Conectar
To explore the influence of oral health-related knowledge, attitudes and practices on oral health risk-related behaviours of people in custodial settings.
Integrative review.
Scopus, ProQuest Central, Web of Science, Medline, CINAHL, Academic Search Complete, PsycINFO and Education Research Complete were searched in March 2024 and December 2025.
Studies reporting on any individuals in custodial settings, at least one oral health-related knowledge, attitude or practice and at least one oral health risk-related behaviour (either smoking, alcohol, illicit substances or sugar consumption). Data related to custodial population's oral health knowledge, attitudes, or practices and oral health risk-related behaviour were extracted, synthesised narratively and reported thematically.
Findings from the 26 studies reveal that people in custodial settings had a general lack of oral health knowledge, and oral health risk-related behaviours were prevalent. The most common risk-related behaviours reported were tobacco use and free sugar consumption. Oral health knowledge, attitudes and practices of this population were influenced by custodial healthcare systems and attitudes of dental professionals.
This review highlights the influence custodial healthcare and dental professionals have on the knowledge, attitudes, practices and risk-related behaviours of people in custodial settings. Oral health targeted interventions and strategies are required to improve oral health-related knowledge and attitudes thereby encouraging oral health practices among people in custodial settings.
This review will inform targeted oral health promotion programs that can improve oral health outcomes and experiences of this population.
People in custodial settings experience a disproportionate burden of oral diseases. This review underscores the need for proactive interventions and systemic reform to improve correctional healthcare experiences globally.
Preferred Reporting Items for Systematic Reviews and Meta-Analysis, Extension for Scoping Reviews (PRISMA-ScR) 2018.
No patient or public contribution.
Synthesises evidence on influencing factors contributing to poor oral health among people in custodial settings. Highlights impact of healthcare staff and custodial healthcare systems on population health. Highlights the necessity of oral health promotion programs to improve oral health knowledge and to promote oral health protective behaviours.
A clinical prediction model (IMPROVE) for ipsilateral ischaemic stroke risk in symptomatic patients with carotid disease was recently developed with good performance. We aim to evaluate the model-based cost-effectiveness of IMPROVE-based triage versus triage in care-as-usual (CAU) for optimal medical treatment (OMT) alone or carotid endarterectomy plus OMT.
A dataset of 678 patients with carotid disease and a recent ipsilateral ischaemic stroke, transient ischaemic attack or amaurosis fugax from four cohort studies informed a decision-analytic model. Stratification of patients for carotid endarterectomy was based on ≥50% carotid stenosis (CAU arm) or a range of 3-year ipsilateral ischaemic stroke risk thresholds (IMPROVE arm). The threshold resulting in the lowest number of ipsilateral strokes and perioperative strokes and deaths was selected as the optimal threshold. Patients with
IMPROVE-based triage reduced ipsilateral ischaemic strokes and perioperative strokes and deaths by 34.5% (CAU: 4.3%, IMPROVE: 2.8%) over 3 years. Revascularisations decreased by 20% with IMPROVE, while Quality-Adjusted Life Years slightly increased. Procedural stroke occurred in 1.8% of patients in CAU versus 1.4% of patients for IMPROVE. Societal costs decreased on average by 1441/patient for IMPROVE versus CAU for a 3-year time horizon (lifetime cost reduction: 6101/patient). Subgroup analyses identified IMPROVE as the superior strategy for 50–69% and 70–99% stenosis (3-year and lifetime horizon) and
In this modelling analysis, triage of symptomatic patients with carotid disease with the IMPROVE model can lead to the prevention of one-third of ipsilateral ischaemic strokes and perioperative strokes and deaths, while also reducing societal costs. These findings should be validated in a clinical trial.
Remote consultations (video, telephone, text) have become integral to the delivery of primary care and are promoted by government initiatives. While many find these more convenient, they may also discriminate against those with lower digital literacy and present a barrier to empathy by removing some non-verbal communication. The aim of this realist review is to understand how therapeutic empathy can be effectively expressed during remote consultations in general practice across different situations and for different people.
This realist review will follow the methodological framework proposed by Pawson and colleagues, which includes the following five steps: (1) identify existing theories to develop an initial programme theory; (2) systematically search bibliographic databases to identify relevant literature; (3) select, extract and organise data; (4) synthesise evidence to develop context-mechanism-outcome configurations; (5) refine and finalise programme theory. This iterative process will be guided by a Content Expert Group consisting of patients, carers, clinical staff working in general practice and representatives from national stakeholder groups. The final programme theory will inform the development of evidence-based recommendations to help clinical staff working in general practice express empathy during remote consultations.
