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BMC Public Health Jul 2024The prevailing nutritional conditions and the triple challenge of malnutrition faced by adolescents have adverse consequences for both the present and future...
INTRODUCTION
The prevailing nutritional conditions and the triple challenge of malnutrition faced by adolescents have adverse consequences for both the present and future generations' health and nutrition. Summarizing the available research on the nutritional status and dietary habits of adolescents in Nigeria is crucial.
OBJECTIVE
This study aims to systematically evaluate available literature on the nutritional status of adolescent aged 10 to 19years in Nigeria.
METHODOLOGY
A systematic search using PRISMA guideline was conducted. Three electronic databases were searched i.e., PubMed, Web of Science and Scopus using specific terms and keywords for online articles published between 2013 and 2023. After applying specified inclusion and exclusion criteria, 51 articles were selected for data extraction, synthesis and quality assessment.
RESULTS
Of the 51 included studies, 78.4% were conducted in the Southern Nigeria, 11.8% in the Northern Nigeria and 9.8% included both regions. The prevalence of overweight ranged between 0.8 and 31% and obesity ranged between 0.1 and 14%. The prevalence of thinness, stunting and underweight ranged between 3 and 31%, 0.4 to 41.6%, 0.3 to 73.3% respectively. The review also identified an inadequate intake of essential nutrients including iron, zinc, calcium, vitamin A, C, D, niacin, thiamin, riboflavin, cobalamin, and folate, with vitamin A deficiency prevalence ranges from 44 to 96%. The dietary patterns were characterized by a high consumption of cereals grains and starchy foods, low animal proteins, fast-food with soft drinks, and limited consumption of fruits and vegetables along with meal skipping.
CONCLUSION
These findings portray a complex picture of the nutritional challenges faced by this demographic group, highlighting both undernutrition and overnutrition, poor eating behaviour and micronutrient deficiency as significant concerns. The review revealed regional disparities in research representation, with a concentration of studies in Southern Nigeria. This highlights the importance of directing research efforts toward the northern regions, where the prevalence of nutritional issues is equally severe, but less studied.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42023481095.
Topics: Humans; Nigeria; Adolescent; Nutritional Status; Child; Diet; Young Adult; Feeding Behavior; Malnutrition; Male; Female; Prevalence
PubMed: 38956547
DOI: 10.1186/s12889-024-19219-w -
Seminars in Ophthalmology Apr 2021: To review the scientific literature on the comparison of the efficacy of different corneal collagen crosslinking (CXL) protocols for the treatment of progressive...
: To review the scientific literature on the comparison of the efficacy of different corneal collagen crosslinking (CXL) protocols for the treatment of progressive keratoconus. Systematic review of randomized clinical trials (RCTs) on CXL outcomes. A search was carried out using the Cochrane Library, PubMed, EMBASE, Web of Science, Ovid MEDLINE, and Scopus databases. Internal validity was analyzed by applying the filter CASPe (Critical Appraisal Skills Program Spain). The search yielded 1151 articles, and among these, 14 articles met the inclusion and exclusion criteria defined. Conventional (S) crosslinking (CXL) provided better topographic outcomes than transepithelial (TE) CXL, and S-CXL had a better therapeutic effect of corneal flattening than accelerated (A) CXL. The corneal thinning after CXL was lower with hypotonic riboflavin than with riboflavin-dextran. While one study demonstrated a better therapeutic effect of corneal flattening with S-CXL than with A-CXL, another study showed similar results between both techniques. No correlation was found between the depth of the demarcation line and topographic changes, which was not a direct measure of treatment effectiveness. Quality analysis of the literature reviewed yielded a mean score of 8.64, indicating that the RCTs evaluated had an overall acceptable quality. Good-quality RCTs comparing CXL techniques have been conducted, and most of them suggest that epi-off CXL can be considered the standard treatment for progressive keratoconus. TE-CXL and iontophoresis-assisted CXL are mainly indicated in patients with a risk of corneal scarring and patients with pain intolerance, respectively.
Topics: Collagen; Cross-Linking Reagents; Humans; Keratoconus; Photochemotherapy; Photosensitizing Agents
PubMed: 33617389
DOI: 10.1080/08820538.2021.1890784 -
Journal of Refractive Surgery... Oct 2018To evaluate the outcomes of simultaneous and sequential corneal crosslinking (CXL) and excimer laser surface ablation protocols in keratoconus. (Comparative Study)
Comparative Study
PURPOSE
To evaluate the outcomes of simultaneous and sequential corneal crosslinking (CXL) and excimer laser surface ablation protocols in keratoconus.
