) being refractory to medication therapy or conservative surgery. However, the evidence bases for its benefit remain debatable. In this study, we conducted a systematic review and meta-analysis to clarify the therapeutic role of various forms of vidian neurectomy in refractory AR. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used to conduct a systematic review of primary studies that reported original patient data for endoscopic vidian neurectomy (EVN) and vidian-branch neurectomy, which includes selective vidian neurectomy (SVN) and posterior nasal neurectomy (PNN). The primary outcome was patient-reported outcome measures (PROMs), including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and Visual Analog Scale (VAS), to assess an improvement in nasal symptom severity and quality of patient's life. The incidence of surgical complications and other objective outcomes were considered secondary outcomes. This review included 24 clinical studies involving 1677 patients with refractory AR, of which 510 patients in six studies had combined chronic rhinosinusitis with nasal polyps (CRSwNP) and 95 patients in one study had combined asthma. Postoperative PROMs were significantly better than preoperatively in almost all patients who underwent vidianp (RQLQ: standardized mean difference [SMD]=2.66, 95% confidence interval [CI]=2.40-2.92, p<0.001; VAS: SMD=5.15, 95% CI=4.29-6.02, p<0.001) or vidian-branch neurectomy (RQLQ in PNN: SMD=3.29, 95% CI=2.45-4.13, p<0.001; VAS in PNN: SMD=4.38, 95% CI=3.41-5.34, p<0.001), and were generally better than in the conservative treatment group. Dividing with 18 months as the cutoff point, a subgroup analysis of the follow-up period was conducted, and the results showed that both long-term and short-term postoperative patients had considerably reduced symptoms compared to the preoperative period. The two surgical procedures, SVN and PNN, attributed to vidian-branch neurectomy have extremely few complications. However, EVN is more likely to cause dry eyes and palatal numbness, with no other serious complications. In patients with AR and CRSwNP, vidian or selective vidian neurectomy combined with functional endoscopic sinus surgery (FESS) is more effective than conventional FESS (RQLQ: SMD=2.17, 95% CI=1.66-2.69, p<0.001; VAS: SMD=6.42, 95% CI=4.78-8.06, p<0.001). For patients who have both AR and asthma, SVN with pharyngeal branch excision is a potential treatment option. EVN and vidian-branch neurectomy (including SVN and PNN) are effective treatments, but the former has a higher risk of complications. Additionally, vidian-branch neurectomy with FESS is beneficial for patients with mixed CRSwNP. SVN is a potential approach for patients with coexisting AR and asthma.

Development of minimum reporting sets of patient characteristics in epidemiological research: A methodological systematic review

Background Core patient characteristic sets (CPCSs) are increasingly developed to identify variables that should be reported to describe the target population of epidemiological studies in the same medical area, while keeping the additional burden on the data collection acceptable. Methods We conduct a systematic review of primary studies and protocols that aim to develop a CPCS, using the PubMed database. We extract information on the study design and the characteristics of the proposed CPCS. The quality of Delphi studies is assessed by a tool proposed in the literature. All results are reported descriptively. Results Among 23 eligible studies, Delphi survey is the most frequently used technique to obtain consensus in CPCS development (69.6%, n = 16). Most studies do not include patients as stakeholders. The final CPCS rarely includes socioeconomic factors (26.1%, n = 6). Besides, 60.9% ( n = 14) and 26.1% ( n = 6) of the studies provide definitions and measurement methods for items in the CPCS, respectively. Conclusion This review identifies considerable variation and suboptimality in many methodological aspects of CPCS studies. To improve these shortcomings, guidance on the conduct and reporting of CPCS studies should be established in the future.

Implementing organized colorectal cancer screening programs in Europe—protocol for a systematic review of determinants and strategies

