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The British Journal of Nutrition Apr 2015Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with... (Review)
Review
Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial for guiding future interventions. We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Observational cohort and longitudinal studies presenting the habitual dietary intakes of older adults (≥65 years) were included. Sex-specific mean (and standard deviation) habitual micronutrient intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using the estimated average requirement (EAR) cut-point method. The percentage at risk for inadequate micronutrient intakes from habitual dietary intakes was calculated for twenty micronutrients. A total of thirty-seven articles were included in the pooled systematic analysis. Of the twenty nutrients analysed, six were considered a possible public health concern: vitamin D, thiamin, riboflavin, Ca, Mg and Se. The extent to which these apparent inadequacies are relevant depends on dynamic factors, including absorption and utilisation, vitamin and mineral supplement use, dietary assessment methods and the selection of the reference value. In light of these considerations, the present review provides insight into the type and magnitude of vitamin and mineral inadequacies.
Topics: Aged; Calcium; Diet; Diet Surveys; Dietary Supplements; Female; Humans; Magnesium; Male; Micronutrients; Nutritional Requirements; Nutritional Status; Riboflavin; Selenium; Thiamine; Vitamin D
PubMed: 25822905
DOI: 10.1017/S0007114515000203 -
Journal of Lasers in Medical Sciences 2021The aim of this article was to evaluate reports in the scientific literature that used antimicrobial photodynamic therapy (aPDT) with a blue light source and curcumin... (Review)
Review
The aim of this article was to evaluate reports in the scientific literature that used antimicrobial photodynamic therapy (aPDT) with a blue light source and curcumin and riboflavin as photosensitizers in the management of periodontitis. The search was conducted in electronic databases, including PubMed, Web of Science, and Scopus, with the keywords "photodynamic therapy", "antimicrobial photodynamic therapy", "laser activated disinfection", "photoactivated disinfection", "light activated disinfection" "LED", "Periodontitis", "Curcumin", "Riboflavin", and "periodontitis" from 2012 to 2020. After evaluating a total of 24 relevant articles, 13 articles were selected, full texts were read, and the data were extracted and placed in a table. Reviewing articles showed that curcumin as a photosensitizer activated by a blue wavelength is effective in the elimination of the various bacterial species involved in periodontal disease, and to the best of our knowledge, there is no study that has shown this substance does not reduce bacteria. According to the result of the articles, riboflavin as a photosensitizer activated by blue light can reduce bacteria that are involved in periodontitis, but other studies have reported that blue light alone can also reduce bacteria significantly. Therefore, more in-vitro and clinical trial studies are needed to give a more conclusive opinion on the effectiveness of riboflavin as a photosensitizer in the treatment of periodontitis.
PubMed: 34733738
DOI: 10.34172/jlms.2021.15 -
Journal of Cataract and Refractive... Oct 2021Corneal crosslinking (CXL) is the current mainstay treatment for progressive keratoconus. In the past 15 years, a variety of other indications have been tested. A...
Corneal crosslinking (CXL) is the current mainstay treatment for progressive keratoconus. In the past 15 years, a variety of other indications have been tested. A systematic review was conducted to examine these alternative indications for CXL. In total, 143 papers on crosslinking as a treatment for infectious keratitis, bullous keratopathy, pellucid marginal degeneration, and postlaser in situ keratomileusis (LASIK) ectasia and as a way to improve vision either on its own or in combination with other interventions were included. Post-LASIK ectasia is a definite indication for crosslinking. Surprisingly, only limited research has been performed on pellucid marginal degeneration, with no randomized trials available to date. Other interesting applications are the combined use of refractive lasers and crosslinking for suspicious or ectatic corneas and crosslinking as a standalone intervention for minor refractive errors. CXL might offer a solution for refractory bacterial keratitis. In bullous keratopathy, it seems to offer only a transient benefit.