This review does not require ethics approval. Findings will be disseminated through peer-reviewed journals, national and international conferences and through relevant professional associations and primary care networks in the UK.
CRD420261306014.
To describe the characteristics of paediatric postoperative patients with cognitive dysfunction and assess the prevalence of pain and associated factors.
A descriptive observational study.
Cross-sectional study in children and adolescents who had undergone surgery in the previous 72 h with cognitive dysfunction impeding verbal communication of pain. The Spanish-language version of the revised Face, Legs, Activity, Cry and Consolability scale was used to assess pain intensity.
The 51 included patients underwent 1072 pain assessments. Moderate to severe pain was detected in 12.1% of the evaluations (n = 130). Girls showed more intense pain after analgesia than boys. Higher pain intensity before analgesia was associated with neurodegenerative disease and autism spectrum disorder.
In children with cognitive dysfunction, female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain.
Hospital pain management protocols should differentiate between patients with cognitive dysfunction and patients with neurotypical development.
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This study addresses the prevalence of postsurgical pain in paediatric patients with cognitive dysfunction and associated factors
–12.1% of postsurgical evaluations showed moderate to severe pain. Female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain.
–This research will have an impact on the care of paediatric patients with cognitive dysfunction in postsurgical hospitalization units.
This study was performed according to EQUATOR GUIDELINES and the STROBE statement.
No Patient or Public Contribution.
Data on long-term outcomes after surgical repair of pulmonary valve stenosis are limited. This study evaluated survival, clinical outcomes and quality of life (QoL) after surgery during childhood.
Single centre, longitudinal cohort study evaluating consecutive patients with pulmonary valve stenosis who underwent surgical repair between 1968–1980 and were evaluated every decade since 1990.
Of the original cohort of 89 operated patients, 11 died (12%), including 2 who died within 30 days postsurgery (2%), and 7 (8%) were lost to follow-up. Survival at 50 years follow-up was 87%, which was not significantly different from the GDP. Of the remaining 71 survivors, 32 refrained earlier from participating in this cohort study, leaving 39 eligible, of whom 34 (87%) participated again (50% male, median age 48 years) with a median follow-up of 45 (range 40–52) years. Event-free survival was 50%, with supraventricular tachycardia (14%) and reintervention (13%) being the most frequent events, although less frequently in the last 10 years. At last follow-up, biventricular function was preserved in most patients. Reduced right and left ventricular ejection fraction (EF) was found in 33% and 13%, respectively. Exercise capacity and maximum rate of oxygen consumption were mildly impaired in 14% and 32% of patients. Patients who underwent an infundibulectomy during initial surgery were significantly more likely to undergo reintervention (HR=8.32, p=0.003). Patient-reported QoL scores remained stable over time and consistently exceeded those of the age-matched GDP.
Fifty-year survival after surgery for pulmonary valve stenosis was excellent and comparable to the GDP. Most patients maintained preserved ventricular function, functional capacity and excellent QoL. Routine lifelong follow-up may not be necessary for all patients, but should be considered for those who underwent an infundibulectomy or have residual lesions.
by Sandra S. Chaves, Valérie Bosch Castells, Ainara Mira-Iglesias, Joan Puig-Barberà, F. Xavier López-Labrador, Miguel Tortajada-Girbés, Mario Carballido-Fernández, Joan Mollar-Maseres, Germán Schwarz-Chávarri, Javier Díez-Domingo, Alejandro Orrico-Sánchez, Valencia Hospital Network for the Study of Influenza and other Respiratory Viruses (VAHNSI)
BackgroundUnderstanding the burden of acute viral respiratory infection-related hospitalizations is crucial for guiding research and development. Unlike influenza, respiratory syncytial virus (RSV), or severe acute respiratory syndrome coronavirus 2, no pharmaceutical interventions exist for other respiratory viruses; therefore, their impact remains poorly characterized. This study aimed to investigate the association of current non-vaccine-preventable respiratory viruses, especially rhinovirus/enterovirus (RV/EV), on hospitalizations during the respiratory seasons.
