Systematic Reviews最新文献

{"title":"Prevalence and risk factors of under-five mortality due to severe acute malnutrition in Africa: a systematic review and meta-analysis.","authors":"Joshua Wambua, Anahita Ali, Jean Baptiste Ukwizabigira, Paul Kuodi","doi":"10.1186/s13643-024-02740-9","DOIUrl":"10.1186/s13643-024-02740-9","url":null,"abstract":"<p><strong>Background: </strong>Despite a global drop of under-five mortality by 59% between 1990 and 2019, it remains high in Low- and Middle- income Countries (LMICs)with a preponderance in Sub-Saharan Africa (SSA), Southern and Central Asia. Besides preterm and intrapartum complications, undernutrition contributes 45% of the deaths in these developing regions. In Africa, under-five mortality due to severe acute malnutrition (SAM) has stagnated at 10-40%, higher than WHO targets and the SDGs projections.</p><p><strong>Methods: </strong>We searched MEDLINE (via PubMed), Scopus, Web of Science, Science direct, Google Scholar, Cochrane Library and Open Grey databases for literature reporting under-five mortality due to SAM in Africa from 2014 to 2024. Estimates of the primary and secondary outcomes were pooled using a random-effects meta-analysis due to the anticipated between study heterogeneity.</p><p><strong>Results: </strong>Fifty-two out of 82 studies (63.4%) analyzed reported an overall under-five mortality of 11% (95%CI: 0.08-0.13). Diarrheal diseases, human immunodeficiency virus (HIV) and pneumonia were the three most frequently reported risk factors associated with mortality by 21 (40.1%), 20 (38.5%), and 14 (26.9%) studies, respectively. No significant regional variation was found.</p><p><strong>Conclusion: </strong>Under-five mortality due to SAM in Africa is still high as reported in the included studies. There were no regional variations. Diarrheal diseases, HIV and pneumonia were the most frequently reported risk factors associated with under-five mortality due to SAM in Africa.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"29"},"PeriodicalIF":6.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of religion and spirituality on head and neck cancer patients and their caregivers: a protocol for a scoping review.","authors":"Maheeka Seneviwickrama, Ruwan Jayasinghe, Kehinde Kazeem Kanmodi, Simon N Rogers, Su Keill, Sakuntha Ratnapreya, Sriyani Ranasinghe, Sashini Shehana Denagamagei, Irosha Perera","doi":"10.1186/s13643-025-02768-5","DOIUrl":"10.1186/s13643-025-02768-5","url":null,"abstract":"<p><strong>Introduction: </strong>Head and neck cancers (HNC) are devastating, thus imposing a negative impact on the appearance of an individual as well as vital activities such as eating, swallowing, speaking, and breathing. Therefore, HNC patients undergo distress, while their caregivers become overburdened. Religion and spirituality can be helpful for patients and their caregivers from diverse cultural backgrounds to cope with cancer. Though well established in palliative care, religion and spirituality are rarely incorporated into usual early oncological care. Despite the availability of heterogeneous literature examining the influence of religion and spirituality on cancer patients, there is notably limited research on this topic across the HNC trajectory. Therefore, this scoping review attempts to answer \"What is the influence of religion or spirituality on HNC patients and their caregivers in different contexts?\" and will map the evidence on the influence of religion and spirituality on HNC patients and their caregivers in different contexts including geographical areas, cultures, health care systems, and different study settings.</p><p><strong>Methods: </strong>This scoping review was formulated using the guidelines of Joanna Briggs Institute (JBI) manual for evidence synthesis: scoping reviews and will be reported confirming to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR checklist). A comprehensive search strategy will include Embase, CINAHL, Scopus, and APA PsycINFO. The OPENGREU.EU and Google Scholar will be used as gray literature sources complimented by manual searches. Our eligibility criteria follow the population, concept, and context (PCC) framework. Patients aged ≥ 18 years diagnosed with HNC and their informal, nonpaid caregivers aged > 18 years will be included. The data will be extracted using piloted data extraction form on sociodemographic, disease-related, and treatment-related factors and outcomes, and the data will be analyzed through descriptive statistics and thematic analysis. The results will be narratively synthesized.</p><p><strong>Conclusions/discussion: </strong>This review will aim to explore existing literature and summarize the findings of studies that examine the influence of religion and spirituality among HNC patients and their caregivers and vice versa over a range of physical, psychological, and social outcomes including quality of life. We also aim to identify existing research gaps. The findings of this review would generate evidence to better inform health care providers in countries and cultures in the management of patients diagnosed with HNC in usual oncological care with due consideration to caregivers.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"27"},"PeriodicalIF":6.