METHODS
A literature review was conducted using MEDLINE. The studies were divided into three groups: the sequential group included studies with CXL followed by excimer laser surface ablation later, the simultaneous group included simultaneous excimer laser surface ablation and CXL, and the no CXL group included excimer laser surface ablation only with no CXL. The data on change in logMAR uncorrected distance visual acuity (UDVA), spectacle corrected distance visual acuity (CDVA), change in spherical equivalent (SE) and refractive astigmatism, change in maximum keratometry (Kmax), complications, and safety and efficacy indices were presented for the latest follow-up visits in all groups.
RESULTS
Twenty-one studies (3 = sequential; 11 = simultaneous, 7 = no CXL) were included. UDVA improved in all groups. CDVA improved more in the sequential group. SE change was greatest in the no CXL group and the refractive astigmatism reduced comparably in the sequential and no CXL groups but less in the simultaneous group. Kmax reduced in all groups. Only the sequential group showed no progression. Corneal haze was reported in 100%, 54.5%, and 57.1% studies, respectively. Safety and efficacy indices were 1.96 and 1.58, 1.41 ± 0.32 and 0.91 ± 0.41, and 1 and 0.82, respectively.
CONCLUSIONS
The sequential group showed greater improvement in CDVA, SE, and refractive astigmatism. Corneal haze was frequently reported in all protocols. Safety and efficacy indices were highest when CXL was performed before excimer laser and least when excimer laser was performed alone without CXL. [J Refract Surg. 2018;34(10):690-696.].
Topics: Collagen; Corneal Pachymetry; Corneal Stroma; Cross-Linking Reagents; Humans; Keratoconus; Lasers, Excimer; Photochemotherapy; Photorefractive Keratectomy; Photosensitizing Agents; Refraction, Ocular; Riboflavin; Ultraviolet Rays; Visual Acuity
PubMed: 30296330
DOI: 10.3928/1081597X-20180824-01 -
Frontiers in Pediatrics 2021Diagnosis of pediatric steatohepatitis is a challenging issue due to a vast number of established and novel causes. Here, we report a child with Multiple Acyl-CoA...
Diagnosis of pediatric steatohepatitis is a challenging issue due to a vast number of established and novel causes. Here, we report a child with Multiple Acyl-CoA Dehydrogenase Deficiency (MADD) presenting with an underrated muscle weakness, exercise intolerance and an atypically severe steatotic liver involvement. A systematic literature review of liver involvement in MADD was performed as well. Our patient is a 11-year-old otherwise healthy, non-obese, male child admitted for some weakness/asthenia, vomiting and recurrent severe hypertransaminasemia (aspartate and alanine aminotransferases up to ×20 times upper limit of normal). Hepatic ultrasound showed a bright liver. MRI detected mild lipid storage of thighs muscles. A liver biopsy showed a micro-macrovacuolar steatohepatitis with minimal fibrosis. Main causes of hypertransaminasemia were ruled out. Serum aminoacids (increased proline), acylcarnitines (increased C4-C18) and a large excretion of urinary glutaric acid, ethylmalonic, butyric, isobutyric, 2-methyl-butyric and isovaleric acids suggested a diagnosis of MADD. Serum acylcarnitines and urinary organic acids fluctuated overtime paralleling serum transaminases during periods of illness/catabolic stress, confirming their recurrent nature. Genetic testing confirmed the diagnosis [homozygous c.1658A > G (p.Tyr553Cys) in exon 12 of the ETFDH gene]. Lipid-restricted diet and riboflavin treatment rapidly ameliorated symptoms, hepatic ultrasonography/enzymes, and metabolic profiles. Literature review (37 retrieved eligible studies, 283 patients) showed that liver is an extramuscular organ rarely involved in late-onset MADD (70 patients), and that amongst 45 patients who had fatty liver only nine had severe presentation. MADD is a disorder with a clinically heterogeneous phenotype. Our study suggests that MADD warrants consideration in the work-up of obesity-unrelated severe steatohepatitis.
PubMed: 34041209
DOI: 10.3389/fped.2021.672004 -
Journal of AAPOS : the Official... Dec 2020Keratoconus is a bilateral progressive noninflammatory degenerative disease of the cornea characterized by corneal thinning, irregular astigmatism, and subsequent visual... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Keratoconus is a bilateral progressive noninflammatory degenerative disease of the cornea characterized by corneal thinning, irregular astigmatism, and subsequent visual impairment. It has an aggressive course in children. This systematic review evaluates the efficacy of available corneal collagen cross-linking (CXL) protocols for stabilizing the cornea in pediatric patients with keratoconus.