MethodsData from a prospective study that used multiplex polymerase chain reaction to conduct long-term surveillance on respiratory viruses in Valencia, Spain were analyzed. Patients aged ≥50 years hospitalized due to respiratory illness from 2014–15–2019–20 were included.
ResultsRespiratory viruses were detected in 35.2% (3,755/10,675) of hospitalized patients with acute respiratory illness. Influenza and RSV accounted for 22.1% of hospitalizations, RV/EV for 7.6%, and other non-vaccine-preventable viruses for 5.4%. Adults ≥75 years had average seasonal hospitalization incidence rates more than twice those aged 65–74 years and eight times those aged 50–64-year-olds. No significant differences in severity markers were observed among patients with or without virus identified, those aged ≥75 years had a 2–3 times higher mortality rate compared to younger age groups.
ConclusionsThe potential impact of respiratory viruses on hospitalization rates among older adults, particularly those aged ≥75 years, highlights the need for targeted interventions to reduce healthcare system burden. Enhanced diagnostic capabilities and the development of next-generation preventive strategies, including vaccines and therapeutics, could improve patient outcomes and strengthen the resilience of the healthcare system during respiratory virus seasons.
Visual impairment is reported to affect 40%–50% of children with cerebral palsy (CP). Vision difficulties in the context of rehabilitation are often under-recognised, under-treated and therefore under-studied, pointing to an urgent need for the development of evidence-based vision interventions for infants and toddlers with cerebral vision impairment (CVI). We present the protocol of a multisite pragmatic pilot randomised controlled trial (RCT) of feasibility, acceptability and preliminary efficacy of an early vision-awareness and parent-directed environmental enrichment programme for infants with or at risk of CP under 7 months corrected age (CA) with vision impairment.
The main objective is to determine the feasibility and acceptability of the Vision Intervention for Seeing Impaired Babies: Learning through Enrichment (VISIBLE) intervention. We will estimate the preliminary effects of the programme on infants’ visual functions and early development, as compared with standard community-based care (SCC).
A two-group RCT will be conducted. Infants at 3–6 months at entry, with severe visual impairment and at high risk of CP, will be enrolled and randomised (n=16 per group) to receive the VISIBLE intervention compared to SCC. Randomisation will be completed through an independent automated process (Research Electronic Data Capture). VISIBLE intervention will be delivered by a therapist through home visits (90–120 min) once every 2 weeks. Completion of 10 visits (80% of the intervention target dose) within 6 months is required for adherence to the VISIBLE trial. Outcome will be assessed at 12 months CA. Visual function will be evaluated with the Infant Battery for Vision, motor outcomes with the Peabody Developmental Motor Scales, Second Edition. Developmental quotients, infant quality of life, parent well-being and parent-infant relationship will be also monitored through standardised tools.
The enrolling sites have historically demonstrated rapid and effective translation of successful evidence-based interventions into routine clinical practice, as well as the dissemination of the findings through local, national and international scientific meetings.
ACTRN12618000932268.
Chronic wounds represent a major global health and economic burden. Smart wound dressings integrate biosensing and stimuli-responsive materials to monitor and modulate biological parameters within the wound microenvironment. This scoping review maps the biological parameters monitored by smart wound dressings, an area not previously synthesized across preclinical and clinical contexts. Following Joanna Briggs Institute (JBI) and PRISMA-ScR frameworks, five databases were searched in March 2025. Studies published between 2008 and 2025 reporting biosensing or responding technologies in wound dressings were included. A total of 179 studies met the inclusion criteria, most being preclinical (in vitro or in vivo rodent models), with few human investigations. The most frequently monitored parameters were pH, temperature, oxygenation, moisture, bacterial burden, and protease activity (particularly MMP-9). Preclinical data showed enhanced collagen deposition, angiogenesis, and infection control compared with conventional dressings, whereas human studies mainly assessed feasibility and biocompatibility. Smart dressings demonstrate strong technical and biological performance, but clinical validation and standardized outcome reporting remain limited. Future interdisciplinary research should prioritize well-designed clinical trials to confirm therapeutic and economic benefits and enable translation into personalized wound care.
Shared decision making (SDM) is advocated as an approach for patient-centred asthma care. However, this approach may not always be feasible or preferred by patients and/or healthcare professionals (HCPs). Knowledge and insights into whether and how the preferred collaboration style in medical decision making is discussed and managed during consultations for severe asthma are limited.
