Postgraduate medicine最新文献

{"title":"Impact of low-dose aspirin on the prevalence of anemia in elderly patients: a systematic review and meta-analysis.","authors":"Vitória Martins Prizão, Mariana de Moura de Souza, Beatriz Austregésilo de Athayde De Hollanda Morais, Beatriz Ximenes Mendes, Otávio Cosendey Martins, Maria Luiza Rodrigues Defante, Juliana Queiroz Vasconcelos Muniz, Bruno Francisco Buzetti Spinelli","doi":"10.1080/00325481.2024.2446010","DOIUrl":"10.1080/00325481.2024.2446010","url":null,"abstract":"<p><strong>Background: </strong>Aspirin is largely used for cardiovascular prevention. While its adverse effect on bleeding is well-documented, the prevalence of anemia remains uncertain. We conducted a meta-analysis on how low-dose aspirin affects hemoglobin and other hematologic parameters in the elderly.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane for studies comparing the hematological parameters and the prevalence of anemia between low-dose aspirin (≤325 mg) and non-aspirin users in individuals aged older than 60 years. We pooled mean differences (MD) for continuous outcomes and odds ratio (OR) for binary outcomes, with 95% confidence intervals (CI), under a random-effects model for both.</p><p><strong>Results: </strong>Seven studies were included, including three randomized controlled trials (RCTs), totaling 19,792 participants. Among them, 9,771 (49.3%) were treated with aspirin; 55.4% were women and 44% had a history of smoking. There was no significant difference in anemia prevalence (OR 0.85; 95% CI 0.52-1.38; <i>p</i> = 0.50). Mean Corpuscular Hemoglobin (MD 0.06 pg; 95% CI -0.37 to 0.49; <i>p</i> = 0.79), Mean Corpuscular Volume (MD -0.31 fl; 95% CI -1.17 to 0.56; <i>p</i> = 0.49), and hemoglobin concentration (MD -0.02 g/dL; 95% CI -0.26 to 0.21; <i>p</i> = 0.85) between the two groups. However, hemoglobin decline from baseline was higher in aspirin users (MD -0.11 g/dL; 95% CI -0.17 to -0.05; <i>p</i> = 0.0002; I² = 0%).</p><p><strong>Discussion: </strong>Our study employs rigorous methodology and a substantial patient cohort, marking the first quantitative meta-analysis in the past decade. Limitations include diverse study designs, short follow-up durations, gender-specific anemia criteria, and insufficient ferritin and iron levels data. Nonetheless, our findings suggest that while low-dose aspirin does not increase anemia prevalence, it is associated with declining hemoglobin levels over time.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"148-154"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical intervention for patients with fibrinopurulent pleural empyema and acute respiratory failure: a case report.","authors":"Hang Guo, Wenmao Zhuang, Yan Zhang, Xiao Qi, Baofeng Li, Jingcheng Wang, Chunguang Wang","doi":"10.1080/00325481.2024.2446009","DOIUrl":"10.1080/00325481.2024.2446009","url":null,"abstract":"<p><strong>Background: </strong>Fibrinopurulent thorax is a rare condition that can lead to respiratory failure. Fibroblastic decortication surgery has been shown to be an effective treatment for chronic empyema in previous studies. However, there is limited evidence supporting surgical intervention for fibrinopurulent thorax in cases of respiratory failure.</p><p><strong>Case description: </strong>We report a case of a male patient with a fibrinopurulent thorax and acute respiratory failure. The patient required invasive mechanical ventilation but showed no improvement, necessitating surgical intervention for empyema drainage. DNA gene sequencing technology was employed to diagnose the infection etiology, which facilitated the adjustment of antibiotics. This approach ultimately led to the patient's improvement and liberation from the ventilator.</p><p><strong>Conclusion: </strong>This case demonstrates the efficacy of surgical treatment for fibrinopurulent thorax with respiratory failure, a scenario not previously documented in literature. Successful treatments for pneumonia and chronic empyema in the context of respiratory failure have provided both inspiration and validation for this approach. The findings of this case highlight the potential of surgical intervention as a new treatment option for clinical practice. However, as this is a single case report, further research is necessary to validate the efficacy and safety of this treatment method.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with renal involvement in adult immunoglobulin a vasculitis: what is it?","authors":"Özlem Kılıç, Duygu Tecer, Mehmet Nur Kaya, Merve Sungur Özgünen, Muhammet Çınar, Sedat Yılmaz","doi":"10.1080/00325481.2025.2454216","DOIUrl":"10.1080/00325481.2025.2454216","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to examine the potential of specific parameters in determining renal involvement in adult patients diagnosed with Immunoglobulin A vasculitis (IgAV).