METHODS
We searched all peer-reviewed publications from 2000 to 2019 indexed in PubMed, Google Scholars, Web of Science, and Cochrane's Database for the terms keratoconus and cross-linking. The following data were extracted from eligible studies: study design, type of intervention, number of the eyes and mean age of patients for each study, duration of follow-up period, mean pre- and postoperative uncorrected and corrected visual acuity, keratometric and aberrometric indices, were analyzed with RevMan 5.3 software. Intra-and intergroup post hoc analyses of outcome variables were performed using t tests.
RESULTS
A total of 28 studies, including 1,300 eyes, were reviewed. In conventional and accelerated epithelium-off techniques, there was a significant improvement in uncorrected and corrected visual acuities. Similarly, the keratometric indices improved significantly after CXL. Uncorrected visual acuity did not alter after CXL using transepithelial method.
CONCLUSIONS
Both conventional and accelerated collagen CXL of the cornea are effective therapeutic options in management of keratoconus in children.
Topics: Child; Humans; Collagen; Cornea; Corneal Topography; Cross-Linking Reagents; Keratoconus; Photochemotherapy; Photosensitizing Agents; Riboflavin; Ultraviolet Rays
PubMed: 33279597
DOI: 10.1016/j.jaapos.2020.08.013 -
Frontiers in Immunology 2022Mucosal-associated invariant T (MAIT) cells are evolutionarily conserved innate-like T cells capable of recognizing bacterial and fungal ligands derived from vitamin B...
Mining the multifunction of mucosal-associated invariant T cells in hematological malignancies and transplantation immunity: A promising hexagon soldier in immunomodulatory.
Mucosal-associated invariant T (MAIT) cells are evolutionarily conserved innate-like T cells capable of recognizing bacterial and fungal ligands derived from vitamin B biosynthesis. Under different stimulation conditions, MAIT cells can display different immune effector phenotypes, exerting immune regulation and anti-/protumor responses. Based on basic biological characteristics, including the enrichment of mucosal tissue, the secretion of mucosal repair protective factors (interleukin-17, ), and the activation of riboflavin metabolites by intestinal flora, MAIT cells may play an important role in the immune regulation effect of mucosal lesions or inflammation. At the same time, activated MAIT cells secrete granzyme B, perforin, interferon γ, and other toxic cytokines, which can mediate anti-tumor effects. In addition, since a variety of hematological malignancies express the targets of MAIT cell-specific effector molecules, MAIT cells are also a potentially attractive target for cell therapy or immunotherapy for hematological malignancies. In this review, we will provide an overview of MAIT research related to blood system diseases and discuss the possible immunomodulatory or anti-tumor roles that unique biological characteristics or effector phenotypes may play in hematological diseases.
Topics: Cytokines; Hematologic Neoplasms; Humans; Interferon-gamma; Military Personnel; Mucosal-Associated Invariant T Cells
PubMed: 36052080
DOI: 10.3389/fimmu.2022.931764 -
American Journal of Ophthalmology Sep 2021The purpose of this study was to summarize key findings from a systematic review of the effectiveness and safety of transepithelial corneal crosslinking (CXL) compared... (Meta-Analysis)
Meta-Analysis
PURPOSE
The purpose of this study was to summarize key findings from a systematic review of the effectiveness and safety of transepithelial corneal crosslinking (CXL) compared with epithelium-off CXL for progressive keratoconus.
DESIGN
Cochrane systematic review.
METHODS
We included in our review only randomized controlled trials (RCTs) in which transepithelial and epithelium-off CXL had been compared among participants with progressive keratoconus. The primary outcome was keratoconus stabilization based on post-operative maximum keratometry (Kmax). We adhered to Cochrane methods for trial selection, data extraction, risk of bias evaluation, and data synthesis.
RESULTS
Thirteen RCTs with 567 participants (661 eyes) were included; 11 studies compared non-iontophoresis-assisted transepithelial with epithelium-off CXL. Keratoconus stabilization was described as an outcome in 2 studies. The estimated difference in Kmax means (ie, the "mean difference," MD) from meta-analysis of 177 eyes in 5 RCTs indicated that there were no differences between intervention groups in Kmax at 12 months or later (MD: 0.99 diopter [D]; 95% confidence interval: -0.11 to 2.09). Meta-analysis of keratometry and visual acuity outcomes at 12 months or longer after surgery from 2 studies that had compared transepithelial CXL using iontophoresis provided no conclusive evidence of an advantage over epithelium-off CXL.
