IntroductionSkin aging manifests as wrinkles, reduced elasticity, and roughness due to intrinsic and extrinsic factors. Peptide-based therapies enhance collagen synthesis and extracellular matrix integrity. This systematic review and meta-analysis (SRMA) evaluates the efficacy and safety of oral and topical peptides in improving hydration, elasticity, wrinkles, and brightness.MethodsA comprehensive search of MEDLINE, CENTRAL, and Web of Science was conducted following PRISMA guidelines. Randomized controlled trials (RCTs) assessing peptide effects on skin aging parameters were included. The Cochrane Risk of Bias Tool (RoB 2) assessed study quality. Data were synthesized using a random-effects model in RStudio (R version 4.1.1).ConclusionNineteen RCTs involving 1,341 participants were analyzed. Peptides, particularly oral formulations, significantly improved hydration and brightness, with a modest pooled effect on wrinkle reduction (MD = 0.27, p = 0.04). Subgroup analysis indicated that this benefit was largely driven by oral polypeptides (MD = 1.5, p = 0.01). While effects on elasticity and density were inconsistent, peptides were well tolerated, with minimal adverse events reported across trials. Overall, peptides appear to be safe, non-invasive anti-aging agents, though larger RCTs with standardized outcomes and histopathologic assessment are warranted.Systematic review registrationidentifier CRD420250652779.
Clostridioides difficile is an opportunistic pathogen of the gastrointestinal tract that can cause illnesses ranging from diarrhea to pseudomembranous colitis. Recurrent Clostridioides difficile infection remains a major clinical challenge, with substantial relapse rates after standard antibiotic therapy. Emerging evidence suggests that rifaximin can be used after the conventional therapy to reduce risk of the recurrence. However, rifaximin resistance in Clostridioides difficile remains the primary concern. The aim of this systematic review and meta-analysis is to estimate the risk of rifaximin resistance in Clostridioides difficile infection and among different ribotypes. The search included PubMed, Scopus, Web of Science, and Cochrane Library for studies reporting rifaximin resistance in Clostridioides difficile isolates. After systematically screening 731 records from all databases and excluding 664 studies, a total of 67 studies were included in the meta-analysis. The findings of the meta-analaysis indicated a resistance rate of 15.1% (95% CI, 12.0%-18.9%) for rifaximin and/or rifampicin and 12.8% (95% CI, 8.8%-18.2%) for rifaximin alone. Ribotype-specific analysis revealed high rifaximin resistance in RT017 (72.3%), RT027 (47.0%), and RT018 (20.9%), while RT012, RT002, RT112, and RT014/020 demonstrated low resistance. The study finding indicate that rifaximin/rifamycin resistance in Clostridioides difficile is concerning and not randomly distributed but is more frequently associated with certain ribotypes.
Autologous fat grafting is a cornerstone in plastic and reconstructive surgery, yet its efficacy remains limited by variable resorption rates. Stromal vascular fraction (SVF) has emerged as a promising adjunct to enhance graft survival. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of SVF-enriched fat grafting compared with conventional fat grafting techniques. A comprehensive literature search was conducted across Web of Science, PubMed, Embase, Ovid Cochrane, and Google Scholar up to September 2025, following PRISMA guidelines. Eligible studies included randomized controlled trials and observational studies comparing SVF-enriched and conventional fat grafting. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB-2) tool for randomized trials, and both the Newcastle–Ottawa Scale (NOS) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for observational studies. A random-effects model was used to calculate pooled mean differences and risk ratios, with heterogeneity assessed using the I2 statistic. Eighteen studies involving eight hundred ninety-three patients were included. SVF-enriched fat grafting demonstrated significantly higher fat retention rates compared with conventional grafting (mean difference: 17.20 www.springer.com/00266 .
BackgroundSaudi Arabia has one of the highest prevalences of diabetes globally, with 16.4% of the population living with type 2 diabetes (T2D). While continuous glucose monitoring (CGM) is widely used for patients with type 1 diabetes, evidence suggests its benefits can extend to patients with T2D. The aim of this Delphi consensus was to provide a framework for the use of CGM in patients with T2D who are non-intensively managed in Saudi Arabia.MethodsAn expert panel of ten adult endocrinology physicians, one internal medicine and diabetology specialist, and one family medicine physician was formed. Consensus generation was undertaken using Delphi methodology; a face-to-face expert meeting and literature review formed the basis of preliminary statements, which were further refined by the panel. Two rounds of voting were used to confirm the level of agreement to each statement.ResultsConsensus was reached on 27 statements relating to the use of CGM in non-intensively managed T2D. Recommended patient profiles for continuous and intermittent use of CGM are provided, alongside general principles of CGM use and background statements.ConclusionsThis consensus provides recommendations and summarizes local and international evidence as well as expert opinion regarding CGM use in patients with T2D. To expand the use of CGM into the wider population of T2D in Saudi Arabia and enable these individuals to benefit from the technology, a shift in healthcare services, education, and attitudes across the country is necessary.
Background: Abdominal wall endometriosis (AWE) is a rare form of endometriosis that often results in cyclic abdominal pain. The current treatment algorithm for AWE is not well established. Radiofrequency ablation (RFA) is an emerging technique that shows promise in treating AWE. Objective: This retrospective study aims to evaluate the safety and efficacy of ultrasound (US)-guided RFA for patients with AWE at the Security Forces Hospital in Riyadh, Saudi Arabia, between January 2020 and January 2024. Methods: Forty-two female patients with pathologically confirmed AWE who underwent US-guided RFA were included in the study. Lesions were assessed radiologically before the procedure using abdominal US, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). All patients were followed for a minimum of 6 months after the intervention, with MRI used to evaluate lesion response. Treatment efficacy was assessed based on symptom relief, lesion volume reduction, and complication rates during the follow-up period. Results: Patient ages ranged from 28 to 52 years, with a median age of 42 years. All patients had a history of cesarean section and presented with cyclic pain. Preprocedure imaging revealed irregular hypoechoic lesions on US, solid soft-tissue masses on CT, and low signal intensity with heterogeneous enhancement on MRI. Histopathology confirmed the presence of endometrial cells in all cases, with most patients (40.48%) having lesions located below the scar. The majority of patients (95.2%) required only a single session of RFA. The complications included a minor scar wound, occurring in one case (2.4%). Complete radiological resolution was achieved in all patients (100%). Conclusion: This study demonstrates that RFA is a safe and effective treatment for AWE, offering significant symptom relief with minimal complications. Further research is warranted to validate these findings and optimize the treatment protocol.
