Systematic Reviews最新文献

{"title":"Effect of exercise training on cardiac autonomic function in type 2 diabetes mellitus: a systematic review and meta-analysis.","authors":"Sohini Raje, G Arun Maiya, Padmakumar R, Mukund A Prabhu, Krishnananda Nayak, Shivashankara Kn, B A Shastry, Megha Nataraj","doi":"10.1186/s13643-025-02772-9","DOIUrl":"10.1186/s13643-025-02772-9","url":null,"abstract":"<p><strong>Background: </strong>Cardiac autonomic neuropathy (CAN) is an underdiagnosed complication of type 2 diabetes mellitus (T2DM) and is associated with cardiovascular morbidity and mortality. Cardiac autonomic reflex tests (CARTs) are the gold standard; they are non-invasive and clinically feasible for screening CAN. The objective of the present meta-analysis was to examine exercise's effect on cardiac autonomic function using CARTs in T2DM.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Review and Meta-Analysis Checklist (PRISMA) was used. Electronic databases were systematically used to retrieve relevant studies after title and abstract screening. Studies utilizing exercise training with cardiac autonomic function (CARTs) outcomes in individuals with type 2 diabetes mellitus were included. The meta-analysis was conducted using RevMan 5.4.1, using the random effects model, and appropriate tests for heterogeneity. The Cohrane ROB-2 tool was used for randomized controlled trials (RCTs) and the ROBINS-I tool for non-RCT for risk of bias assessment were used.</p><p><strong>Results: </strong>Three studies were included (two for meta-analysis), considering the outcome of the E:I ratio, 30:15 ratio, and Valsalva ratio. The studies did not show any influence on the E:I and 30:15 ratio in the pooled analysis with a low risk of ineffectiveness for the exercise intervention. Exercise training significantly affected the Valsalva ratio. A different type of exercise intervention was utilized in all three studies. There was a low to moderate certainty for the evidence.</p><p><strong>Conclusion: </strong>The results indicate that further robust and high-quality randomized controlled trials utilizing cardiac autonomic reflex tests (which have clinical and physiological relevance) in type 2 diabetes mellitus are required for drawing conclusions.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023445561.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"34"},"PeriodicalIF":6.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190420","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":"Acupoint stimulation for postpartum breastfeeding insufficiency: a systematic review and meta-analysis.","authors":"Ya-Ching Chang, Yi-An Wang, Zi-Yu Chang, Jian-An Liao","doi":"10.1186/s13643-025-02773-8","DOIUrl":"10.1186/s13643-025-02773-8","url":null,"abstract":"<p><strong>Background: </strong>Insufficient lactation, known as hypogalactia, is an important reason for weaning. To date, no effective methods have been established to increase lactation volume. With the advantages of low cost and convenience, acupoint stimulation-defined as any stimulation applied at acupoints-is a promising option.</p><p><strong>Objectives: </strong>The aim of this systematic review was to evaluate the effectiveness of acupoint stimulation for postpartum breastfeeding insufficiency.</p><p><strong>Methods: </strong>A systematic search of seven databases (PubMed, MEDLINE, Embase, Cochrane, CNKI, Airiti Library, ClinicalTrials.gov) was performed from their inception dates to September 30, 2023. Randomized trials were included. The inclusion criteria of the intervention included acupuncture, acupressure (including tuina and massage), electroacupuncture, laser stimulation, catgut embedding, and auriculotherapy. The primary outcomes were the amount of lactation and the level of prolactin. Secondary outcomes were colostrum time and adverse effects. The risks of bias were assessed using RoB 2.0.</p><p><strong>Results: </strong>Twenty-four studies involving 3214 participants were included. When compared to the control group, the experimental group exhibited improved volume of milk production (MD = 81.30; 95% CI = 58.94-103.67) and higher prolactin levels (MD = 41.90, 95% CI = 28.57-55.22). Colostrum time was shorter in the control group ([MD = - 7.26; 95% CI = - 10.69 to - 3.83] for continuous data; [RR = 1.70; 95% CI = 1.38-2.08] for dichotomous data). Adverse effects were reported in only one trial, which included three cases of fear of acupuncture and one case of hypotension.</p><p><strong>Conclusions: </strong>Acupoint stimulation may have beneficial effects on postpartum breastfeeding insufficiency. However, the results should be interpreted with caution because of the presence of risks of bias and heterogeneity among studies.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"32"},"PeriodicalIF":6.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123739","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":"Redefining outcomes of ventricular arrhythmia for SGLT2 inhibitor medication in heart failure patients: a meta-analysis of randomized controlled trials.","authors":"Miao Lin, Shiyu Zhang, Lu Zhang, Chengying Yang, Yang Luo, Yajin Peng, Xiaoqiu Tan, Qiang Wen, Xinrong Fan, Xianhong Ou","doi":"10.1186/s13643-025-02766-7","DOIUrl":"10.1186/s13643-025-02766-7","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been shown to lower the risk of re-hospitalization and cardiovascular mortality among heart failure (HF) patients. Nevertheless, the impact of these agents on ventricular arrhythmias (VAs) has not been thoroughly investigated. To assess the beneficial impact of SGLT2 inhibitors on VAs in patients at various stages of HF, a systematic review and meta-analysis of randomized controlled trials involving SGLT2 inhibitors in this patient population was performed.