Background: Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by pruritus and eczematous lesions. Conventional topical therapies, including corticosteroids and calcineurin inhibitors, are often associated with adverse effects, highlighting the need for safer long-term alternatives. Tapinarof, a novel aryl hydrocarbon receptor (AhR) modulator, has emerged as a promising nonsteroidal topical agent for AD treatment. This systematic review and meta-analysis aimed to assess the efficacy and safety of tapinarof cream in patients with AD. Methods: We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science from inception to March 2025 to identify studies assessing the efficacy of tapinarof cream in AD. Randomized controlled trials (RCTs) reporting quantitative outcomes were included. Meta-analysis was performed using Review Manager V5.4, calculating relative risks (RRs) and 95% confidence intervals (CIs) for primary and secondary outcomes. Results: Five studies (six RCTs) involving 1,096 patients treated with tapinarof and 446 with vehicle were analyzed.... Continue Reading

Abstract Background:Heart failure with preserved ejection fraction (HFpEF) affects nearly half of heart failure patients, with over 80% being either overweight or obese. Obesity is strongly associated with the pathogenesis of HFpEF, exacerbating diastolic dysfunction. Despite available therapies, effective treatments are limited, particularly in obese individuals. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of semaglutide in obese patients with HFpEF. Methods:A comprehensive literature search was conducted in PubMed, Google Scholar, and the Cochrane Library, adhering to PRISMA guidelines. Three studies (2 RCTs and 1 observational study) with 1,463 patients (677 in the semaglutide group, 786 in placebo) were included. Outcomes included percentage change in body weight, 6-minute walk distance, heart failure hospitalizations, cardiovascular mortality, and quality of life improvements. A random effects model was used, and heterogeneity was assessed using I² statistics. Results:The meta-analysis demonstrated that semaglutide significantly reduced body weight (MD = -6.68; P... Continue Reading

Background: Coronary artery disease (CAD) and essential hypertension (HTN) frequently coexist in late life and remain dominant drivers of cardiovascular mortality in the United States. We evaluated national trends and demographic disparities in CAD‑related mortality among older adults (≥65 years) with essential HTN from 1999–2020. Methods: We queried the Centers for Disease Control and Prevention (CDC) Wide‑ranging Online Data for Epidemiologic Research (WONDER) Multiple Cause of Death (MCD) files. Deaths listing essential HTN (ICD‑10 I10) and ischemic heart disease/CAD (ICD‑10 I20–I25) as underlying or contributing causes were included. We calculated annual age‑adjusted mortality rates (AAMRs) per 100,000 using the 2000 U.S. standard population and estimated annual percent change (APC) and average annual percent change (AAPC) with Joinpoint regression (Version 5.1.0). Analyses were stratified by sex, race/ethnicity, U.S. Census region, urbanization, place of death, and state. Results: We identified 1,878,811 deaths in older adults with coexisting essential HTN and CAD from... Continue Reading

Background: Cardiovascular disease is a leading cause of death in older adults who have both renal failureand hypertensive disease. However, national trends describing mortality in this high-risk population remainunclear. Hypothesis: We hypothesized that cardiovascular mortality in older adults with renal failure and hypertensivedisease experienced significant changes from 1999 to 2020, with variations by sex, race, region, and urbanization status. Methods: We used public-use mortality data from the Centers for Disease Control and Prevention for decedents ≥65 years with renal failure and hypertensive disease listed as contributing conditions and cardiovascular disease as the underlying cause of death. Annual percentage changes (APCs) in age-adjusted mortality rates were estimated using joinpoint regression. Statistical significance was set at P < 0.05. Results: From 1999 to 2012, the overall mortality rate rose modestly (APC ~+2.1; P = 0.12), followed by a sharp decline from 2012 to 2015 (APC ~−47; P < 0.01). A subsequent increase... Continue Reading