To investigate how HCPs’ and patients’ preferred collaboration styles in treatment decision making are experienced, discussed and managed during consultations.
Qualitative research using semi-structured interviews with HCPs specialised in severe asthma and a focus group with severe asthma patients in The Netherlands. Inductive thematic analysis was used, with results reported according to the COREQ checklist.
Four themes concerning HCPs’ and patients’ experiences were identified: (1) overall preference for SDM, yet (2) ambiguity of SDM’s content, (3) variation in application of SDM and (4) friction between medical focus and patient autonomy in SDM. A fifth theme concerned the discussion and management of collaboration style preferences: limited metacommunication. HCPs and patients seem unable to identify each other’s preferences in collaboration styles. Overall, a lack of communication regarding how to collaborate in making treatment decisions was found. Varying views on meaning and content of collaboration styles, especially SDM, and HCPs’ medical focus seemed to contribute to the lack of communication.
With the lack of communication regarding preferences in collaborating, HCPs and patients are likely to miss out on effective collaboration. Future studies should explore how views and preferences regarding HCP-patient collaboration can be bridged.
Surgical site infection (SSI) following transmetatarsal amputation (TMA) is common and associated with significant morbidity. However, there is limited evidence to guide perioperative strategies for SSI prevention in this population. A prospective, cross-sectional survey was conducted among vascular specialists. The questionnaire assessed current practice in SSI prevention for TMA, perceptions of evidence gaps, and willingness to participate in future research. Responses were analysed descriptively. Eighty-four valid responses were analysed, with 64.3% from consultant vascular surgeons and 84.5% from UK centres. Most respondents (84.5%) considered SSI after TMA to be a significant issue. The majority preferred primary closure in clean wounds (78.6%) and commonly used short-course antibiotics and interrupted sutures. Over 70% agreed no clear best practice exists, and 65.5% felt high-quality randomised trials are needed. Ninety-three percent expressed willingness to engage in future studies. Equipoise existed regarding interventions including antibiotic duration, wound adjuncts, and closure techniques. Opinion varied regarding whether TMA and major lower limb amputation should be pooled when undertaking research into SSI prevention. Current practice in SSI prevention for TMA is highly variable. This survey demonstrates broad support for rigorous trials to establish effective strategies and highlights the feasibility of future research in this area.
We aim the isolated and combined effects of sedentary behaviour exposure time and physical activity levels on muscle strength in older adults.
This prospective observational cohort study, analytical in nature, using exploratory survey methods and physical performance testing. With 5-year longitudinal follow-up (2015–2020).
A total of 459 older adults participated in the baseline, with a total of 224 being included/located again in the follow-up. We evaluate muscle strength using handgrip tests and sit-to-stand tests. The international physical activity questionnaire was used to measure physical activity and sedentary behaviour. Generalised Estimation Equations tested both independent and combined effects, reporting results as β coefficients and confidence intervals.
Older adults exhibiting low sedentary behaviour displayed enhanced handgrip strength compared to those with high sedentary behaviour. Notably, older adults who were sufficiently active with low sedentary behaviour, sufficiently active with high sedentary behaviour, and insufficiently active with low sedentary behaviour showed increased handgrip strength compared to their counterparts who were insufficiently active with high sedentary behaviour. This trend was consistent for lower limb strength.
Interventions that encourage a reduction in sedentary behaviour and an increase in physical activity are essential to maintain muscle strength among older adults.
The findings of this study underscore the importance of addressing both sedentary behaviour and physical activity levels in clinical interventions aimed at preserving muscle strength in older adults. Routine assessments of physical activity and sedentary behaviour could help tailor personalised exercise programs, potentially enhancing functional independence and reducing the risk of frailty and disability in older patients.
Patients were involved in the sample of the study.
This study was conducted in accordance with the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.
This study aimed to determine the discharge learning needs of patients undergoing cardiac surgery and to identify sociodemographic and clinical factors associated with these needs.
A descriptive, cross-sectional study.
This study was conducted among 130 adults who had undergone cardiac surgery in a public hospital in western Türkiye between 15 January and 30 August 2025. Data were collected at hospital discharge using a patient information form and the Patient Learning Needs Scale (PLNS), which measures learning needs across seven domains. Descriptive statistics, independent-samples t-tests, and multiple linear regression analysis were used to examine associations between patient characteristics and PLNS scores.
