Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews Analysis 10.1. Comparison 10 Polymerized collagen intralesional injection (0.2 to 1.0 mL / 1.66 to 8.3 mg weekly) × Methylprednisolone subcutaneous injection (maximum dose of 20 mg or 5.0 mL monthly) plus placebo intralesional injection, Outcome

Background: The coronavirus disease 2019 (COVID-19) pandemic has been very disruptive, and thus is likely to result in substantial challenges to mental health. Objectives: This study aimed to investigate the effects of fear of COVID-19 on the mental well-being and quality of life among Saudi adult population and to evaluate the impact of perceived social support. Materials and Methods: This cross-sectional study used an anonymous online survey, where participants were administered the Fear of COVID-19 Scale, Hospital Anxiety and Depression Scale, European Health Interview Survey-Quality of Life and Medical Outcomes Study Social Support Survey. A path analysis was used to investigate the proposed theoretical domain structure linking fear of COVID-19 with perceived social support, mental well-being and quality of life. Results: A total of 1029 Saudi adults with a mean age of 33.7 years (SD 11.5) responded to the survey. Descriptive analysis showed that this sample was fearful of COVID-19, anxious and depressed but, at the same time, reported high quality of life and perceived social support scores. Path analysis indicated that increased fear of COVID-19 was directly associated with diminished mental well-being, which in turn was associated with lower quality of life. The beneficial effects of perceived social support were stronger on quality of life than on mental well-being. No direct link was found between fear of COVID-19 and quality of life. Conclusion: These findings emphasize the importance of having effective social systems in place to minimize the impact of the COVID-19 pandemic on mental well-being and quality of life.

BackgroundPrimary Sjögren’s Syndrome (pSS) is a systemic autoimmune disease that involves the exocrine glands and internal organs. pSS leads to destruction and loss of secretory function due to intense lymphoplasmacytic infiltration. Therapeutic options include mainly symptomatic and supportive measures, and traditional immunosuppressant drugs have shown no effectiveness in randomized trials. Rituximab (RTX) is a chimeric antibody anti-CD20 that leads to B cell depletion by diverse mechanisms. There is evidence that this drug may be effective for treating pSS. The objective of this systematic review was to evaluate Rituximab effectiveness and safety for treating pSS.Methods and FindingsWe conducted a systematic review of RCTs published until December 2015, with no language restriction. We registered a protocol on Plataforma Brasil (40654814.6.0000.5505) and developed search strategies for the following scientific databases: MEDLINE, EMBASE, CENTRAL and LILACS. We included adults with established pSS diagnosis and considered the use of Rituximab as intervention and the use of other drugs or placebo as control. Four studies met our eligibility criteria: three with low risk of bias and one with uncertain risk of bias. The total number of participants was 276 (145 RTX, 131 placebo). We assessed the risk of bias of each included study and evaluated the following as primary outcomes: lacrimal gland function, salivary gland function, fatigue improvement and adverse events. We found no significant differences between the groups in the Schirmer test at week 24 meta-analysis (MD 3.59, 95% CI -2.89 to 10.07). Only one study evaluated the lissamine green test and reported a statistically significant difference between the groups at week 24 (MD -2.00, 95% CI -3.52 to -0.48). There was a significant difference between the groups regarding salivary flow rate (MD 0.09, 95% CI 0.02 to 0.16) and improvement in fatigue VAS at weeks 6 (RR 3.98, 95% CI 1.61 to 9.82) and week 16 (RR 3.08, 95% CI 1.21 to 7.80).ConclusionsAccording to moderate quality evidence, the treatment with a single RTX course in patients with SSp presents discrete effect for improving lacrimal gland function. Low-quality evidence indicates the potential of this drug for improving salivary flow. According to low quality evidence, no differences were observed in the evaluation after 24 weeks regarding fatigue reduction (30% VAS), serious adverse events occurrence, quality of life improvement and disease activity. With a very low level of evidence, there was no improvement in oral dryness VAS evaluation.

The COVID-19 pandemic has been very disruptive and thus likely to result in substantial challenges to mental health. This study aimed to investigate the effects of fear of COVID-19 on mental well-being and quality of life among Saudi adult population, and to evaluate the impact of perceived social support. A total of 1029 Saudi adults with a mean age of 33.7 years (SD 11.5) took part in an anonymous online survey. Path analysis indicated that fear of COVID-19 was directly associated with mental well-being, which in turn was associated with lower quality of life. Perceived social support had more influence on quality of life than mental well-being. No direct link between fear of COVID-19 and quality of life was found. These findings emphasize the importance of having effective systems, in addition to social support, in place in order to minimize the impact of the COVID-19 pandemic on mental well-being and quality of life.

The objective of this review is to map the details of school-based interventions used to improve health literacy of senior high school students. Introduction:The global prevalence of poor adult health literacy is caused, in part, by limited health education in secondary schools. Enhancing adolescent health literacy could potentially improve adult health literacy, health behavior, and health outcomes.Inclusion criteria: Studies investigating school-based interventions to improve health literacy of senior high school students, regardless of design, characteristics, and assessment tools, will be eligible for inclusion. Studies that provide combined data (senior high school students mixed with other students) or have a compulsory component outside of school will be excluded.