</p><p><strong>Methods: </strong>The patients' records with IgAV meeting the EULAR/PRINTO/PRES classification criteria who were diagnosed between January 2017 and January 2022 were retrospectively reviewed. The Birmingham Vasculitis Activity Score (BVAS) version 3 was used to assess initial disease activity. A comparison was conducted between the data of patients with and without renal involvement. To investigate factors associated with renal involvement, the significant parameters were used to develop a forward stepwise multivariate regression model. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the predictive ability of significant parameters for renal involvement.</p><p><strong>Results: </strong>The study included 85 patients, of whom 22 (25.9%) had renal involvement. Patients with renal involvement had a median age of 60.5 years and a median follow-up of 56.3 months. The median BVAS and ferritin/albumin ratio (FAR) values were significantly higher in patients with renal involvement (<i>p</i> < 0.001). Multivariate regression analysis identified initial BVAS and FAR values as factors associated with renal involvement. ROC analysis demonstrated that the initial BVAS and FAR values were associated with renal involvement, with AUCs of 0.882 and 0.817, respectively (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The initial BVAS above 7.5, and baseline FAR above 24.97 are factors associated with renal involvement. The results of this study may provide the basis for identifying individuals at high risk for renal involvement and, consequently, for more rigorous monitoring.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"174-181"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of primary health care practitioners toward bleeding management in Saudi Arabia: a cross-sectional analysis.","authors":"Abdulaziz Mohammad Al-Sharydah, Faisal Ahmad Katbi, Razan Essam AlHarbi, Faisal Al-Ghamdi, Saleh AlShreadah, Bander Fuhaid AlDhafery","doi":"10.1080/00325481.2025.2452146","DOIUrl":"10.1080/00325481.2025.2452146","url":null,"abstract":"<p><strong>Objectives: </strong>High rates of morbidity and mortality are a result of trauma being a significant health burden in Saudi Arabia. We evaluated the current trends of primary healthcare (PHC) physicians in Saudi Arabia toward patients with bleeding and their referral awareness for percutaneous endovascular arterial embolization (EAE).</p><p><strong>Methods: </strong>We formulated a 13-question survey to assess PHC physicians' knowledge regarding decision-making and appropriate approaches to manage patients with traumatic and non-traumatic abdominopelvic and lower limb bleeding. We conducted in-person surveys with various specialists with varying levels of clinical experience in Saudi Arabia.</p><p><strong>Results: </strong>Overall, 112 PHC physicians were assessed. Of them, 43.75% had ≥ 5 years of independent practice experience, and 72.3% and 27.7% encountered bleeding patients rarely and routinely, respectively. General practitioners scored lower across all questions than other PHC physicians. Physicians with > 10 years of practice had higher median scores in decision-making questions (<i>p</i> = 0.159). Internists and gynecologists (<i>p</i> = 0.046) and physicians (<i>p</i> = 0.050) in tertiary-care settings had significantly higher median scores on decision-making questions. Pediatricians (<i>p</i> = 0.091) and PHC physicians (<i>p</i> = 0.440) at private institutions had higher median scores on approach appropriateness questions.</p><p><strong>Conclusions: </strong>PHC physicians in Saudi Arabia require a better understanding of the indications of EAE to avoid referral and triage errors, inefficient use of healthcare resources, and suboptimal patient outcomes.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"189-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of guidelines for hyperthyroidism: systematic quality assessment using the AGREE II tool.","authors":"Yuanshan Wang, Jun Zhang, Xiaoliang Cheng, Xiaoling Duan, Ying Liang, Dali Sun","doi":"10.1080/00325481.2025.2451019","DOIUrl":"10.1080/00325481.2025.2451019","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to systematically assess the quality of different guidelines for the management of patients with hyperthyroidism and to explore and analyze the recommendations and key evidence in different guidelines.</p><p><strong>Methods: </strong>A systematic search of databases and websites was conducted to identify treatment guidelines for hyperthyroidism. The quality of the included guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. To evaluate the level of agreement among the guidelines, we employed the Measurement Scale of Rate of Agreement (MSRA), extracting and analyzing the evidence supporting these recommendations.</p><p><strong>Results: </strong>Eleven guidelines for the management of patients with hyperthyroidism were identified. The guidelines from the American Thyroid Association (ATA), the Japanese Thyroid Association (JTA), the European Thyroid Association (ETA, 2022) and the Chinese Medical Association (CMA) had overall quality scores greater than 60% and warranted clinical recommendation. Recommendations vary widely across guidelines, and the main reasons included different emphases on the diagnosis of hyperthyroidism, different target populations, irrational selection of evidence and geographic variation.