Conectar
Neonatal haemochromatosis, considered to be a gestational alloimmune liver disease (NH-GALD), is a rare but serious disease that results in fulminant hepatic failure. The recurrence rate of NH-GALD in a subsequent infant of a mother with an affected infant is 70%–90%. Recently, antenatal maternal high-dose intravenous immunoglobulin (IVIG) therapy has been reported as being effective for preventing recurrence of NH-GALD in a subsequent infant. However, no clinical trial has been conducted to date.
This is a multicentre open-label, single-arm study of antenatal maternal high-dose IVIG therapy in pregnant women with a history of documented NH in a previous offspring. The objective of this study is to evaluate the efficacy and safety of antenatal maternal high-dose IVIG therapy in preventing or reducing the severity of alloimmune injury to the fetal liver.
The clinical trial is being performed in accordance with the Declaration of Helsinki. The trial protocol was approved by the Clinical Research Review Board at four hospitals. Before enrolment, written informed consent would be obtained from eligible pregnant women. The results are expected to be published in a scientific journal.
28 October 2024, V.8.0.
jRCT1091220353.
This study aimed to assess the methodological quality of published systematic reviews of exercise therapy in knee osteoarthritis and summarise their reported effectiveness on quality of life, knee joint function, or adverse events.
Overview of systematic reviews.
PubMed, Embase, CINAHL, Web of Science and CENTRAL (searched on 14 April 2025), plus grey literature (PROSPERO, Epistemonikos, OpenGrey).
We included systematic reviews of randomised controlled trials in patients diagnosed with knee osteoarthritis by imaging or clinical criteria and treated conservatively with exercise therapy; we excluded reviews that enrolled patients scheduled for surgery, with acute inflammation or osteoarthritis of other joints (hand, hip, ankle), for which relevant author data could not be obtained after one contact attempt, or that did not report at least one primary outcome (quality of life, knee joint function or adverse events).
Two reviewers independently extracted data on study characteristics, interventions and outcomes, and assessed methodological quality using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2) tool. Due to heterogeneity in outcome measures across systematic reviews, meta-analysis was not conducted. Effectiveness was defined as any reported beneficial outcome of exercise therapy on predefined outcomes, including quality of life, physical function, pain or adverse events.
58 systematic reviews were selected. Muscle-strengthening (74.1%) and aerobic (48.2%) exercises were the most commonly prescribed exercise-based interventions. SF-36 (36-Item Short Form Health Survey) and the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) were the most popular outcome-evaluation tools. Furthermore, 63.7% of the systematic reviews revealed that exercise therapy improved all outcomes. The number of intervention-related adverse events was small. Notably, almost all systematic reviews (87.4%) had a critically low quality.
Current evidence on exercise therapy for knee osteoarthritis is inadequate. Nevertheless, exercise therapy can be considered for conservative treatment of knee osteoarthritis. Future studies should use network meta-analyses to compare the effects of different exercise therapies and determine their superiority over other conservative therapies.
by Akiyo Sasaki-Otomaru, Kyoko Saito, Kotaro Yamasue, Osamu Tochikubo, Yuka Kanoya
Wearable devices have the potential to promote a healthy lifestyle; however, studies on the use of wearable devices in monitoring health in older adults are limited. We aimed to investigate the relationship of sleep and activity data with health status among older adults. Fifty-five community-dwelling older adults were asked to wear a wristwatch-type wearable device (the Pulsense [PS]) and measure home blood pressure (HBP) over a period of 5–7 consecutive days. Deep-sleep duration, physical and mental activity duration, and body-movement duration were obtained from PS data using special software. We also collected data on demographics and physical and mental health status. We found that the body-movement duration in women was longer than that in men. Among men, body-movement duration was strongly and negatively correlated with the Kihon Checklist (KCL) score. It also showed moderate correlations with the Geriatric Depression score, physical functioning, bodily pain, vitality, social function, and role emotional scores from the Medical Outcomes Survey Short Form-8 questionnaire, as well as with hand-grip strength. There was no significant correlation between monitoring data and health status in women. In the multiple linear regression analysis, body-movement duration was negatively associated with age and the KCL score. KCL is a common questionnaire for screening frailty in Japan. Our results showed that body-movement duration was negatively associated with age and the KCL score, suggesting the potential of PS in guiding personalized health management of older community-dwelling adults with risks of frailty.This study observed changes in respiratory rate measurement (RRM) and identified barriers and challenges in clinical practice that influence healthcare worker behaviour, aiming to improve RRM in a hospital setting.
An observational study was conducted.
We observed and analysed changes in the behaviour of healthcare workers at a hospital where multi-nudges were introduced to improve RRM.
We checked respiration rate using electronic data and discovered that the original measurement rates were low. Measurement rates rapidly increased after posters were added. Barriers such as time constraints and measurement equipment were also noted.
RRM was found to be effective in promoting behavioural economics in medical settings. The results show that incorporating behavioural science principles into medical interventions has the potential to positively change behaviour.
By increasing nurses' awareness of respiratory rate measurement and addressing barriers to it, the measurement rate of respiratory rate can also increase, leading to more accurate patient evaluations and triage.
The proportion of respiratory rate measurements leading to rapid response system (RRS) calls was low.
The study observed that a multi-nudge approach effectively changes the behaviour of ward nurses, resulting in enhanced quality of medical care.
This research can serve as a valuable reference for leaders promoting healthcare quality projects, by offering a method to encourage behavioural change.
This study complied with the EQUATOR guidelines and its reporting adheres to the STROBE checklist.
No patient or public contribution.
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