CONCLUSIONS
Lack of precision due to small sample sizes, indeterminate risk of bias due to inadequate reporting, and inconsistency in how outcomes were measured and reported among studies make it difficult to state with confidence whether transepithelial CXL confers an advantage over epithelium-off CXL for patients with progressive keratoconus with respect to stabilization of keratoconus, visual acuity, or patient-reported outcomes based on available data.
Topics: Collagen; Corneal Pachymetry; Corneal Topography; Cross-Linking Reagents; Epithelium; Humans; Keratoconus; Photochemotherapy; Photosensitizing Agents; Riboflavin; Ultraviolet Rays
PubMed: 34048801
DOI: 10.1016/j.ajo.2021.05.009 -
The Ocular Surface Oct 2019To examine the efficacy of adjuvant photoactivated chromophore for infectious keratitis-corneal cross-linking (PACK-CXL) for the treatment of infectious keratitis (IK). (Meta-Analysis)
Meta-Analysis
PURPOSE
To examine the efficacy of adjuvant photoactivated chromophore for infectious keratitis-corneal cross-linking (PACK-CXL) for the treatment of infectious keratitis (IK).
METHODS
Electronic databases, including MEDLINE, EMBASE and Cochrane Central, were searched for articles related to PACK-CXL. All clinical studies, including randomized controlled trials (RCTs), non-randomized controlled studies, case series and case reports, were included. A meta-analysis was further performed when there were sufficient similarities in the included RCTs. Primary outcome measure was time to complete corneal healing and secondary outcome measures included size of epithelial defect and infiltrate, corrected-distance-visual-acuity (CDVA), and adverse events.
RESULTS
Forty-six eligible studies (including four RCTs) with 435 patients were included. When compared to standard antimicrobial treatment (SAT) alone, adjuvant PACK-CXL resulted in shorter mean time to complete corneal healing (-7.44 days; 95% CI, -10.71 to -4.16) and quicker resolution of the infiltrate at 7 days (-5.49 mm; 95% CI, -7.44 to -3.54) and at 14-30 days (-5.27 mm; 95% CI, -9.12 to -1.41). There was no significant difference in the size of epithelial defect, CDVA and risk of adverse events. Evidence on the use of PACK-CXL in acanthamoeba and mixed IK was insufficient.
CONCLUSIONS
Our study demonstrates that adjuvant PACK-CXL expedites the healing of IK when compared to SAT alone (low-quality evidence). Further adequately powered, high-quality RCTs are required to fully ascertain the therapeutic effect of PACK-CXL.
Topics: Chromophore-Assisted Light Inactivation; Collagen; Cross-Linking Reagents; Eye Infections, Bacterial; Humans; Keratitis; Photochemotherapy; Photosensitizing Agents; Riboflavin; Visual Acuity
PubMed: 31401338
DOI: 10.1016/j.jtos.2019.08.006 -
European Journal of Nutrition Jun 2019Several epidemiological studies have assessed the ability of vitamin B to prevent colorectal cancer (CRC), but the results are controversial results. We conducted a... (Meta-Analysis)
Meta-Analysis
PURPOSE
Several epidemiological studies have assessed the ability of vitamin B to prevent colorectal cancer (CRC), but the results are controversial results. We conducted a dose-response meta-analysis to investigate the association between vitamin B and CRC risk.
METHODS
We searched the PubMed and EMBASE database until January 3, 2018 to identify relevant studies. The pooled relative risks (RRs) with the corresponding 95% confidence intervals (CIs) were calculated using a random-effects model or fixed-effects model. The dose-response relationship was assessed by restricted cubic splines.
RESULTS
A total of 14 studies reporting vitamin B intake and two studies reporting blood vitamin B concentration, comprising 14,934 cases and 1593 cases, respectively, were included in the meta-analysis. Vitamin B intake was inversely associated with CRC risk (RR = 0.87; 95% CI 0.81-0.93). Similar results were found for total vitamin B intake from diet and supplements (RR = 0.86; 95% CI 0.78-0.94) and dietary vitamin B intake (RR = 0.89, 95% CI 0.82-0.98) in subgroup analyses. The dose-response model indicated a non-linear trend, and CRC risk was reduced by 10% when vitamin B intake increased to 5 mg/day. In addition, high blood concentrations of vitamin B could also reduce the CRC risk (RR = 0.74; 95% CI 0.59-0.92).
CONCLUSIONS
This dose-response analysis indicates that vitamin B intake is inversely associated with CRC risk. The inverse association may also exist between blood vitamin B concentration and CRC risk. These results suggest the importance of vitamin B intake in the prevention of CRC.