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To what extent are digital health interventions targeting HIV care cascade among mobile populations feasible, acceptable, and effective? A mixed methods systematic review protocol.","authors":"Thulile Mathenjwa, Bessie Malila, Lucia Knight, Frank Tanser, Patricia Makwambeni, Tamsin K Phillips","doi":"10.1186/s13643-024-02747-2","DOIUrl":"10.1186/s13643-024-02747-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Human mobility is associated with an increased risk of HIV acquisition and disengagement from HIV care, leading to poorer health outcomes among highly mobile individuals compared to less mobile individuals. Mobile individuals, broadly defined as those who temporally, seasonally, or permanently move from one place to another for voluntary or involuntary reasons, face many challenges in accessing HIV care services. These challenges include logistical difficulties, interruptions in HIV care continuity, and limited access to services across different locations, which together hinder timely testing, treatment initiation, and viral suppression. Digital health interventions offer flexible approaches that can adjust to the mobile individual's location to improve HIV care engagement and health outcomes for this underserved and hard-to-reach population. However, evidence on the feasibility, acceptability, and efficacy of digital health interventions across the HIV care cascade among mobile populations has not yet been appraised.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We seek to synthesize empirical evidence on the feasibility, acceptability, and efficacy of digital health interventions targeting the HIV care cascade among mobile populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We will conduct a mixed methods systematic review of peer reviewed studies published between 1 January 2010 and 31 July 2024 that evaluated digital health interventions targeting the HIV care cascade among mobile populations. We will search PubMed, Web of Science, and EBSCOhost (Academic Search Premier, Africa-Wide information, CINAHL, Health Source: Nursing/Academic Edition, APA PsycInfo, APA PsycArticles) electronic databases. Bibliographies of retrieved studies will also be reviewed for relevant citations. Only studies published in English language and involved a digital health intervention, report an outcome related to the HIV care cascade, and involve mobile populations either partially or completely will be included. Two reviewers will independently screen titles and abstracts against the inclusion criteria, followed by full text screening for eligible articles. In case of disagreements, consensus will be sought from a third reviewer. Data synthesis will follow the Joanne Briggs Institute's convergent segregated approach. If sufficient quantitative studies with comparable outcome measures are available, a meta-analysis will be performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This review will address a critical evidence gap by consolidating data on digital health interventions' feasibility, acceptability, and efficacy across the HIV care cascade among mobile populations. The results will inform the development of tailored digital health interventions to enhance HIV care delivery and health outcomes for this hard-to-reach population, supporting global HIV prevention and treatment goals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Systematic review registration: &lt;/strong&gt;This protocol is","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"28"},"PeriodicalIF":6.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II-IVa esophageal cancer: a network meta-analysis.","authors":"Mingxing Wang, Wanhui Dong, Gongyi Wu, Baorui Zhang, Tong Lai, Aixin Liu, Qingming Sun","doi":"10.1186/s13643-025-02765-8","DOIUrl":"10.1186/s13643-025-02765-8","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the clinical efficacy and safety of neoadjuvant immunochemotherapy in the treatment of locally advanced, resectable esophageal cancer.</p><p><strong>Methods: </strong>Literature published before November 2023 on the clinical efficacy and safety of neoadjuvant immunotherapy in resectable esophageal squamous cell carcinoma was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature, PubMed, Embase, Cochrane, and the Web of Science. A meta-analysis was conducted using Stata 17.0.</p><p><strong>Results: </strong>The cumulative ranked probability results indicated that Camrelizumab + TN had the highest probability of achieving pCR, Camrelizumab + TP of achieving MPR, and Sintilimab + TP of achieving DCR and ORR. Camrelizumab + TP also had the highest probability of achieving an R0 resection rate. In terms of adverse events and postoperative complications, Pembrolizumab + TN had the highest likelihood of inducing myelosuppression and rash. Toripalimab + TP had the highest probability of inducing vomiting, while traditional chemotherapy alone had the highest likelihood of inducing postoperative cardiac adverse events.