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Near infrared (NIR) therapy is increasingly used to enhance postoperative wound healing, yet clinical trial results remain inconsistent. To evaluate the effectiveness of NIR therapy on postoperative wound healing and identify treatment parameters associated with optimal outcomes: This systematic review and meta-analysis registered at PROSPERO (CRD420251163415) assessed evidence on comparing NIR therapy (630–1100 nm) with standard care or placebo on healing of surgical-induced wounds. A multilevel random-effects meta-analysis of standardised mean differences (SMDs) was conducted. Moderator analyses examined the wavelength, fluence, session number, application technique and anatomical site. Risk of bias was assessed using Cochrane RoB 2.0 and certainty of evidence was rated with GRADE. Fifty-six trials (N = 4920) were included for systematic review and 35 trials contributed 69 outcomes to meta-analysis. NIR significantly improved wound healing (0.78, [0.46–1.09], p < 0.01) and reduced postoperative pain (0.71, [0.24–1.17], p < 0.01), but heterogeneity was high and effects varied across studies. Optimal outcomes were associated with short NIR wavelengths (700–850 nm), 4–10 sessions and non-contact application. Effects on swelling, scarring and inflammatory markers were inconsistent. Overall, certainty of evidence was very low. This first systematic review and meta-analysis indicates that NIR therapy demonstrates promise for enhancing postoperative healing and reducing pain, though effects vary by protocols.
This systematic review and meta-analysis evaluated the efficacy of infrared (IR) devices versus the traditional palpation technique for first-attempt success of peripheral intravenous catheter (PIVC) insertion in adults.
Systematic review and meta-analysis of randomised controlled trials (RCTs).
A comprehensive search of PubMed, Embase, Cochrane Library, Scopus and CINAHL was conducted on 28 May 2024 and included articles in English or French published from 1st January 2000 onwards.
Eligible studies included RCTs comparing IR devices with the traditional palpation method for PIVC insertion in adults. The primary outcome was first-attempt success. Secondary outcomes included overall success, number of attempts, cannulation time and patient pain. The risk of bias was assessed using the RoB2 tool, and a random-effects model was applied for meta-analysis.
Five RCTs were included, involving 690 patients and 704 catheters, including 289 PIVCs in patients with Difficult Intravascular Access (DIVA) criteria. First attempt insertion success was similar when using infrared devices (139/331, 42%) and traditional palpation (143/373, 38%) with Risk Ratio (RR) 1.08 (95% CI, 0.69 to 1.70). No significant statistical differences were noted in secondary outcomes: overall insertion success, number of attempts, time to cannulate and patient pain. Clinical and statistical heterogeneity were substantial (primary analysis I 2 = 83%).
Current evidence does not support the systematic use of infrared devices to improve PIVC insertion success, reduce the number of attempts or alleviate patient pain compared with traditional palpation in adults. Further high-quality studies with suitable sample sizes and varied populations are needed to better establish the potential place of infrared devices.
This study highlights the limited benefit of IR devices in routine clinical practice and underscores the need for further research into their use in specialised settings.
No Patient or Public Involvement. This study did not include patient or public involvement in its design, conduct or reporting.
Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although many interventions for tobacco smoking cessation have been implemented, their effectiveness remains unclear. This study aimed to assess the long-term effectiveness of various smoking cessation interventions in adults.
We conducted a systematic review and meta-analysis of randomized controlled trials reporting long-term outcomes.
Evidence searches were conducted in the Cochrane Library, Embase, Medline-OVID, PubMed, Web of Science, and Clinicaltrials.gov. Two researchers searched until August 2023 without restrictions on country, language, or year of publication. The risk ratio (RR) for continuous abstinence was obtained through biochemical verification at measurements ≥ 6 months post-intervention. Data were extracted and assessed for quality using Risk of Bias 2. Meta-analysis was carried out using a random effects model. Subgroup analyses and meta-regression were performed to explore moderator variables. Sensitivity and publication bias analyses were also performed.
Twenty-two effect sizes from 13 studies showed that tobacco smoking cessation interventions increased continuous abstinence by 2.5 times (RR 3.52; 95% CI; 2.19–5.65). The highest ratio was in the behavioral intervention (RR 7.83) with more than 6 months of therapy (RR 10.57). The tobacco smoking cessation intervention worked better in 55–64 years (RR 7.29), especially in Asia (RR 10.08). The intervention was more effective for female respondents (RR 4.21) and combination therapy format (RR 3.82). However, meta-regression showed that differences in gender and therapy format did not significantly influence the effectiveness of tobacco smoking cessation interventions in adults (p values 0.2748 and 0.8769). Sensitivity analysis (p-value 0.0025) further strengthens the evidence of the conclusions and credibility of the findings.
Behavioral therapy lasting more than 6 months was the most successful tobacco smoking cessation intervention in respondents aged 55–64 years, especially when implemented in Asia. Although not significant, therapies delivered in combination formats, especially in women, have the potential to increase continuous abstinence for adults. These findings provide important evidence for developing effective prevention and treatment strategies for long-term smoking cessation concerning the type, format, and total of therapy.
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