Topics: Colorectal Neoplasms; Dietary Supplements; Dose-Response Relationship, Drug; Humans; Riboflavin; Risk; Vitamin B Complex
PubMed: 29744609
DOI: 10.1007/s00394-018-1702-5 -
The Cochrane Database of Systematic... Apr 2020Zinc is a vital micronutrient for humans and is essential for protein synthesis, cell growth, and differentiation. Severe zinc deficiency can lead to slower physical,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Zinc is a vital micronutrient for humans and is essential for protein synthesis, cell growth, and differentiation. Severe zinc deficiency can lead to slower physical, cognitive and sexual growth, cause skin disorders, decrease immunity, increase incidence of acute illnesses in infants and children and contribute to childhood stunting. By estimation, 17.3% of the world population is at risk of inadequate zinc intake. Such nutritional impairment increases the risk of diarrhoea and pneumonia by 20%, as well as leads to a global loss of more than 16 million disability-adjusted life years in children less than five years of age. Not only does zinc deficiency affect lives, it adds to the considerable financial burden on depleted resources in countries that are most affected. By preventing or curing this deficiency, we can improve childhood mortality, morbidity and growth.
OBJECTIVES
To assess the effectiveness of zinc supplementation for the promotion of growth, reduction in mortality, and the prevention of infections in infants less than six months of age.
SEARCH METHODS
We used the standard search strategy of the Cochrane Neonatal Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 4), MEDLINE via PubMed (1966 to 18 May 2018), Embase (1980 to 18 May 2018), and CINAHL (1982 to 18 May 2018). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. An updated search from 1 January 2018 to 29 January 2020 was run in the following databases: CENTRAL via CRS Web, MEDLINE via Ovid, and CINAHL via EBSCOhost.
SELECTION CRITERIA
All randomised controlled (individual and cluster randomised) and quasi-randomised trials of zinc supplementation in healthy, term infants, less than six months of age comparing infant mortality, incidence of diarrhoea or respiratory illnesses, growth and/or serum zinc levels were eligible.
DATA COLLECTION AND ANALYSIS
Two review authors screened search results (title and abstracts) and relevant full texts. Studies fulfilling prespecified inclusion criteria were included with any disagreements resolved by consensus. Extraction and analysis were then conducted. We used the GRADE approach to assess the quality of evidence as indicated by certainty in effect estimates.
MAIN RESULTS
Eight studies (with 85,629 infants) were included and five studies were meta-analysed, out of which four studies compared zinc with placebo, and one compared zinc plus riboflavin versus riboflavin. Certain growth outcomes after six months of intervention (Weight for Age Z-scores (WAZ) (standardised mean difference) (SMD) 0.16, 95% CI 0.03 to 0.29; three studies, n = 955; fixed-effect; heterogeneity Chi² P = 0.96); I² = 0%); change in WAZ (SMD 0.16, 95% CI 0.07 to 0.25; one study, n = 386; fixed-effect); (Weight-for-Length Z-score (WLZ) (SMD 0.15, 95% CI 0.02 to 0.28; three studies, n = 955; fixed-effect; heterogeneity: Chi² P = 0.81); I² = 0%); (change in WLZ (SMD 0.17, 95% CI 0.06 to 0.28; one study, n = 386; fixed-effect)) were positively affected by zinc supplementation compared to placebo. A single study reported no difference in the incidence of diarrhoea and lower respiratory tract infection with zinc supplementation. Zinc had no effect on mortality in children younger than 12 months. When zinc plus riboflavin was compared to riboflavin only, significant improvement was observed in the incidence of wasting at 24 months (risk ratio (RR) 0.59, 95% CI 0.37 to 0.96; one study, n = 296; fixed-effect), but significant worsening of incidence of stunting was present at 21 months (RR 1.53, 95% CI 1.09 to 2.16; one study, n = 298; fixed-effect).
AUTHORS' CONCLUSIONS
There was a significant positive impact of zinc supplementation on WAZ and WLZ after six months of intervention in infants compared to placebo. When a combined supplement of zinc and riboflavin was compared to riboflavin, there was a significant reduction in wasting at 24 months, but stunting at 21 months was negatively affected. Although included trials were of good-to-moderate quality, evidence that could be meta-analysed was based on a few studies which affected the overall quality of results. Regardless, there is a need for strong trials conducted in infants younger than six months before a strong recommendation can be made supporting zinc supplementation in this age group.
Topics: Body Weight; Growth; Humans; Infant; Infant Mortality; Infant, Newborn; Infection Control; Randomized Controlled Trials as Topic; Riboflavin; Trace Elements; Vitamin B Complex; Wasting Syndrome; Zinc
PubMed: 32266964
DOI: 10.1002/14651858.CD010205.pub2