BackgroundWith a high mortality of 12.6% of all cancer cases, colorectal cancer (CRC) accounts for substantial burden of disease in Europe. In the past decade, more and more countries have introduced organized colorectal cancer screening programs, making systematic screening available to entire segments of a population, typically based on routine stool tests and/or colonoscopy. While the effectiveness of organized screening in reducing CRC incidence and mortality has been confirmed, studies continuously report persistent program implementation challenges. This systematic review will synthesize the literature on organized CRC screening programs. Its aim is to understand what is currently known about the barriers and facilitators that influence the implementation of these programs and about the implementation strategies used to navigate these determinants.MethodsA systematic review of primary studies of any research design will be conducted. CENTRAL, CINAHL, EMBASE, International Clinical Trials Registry Platform, MEDLINE, PsycINFO, and Scopus will be searched. Websites of (non-)government health care organizations and websites of organizations affiliated with authors of included studies will be screened for unpublished evaluation reports. Existing organized CRC screening programs will be contacted with a request to share program-specific grey literature. Two researchers will independently screen each publication in two rounds for eligibility. Included studies will focus on adult populations involved in the implementation of organized CRC screening programs and contain information about implementation determinants/ strategies. Publications will be assessed for their risk of bias. Data extraction will include study aim, design, location, setting, sample, methods, and measures; program characteristics; implementation stage, framework, determinants, strategies, and outcomes; and service and other outcome information. Findings will be synthesized narratively using the three stages of thematic synthesis.DiscussionWith its sole focus on the implementation of organized CRC screening programs, this review will help to fill a central knowledge gap in the literature on colorectal cancer screening. Its findings can inform the decision-making in policy and practice needed to prioritize resources for establishing new and maintaining existing programs in the future.Systematic review registrationPROSPERO (CRD42022306580).

FAT/CD36 Participation in Human Skeletal Muscle Lipid Metabolism: A Systematic Review

Fatty acid translocase/cluster of differentiation 36 (FAT/CD36) is a multifunctional membrane protein activated by a high-fat diet, physical exercise, fatty acids (FAs), leptin, and insulin. The principal function of FAT/CD36 is to facilitate the transport of long-chain fatty acids through cell membranes such as myocytes, adipocytes, heart, and liver. Under high-energy expenditure, the different isoforms of FAT/CD36 in the plasma membrane and mitochondria bind to the mobilization and oxidation of FAs. Furthermore, FAT/CD36 is released in its soluble form and becomes a marker of metabolic dysfunction. Studies with healthy animals and humans show that physical exercise and a high-lipid diet increase FAT/CD36 expression and caloric expenditure. However, several aspects such as obesity, diabetes, Single Nucleotide polymorphisms (SNPs), and oxidative stress affect the normal FAs metabolism and function of FAT/CD36, inducing metabolic disease. Through a comprehensive systematic review of primary studies, this work aimed to document molecular mechanisms related to FAT/CD36 in FAs oxidation and trafficking in skeletal muscle under basal conditions, physical exercise, and diet in healthy individuals.

Are We Agreed? Self- Versus Proxy-Reporting of Paediatric Health-Related Quality of Life (HRQoL) Using Generic Preference-Based Measures: A Systematic Review and Meta-Analysis.

ObjectiveThe aim of this study was to examine the level of agreement between self- and proxy-reporting of health-related quality of life (HRQoL) in children (under 18 years of age) using generic preference-based measures.MethodsA systematic review of primary studies that reported agreement statistics for self and proxy assessments of overall and/or dimension-level paediatric HRQoL using generic preference-based measures was conducted. Where available, data on intraclass correlation coefficients (ICCs) were extracted to summarise overall agreement levels, and Cohen’s kappa was used to describe agreement across domains. A meta-analysis was also performed to synthesise studies and estimate the level of agreement between self- and proxy-reported paediatric overall and domain-level HRQoL.ResultsOf the 30 studies included, 25 reported inter-rater agreement for overall utilities, while 17 reported domain-specific agreement. Seven generic preference-based measures were identified as having been applied: Health Utilities Index (HUI) Mark 2 and 3, EQ-5D measures, Child Health Utility 9 Dimensions (CHU9D), and the Quality of Well-Being (QWB) scale. A total of 45 dyad samples were included, with a total pooled sample of 3084 children and 3300 proxies. Most of the identified studies reported a poor inter-rater agreement for the overall HRQoL using ICCs. In contrast to more observable HRQoL domains relating to physical health and functioning, the inter-rater agreement was low for psychosocial-related domains, e.g., ‘emotion’ and ‘cognition’ attributes of both HUI2 and HUI3, and ‘feeling worried, sad, or unhappy’ and ‘having pain or discomfort’ domains of the EQ-5D. Parents demonstrated a higher level of agreement with children relative to health professionals. Child self- and proxy-reports of HRQoL showed lower agreement in cancer-related studies than in non-cancer-related studies. The overall ICC from the meta-analysis was estimated to be 0.49 (95% confidence interval 0.34–0.61) with poor inter-rater agreement.ConclusionThis study provides evidence from a systematic review of studies reporting dyad assessments to demonstrate the discrepancies in inter-rater agreement between child and proxy reporting of overall and domain-level paediatric HRQoL using generic preference-based measures. Further research to drive the inclusion of children in self-reporting their own HRQoL wherever possible and limiting the reliance on proxy reporting of children’s HRQoL is warranted.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40273-022-01177-z.