Topics: Collagen; Cornea; Corneal Topography; Cross-Linking Reagents; Humans; Keratoconus; Keratomileusis, Laser In Situ; Photosensitizing Agents; Riboflavin; Ultraviolet Rays
PubMed: 33929804
DOI: 10.1097/j.jcrs.0000000000000663 -
The Cochrane Database of Systematic... Mar 2015Keratoconus is a condition of the eye that affects approximately 1 in 2000 people. The disease leads to a gradual increase in corneal curvature and decrease in visual... (Review)
Review
BACKGROUND
Keratoconus is a condition of the eye that affects approximately 1 in 2000 people. The disease leads to a gradual increase in corneal curvature and decrease in visual acuity with consequent impact on quality of life. Collagen cross-linking (CXL) with ultraviolet A (UVA) light and riboflavin (vitamin B2) is a relatively new treatment that has been reported to slow or halt the progression of the disease in its early stages.
OBJECTIVES
The objective of this review was to assess whether there is evidence that CXL is an effective and safe treatment for halting the progression of keratoconus compared to no treatment.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2014), EMBASE (January 1980 to August 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to August 2014), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to August 2014), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organisation International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We used no date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 August 2014.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) where CXL with UVA light and riboflavin was used to treat people with keratoconus and was compared to no treatment.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the search results, assessed trial quality, and extracted data using standard methodological procedures expected by Cochrane. Our primary outcomes were two indicators of progression at 12 months: increase in maximum keratometry of 1.5 dioptres (D) or more and deterioration in uncorrected visual acuity of more than 0.2 logMAR.
MAIN RESULTS
We included three RCTs conducted in Australia, the United Kingdom, and the United States that enrolled a total of 225 eyes and analysed 219 eyes. The total number of people enrolled was not clear in two of the studies. Only adults were enrolled into these studies. Out of the eyes analysed, 119 had CXL (all using the epithelium-off technique) and 100 served as controls. One of these studies only reported comparative data on review outcomes. All three studies were at high risk for performance bias (lack of masking), detection bias (only one trial attempted to mask outcome assessment), and attrition bias (incomplete follow-up). It was not possible to pool data due to differences in measuring and reporting outcomes. We identified a further three unpublished trials that potentially had enrolled a total of 195 participants.There was limited evidence on the risk of progression. Analysis of the first few participants followed up to one year in one study suggested that eyes given CXL were less likely to have an increase in maximum keratometry of 1.5 D or more at 12 months compared to eyes given no treatment, but the confidence intervals (CI) were wide and compatible with no effect or more progression in the CXL group (risk ratio (RR) 0.12, 95% CI 0.01 to 2.00, 19 eyes). The same study reported the number of eyes with an increase of 2 D or more at 36 months in the whole cohort with a RR of 0.03 favouring CXL (95% CI 0.00 to 0.43, 94 eyes). Another study reported "progression" at 18 months using a different definition; people receiving CXL were less likely to progress, but again the effect was uncertain (RR 0.14, 95% CI 0.01 to 2.61, 44 eyes). We judged this to be very low-quality evidence due to the risk of bias of included studies, imprecision, indirectness and publication bias but noted that the size of the potential effect was large.On average, treated eyes had a less steep cornea (approximately 2 D less steep) (mean difference (MD) -1.92, 95% CI -2.54 to -1.30, 94 eyes, 1 RCT, very low-quality evidence) and better uncorrected visual acuity (approximately 2 lines or 10 letters better) (MD -0.20, 95% CI -0.31 to -0.09, 94 eyes, 1 RCT, very low-quality evidence) at 12 months. None of the studies reported loss of 0.2 logMAR acuity. The data on corneal thickness were inconsistent. There were no data available on quality of life or costs. Adverse effects were not uncommon but mostly transient and of low clinical significance. In one trial, 3 out of 12 participants treated with CXL had an adverse effect including corneal oedema, anterior chamber inflammation, and recurrent corneal erosions. In one trial at 3 years 3 out of 50 participants experienced adverse events including mild diffuse corneal oedema and paracentral infiltrate, peripheral corneal vascularisation, and subepithelial infiltrates and anterior chamber inflammation. No adverse effects were reported in the control groups.
AUTHORS' CONCLUSIONS
The evidence for the use of CXL in the management of keratoconus is limited due the lack of properly conducted RCTs.
