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Genetics Research 2023Pharmacogenetics is a potential approach that can be applied to decline the burden of rivaroxaban's ADRs. The current systematic review and meta-analysis aim to identify... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Pharmacogenetics is a potential approach that can be applied to decline the burden of rivaroxaban's ADRs. The current systematic review and meta-analysis aim to identify genetic variants correlated with rivaroxaban exposure and evaluate their importance.
METHODS
We systematically searched PubMed, Web of Science, and Scopus databases for all observational and interventional studies. The fixed effect method was used to pool the data when the Q-test's value was higher than 0.1. We used random models when the value was less than 0.1.
RESULTS
Data from ten studies (4721 participants) were analyzed in the current review. Qualitative synthesis from included studies found that two variants of ABCB1 (rs1045642 and rs2032582) and one variant of APOB (rs13306198) are potential contributors to rivaroxaban concentrations. Both wild homozygotes (AA) and heterozygotes (AC) of rs1045642 have significantly lower rivaroxaban concentrations compared to mutated homozygotes (CC) (SMD = 0.516, 95% CI: 0.115 to 0.917; SMD = 0.772, 95% CI: 0.088 to 1.455, respectively). Nevertheless, pooling unadjusted odds ratios did not yield a statistically significant correlation between rivaroxaban ADRs and genetic mutations.
CONCLUSION
This study revealed that being an AC or CC for rs1045642 is attributed to a considerably higher rivaroxaban level in participants using rivaroxaban. That is to say, rs1045642 is a remarkable predictor of rivaroxaban metabolism. We concluded that identifying rs1045642 before drug administration might decrease ADRs although further studies adjusted for potential confounders are strongly suggested.
Topics: Humans; Rivaroxaban; Pharmacogenetics; Homozygote; Heterozygote; Drug-Related Side Effects and Adverse Reactions
PubMed: 37942082
DOI: 10.1155/2023/6105320 -
Current Medicinal Chemistry Mar 2024The beneficial effects of curcumin against various chronic disorders have been shown in the last few decades. However, due to its low bioavailability, therapeutic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The beneficial effects of curcumin against various chronic disorders have been shown in the last few decades. However, due to its low bioavailability, therapeutic effects are less than expected. Piperine has been used in scientific evaluations as an effective compound to increase the bioavailability of curcumin. The present review investigated the impact of curcumin plus piperine intake on oxidative stress and inflammatory markers of Randomized Clinical Trials (RCTs).
METHODS
Using relevant keywords, we searched Cochrane Library, Scopus, PubMed, and Web of Science between January 1st, 1970, and September 30th, 2022. A comprehensive search for RCTs was performed. Continuous data were pooled by Standard Mean Difference (SMD) and 95% confidence interval. All related statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software.
RESULTS
A total of 13 articles were incorporated into the final meta-analysis. According to the current meta-analysis, curcumin plus piperine administration showed a significantly increased SOD activity and GSH levels while significantly decreased MDA concentrations. In addition, our study revealed that curcumin plus piperine significantly decreased TNF-α and IL-6 concentrations.
CONCLUSION
These results indicated that curcumin plus piperine administration could effectively reduce oxidative stress and inflammation.
PubMed: 38561618
DOI: 10.2174/0109298673260515240322074849 -
Pharmaceuticals (Basel, Switzerland) Aug 2023Major depressive disorder (MDD) is a medical condition involving persistent sadness and loss of interest; however, conventional treatments with antidepressants and... (Review)
Review
Major depressive disorder (MDD) is a medical condition involving persistent sadness and loss of interest; however, conventional treatments with antidepressants and cognitive behavioral therapy have limitations. Based on the pathogenesis of MDD, treatments using herbal medicines (HM) have been identified in animal studies. We conducted a systematic review of clinical studies to identify neurobiological outcomes and evaluate the effectiveness of HM in treating MDD. A meta-analysis was performed by searching nine databases from their inception until 12 September 2022, including 31 randomized controlled trials with 3133 participants, to examine the effects of HM on MDD using neurobiological biomarkers and a depression questionnaire scale. Quality assessment was performed using a risk of bias tool. Compared to antidepressants alone, HM combined with an antidepressant significantly increased concentrations of serotonin (SMD = 1.96, 95% CI: 1.24-2.68, < 0.00001, I = 97%), brain-derived neurotrophic factor (SMD = 1.38, 95% CI: 0.92-1.83, < 0.00001, I = 91%), and nerve growth factors (SMD = 2.38, 95% CI: 0.67-4.10, = 0.006, I = 96%), and decreased cortisol concentrations (SMD = -3.78, 95% CI: -4.71 to -2.86, < 0.00001, I = 87%). Although HM or HM with an antidepressant benefits MDD treatment through improving neuroendocrine factors, these findings should be interpreted with caution because of the low methodological quality and clinical heterogeneity of the included studies.
PubMed: 37631092
DOI: 10.3390/ph16081176 -
Aesthetic Plastic Surgery Mar 2024Triamcinolone acetonide injections (TAIs) have been suggested to decrease complications following rhinoplasty. This systematic review aimed to assess the efficacy and... (Review)
Review
BACKGROUND
Triamcinolone acetonide injections (TAIs) have been suggested to decrease complications following rhinoplasty. This systematic review aimed to assess the efficacy and safety of TAIs following rhinoplasty.
METHODS
We performed a systematic literature search on Medline, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials from inception to May 2023, without any timeframe limitations. The following terms were used: (Triamcinolone OR steroid injections OR triamcinolone acetonide) AND (Skin thickness OR supratip edema OR supratip deformity OR Pollybeak deformity) AND (rhinoplasty OR external rhinoplasty). We included randomized controlled trials and observational studies (prospective, retrospective, and case series).