A Transparency Checklist for Carbon Footprint Calculations Applied within a Systematic Review of Virtual Care Interventions.

Increasing concerns about climate change imply that decisions on the digitization of healthcare should consider evidence about its carbon footprint (CF). This study aims to develop a transparency catalogue for reporting CF calculations, to compare results, and to assess the transparency (reporting quality) of the current evidence of virtual care (VC) intervention. We developed a checklist of transparency criteria based on the consolidation of three established standards/norms for CF calculation. We conducted a systematic review of primary studies written in English or German on the CF of VC interventions to check applicability. Based on our checklist, we extracted methodological information. We compared the results and calculated a transparency score. The checklist comprises 22 items in the aim, scope, data and analysis categories. Twenty-three studies out of 1466 records were included, mostly addressing telemedicine. The mean transparency score was 38% (minimum 14%, maximum 68%). On average, 148 kg carbon dioxide equivalents per patient were saved. Digitization may have co-benefits, improving care and reducing the healthcare CF. However, the evidence for this is weak, and CF reports are heterogeneous. Our transparency checklist may serve as a reference for developing a standard to assess the CF of virtual and other healthcare and public health services.

Effectiveness of posture-correction interventions for mechanical neck pain and posture among people with forward head posture: protocol for a systematic review

IntroductionForward head posture (FHP) is the most common postural deviation of the upper back. It is believed to be one of the predisposing factors for the development of mechanical neck...

ANATOMICAL VARIATIONS OF PORTAL VENOUS SYSTEM: IMPORTANCE IN SURGICAL CLINIC.

ABSTRACT - BACKGROUND:Knowledge of the portal system and its anatomical variations aids to prevent surgical adverse events. The portal vein is usually made by the confluence of the superior mesenteric and splenic veins, together with their main tributaries, the inferior mesenteric, left gastric, and pancreaticoduodenal veins; however, anatomical variations are frequent.AIM: This article presents a literature review regarding previously described anatomical variations of the portal venous system and their frequency.METHODS: A systematic review of primary studies was performed in the databases PubMed, SciELO, BIREME, LILACS, Embase, ScienceDirect, and Scopus. Databases were searched for the following key terms: Anatomy, Portal vein, Mesenteric vein, Formation, Variation, Variant anatomic, Splenomesenteric vein, Splenic vein tributaries, and Confluence.RESULTS: We identified 12 variants of the portal venous bed, representing different unions of the splenic vein, superior mesenteric vein, and inferior mesenteric vein. Thomson classification of the end of 19th century refers to the three most frequent variants, with type I as predominant (M=47%), followed by type III (M=27.8%) and type II (M=18.6%).CONCLUSION: Thomson classification of variants is the most well-known, accounting for over 90% of portal venous variant found in clinical practice, inasmuch as the sum of the three junctions are found in over 93% of the patients. Even though rarer and accounting for less than 7% of variants, the other nine reported variations will occasionally be found during many abdominal operations.

School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews.

Schools are identified as a key setting to influence children’s and adolescents’ healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.

1226 The Clinical Utility of Prostate Health Index Density in The Diagnosis of Clinically Significant Prostate Cancer: A Systematic Review

Abstract Aim Prostate health index (PHI) is a diagnostic test for prostate cancer that combines free prostate specific antigen (PSA), total PSA and [-2]proPSA. PHI has been shown to be more accurate than PSA testing at detecting prostate cancer and its use has been shown to reduce unnecessary prostate biopsies. Prostate health index density (PHID), derived by dividing PHI by prostate volume, has been suggested as a more accurate test compared to standard PHI by several authors. The aim of this systematic review was to evaluate the diagnostic accuracy of PHID for clinically significant prostate cancer, identify an optimal diagnostic threshold and assess the clinical utility of PHID as a novel diagnostic test for prostate cancer. Method A systematic review of primary studies was conducted. Medline, Embase, Scopus and Cochrane databases were searched with key terms. Results were screened and full papers reviewed by two reviewers with pre-determined inclusion criteria. QUADAS-2 was used for quality appraisal. Data analysis was conducted in line with PRISMA guidelines. Results Nine studies were included. Quality appraisal revealed a high degree of heterogeneity between studies. PHID thresholds ranged 0.32-1.38. PHID had an area under the curve value of 0.59-0.9 and negative predictive value of 81-100% for clinically significant disease. PHID outperformed PHI in three studies, but this was not replicated in the other studies. Conclusions This systematic review found PHID did not consistently outperform PHI. PHID was found to have low clinical utility in the diagnosis of prostate cancer based on the available evidence, with further research warranted.