</p><p><strong>Conclusions: </strong>The quality of hyperthyroidism treatment guidelines is variable, and treatment recommendations vary greatly from guideline between guidelines. Analyzing and improving the causes of inconsistencies in recommendations for patients with hyperthyroidism could be a reasonable and effective way for developers to improve the quality of guidelines for the management of hyperthyroidism.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"139-147"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic, hormonal profiles and comorbidities in pituitary Cushing's syndrome, adrenal Cushing's syndrome and mild autonomous cortisol secretion: a comparative study.","authors":"Belma Özlem Tural Balsak, Narin NasiroglU Imga, Şefika Burçak Polat, Cevdet Aydin, Oya Topaloğlu, Reyhan Ersoy, Bekir Çakir","doi":"10.1080/00325481.2025.2455373","DOIUrl":"10.1080/00325481.2025.2455373","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aimed to discern disparities in metabolic, hormonal profiles, and comorbidities among patients with pituitary Cushing (PC), adrenal Cushing (AC), and Mild autonomous cortisol secretion (MACS).</p><p><strong>Methods: </strong>We conducted a retrospective analysis involving 76 patients diagnosed with PC (<i>n</i> = 26), AC (<i>n</i> = 21), and MACS (<i>n</i> = 29) at our clinic. We compared the groups' demographic data, clinical characteristics, biochemical profiles, hormonal analyses, and surgical interventions.</p><p><strong>Results: </strong>No significant differences were noted in age, height, body mass index, or gender distribution among the groups, although a higher proportion of females was observed across all three groups. However, PC patients exhibited markedly elevated 24-hour urinary cortisol levels compared to AC and MACS patients. Furthermore, alanine aminotransferase, triglycerides, very low-density lipoprotein, insulin, and basal cortisol levels were significantly elevated in PC and AC cases compared to MACS cases. Interestingly, no significant differences were observed in terms of comorbidities among the groups.</p><p><strong>Conclusion: </strong>Our findings suggest that urinary cortisol levels were significantly higher in the PC group than in the AC and MACS groups, potentially indicating that high-amplitude adrenocorticotropic hormone stimulation may lead to increased cortisol secretion in PC patients. The increased utilization of imaging methods has facilitated the earlier detection of adrenal incidentalomas, enabling the diagnosis of adrenal Cushing's cases with milder cortisol elevations. Additionally, the severity of disease symptoms worsens with increasing cortisol levels.Notably, moderate increases in cortisol are associated with heightened comorbidities, underscoring the importance of vigilant management in Cushing's syndrome patients. Despite a lower degree of hypercortisolism in MACS, there were no differences in comorbidities, suggesting that even mild cortisol secretion abnormalities are sufficient to establish the presence of comorbidities. Even moderate increases in cortisol levels can impact bone metabolism.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"182-188"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of rhabdomyolysis in patients with mental disorders.","authors":"Ya-Wen Lu, Jong-Yi Wang, Tzu-Ju Hsu, Wei-Sheng Chung","doi":"10.1080/00325481.2025.2466411","DOIUrl":"10.1080/00325481.2025.2466411","url":null,"abstract":"<p><strong>Objectives: </strong>Rhabdomyolysis is caused by rapid muscle breakdown. Although patients with mental disorders are more susceptible to rhabdomyolysis, its incidence in this group is poorly established. Therefore, we conducted a population-based cohort study to investigate its incidence and risk in this group.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 120,094 patients with mental disorders and 120,094 control patients from the Taiwan National Health Insurance Research Database. We excluded patients with rhabdomyolysis diagnosed before the index date, which was defined as the date of the first diagnosis of the mental disorder and beginning of antipsychotic medication. We matched the case cohort 1:1 with a control cohort by a propensity score method.</p><p><strong>Results: </strong>The overall incidence of rhabdomyolysis were 3.21 per 1000 person-years in the patients with mental disorders and 1.16 per 1000 person-years in the patients without mental disorders. After controlling for potential covariates, the patients with mental disorders showed an adjusted hazard ratio (aHR) of 2.77 (95% Cl: 2.62-2.92) compared with the controls. Men exhibited a risk of rhabdomyolysis 1.29-fold that exhibited by women (95% CI: 1.22-1.35). Alcoholic liver disease (aHR, 2.35) and generalized convulsive epilepsy (aHR, 2.06) were independent risk factors for rhabdomyolysis. Phenothiazines with aliphatic side-chains (aHR, 1.43), or piperidine structures (aHR, 1.54); butyrophenone derivatives (aHR, 1.24); lithium (aHR, 1.18) were independent risk factors for rhabdomyolysis after adjustment for covariates.