Healthcare

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent among adolescents, especially those with obesity. It is the leading cause of liver-related morbidity and mortality and can progress to metabolic dysfunction-associated steatohepatitis, and eventually irreversible cirrhosis. There is currently no medical treatment recommended for MASLD in adolescents. Nutritional interventions, such as polyphenol supplementation, could be a non-pharmacological option to improve metabolic outcomes. Objectives: This pilot study aimed to preliminarily assess the impact of a 60-day polyphenol supplementation on measured resting energy expenditure (mREE) by indirect calorimetry (IC) in adolescents with MASLD. It also compared mREE by IC with predicted resting energy expenditure (pREE) using the WHO and Schofield formulae. Methods: This single-blind randomized controlled trial enrolled 23 adolescents with MASLD, of which 11 completed IC assessments before and after the 60-day polyphenol supplementation (intervention group, n = 5) or no supplementation (controls, n = 6). There was no placebo. Caloric intake was assessed to evaluate its impact on mREE and mREE was compared to pREE using the WHO and Schofield equations. Results: Participants in the intervention group had a statistically significant increase in mREE between the two visits (+89.6 kcal/day, p = 0.037), while no difference was found in the control group. When compared to the control group, the intervention group had a greater variation in mREE between visits (+100.4 kcal/day, p = 0.021). No significant changes were observed when adjusting mREE for body weight. Also, there were no significant changes in body weight in the two groups between the visits. Both the WHO and Schofield equations overestimated pREE with an average percentage of pREE of 88.8% and 91.0%, respectively. Conclusions: Although several methodological limitations prevent clear conclusions from being drawn at this stage, this study suggests that polyphenol supplementation could increase REE in adolescents with MASLD and that the WHO and Schofield equations tend to overestimate REE in obese patients.

Background: Middle-aged women frequently experience diverse physical and psychological symptoms, including depression, anxiety, sleep disturbances, vasomotor symptoms, and reduced quality of life, during menopause. With increasing concerns regarding the side effects of hormone therapy, nonpharmacological interventions have emerged as safer alternatives for symptom management. Purpose: This systematic review and meta-analysis evaluated the effectiveness of nonpharmacological interventions for menopausal symptoms in middle-aged women. Methods: Thirty-two randomized controlled trials were selected from eight international and domestic databases. Interventions were categorized as nutritional or herbal, psychological, exercise-based, and complementary therapies. Risk of bias was assessed using the Cochrane risk of bias tool, and meta-analyses were performed using a random effects model. Results: Nonpharmacological interventions significantly reduced symptoms of depression (standardized mean difference (SMD) = −1.10), anxiety (−0.82), sleep disturbances (−0.90), menopausal symptoms (−1.18), and hot flashes (−0.34). Improvement in quality of life was observed, but it was not statistically significant (SMD = 1.40). Subgroup analyses revealed that nutritional and herbal interventions had the most consistent effects, and psychological and exercise-based interventions were particularly effective for improving sleep outcomes and emotional well-being. Conclusions: Nonpharmacological interventions effectively improve menopausal symptoms and quality of life, with tailored and multifaceted approaches showing the greatest impact. Nurse-led, community-based programs are key delivery platforms, and sustainable outcomes require standardized protocols, cultural responsiveness, and ongoing evaluation.

Objective: To scope the available literature on antipsychotic treatment in substance-induced psychotic disorders, summarize evidence across substance categories, and highlight priorities for future research. Methods: This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, Embase, PsycINFO, and Cochrane Library (January 1985–August 2025) identified studies examining antipsychotic treatment in cannabis-, stimulant-, and hallucinogen-induced psychoses. Two reviewers independently screened studies and extracted data using a standardized form. Given marked heterogeneity, findings were synthesized descriptively. Results: Seventeen studies met inclusion criteria: 3 randomized controlled trials (17.6%), 10 observational studies (58.8%), and 4 case series (23.5%). Most evidence involved cannabis-induced (n = 7) and methamphetamine-induced (n = 6) psychosis. Randomized trials showed comparable efficacy between risperidone and haloperidol for cannabis-induced psychosis, and between quetiapine and haloperidol for methamphetamine-induced psychosis. Case series suggested potential benefits of third-generation antipsychotics such as lurasidone and cariprazine. No controlled studies were identified for cocaine- or hallucinogen-induced psychoses. Conclusions: Evidence for antipsychotic treatment in substance-induced psychoses remains scarce and uneven. While conventional antipsychotics appear effective for cannabis- and methamphetamine-related presentations, other substances remain virtually unstudied. Substantial evidence gaps and limited methodological quality highlight urgent research needs.