</p><p><strong>Conclusion: </strong>Neoadjuvant immunotherapy combined with chemotherapy has demonstrated superior clinical efficacy and safety compared to chemotherapy alone. The regimen of Camrelizumab + TP showed significant advantages in pCR, MPR, DCR, and R0 resection rates, particularly excelling in MPR and R0 resection rates. However, it was associated with a higher incidence of rash compared to chemotherapy alone and the Toripalimab + TP regimen. Neoadjuvant immunotherapy, when combined with chemotherapy, has been shown to reduce the occurrence of postoperative cardiac adverse events. Among the various treatment options, Sintilimab + TP exhibited the most favorable outcomes.</p><p><strong>Systematic review registration: </strong>PROSPERO Protocol Number: CRD42024623160.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"26"},"PeriodicalIF":6.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of sodium-glucose cotransporter-2 inhibitors on the incidence, therapy, and outcomes of fournier gangrene: insights from a systematic review of case reports.","authors":"Yufi Aulia Azmi, Firas F Alkaff, Kevin Muliawan Soetanto, Soetojo Wirjopranoto, Maarten J Postma, Abdul Khairul Rizki Purba","doi":"10.1186/s13643-024-02746-3","DOIUrl":"10.1186/s13643-024-02746-3","url":null,"abstract":"<p><strong>Background: </strong>The clinical characteristics, therapy, and outcome of Fournier Gangrene (FG) in patients using sodium-glucose cotransporter-2 inhibitors (SGLT2i) were examined in this systematic review.</p><p><strong>Methods: </strong>Without a publication year restriction, we searched PubMed, ScienceDirect, and Cochrane. Additionally, we manually searched bibliographies using the terms \"Fournier's gangrene\" and \"SGLT2 inhibitors.\" The requirements for inclusion were the English language case reports with specific patient data and FG patients with diabetes who were using SGLT2 medication. The risk of bias was analyzed utilizing the Joanna Briggs Institute checklists.</p><p><strong>Results: </strong>A total of 78 studies were identified, and 14 of them were included in this review. The duration of SGLT2i use varied from 6 months to 6 years. The patients' age varied from 34 to 72 years, with 10 studies including male participants only and patients with obesity. All studies have discontinued SGLT2i and replaced them with other anti-diabetic drugs. Therapy options included perianal ring block, insulin, rigid sigmoidoscopy, aggressive debridement, antibiotics, fluid resuscitation, incision, drainage, surgery, hyperbaric oxygen therapy, plastic surgery, and fasciocutaneous flaps. Seven studies reported patients discharged in the range of 9-51 days.</p><p><strong>Conclusions: </strong>The incidence of FG following SGLT2i use is rare. Therapy was performed by replacing SGLT2i with other anti-diabetic drugs. The patient's outcome improved after treatment.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"25"},"PeriodicalIF":6.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and efficacy of cannabinoids for the treatment of mental health and substance use disorders: protocol for a systematic review and meta-analysis.","authors":"Jack Wilson, Andrew Langcake, Zachary Bryant, Tom P Freeman, Janni Leung, Gary C K Chan, Amir Englund, Myfanwy Graham, Emily Stockings","doi":"10.1186/s13643-024-02657-3","DOIUrl":"10.1186/s13643-024-02657-3","url":null,"abstract":"<p><p>There has been a global increase in the use of cannabinoids as a treatment for mental health (MH) and substance use disorders (SUD). In 2016, an Australian government-funded review found that although medicinal cannabinoids accounted for a small reduction in MH symptoms, the results varied according to study design. There has since been a rise in randomised controlled trials (RCTs) aiming to examine the efficacy of cannabinoids for the treatment of MH and SUD. Therefore, the current systematic review will (a) identify all RCTs examining the efficacy of cannabinoids in treating MH and SUD, (b) provide a quantitative or narrative synthesis of the evidence examining efficacy, and (c) synthesise adverse event data to examine evidence of harm. Electronic databases (Ovid MEDLINE, PsychINFO, Cochrane Central Register of Controlled Clinical Trials, Cochrane Database of Systematic Reviews, and Embase) were searched from 1980 to 24 May 2023. The study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. Articles will be screened to capture peer-reviewed RCTs evaluating the efficacy of plant-based and pharmaceutical cannabinoids in reducing or treating MH and SUD among people of any age. The Cochrane risk of bias tool 2.0 will be used to assess bias, while the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool will be used to assess the quality of evidence for each outcome. Study findings will be disseminated through published manuscripts, conferences, and health policy guidelines.Systematic review registration PROSPERO CRD42023392718.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"23"},"PeriodicalIF":6.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative or neo/adjuvant chemoimmunotherapy versus chemotherapy for resectable non-small cell lung cancer: a systematic review and network meta-analysis.","authors":"Qiong Zhang, Jia Duan, Yuanmei Zhang, Lei Yang, Duo Li","doi":"10.1186/s13643-025-02767-6","DOIUrl":"10.1186/s13643-025-02767-6","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer, particularly non-small cell lung cancer (NSCLC), is a leading cause of cancer-related deaths globally. Despite surgery being the main treatment for resectable NSCLC, many patients experience postoperative recurrence. Neoadjuvant chemotherapy may shrink tumors and improve surgical outcomes, while adjuvant chemotherapy targets residual disease post-surgery. Recent advancements in immunotherapy have introduced its use in the perioperative phase for resectable NSCLC. This study investigates the relative benefits and potential complications of neoadjuvant, adjuvant, and perioperative immunotherapy combined with chemotherapy compared to chemotherapy alone, focusing on event-free survival (EFS), overall survival (OS), and adverse events (AEs).