Overall learning needs were moderately high (mean total PLNS score 183.65 ± 25.25). Treatment and complications (35.62 ± 5.04) and activities of daily living (32.92 ± 6.19) were the highest-priority domains. These were followed by enhancing quality of life (31.77 ± 4.71) and medications (31.13 ± 5.09), while the feelings-related-to-condition domain had the lowest importance (15.54 ± 3.99). Female patients reported significantly higher total PLNS scores than males (190.43 ± 25.36 vs. 177.65 ± 23.74, p = 0.002). In multivariable analysis, male gender (B = −15.27, p < 0.001) and lack of health insurance (B = −17.71, p = 0.004) were independently associated with lower total PLNS scores.
Patients undergoing cardiac surgery have important discharge learning needs that vary according to gender, education, employment status and insurance coverage. Systematic assessment of learning needs can help nurses design individualized, patient-centred discharge education to support safer recovery.
This study highlights the importance of systematically assessing discharge learning needs among patients undergoing cardiac surgery. Understanding individual learning priorities enables nurses to tailor discharge education, address potential gaps in self-care knowledge, and enhance continuity of care during the transition from hospital to home. Incorporating structured learning needs assessments into routine discharge planning may support safer recovery, improve adherence to postoperative recommendations, and reduce preventable complications.
This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Patients were involved in the study by completing study questionnaires at the time of hospital discharge. However, patients or members of the public were not involved in the study design, analysis, interpretation of data, or preparation of the manuscript.
Spirituality is a crucial yet complex element of holistic nursing care, particularly when providing care for older adults with depression. In Thailand, depression poses a significant mental health challenge. Thai cultural values are deeply interwoven with individuals' beliefs, making spirituality a critical factor in addressing the care of older adults with depression. This study aimed to explore how older adults with depression experience spirituality and construct meaning from it in their daily lives.
An interpretative phenomenological study.
In-depth interviews of 30 older Thai adults living with depression (aged 60–85 years) from an outpatient psychiatric clinic in southern Thailand were conducted using semi-structured interview questionnaires. Interpretive phenomenological analysis was employed. Data were collected from June to August 2024.
Five themes emerged from the phenomenological data analysis: (1) elusiveness of spiritual meaning, (2) holding oneself together through inner power, (3) finding acceptance through faith in a higher power, (4) family ties shaping peace and despair, and (5) being guided and cared for.
This study highlights that older adults with depression perceive spirituality as essential for their well-being. Personal practices, such as meditation and chanting, played a key role in strengthening spirituality and reducing the risk of relapse in depressive symptoms, which are distinct for each older adult. Understanding spirituality's role in mental health guides nurses to develop strategies for providing more empathetic spiritual care.
Nurses must address depression in older adults through individualized practices to effectively empower their inner strength and coping mechanisms. Understanding each individual's spiritual practices is essential to help them harness their inner strength when coping with depression.
Regular physical activity declines with age, particularly among older adults with health conditions. Digital tools, including wearable devices, mobile applications, virtual reality systems and tele-exercise platforms, offer promising ways to promote physical activity. However, the technological components of these tools and their reported associations with motivation, adherence and physical activity levels remain underexplored. This scoping review aims to map the characteristics and functionalities of digital tools used to promote physical activity among older adults with health conditions and to examine how these components are described in relation to psychobehavioural outcomes.
This review will follow the Joanna Briggs Institute methodological guidance. Searches will be conducted in PubMed, Web of Science, PsycInfo and SportDiscus. The reference lists of included studies will also be screened to identify additional relevant articles. Eligible studies will include adults aged 60 years or older with health conditions using digital tools for physical activity. Two reviewers will independently select studies and extract data on the components of digital tools. A descriptive synthesis will summarise the key technological characteristics, and a content analysis will identify and categorise tool components, describing how they are reported in relation to psychobehavioural outcomes and theoretical constructs.