Background: Essential hypertension and type 2 diabetes mellitus frequently coexist in older adults, increasingcardiovascular morbidity and mortality risks. Despite advancements in care, recent evidence shows thatcardiovascular mortality has plateaued, with increased hypertension-related deaths in the U.S. This studyaims to analyze mortality trends in older adults (≥65) with both conditions and examine disparities based ondemographics and geography.Hypothesis: We hypothesized that age-adjusted mortality rates (AAMRs) for older adults with coexistinghypertension and diabetes significantly increased from 1999 to 2024, with variations by sex, race/ethnicity,region, and urbanization.Methods: We conducted a retrospective analysis using the CDC WONDER database, identifying deaths from1999-2024 where essential hypertension (ICD-10 I10) and type 2 diabetes (ICD-10 E11.x) were listed as causes. Mortality rates were calculated per 100,000, and Joinpoint regression analyzed trends.Results: From 1999 to 2024, there were 331,823 eligible deaths (aggregate AAMR 60.3/100,000). The AAMRrose sharply from 10.1 in 1999 to 106.1 in 2021, before slight declines in 2022-2024.... Continue Reading

Background: Essential hypertension and obesity are leading, interrelated risk factors for cardiovascular morbidity and mortality. The joint mortality burden of these conditions appears to be rising in the US, but detailed trend analyses are limited. We analyzed national mortality involving essential (primary) hypertension with obesity to assess temporal trends and demographic and geographic disparities from 1999 to 2020. Methods: We used the CDC WONDER multiple-cause-of-death database (1999–2020) to identify deaths listing essential hypertension (ICD-10 I10) and obesity (ICD-10 E66) on the death certificate. Annual age-adjusted mortality rates (AAMRs) per 100,000 population (2000 US standard) were calculated. Trends were stratified by sex, race/ethnicity, U.S. Census region, state, and urban vs. rural residence. Joinpoint regression identified trend inflection points and was used to estimate annual percent change (APC) and average annual percent change (AAPC) in AAMRs. Results: From 1999 to 2020 there were 162,274 deaths (54% in men) involving co-listed essential hypertension... Continue Reading

Abstract Background and Objective Diabetic ketoacidosis (DKA) is a serious and increasingly common complication of diabetes with high morbidity and mortality. Early use of long-acting basal insulin alongside IV insulin may improve outcomes. This systematic review and meta-analysis aims to evaluate the efficacy and safety of co-administering insulin glargine with IV insulin in DKA management. Methods A literature search was conducted to identify relevant studies. Key outcomes included time to DKA resolution, hospital stay length, and hypoglycemia risk. RCT quality was assessed using the Cochrane risk of bias tool, and retrospective studies with the Newcastle-Ottawa Scale. Standardized mean differences with 95% CIs were used for continuous outcomes, and risk ratios for dichotomous outcomes. A random-effects model was applied using RevMan (version 5.4). Results A total of six studies were included in this meta-analysis comprising of a cumulative sample size of 302 patients with 127 in the intervention group and 175... Continue Reading

Background:The global burden of HIV remains significant, with approximately 39.9 million people living with the virus. Multi-drug antiretroviral therapy (ART) regimens can complicate treatment due to drug interactions, costs, and adherence issues. Dolutegravir (DTG) and Lamivudine (3TC) represent a promising two-drug regimen that may simplify therapy while maintaining efficacy. Methods:We searched databases PubMed, Cochrane CENTRAL, Science direct and Google scholar for randomized controlled trials (RCTs) assessing the safety and efficacy of switching to a dual therapy regimen of DTG and 3TC in HIV-1 seropositive adults. Primary outcomes included rates of virological suppression (HIV-1 RNA < 50 copies/mL) and virological failure. Results:Five RCTs with 1,654 participants met the eligibility criteria. The rate of virological suppression (HIV-1 RNA < 50 copies/mL) was similar between those switching to DTG/3TC and those remaining on CAR (RR = 1.03, P = 0.11). No significant differences in virological failure rates or CD4+ cell counts were observed... Continue Reading