</p><p><strong>Conclusions: </strong>The risk of rhabdomyolysis is significantly higher for patients with mental disorders than that for patients without mental disorders.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"201-208"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thickening liquids for pediatric dysphagia: a perspective from clinical practice.","authors":"Karen van Hulst, Esther van Ijken, Leonie van Vliet","doi":"10.1080/00325481.2025.2457318","DOIUrl":"10.1080/00325481.2025.2457318","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is a common condition in infants and young children, particularly among those with neurodevelopmental disabilities. The management of pediatric dysphagia requires customized approaches based on individual clinical features. This report describes our experience in managing pediatric dysphagia using a locust bean- and xanthan gum-based thickener (ThickenUp® Junior), which offers stable consistency and preserves the original taste of liquids.</p><p><strong>Case report: </strong>Four cases were discussed to highlight the use of the new thickener. Each case illustrates different aspects of dysphagia management, such as improving swallowing safety, enhancing oral control, and maintaining nutritional intake through tailored thickening strategies. Our experience demonstrates the importance of using specialized thickening agents to prevent aspiration pneumonia and, ultimately, improve the well-being of affected children. We also highlighted the importance of individualized treatment plans, which consider each child's unique needs. A comprehensive evaluation by a multidisciplinary team led to an effective treatment strategy tailored to the child's specific condition and challenges.</p><p><strong>Conclusions: </strong>The new locust bean- and xanthan gum-based thickener is effective in managing dysphagia and preventing complications in infants and young children. Such agents can improve swallowing safety, enhance oral control, and maintain nutritional intake, ultimately improving the well-being of the affected children.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"113-120"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post cardiac surgery acute kidney injury and the role of intravenous amino acids infusions.","authors":"Muhammad Adnan Zaman, Zongaho Pan","doi":"10.1080/00325481.2025.2455370","DOIUrl":"10.1080/00325481.2025.2455370","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"109-112"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative intravenous versus oral iron supplementation for elective surgery: evidence based on 12 randomized trials.","authors":"Lei Yue, Jianming Zhang, Chao Li, Ziqi Wang, Longtao Qi, Yao Zhao, Shijun Wang, Meixia Shang, Chunde Li, Haolin Sun","doi":"10.1080/00325481.2025.2454218","DOIUrl":"10.1080/00325481.2025.2454218","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to clarify hematological parameters, transfusion requirements, and adverse events of preoperative intravenous (IVIS) versus oral iron supplementation (OIS) in elective surgery patients.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search across multiple databases up to 10 December 2023. Twelve RCTs involving 930 participants met our eligibility criteria. Our analysis focused on post-treatment hemoglobin levels, changes in hemoglobin from baseline, ferritin levels, hemoglobin attainment rates, transfusion requirements, and adverse events. We employed the random-effects model for data synthesis, calculating pooled standard mean differences (SMD) or mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI). Methodological quality was assessed using the Cochrane ROB 2 tool. The GRADE approach evaluated the confidence in effect estimates.</p><p><strong>Findings: </strong>IVIS significantly improved post-treatment hemoglobin levels (MD = 0.77 g/dL, 95% CI [0.30 to 1.23]), hemoglobin increments (MD = 0.69 g/dL, 95% CI [0.01 to 1.37]), and ferritin levels (MD = 260.03 ng/mL, 95% CI [119.65 to 400.42]) compared to OIS. IVIS also led to a higher hemoglobin attainment rate (RR = 1.88, 95% CI [1.24 to 2.86]). No significant differences were noted in transfusion rates or volumes. IVIS was associated with fewer digestive (RR = 0.10, 95% CI [0.05 to 0.22]; I2 = 0%) but more pain-related adverse events (RR = 7.79, 95% CI [1.78 to 34.07]; I2 = 0%). Hospital stay durations and mortality rates were similar between the two groups.</p><p><strong>Interpretation: </strong>IVIS offers a superior improvement in hematological parameters for elective surgery patients but not reducing transfusion needs compared to OIS. While IVIS has fewer digestive adverse events, it increases pain-related complications. These findings highlight the importance of personalized approaches in selecting iron supplementation methods, carefully balancing time, efficacy, and adverse event profiles.</p><p><strong>Registration: </strong>PROSPERO CRD42023483284.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"155-163"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}