This review does not involve human participants, so ethical approval is not required. Findings will be disseminated through peer-reviewed publications, conference presentations and stakeholder summaries.
by Cecilia Aguilar-Vega, Jaime Bosch, Satoshi Ito, Benjamin Ivorra, Hyunkyu Jeong, José Manuel Sánchez-Vizcaíno
African swine fever (ASF) is a lethal disease of swine that has spread across Asia since its introduction in 2018. South Korea first reported the disease in September 2019 in domestic pigs, and since then, more than 4,000 cases have been reported in wild boars during its expansion up to August 2024. Due to the high number of ASF notifications in wild boars in South Korea, contrasted with their scarcity in most Asian countries, analyzing the spatiotemporal spread of the disease in a setting with active surveillance provides valuable insights. In this study, we performed a trend-surface analysis on temporally gridded case data to characterize the overall geographic spread and direction of ASF in wild boars across South Korea, from its emergence to August 2022. Additionally, we propose a novel approach distinct from previous studies, to estimate spread velocity by incorporating an upper threshold to avoid unrealistic values. The model described the spread of ASF in the study area. The disease showed greater expansion in the east of the country. Initially, a south and eastward direction was estimated. The estimated median velocity was 19.53 km/month, with cell-level velocities ranging from 2.45 to 69.99 km/month. Velocity increased notably from autumn 2021 onward and varied substantially across years. Our results show the dynamics of ASF in wild boars of South Korea, providing new evidence of their role in the epidemiology of the disease.by Ana Laura Januário Lelis, Leandro Aparecido Ferreira da Silva, Daniel Moretto Casali, Tiago Leiva, Murilo Chuba Rodrigues, José Paulo Roman Barroso, Pedro Veloso Facury Lasmar, Camila Lisboa Tomaz, Anabelle Jorge Barbosa, Camila Cesario Fernandes Sartini, Johnny Maciel de Souza, Danilo Domingues Millen
This study evaluated the effects of increasing narasin doses on ruminal fermentation, nutrient digestibility, ruminal pH stability, papillae histology, and microbial composition in Angus cattle fed feedlot diets. Three rumen-cannulated Angus steers (average body weight: 680 kg) were assigned to a 3 × 3 Latin square design and received diets containing 13, 20, or 27-ppm of narasin. Each experimental period consisted of 14 days of adaptation followed by seven days of sampling. Ruminal degradability was assessed on days 15–17, apparent digestibility on days 15–19, continuous ruminal pH on days 19–20, and samples for short-chain fatty acids (SCFA), microbiota, and ruminal histology were collected on days 20 and 21. Ruminal degradability was not affected by narasin dose. Digestibility of acid detergent fiber (ADF) was significantly influenced, with the greatest values observed at 27-ppm (P = 0.01). Increasing narasin doses improved ruminal pH stability, as indicated by a linear increase in minimum pH (P = 0.01) and a reduction in the duration of pH below 5.6 (P = 0.10). At 13 ppm, SCFA production, particularly acetate and propionate, increased (P P P = 0.02), and butyrate (P P P = 0.03). Narasin supplementation altered ruminal microbial composition, increasing the relative abundance of Lachnospiraceae and Isotricha while reducing lactic acid–producing bacteria. In terms of ruminal morphology, supplementation with 20-ppm of narasin increased the keratin layer thickness of ruminal papillae (P = 0.02), suggesting enhanced epithelial development. Overall, narasin supplementation modulated ruminal function and microbial ecology, with doses between 13 and 20-ppm providing the most favorable balance between fermentative efficiency and ruminal health in feedlot cattle.Split-thickness skin autografts are commonly used to treat extensive cutaneous defects. However, donor site morbidity, including pain, bleeding, and delayed epithelialization, remains a major clinical challenge. This study evaluates whether applying autologous platelet-rich plasma (PRP) to the donor site improves healing outcomes. A prospective cohort study was conducted at a tertiary-level academic hospital in Colombia. The study protocol was approved by the local Institutional Ethics Committee. Adult patients (> 18 years) undergoing split-thickness skin grafts for trauma, burns, oncologic resections, or chronic ulcers were included. Two groups were compared: the PRP group, in which autologous platelet-rich plasma was applied to the donor site, and the control group, which received standard wound care. The primary outcome was the quality of epithelialization at the donor site, while pain, assessed using the Numeric Rating Scale, was evaluated as a secondary outcome at multiple postoperative time points. Data were analysed using descriptive statistics and linear mixed-effects models adjusted for potential confounders, with statistical significance set at p < 0.05. A total of 46 patients were included (16 in the PRP group and 30 in the control group), with no significant demographic differences between groups. The PRP group demonstrated improved epithelialization quality, with lower Vancouver Scar Scale scores on postoperative days 7 and 14 (p < 0.05). Patients treated with PRP also reported a reduction of up to 50% in postoperative pain during early assessments (p < 0.001). These effects were maintained throughout the follow-up period, suggesting a sustained benefit of PRP on both healing quality and pain control. These findings suggest that autologous PRP application at split-thickness skin graft donor sites may enhance early epithelialization quality and reduce postoperative pain compared with standard wound care. PRP appears to be safe and may represent a useful adjunct to promote improved wound healing and patient recovery in reconstructive surgery. However, larger randomised controlled trials are required to confirm these findings and to establish the clinical effectiveness of autologous PRP in this setting.
