Latest Articles
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Cochrane Db Syst Rev · Feb 2025
Review Meta AnalysisTransfusion of blood and blood products for the management of postpartum haemorrhage.
Postpartum haemorrhage (PPH) is commonly defined as blood loss of 500 mL or greater within 24 hours after birth. Intravenous transfusions of whole blood, red blood cells (RBC), or other blood components collected from a donor may be administered to manage PPH. Key questions remain regarding optimal timing for initiating blood and blood product transfusion in managing PPH and whether the use of fractionated blood products, either as replacement for or in addition to whole blood transfusion, could improve maternal outcomes. No systematic review has examined appropriate transfusion strategies for managing PPH. ⋯ This protocol for this Cochrane review is registered with PROSPERO. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024599608.
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Review Meta Analysis
The safety and efficacy of stem cell therapy for diabetic peripheral neuropathy in animal studies: A systematic review and meta-analysis.
Diabetic peripheral neuropathy (DPN) is the most common form of diabetic neuropathy, representing 75% of cases and posing a substantial public health challenge. Emerging evidence from animal studies indicates that stem cell therapy holds significant promise as a potential treatment for diabetic neuropathy. Nevertheless, a comprehensive evaluation of the safety and efficacy of stem cell therapy for DPN in animal studies remains outstanding. ⋯ The stem cell subgroup analysis showed that dental pulp stem cells had the greatest effects across all parameters, while bone marrow mononuclear cells had strong biochemical responses. Stem cell therapy demonstrates promising efficacy in ameliorating neuropathic symptoms in DPN animal models. Human patient studies and targeted treatment procedures for specific neuropathic disorders are advocated to improve therapeutic outcomes.
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Meta Analysis
Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: a meta-analysis.
Since its emergence in 2019, COVID-19 has continued to pose significant threats to both the physical and mental health of the global population, as well as to healthcare systems worldwide (Raman et al., Eur Heart J 43:1157-1172, 2022). Emerging evidence indicates that COVID-19 may lead to post-acute COVID-19 syndrome (PACS) with cardiovascular implications, potentially driven by factors such as ACE2 interaction with viruses, systemic inflammation, and endothelial dysfunction. However, there remains a limited amount of research on the cardiovascular manifestations of PACS, which may delay the development of optimal treatment strategies for affected patients. Therefore, it is crucial to investigate the prevalence of cardiovascular sequelae in COVID-19 patients and to determine whether COVID-19 infection acts as an independent risk factor for these outcomes. ⋯ Our findings indicate that 15% of COVID-19 patients experience cardiovascular sequelae. Furthermore, COVID-19 infection significantly increases the likelihood of developing these sequelae compared to uninfected individuals. Future research should prioritize investigating the underlying pathological mechanisms and developing targeted preventive and management strategies.
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Cochrane Db Syst Rev · Feb 2025
Review Meta AnalysisHome-based educational interventions for children with asthma.
Asthma is a chronic airway condition with a global prevalence of 262.4 million people. Asthma education is an essential component of management and includes provision of information on the disease process and self-management skills development such as trigger avoidance. Education may be provided in various settings. The home setting allows educators to reach populations (e.g. financially poor) that may experience barriers to care (e.g. transport limitations) within a familiar environment, and allows for avoidance of attendance at healthcare settings. However, it is unknown if education delivered in the home is superior to usual care or the same education delivered elsewhere. There are large variations in asthma education programmes (e.g. patient-specific content versus broad asthma education, number/frequency/duration of education sessions). This is an update of the 2011 review with 14 new studies added. ⋯ We found uncertain evidence for home-based asthma educational interventions compared to usual care, education delivered outside the home or a less-intensive educational intervention. Home-based education may improve quality of life compared to control and reduce the odds of hospitalisation compared to less-intensive educational intervention. Although asthma education is recommended in guidelines, the considerable diversity in the studies makes the evidence difficult to interpret about whether home-based education is superior to none, or education delivered in another setting. This review contributes limited information on the fundamental optimum content and setting for educational interventions in children. Further studies should use standard outcomes from this review and design trials to determine what components of an education programme are most important.
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Reg Anesth Pain Med · Feb 2025
Review Meta AnalysisPrognostic factors of chronic postsurgical pain in children and adolescents: a systematic review and meta-analysis.
Approximately 28% of children and adolescents undergoing major surgery develop chronic postsurgical pain (CPSP; pain persisting>3 months). A previous review attempted to investigate biopsychosocial prognostic factors for pediatric CPSP; however, due to lack of data, no meta-analytic techniques were employed. Since that review, numerous studies have investigated risk/protective factors that fall within an Interpersonal Fear Avoidance Model for CPSP, thus warranting a reinvestigation of prognostic factors. ⋯ CRD42022306340.