</p><p><strong>Methods: </strong>A comprehensive search of the PubMed, Embase, Ovid, ProQuest, Scopus, and Cochrane databases was performed for clinical trials published up to November 21, 2024. The primary outcomes of interest were incidences of VAs and sudden cardiac death (SCD) between the groups receiving SGLT2 inhibitors and the control drugs. For the outcomes observed in the populations of the included trials and in specific subgroups, hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled and meta-analysed across the analyses.</p><p><strong>Results: </strong>A total of 23 randomized trials (22 placebo-controlled trials and 1 active-controlled trial) involving 74,380 patients (37,372 receiving SGLT2 inhibitors and 37,008 in the control group) were included. The analysed SGLT2 inhibitors included canagliflozin, dapagliflozin, empagliflozin, bexagliflozin, sotagliflozin, and ertugliflozin. The participants were non-advanced HF patients, including at-risk for HF, pre-HF, and symptomatic HF, with follow-up duration ranging from 12 to 296 weeks. Compared with the control, treatment with SGLT2 inhibitors was associated with significantly reduced risk of VAs (risk ratio (RR) 0.85, 95% confidence interval (CI) 0.74-0.98; P = 0.02) and SCD (RR 0.79, 95% CI 0.64-0.98; P = 0.03). Subgroup analyses indicated that longer follow-up (≥ 1 year) taking SGLT2 inhibitors can still reduce the risk of VAs (RR 0.79, 95% CI 0.65-0.96; P = 0.02) and SCD (RR 0.80, 95% CI 0.65-0.99; P = 0.04).</p><p><strong>Conclusion: </strong>SGLT2 inhibitors have beneficial effects on lowering risks of VAs and SCD in patients with type 2 diabetes, cardiovascular diseases, heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction (HFpEF), and heart failure with mildly reduced ejection fraction (HFmrEF), with longer follow-up duration reinforcing these findings. However, future prospective trials are needed to verify the effects of SGLT2 inhibitors on VAs and SCD.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD42024601914).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"31"},"PeriodicalIF":6.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075772","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":"Comparative effectiveness of manual therapy, pharmacological treatment, exercise therapy, and education for neck pain (COMPETE study): protocol of a systematic review with network meta-analysis.","authors":"Ana Izabela Sobral de Oliveira-Souza, Jordana Barbosa-Silva, Douglas P Gross, Bruno R da Costa, Nikolaus Ballenberger, Tiago V Pereira, Liz Dennett, Susan Armijo-Olivo","doi":"10.1186/s13643-024-02737-4","DOIUrl":"10.1186/s13643-024-02737-4","url":null,"abstract":"<p><p>BACKGROUND AND CONTEXT OF THE STUDY: Neck pain is a prevalent and globally burdensome problem. Clinical practice guidelines have recommended conservative treatments such as education, exercise therapy (ET), manual therapy (MT), and pharmacological therapy (i.e., medication) to manage all types of neck pain based on the chronicity of the disease (acute, subacute, and chronic pain). However, there is scarce evidence to determine which interventions constitute the most effective strategy for this condition. RESEARCH QUESTION: What are the best conservative treatment options (i.e., ET, MT, education, and/or medication) to relieve pain and disability-related outcomes in patients with neck pain? THE OVERALL PURPOSE OF THE STUDY: (1) To identify which type of conservative treatment (education, ET, MT, and/or medication) and their combinations have the greatest probability of being most effective for neck pain using a network meta-analysis (NMA) approach. (2) To rank these conservative treatments in terms of safety (when possible) and effectiveness for managing neck pain. METHODOLOGY: Systematic review (SR) with NMA of randomized controlled trials (RCTs). Studies should include adults (aged > 18) with neck pain who received any of the interventions of interest (education, ET, MT, and medication). The main outcome will be pain intensity. Searches will be conducted in Ovid Medline All®, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus, and Cochrane Library Trials database. No language or publication date restrictions will be applied. The revised Cochrane Risk-of-Bias (RoB) tool for RCTs (RoB-2) will be used to evaluate RoB, and the certainty of evidence will be evaluated by Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). NMAs will be conducted to rank interventions according to their effectiveness and safety (when possible), allowing a comprehensive analysis of all available evidence, with different nodes specified for all conservative interventions of interest, placebo, sham therapy, and non-intervention control. This NMA will help clinicians and the scientific community choose the most effective strategy or combinations of strategies for treating neck pain. The information gathered in this project will inform decision-making and guide personalized care of individual patients in the future.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"30"},"PeriodicalIF":6.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075771","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":"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":"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":"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 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}