A global database of diversified farming effects on biodiversity and yield

With the Convention on Biological Diversity conference (COP15), United Nations Climate Change Conference (COP26), and United Nations Food Systems Summit, 2021 is a pivotal year for transitioning towards sustainable food systems. Diversified farming systems are key to more sustainable food production. Here we present a global dataset documenting outcomes of diversified farming practices for biodiversity and yields compiled following best standards for systematic review of primary studies and specifically designed for use in meta-analysis. The dataset includes 4076 comparisons of biodiversity outcomes and 1214 of yield in diversified farming systems compared to one of two reference systems. It contains evidence from 48 countries of effects on species from 33 taxonomic orders (spanning insects, plants, birds, mammals, eukaryotes, annelids, fungi, and bacteria) of diversified farming systems producing annual or perennial crops across 12 commodity groups. The dataset presented provides a resource for researchers and practitioners to easily access information on where diversified farming systems effectively contribute to biodiversity and food production outcomes.

The effectiveness of teleconsultations in primary care: systematic review

BackgroundThe COVID-19 pandemic has focussed attention on models of healthcare that avoid face-to-face contacts between clinicians and patients, and teleconsultations have become the preferred mode of primary care delivery. However, the effectiveness of remote consultations in this setting remains unclear.ObjectiveTo evaluate the impact of telephone or video consultations compared to those conducted face-to-face on key patient-relevant outcomes and healthcare utilisation in primary care, mental health and allied health services, which have had a critical role in the management of the wider and longer-term consequences of COVID-19.MethodsA systematic review of primary studies comparing telephone or video consultations versus face-to-face visits, following the PRISMA guidelines.ResultsOverall, consultations delivered by telephone and videoconference were as effective as face-to-face in-person visits to improve clinical outcomes in adults with mental health conditions and those attending primary care services. Patient satisfaction with telephone and video consultations and the therapeutic alliance was high across the studies. However, high discontinuation rates in patients receiving teleconsultations indicate this may not be a suitable modality of healthcare delivery for all patients. Teleconsultations offer significant patient time savings in primary care, but appropriate implementation, including training of healthcare professionals and management of technical issues, is essential to ensure effective and valuable clinical interventions.ConclusionsTeleconsultations via telephone or videoconference are an effective alternative to face-to-face consultations for many patients attending primary care and mental health services. Teleconsultations have the potential to deliver time-efficient and lower-cost interventions at a distance while improving access to healthcare.

Robot-assisted coronary artery bypass surgery: a systematic review and meta-analysis of comparative studies

Robot-assisted coronary bypass (RCAB) surgery has been proposed as an alternative to conventional coronary artery bypass grafting (C-CABG) for managing coronary heart disease, but the evidence on its performance compared to other existing treatments is unclear. The aim of this study was to assess, through a systematic review of comparative studies, the safety and clinical effectiveness of RCAB compared to C-CABG and other minimally invasive approaches for the treatment of coronary heart disease. We conducted a systematic review of primary studies in the English-language literature comparing RCAB to existing treatment options (C-CABG, minimally invasive direct coronary artery bypass [MIDCAB] and port-access coronary artery bypass [PA-CAB]) following Cochrane Collaboration guidelines. Meta-analyses were performed where appropriate. We reviewed 13 studies: 11 primary studies of RCAB (v. C-CABG in 7, v. MIDCAB in 3 and v. PA-CAB in 1) and 2 multicentre database studies (RCAB v. non-RCAB). The overall quality of the evidence was low. Most studies showed no significant benefit of RCAB over other treatments in a majority of outcome variables. Meta-analyses showed that RCAB had lower rates of pneumonia or wound infection than C-CABG, and shorter intensive care unit length of stay than C-CABG or MIDCAB. Individual studies showed that RCAB had some better outcomes than C-CABG (ventilation time, transfusion, postoperative pain, hospital length of stay) or MIDCAB (transfusion, postoperative pain, time to return to normal activities, physical functioning and hospital length of stay). The review of the database studies showed that RCAB was statistically superior to non-RCAB approaches in postoperative pain, renal failure, transfusion, reoperation for bleeding, stroke and hospital length of stay; however, the difference between the 2 groups in several of these outcomes was small. Although the findings from this review of comparative studies of RCAB appear promising and suggest that RCAB may offer some benefits to patients, in the absence of randomized controlled trials, these results should be interpreted cautiously.