Topics: Adult; Collagen; Confidence Intervals; Cross-Linking Reagents; Disease Progression; Humans; Keratoconus; Photosensitizing Agents; Randomized Controlled Trials as Topic; Riboflavin; Ultraviolet Therapy
PubMed: 25803325
DOI: 10.1002/14651858.CD010621.pub2 -
Archives of Gynecology and Obstetrics Mar 2017Epidemiological studies assessing the relationship between dietary vitamin B2 and the risk of breast cancer have produced inconsistent results. Thus, we conducted this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Epidemiological studies assessing the relationship between dietary vitamin B2 and the risk of breast cancer have produced inconsistent results. Thus, we conducted this meta-analysis of epidemiologic studies to evaluate this association.
METHODS
We searched English-language MEDLINE publications and conducted a manual search to screen eligible articles. A random-effect model was used to pool study-specific risk estimates. Egger's linear regression test was also used to detect publication bias in meta-analysis.
RESULTS
In our meta-analysis, ten studies comprising totally 12,268 breast cancer patients were available in the analyses. Pooled relative risk (RR) comparing the highest to the lowest vitamin B2 intake and breast cancer incidence was 0.85 [95% confidence interval (CI) = 0.76-0.95]. No significant heterogeneity existed across the studies (P = 0.086, I = 40.7%). No publication bias was found. The results of dose-response analysis also showed that an increment of 1 mg/day was inversely related to the risk of breast cancer (RR = 0.94; 95% CI = 0.90-0.99).
CONCLUSIONS
Results from our meta-analysis indicated that dietary vitamin B2 intake is weakly related to the reduced risk of breast cancer. Additional research is also necessary to further explore this association.
Topics: Breast Neoplasms; Dietary Supplements; Female; Humans; Riboflavin; Risk
PubMed: 28035488
DOI: 10.1007/s00404-016-4278-4 -
Nutrients Feb 2023Increasingly, chronic kidney disease (CKD) is becoming an inevitable consequence of obesity, metabolic syndrome, and diabetes. As the disease progresses, and through... (Review)
Review
BACKGROUND
Increasingly, chronic kidney disease (CKD) is becoming an inevitable consequence of obesity, metabolic syndrome, and diabetes. As the disease progresses, and through dialysis, the need for and loss of water-soluble vitamins both increase. This review article looks at the benefits and possible risks of supplementing these vitamins with the treatment of CKD.
METHODS
Data in the PubMed and Embase databases were analyzed. The keywords "chronic kidney disease", in various combinations, are associated with thiamin, riboflavin, pyridoxine, pantothenic acid, folates, niacin, cobalamin, and vitamin C. This review focuses on the possible use of water-soluble vitamin supplementation to improve pharmacological responses and the overall clinical condition of patients.
RESULTS
The mechanism of supportive supplementation is based on reducing oxidative stress, covering the increased demand and losses resulting from the treatment method. In the initial period of failure (G2-G3a), it does not require intervention, but later, especially in the case of inadequate nutrition, the inclusion of supplementation with folate and cobalamin may bring benefits. Such supplementation seems to be a necessity in patients with stage G4 or G5 (uremia). Conversely, the inclusion of additional B6 supplementation to reduce CV risk may be considered. At stage 3b and beyond (stages 4-5), the inclusion of niacin at a dose of 400-1000 mg, depending on the patient's tolerance, is required to lower the phosphate level. The inclusion of supplementation with thiamine and other water-soluble vitamins, especially in peritoneal dialysis and hemodialysis patients, is necessary for reducing dialysis losses. Allowing hemodialysis patients to take low doses of oral vitamin C effectively reduces erythropoietin dose requirements and improves anemia in functional iron-deficient patients. However, it should be considered that doses of B vitamins that are several times higher than the recommended dietary allowance of consumption may exacerbate left ventricular diastolic dysfunction in CKD patients.
CONCLUSIONS
Taking into account the research conducted so far, it seems that the use of vitamin supplementation in CKD patients may have a positive impact on the treatment process and maintaining a disease-free condition.