Cancer is the leading cause of death and morbidity among children and adolescents worldwide. Functionality-based interventions are relevant among children and adolescents with an oncological diagnosis, whence studies summarising evidence on this topic are needed. This systematic review will summarise evidence on the effect of interventions to improve functionality indicators among paediatric patients diagnosed with cancer.
This protocol will follow Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA)-Protocols reporting guidelines. The systematic review will be conducted according to the Cochrane Handbook and PRISMA 2020. Studies will be searched in MEDLINE (PubMed), Embase, Web of Science, CENTRAL, LILACS and PEDro. Additional searches will include Google Scholar, reference lists of included studies, relevant reviews and trial registries. Studies will be included if they implement a functionality-based intervention. They must evaluate effects among paediatric patients with an oncological diagnosis. Secondary outcomes will include health-related quality of life. There will be no limits to language or year of publication, and articles published in peer-reviewed journals will be accepted. Only randomised controlled trials will be included. Risk of bias will be assessed using the Cochrane Risk of Bias Tool 2. Two independent reviewers will select studies, extract data and assess risk of bias. A narrative synthesis and meta-analysis will be conducted if studies are clinically and methodologically homogeneous. Statistical heterogeneity will be assessed using Higgins’ inconsistency test (I²). Meta-analysis may estimate combined effects using random-effects and the inverse variance method. The R statistical software will be used. The certainty of evidence will be evaluated for each outcome using the Grading of Recommendations Assessment, Development and Evaluation system.
This study used data from previously published studies, thus waiving submission to an Ethics Committee. Scientific dissemination strategies will include publication in peer-reviewed journals, conference presentations and workshops for the public.
CRD42024462833.
by Renata dos Santos Guarnieri, Guilherme Sá de Oliveira, Kaylaine Marques Ferreira, Aline Penna-de-Carvalho, Vanessa Souza-Mello, Sandra Barbosa-da-Silva
High-intensity interval training (HIIT) is an effective intervention for improving metabolic health and mitigating metabolic dysfunction-associated steatotic liver disease (MASLD). Nonetheless, the stability of these benefits throughout detraining periods and upon weight regain remains inadequately characterized. This study aimed to evaluate whether hepatic improvements induced by HIIT are sustained during detraining, even after body weight regain. Eighty male C57BL/6 mice were fed either a control (10% fat) or a high-fat (HF) diet (50% fat) for 12 weeks. Following this period, the animals were allocated to groups subjected to continuous HIIT or intermittent training cycles (each lasting 3 weeks). The outcomes assessed included body mass (BM), glucose tolerance, lipid profiles, liver enzyme levels (aspartate aminotransferase and alanine aminotransferase), hepatic steatosis, and the expression profiles of genes associated with lipogenesis (Srebf1, Mlxpl, and Fas), β-oxidation (Ppara and Cpt1a), and endoplasmic reticulum (ER) stress (Atf4, Ddit3, and Gadd45). Compared with the sedentary HF-NT condition, continuous HIIT reduced BM and improved glucose tolerance. Intermittent training (HF-TNT, HF-NTN) preserved metabolic benefits and reduced triglyceride and cholesterol levels. Notably, hepatic steatosis was significantly alleviated in all training groups but persisted even after detraining. Additionally, HIIT downregulated the expression of lipogenic genes and upregulated the expression of genes involved in β-oxidation. The levels of markers indicating ER stress were attenuated by HIIT, with a sustained reduction during periods of detraining. HIIT-induced metabolic and hepatic improvements persist partially during detraining, despite weight regain. These findings underscore the therapeutic value of continued or periodically repeated physical training in mitigating the adverse effects of an HF diet and preventing the progression of metabolic disorders such as MASLD.
FreshRSS 