</p><p><strong>Methods: </strong>This systematic review and network meta-analysis followed PRISMA guidelines and was registered with PROSPERO. The authors searched PUBMED, Embase, and Cochrane databases for randomized controlled trials (RCTs) involving patients with resectable NSCLC treated with neoadjuvant/adjuvant immunotherapy or chemotherapy. Statistical analyses were performed using a frequentist network meta-analysis method in R software.</p><p><strong>Results: </strong>From an initial 5902 articles, 13 RCTs involving 6704 patients were included after extensive filtering. PFS: Neoadjuvant and perioperative immunotherapy combined with chemotherapy showed significant benefits compared to chemotherapy alone. OS: Perioperative immunotherapy was notably more effective than adjuvant immunotherapy and standard chemotherapy. Chemotherapy generally had fewer severe adverse effects compared to neoadjuvant and perioperative immunotherapy. However, these immunotherapy combinations are generally well tolerated.</p><p><strong>Conclusions: </strong>The findings indicate that neoadjuvant and perioperative immunotherapy combined with chemotherapy can significantly improve overall survival in patients with resectable NSCLC compared to standard chemotherapy. However, additional adverse effects associated with long-term immunotherapy require careful management. The lack of significant benefits in specific subgroups suggests a need for further research. The study stresses the importance of optimizing treatment strategies and potentially reassessing immunotherapy's role in certain patient populations. Future clinical trials are anticipated to clarify these results further.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"24"},"PeriodicalIF":6.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The resilience of parents and carers who administer medicines to children at home: a qualitative systematic review protocol.","authors":"Stephen Morris, Simon Pini, Beth Fylan, Franki Wilson, Helen Faulkner, David P Alldred","doi":"10.1186/s13643-024-02724-9","DOIUrl":"10.1186/s13643-024-02724-9","url":null,"abstract":"<p><strong>Background: </strong>Parents and carers are increasingly expected to administer prescribed medicines to their children at home. However, parents and carers are not always able to administer medicines as directed by the prescriber and ultimately must rely on their own judgment to administer medicines safely. This process is often unseen but may contain important learning for professionals, academics, and wider society. Studying safety in everyday healthcare work presents researchers with many challenges. However, recent developments in our understanding of resilience and how it manifests within healthcare can provide an effective framework for enquiry. The aim of this review is to use resilience theory to explore parents' and carers' experiences when administering medicines to children at home.</p><p><strong>Methods: </strong>This systematic review will follow the framework synthesis method. An iterative search strategy, using a scoping search of the major databases (Embase, PyscINFO, CINAHL, Cochrane and PubMed) will be used. The three main search terms are parents and carers, administration of medicines, and the home environment. Included studies will contain qualitative data and investigate the experiences of parents or carers who administer prescribed medicines to children at home. Relevant studies will be quality assessed using the Joanna Briggs Institute critical appraisal checklist for qualitative research. Framework synthesis will be completed by following five stages: familiarisation, thematic framework identification, indexing, charting, mapping, and interpretation. The findings identified in the data extraction phase will be indexed and charted according to the three elements of Moments of Resilience theory.</p><p><strong>Discussion: </strong>This protocol describes a novel method to address an important patient safety issue. A strength of this review will be not only to identify, describe and collate existing studies, but also to learn about the application of resilience theory to a medication safety topic. The knowledge generated from this will inform intervention development to improve the support for families to administer medicines safely at home.</p><p><strong>Systematic review registration: </strong>This review has been registered on the International Prospective Register of Systematic Reviews database (PROSPERO) #487154.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"22"},"PeriodicalIF":6.