Topics: Humans; Niacin; Renal Dialysis; Vitamin B Complex; Thiamine; Ascorbic Acid; Folic Acid; Vitamin B 12; Kidney Failure, Chronic; Renal Insufficiency, Chronic; Dietary Supplements; Water
PubMed: 36839219
DOI: 10.3390/nu15040860 -
Photodiagnosis and Photodynamic Therapy Jun 2023The present study aimed to perform a systematic review and meta-analysis to investigate the effectiveness of the contemporary photoactivated disinfection methods on the... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The present study aimed to perform a systematic review and meta-analysis to investigate the effectiveness of the contemporary photoactivated disinfection methods on the mechanical features and/or antimicrobial activity of polymethyl methacrylate (PMMA) dentures bases.
METHODS
THE FOCUSED RESEARCH QUESTION WAS: "What is the effect of contemporary photoactivated disinfection methods as compared to conventional disinfection protocols on the mechanical features and/or antimicrobial activity of PMMA dentures bases?". An electronic literature search was carried out by the author and a senior librarian specialized in health sciences on Web of Science, PubMed, and Scopus. In vitro investigations evaluating the antimicrobial and/or mechanical effects of photoactivated disinfectants as compared to conventional chemical disinfectants on the microbes formed on PMMA denture bases were included. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval.
RESULTS
Four out of eight studies concluded that photoactivated disinfectants, including riboflavin-mediated photodynamic therapy (PDT), hematoporphyrin-mediated PDT, poly-l-glycolic acid loaded with methylene blue, Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser, erbium-doped yttrium-aluminum-garnet (Er:YAG) laser, and chitosan-mediated PDT, demonstrated a significant reduction in colony-forming unit per milliliter (CFU/mL) of exposed viable colonies of Escherichia coli (E. coli), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Candida albicans (C. albicans) comparable to the conventionally used chemical disinfectants of PMMA denture bases. Contrarily, two studies concluded that the PMMA denture base colonized with C. albicans and disinfected with conventional chemical disinfectants showed the greatest anti-fungal efficaciousness. All the included studies concluded that the application of photoactivated disinfectants does not negatively impact the mechanical features of the PMMA denture bases colonized with microbes including E. coli, S. mutans, S. aureus, and C. albicans. The meta-analysis revealed statistically significant reduction in C. albicans counts (CFU/mL [Log10]) (p < 0.00001) and improvement in the flexural strength (p = 0.0002) of PMMA-based denture base after the application of conventional disinfectants, while a statistically significant improvement in the fracture strength of PMMA-based denture base was observed after the application of photoactivated disinfectants (p = 0.03).
CONCLUSION
According to the systematic review (qualitative synthesis), photoactivated disinfectants demonstrated comparable mechanical features and antimicrobial activity of PMMA dentures bases to conventional chemical disinfectants suggesting their potential to be utilized as an alternative to conventional chemical disinfectants. However, the meta-analysis (quantitative synthesis) revealed that the application of conventional disinfectants demonstrated better outcomes related to antimicrobial activity and flexural strength of PMMA-based denture based.
Topics: Polymethyl Methacrylate; Disinfection; Denture Bases; Escherichia coli; Staphylococcus aureus; Erbium; Photochemotherapy; Photosensitizing Agents; Anti-Infective Agents; Disinfectants; Materials Testing; Candida albicans
PubMed: 36958538
DOI: 10.1016/j.pdpdt.2023.103523 -
Graefe's Archive For Clinical and... Sep 2023The success of corneal collagen cross-linking in altering keratoconus' clinical course has driven a search for further uses of this procedure. This literature review...
PURPOSE
The success of corneal collagen cross-linking in altering keratoconus' clinical course has driven a search for further uses of this procedure. This literature review aims to analyze the scientific evidence available for the benefit of cross-linking in the management of ophthalmic diseases other than progressive keratoconus or ectasia induced by corneal refractive procedures.
METHODS
A systemic literature review.
