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Group arts interventions for depression and anxiety among older adults: a systematic review and meta-analysis

In this systematic review and meta-analysis, we assessed the efficacy of group arts interventions, where individuals engage together in a shared artistic experience (for example, dance or painting), for reducing depression and anxiety among older adults (> 55 yr without dementia). Fifty controlled studies were identified via electronic databases searched to February 2024 (randomised: 42, non-randomised: 8). Thirty-nine studies were included. Thirty-six studies investigated the impact of group arts interventions on depression (n = 3,360) and ten studies investigated anxiety (n = 949). Subgroup analyses assessed whether participant, contextual, intervention and study characteristics moderated the intervention–outcome relationship. Risk of bias was assessed with appropriate tools (RoB-2, ROBINS-1). Group arts interventions were associated with a moderate reduction in depression (Cohen’s d = 0.70, 95% confidence interval (CI) = 0.54–0.87, P < 0.001) and a moderate reduction in anxiety (d = 0.76, 95% CI = 0.37–1.52, P < 0.001), although there was publication bias in the depression studies. After a trim and fill adjustment, the effect for depression remained (d = 0.42; CI = 0.35–0.50; P < 0.001). Context moderated this effect: There was a greater reduction in depression when group arts interventions were delivered in care homes (d = 1.07, 95% CI = 0.72–1.42, P < 0.001) relative to the community (d = 0.51, 95% CI = 0.32–0.70, P < 0.001). Findings indicate that group arts are an effective intervention for addressing depression and anxiety among older adults.

Blood pressure elevations post-lenvatinib treatment in hepatocellular carcinoma: a potential marker for better prognosis

Lenvatinib is a tyrosine kinase inhibitor that effectively inhibits vascular endothelial growth factor signaling and is used for treating hepatocellular carcinoma. However, angiogenesis inhibitors often cause hypertension. Although lenvatinib-induced hypertension has been proposed as a potential surrogate marker for better prognosis, studies on blood pressure elevations and outcomes following lenvatinib initiation are limited. This study included 67 patients who underwent lenvatinib therapy at the Department of Gastroenterology, Kagoshima University Hospital, between May 2018 and December 2023. The median age of the cohort was 71 years, and 82.1% of the patients were male. The median blood pressure at admission was 128/73 mmHg, which significantly increased to 136/76 mmHg the day after lenvatinib administration. Grade 3 hypertension (≥160/100 mmHg) occurred in 37.3% of patients during hospitalization. The median increase in systolic blood pressure from admission to its peak during hospitalization was 26 mmHg. Patients who experienced an increase in blood pressure of ≥26 mmHg were classified into the blood pressure elevation group, which showed a significantly lower mortality rate than that of the blood pressure non-elevation group (35.3% vs. 81.8%, log-rank p = 0.007), even after adjusting for age, sex, disease stage, performance status, and liver reserve function. This study demonstrated that patients who experienced earlier blood pressure elevation after lenvatinib administration had lower overall mortality rates. These findings suggest that blood pressure elevations after lenvatinib initiation may serve as valuable prognostic indicators in patients with cancer undergoing lenvatinib therapy.

Blood pressure management to prevent recurrent stroke: current evidence and perspectives

Hypertension is the leading risk factor for stroke, causing about 60% of cases. Effective blood pressure control is vital for preventing recurrent ischemic strokes, with studies showing mixed results. Intensive control reduces cardiovascular events, as seen in the SPRINT, PROGRESS and STEP studies, while trials like RESPECT show no difference. Technological advances like AI and wearables enhance management, but challenges remain in achieving equitable control, especially for minorities.

Positive impact of sodium L-lactate supplementation on blood acid-base status in preterm newborns

Preclinical studies indicate that lactate is a crucial cerebral energy substrate, with Na-L-lactate administration significantly reducing brain lesion volumes and improving motor and cognitive functions following neonatal hypoxia-ischemia in rat pups. Its neuroprotective effects are linked to neuronal metabolic utilization, making it a promising candidate for treating newborns with hypoxia-ischemia encephalopathy, a condition where hypothermia remains the only established therapy. However, before initiating a clinical trial, it is necessary to assess the effects of Na-L-lactate infusion on blood parameters.

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