Matt Hayward

Background: Posterior nasal nerve (PNN) ablation has demonstrated efficacy for chronic rhinitis, although differences between radiofrequency ablation (RFA) and cryoablation (CA) remain unclear. This meta-analysis aims to indirectly compare long-term efficacy and safety between these modalities. Methods: A search for studies reporting efficacy or adverse events (AEs) of RFA or CA was conducted using 5 health science databases in January 2026. Meta-regression calculated change in the Total Nasal Symptom Score (TNSS), TNSS subscores, and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Fisher's exact test compared overall and specific AE incidences. Results: This meta-analysis includes 12 studies and a total of 859 patients. Mean change for TNSS surpassed minimal clinically important threshold for both modalities at all follow-up time points. RFA demonstrated significantly greater improvement than CA at 30 days (0.63, 95% CI: 0.02-1.26, P = .045) until 365 days (0.60, 95% CI: 0.00-1.20, P = .049). TNSS subscores showed significant differences in favor of RFA over CA, for nasal itching (0.41, 95% CI: 0.23-0.58, P < .001) beginning at 30 days and sneezing (0.21, 95% CI: 0.03-0.39, P = .022) beginning at 90 days. RQLQ improvement at 90 days favored RFA over CA (0.19, 95% CI: 0.00-0.37, P = .047). RFA demonstrated lower AE incidence (5.3% vs 29.4%, P < .001). Specifically, CA had a higher incidence of headache and oral/palatal numbness events. Conclusions: Both treatment modalities effectively reduce symptoms, although RFA demonstrated greater quality of life improvement and symptom relief, particularly for nasal itching and sneezing. While both modalities demonstrated low AE burden, RFA was generally associated with fewer AEs. Direct prospective comparisons are warranted.

Background: Headache following traumatic brain injury (TBI) is a common, yet disabling, disorder with diverse mechanisms and treatment needs that remain poorly defined. Pharmacological regimens are the primary source of remedies for individuals with post-traumatic headaches (PTH). The main objective of this review is to describe the efficacy of pharmacological medications for the treatment of PTH with a specific focus on the effect of these medications on headache characteristics and headache-related quality of life (QoL). Methods: This systematic review (CRD42024537719) followed PRISMA and SWiM guidelines. PubMed, CINAHL, Scopus, PsycINFO and the Cochrane Library were searched in April 2024 for peer-reviewed articles published in English between 2009 and 2024. Eligible studies included randomized controlled trials, controlled cohort studies, and systematic reviews or meta-analyses evaluating pharmacological treatments for PTH in adults. Studies were excluded if they did not assess outcomes related to PTH pain, only included pediatric populations, used animal models, investigated only non-pharmacological interventions, were case reports, narrative reviews, editorials or conference abstracts, or did not involve human participants with TBI-related headache. Risk of bias was assessed using RoB-2 for Randomized controlled trials (RCTs) and ROBINS-I for the non-randomized studies of the effects of interventions. Results: Sixteen studies were included in the final review, comprising retrospective observational ( n = 7), non-randomized prospective ( n = 4) and randomized controlled trials ( n = 5). Most studies reported some improvements in headache frequency and intensity following pharmacological treatment, although findings for headache-related QoL were inconsistent. Erenumab showed potential benefits for persistent PTH in small, uncontrolled studies of civilian samples. However, findings on its impact on headache-related QoL should be interpreted with caution, given the high discontinuation rate observed. Prazosin demonstrated similar benefits in military populations, with minimal side effects. In the acute care setting, metoclopramide, co-administered with diphenhydramine to minimize side effects, was associated with short-term relief of headache symptoms. Of the RCTs, only two had a low risk of bias, of which only one specifically focused on PTH. Conclusions: Pharmacological treatments for PTH may provide improvements in headache frequency and intensity; however, evidence for their efficacy is limited and inconsistent. Given the limited high-quality evidence overall, no specific clinical recommendations can be made at this time. Future research should prioritize rigorous, controlled studies, particularly comparative effectiveness trials, and explore holistic, personalized approaches that incorporate treatment of psychiatric comorbidities and consider patient context.

Despite the success of health programs conducted within Latino churches, research has been limited in understanding facilitators and barriers that exist when conducting adult health programs within Latino churches. Thus, the objective of this study is to systematically review the literature to identify facilitators and barriers that exist when conducting adult health programs within Latino churches, based on the perception of church pastors/leaders and church members, using a socio-ecological approach. A comprehensive literature search in Medline, CINAHL, and Embase was conducted. Studies were included if they were conducted in the U.S., had church pastors/leaders or church members as study participants, and if they identified facilitators and barriers within the study. Facilitators and barriers from each study were also stratified using the Socio-Ecological model (SEM). Out of 123 articles, only seventeen were included. Fifteen articles discussed facilitators and barriers that were specific to conducting health programs such as diabetes or HIV/AIDS. Two articles discussed facilitators and barriers that were specific to conducting health promotion activities within Latino churches. In this study, facilitators were identified within each level of the SEM, except at the policy level. Moreover, barriers were identified within each level of the SEM. It is important for researchers and practitioners to consider these factors to ensure that health programs as well as health promotion activities carried out within Latino churches are successful.