RESULTS
We reviewed 97 studies. We found that collagen cross-linking can limit the progression of several other corneal ectasias, thus reducing and limiting the need for keratoplasty. Collagen cross-linking also can reduce the refractive power of the cornea and can be considered for a moderate degree of bacterial keratitis or when the organism is unidentified, which is refractive to antibiotics alone. However, the comparative rarity of these procedures has limited the extent of evidence. In fungal, Acanthamoeba, and herpes virus keratitis, the evidence is inconclusive of the safety and efficacy of cross-linking.
CONCLUSION
Current clinical data is limited, and laboratory data has not fully correlated with published clinical data.
Topics: Humans; Collagen; Corneal Cross-Linking; Cross-Linking Reagents; Keratitis, Herpetic; Keratoconus; Photochemotherapy; Photosensitizing Agents; Riboflavin; Ultraviolet Rays
PubMed: 36881260
DOI: 10.1007/s00417-023-05994-6 -
Cornea Jan 2016To assess the efficacy of corneal collagen cross-linking (CXL) in the management of infectious keratitis. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To assess the efficacy of corneal collagen cross-linking (CXL) in the management of infectious keratitis.
METHODS
Comprehensive literature search was performed in MEDLINE/PubMed and Cochrane Central Register of Controlled Trials using combinations of the following search terms: "corneal collagen cross linking" or "photoactivated riboflavin" or "UVA light and riboflavin" and "infectious keratitis" or "corneal ulcer." Last search was on March 19, 2015. Extracted data from individual studies were summarized and summary proportions of eyes healed and complications for different subgroups were estimated.
RESULTS
Twenty-five studies were included (2 randomized controlled trials, 13 case series, and 10 case reports) with a total of 210 eyes of 209 patients, of which 175 eyes underwent CXL. Causative microorganisms were bacteria, fungi, acanthamoeba, and Herpes simplex virus in 96, 32, 11, and 2 cases, respectively. Coinfections were present in 13 and cause was inconclusive in 21 cases. Sixteen of 175 eyes received no additional antibiotics, whereas 159 underwent CXL as an adjunct to antimicrobial treatment. Proportion of eyes healed with CXL was 87.2% (95% confidence interval (CI), 81.9%, 91.8%). For bacterial keratitis, the proportion of eyes healed was 85.7% (95% CI, 78.5%, 91.7%), whereas 10/11 and 25/32 eyes with acanthamoeba and fungal keratitis, respectively, were healed (available data not sufficient to provide a valid proportion analysis). Treatment resulted in corneal melting and tectonic keratoplasty in both Herpes simplex virus cases.
CONCLUSIONS
CXL seems promising in the management of infectious keratitis, excluding viral infections. However, more randomized controlled trials are required to assess its efficacy.
Topics: Collagen; Cornea; Cross-Linking Reagents; Eye Infections, Bacterial; Humans; Keratitis
PubMed: 26509768
DOI: 10.1097/ICO.0000000000000644 -
Journal of Cataract and Refractive... Aug 2021Corneal crosslinking is a U.S. Food and Drug Administration--approved therapy to stiffen the cornea and prevent progression of corneal ectasia in patients with...
Corneal crosslinking is a U.S. Food and Drug Administration--approved therapy to stiffen the cornea and prevent progression of corneal ectasia in patients with keratoconus. The standard procedure involves removal of the corneal epithelium (epithelial-off) prior to treatment. Variations to the standard procedure include accelerated crosslinking and transepithelial procedures. This study reviewed what is known regarding the risk for infection after epithelial-off crosslinking, the spectrum of pathogens, and clinical outcomes. 26 publications were identified. All eyes were fit with a bandage contact lens postoperatively. Available data indicate that the overall frequency of infectious keratitis after epithelium-off crosslinking is low. Bacterial infections are the most common, with a mean time of presentation of 4.8 days postoperatively. The use of steroids and bandage contact lenses in the immediate postoperative period and/or a history of atopic or herpetic disease were associated with infection. These patients require intense postoperative care with prophylactic antiviral therapy when appropriate.
Topics: Collagen; Cornea; Cross-Linking Reagents; Humans; Keratitis; Keratoconus; Photosensitizing Agents; Riboflavin
PubMed: 33769765
DOI: 10.1097/j.jcrs.0000000000000620