The rationales for and challenges with employing arts-based health services research (ABHSR): a qualitative systematic review of primary studies

Health services research (HSR) is an interdisciplinary field that investigates and improves the design and delivery of health services from individual, group, organisational and system perspectives. HSR examines complex problems...

Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta-analysis.

Intranasal corticosteroids (INCSs) are widely utilized for the treatment of allergic rhinitis. Epistaxis is a known adverse effect of INCSs, but it is not known if the risk of epistaxis differs among INCSs. Systematic review of primary studies identified through Medline, Embase, Web of Science, PubMed Central, and Cochrane databases. Systematic review was conducted according to the PRISMA standard. English-language studies were queried through February 1, 2018. The search identified randomized controlled trials of INCSs for treatment of allergic rhinitis that reported incidence of epistaxis. An itemized assessment of the risk of bias was conducted for each included study, and meta-analysis was performed of the relative risk of epistaxis for each INCS. Of 949 identified studies, 72 met the criteria for analysis. Meta-analysis demonstrated an overall relative risk of epistaxis of 1.48 (95% CI, 1.32-1.67) for all INCSs. The INCSs associated with the highest risk of epistaxis were beclomethasone hydrofluoroalkane, fluticasone furoate, mometasone furoate, and fluticasone propionate. Beclomethasone aqueous, ciclesonide hydrofluoroalkane, and ciclesonide aqueous were associated with the lowest risk of epistaxis. Conclusions about epistaxis with use of budesonide, triamcinolone, and flunisolide are limited due to the low number of studies and high heterogeneity. While a differential effect on epistaxis among INCS agents is not clearly demonstrated, this meta-analysis does confirm an increased risk of epistaxis for patients using INCSs as compared with placebo for treatment of allergic rhinitis.

The use of mathematical modeling studies for evidence synthesis and guideline development: A glossary.

Mathematical modeling studies are increasingly recognised as an important tool for evidence synthesis and to inform clinical and public health decision‐making, particularly when data from systematic reviews of primary studies do not adequately answer a research question. However, systematic reviewers and guideline developers may struggle with using the results of modeling studies, because, at least in part, of the lack of a common understanding of concepts and terminology between evidence synthesis experts and mathematical modellers. The use of a common terminology for modeling studies across different clinical and epidemiological research fields that span infectious and non‐communicable diseases will help systematic reviewers and guideline developers with the understanding, characterisation, comparison, and use of mathematical modeling studies. This glossary explains key terms used in mathematical modeling studies that are particularly salient to evidence synthesis and knowledge translation in clinical medicine and public health.

Experiences, benefits and challenges of the use of geoprocessing for the development of primary health careExperiências, benefícios e desafios do uso de geoprocessamento para o desenvolvimento da atenção primária à saúde

RESUMENObjetivoRevisar las consecuencias empíricas del uso de geoprocesamiento en la gestión de los servicios de atención primaria de salud (APS), con el propósito de difundir los beneficios del uso de esta tecnología, así como precisar los desafíos que deben ser superados para su contribución en el desarrollo de la APS.MétodosSe realizó una revisión sistemática de estudios primarios publicados en español, inglés o portugués, entre los años 2000 y 2017. En primer lugar, se efectúa una revisión general de la producción académica por continente y tipo de objetivo. En una segunda etapa, se seleccionan los estudios que experimentaron y evaluaron el uso de geoprocesamiento en forma empírica, donde se revisan beneficios concretos y genéricos, así como las limitaciones.ResultadosSe identificaron 134 artículos en la primera etapa de selección, la mitad de ellos provenientes del continente americano. Tan solo nueve estudios cumplieron con los requisitos de la segunda etapa; sin embargo, demostraron que el uso de geoprocesamiento genera beneficios que van más allá de los beneficios técnicos, con limitaciones factibles de ser superadas.ConclusionesAun cuando los beneficios del uso de geoprocesamiento han sido ampliamente discutidos, son escasos los estudios que han evaluado su implementación en APS en forma empírica. Experiencias prácticas, que podrían ser fácilmente reproducidas en otras comunidades, demuestran que su uso continuo podría aumentar la capacidad de respuesta a las metas de APS, así como a las propias metas del desarrollo sostenible.

Laser scanning in vivo confocal microscopy (IVCM) for evaluating human corneal sub-basal nerve plexus parameters: protocol for a systematic review

IntroductionLaser scanning in vivo confocal microscopy (IVCM) enables non-invasive, high-resolution imaging of the cornea. In recent years, there has been a vast increase in researchers using laser scanning IVCM to...