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacillus Calmette-Guerin (BCG) infections following intravesical BCG immunotherapy: a systematic review protocol.","authors":"Roberta Monardo, Sana Arif, Aparna Rege, Erin Simon, Leila Ledbetter, Arthur W Baker, Jason Stout, Manuela Carugati","doi":"10.1186/s13643-025-02761-y","DOIUrl":"10.1186/s13643-025-02761-y","url":null,"abstract":"<p><strong>Background: </strong>Although intravesical Bacillus Calmette-Guerin (BCG) immunotherapy usually exhibits a favorable safety profile, it can lead to the development of BCG infections, both localized and disseminated. Understanding of BCG infections following intravesical BCG immunotherapy is limited because of the lack of consensus definitions of BCG infections and limited post-instillation follow-up. We aim to perform a systematic review of the literature of BCG infections following intravesical BCG immunotherapy to elucidate the epidemiology, risk factors, and outcomes of BCG infections.</p><p><strong>Methods: </strong>Systematic review of peer-reviewed published articles that describe the treatment of one or more persons with intravesical BCG and the occurrence of BCG infections among these patients. No temporal, geographic, or demographic limitations will be applied. Animal studies will be excluded. Gray literature, editorials, and comments will be excluded. Information sources will include the following databases: MEDLINE, Embase, and Web of Science. A search concept representing BCG and intravesical administration will be applied after validation against a set of pre-selected articles. Screening and data extraction will be performed in duplicate by two independent reviewers. Disagreements will be resolved by a third independent reviewer. The methodological quality of studies will be assessed using the Mixed Methods Appraisal Tool. A narrative synthesis of the extracted data will be provided in line with the guidance from the Centre for Reviews and Dissemination. The quality of evidence for all outcomes will be judged using the Grading of Recommendations Assessment, Development, and Evaluation working group methodology.</p><p><strong>Discussion: </strong>The data generated by this review will assist clinicians in managing BCG-infected patients and inform future research efforts.</p><p><strong>Systematic review registration: </strong>In accordance with international guidelines, our systematic review protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on February 26, 2024.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"21"},"PeriodicalIF":6.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internalizing and externalizing symptoms in individuals with neurofibromatosis type 1: a systematic review and meta-analysis.","authors":"Dan Liu, Liyan Yu, Xian Wu, Julia Moreira, Benjamin Felipe Mujica, Elora Shelly Mukhopadhyay, Angelena Novotney, André B Rietman, Yang Hou","doi":"10.1186/s13643-024-02749-0","DOIUrl":"10.1186/s13643-024-02749-0","url":null,"abstract":"<p><strong>Background: </strong>Individuals with neurofibromatosis type 1 (NF1) frequently report psychosocial problems, among which internalizing and externalizing symptoms are the most poorly understood due to limited research and inconsistent evidence. This hinders the overall attendance of their psychosocial needs and has a major impact on their quality of life. Thus, this systematic review and meta-analysis was conducted to synthesize existing findings on the degree to which individuals with NF1 experience internalizing and externalizing symptoms, compared with the unaffected population, and explore moderators of the group disparities.</p><p><strong>Methods: </strong>Scopus, PsycINFO, Web of Science, PubMed, and ProQuest were searched from inception to March 26th, 2024, which identified 59 eligible studies (N of NF1 = 3182, mean ages 2.38 to 46.4 years). Hedges' g was calculated for differences in internalizing and externalizing symptoms between the NF1 group and the unaffected controls. Study effect sizes were pooled using robust variance estimation and random-effects models. Moderators of group differences were tested using meta-regression.</p><p><strong>Results: </strong>Random-effects meta-analyses indicated that compared with unaffected controls, individuals with NF1 showed more severe depressive (k = 21; g = 0.43; 95% CI [0.21, 0.65]), anxiety (k = 24; g = 0.27; 95% CI [0.01, 0.54]), somatic (k = 27; g = 0.56; 95% CI [0.30, 0.83]), total internalizing (k = 75; g = 0.50; 95% CI [0.33, 0.67]), aggression (k = 33; g = 0.33; 95% CI [0.08, 0.58]), delinquency, (k = 37; g = 0.43; 95% CI [0.26, 0.60]), and total externalizing symptoms (k = 47; g = 0.24; 95% CI [0.13, 0.35]). Studies that included more participants with NF1 who had ADHD or a lower verbal IQ reported greater group disparities in total internalizing symptoms or aggression.</p><p><strong>Conclusions: </strong>Findings highlight the importance of promptly recognizing internalizing and externalizing symptoms in individuals with NF1 for timely interventions. Future research should identify predictors of internalizing and externalizing symptoms within the NF1 population to inform our knowledge and intervention development. Other implications for future research were also discussed.</p><p><strong>Systematic review registration: </strong>The study protocol of this meta-analysis was registered at PROSPERO (CRD42023478258).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"20"},"PeriodicalIF":6.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}