RESULTS
In total, six of the 1604 articles met our inclusion criteria. A total of 1524 patients were included in this study. Our results included patient demographics, type of rhinoplasty, post-injection follow-up period, site of injection, type of syringe used, timing of the first dose, volume and concentration used, time interval between doses, response to the injection, and complications of injection.
CONCLUSION
To our knowledge, this is the first systematic review to address this issue. Our results demonstrate the ease and safety of TAIs as a first-line treatment, with positive outcomes and limited complications. TAIs can be used early postoperatively to minimize the need for revision surgery. Despite the limited number of studies on TAIs, this study provides the best available evidence that can help surgeons decide when to use the injection, the intervals between doses, and the duration of use. Further randomized controlled trials are required to confirm our findings.
LEVEL OF EVIDENCE II
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
PubMed: 38519572
DOI: 10.1007/s00266-024-03967-6 -
The Cochrane Database of Systematic... Aug 2023This is an update of a previous Cochrane Review, last updated in 2014. Ovarian cancer is the eighth most common cancer and seventh most common cause of death due to... (Review)
Review
BACKGROUND
This is an update of a previous Cochrane Review, last updated in 2014. Ovarian cancer is the eighth most common cancer and seventh most common cause of death due to cancer in women worldwide. Traditionally, most women who have been treated for cancer undergo long-term follow-up in secondary care. However, it has been suggested that the use of routine review may not be effective in improving survival, or health-related quality of life (HRQOL), or relieving anxiety. In addition, traditional follow-up may not be cost-effective.
OBJECTIVES
To compare the potential effects of different strategies of follow-up in women with epithelial ovarian cancer, following completion of primary treatment.
SEARCH METHODS
For this update, we searched the Cochrane Gynaecological Cancer Group Trials Register, CENTRAL 2022, Issue 11, MEDLINE, and Embase from August 2013 to November 2022. We also searched review articles and contacted experts in the field.
SELECTION CRITERIA
All randomised controlled trials (RCTs) that evaluated follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment.
DATA COLLECTION AND ANALYSIS
We followed standard Cochrane methodology. Two review authors independently selected potentially relevant trials, extracted data, and assessed risk of bias. They compared results, and resolved disagreements by discussion. We assessed the certainty of evidence, using the GRADE approach, for the outcomes of interest: overall survival (OS), health-related quality of life (HRQOL), psychological effects, and cost analysis.
MAIN RESULTS
For this update, we included one new RCT, including 112 women with ovarian, fallopian tube, or peritoneal cancer, who had completed primary treatment by surgery, with or without chemotherapy. This study reported the effect of individualised, i.e. individually tailored, nurse-led follow-up versus conventional medical follow-up on HRQOL, psychological outcomes, and cost-analysis. Individualised follow-up improved HRQOL in one of the two scales, with a decrease in mean difference (MD) in the QLQ-C30 discomfort scale following 12 months of individualised treatment compared to 12 months of conventional treatment (MD -5.76 points, 95% confidence interval (CI) -10.92 to -0.60; 1 study, 112 participants; low-certainty evidence; minimal important difference 4 to 10 points). There may be little or no difference in the other HRQOL scale (QLQ-Ov28, MD -0.97 points, 95% CI -2.57 to 0.63; 1 study, 112 participants: low-certainty evidence); psychological outcome, measured with the hospital anxiety and depression scale (HADS; MD 0.10 point, 95% CI -0.81 to 1.02; 1 study, 112 participants: low-certainty evidence), or cost analysis (MD -GBP 695.00, 95% CI -1467.23 to 77.23; 1 study, 112 participants: moderate-certainty evidence). Our previous review included one RCT, with 529 women in a confirmed remission, with normal CA125 concentration and no radiological evidence of disease, after surgery and first-line chemotherapy for ovarian cancer. This study evaluated immediate treatment of ovarian cancer relapse following a rise of serum CA125 levels versus delaying treatment until symptoms developed for OS, and HRQOL. There was little or no difference in OS between the immediate and delayed arms after a median follow-up of 56.9 months (unadjusted hazard ratio (HR) 0.98, 95% CI 0.80 to 1.20; 1 study, 529 participants; moderate-certainty evidence). Time from randomisation to first deterioration in global health score or death was shorter in the immediate treatment group than in the delayed treatment group (HR 0.71, 95% CI 0.58 to 0.88).
AUTHORS' CONCLUSIONS
Limited evidence from one trial suggests that routine surveillance with CA125 in asymptomatic women and treatment at CA125-defined relapse does not seem to offer survival advantage when compared to treatment at symptomatic relapse. However, this study pre-dates the use of PARPi maintenance treatment and the increased use of secondary cytoreductive surgery, so the results may be limited in their applicability to current practice. Limited evidence from one trial suggests that individualised nurse-led follow-up may improve HRQOL in women with ovarian cancer following completion of primary treatment. Large RCTs are needed to compare different types of follow-up, looking at survival, HRQOL, psychological effects, and cost as outcomes.
Topics: Female; Humans; Carcinoma, Ovarian Epithelial; Follow-Up Studies; Neoplasm Recurrence, Local; Ovarian Neoplasms
PubMed: 37650760
DOI: 10.1002/14651858.CD006119.pub4 -
Current Medical Research and Opinion Feb 2024Studies demonstrate that people who have been infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, have experienced... (Review)
Review
BACKGROUND
Studies demonstrate that people who have been infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, have experienced cognitive dysfunction, including working memory impairment, executive dysfunction, and decreased concentration. This review aimed to explore the incidence of working memory impairment and possible concomitant symptoms in the acute phase (< 3 months) and chronic phase (> 6 months) of COVID-19.
METHODS
We conducted a systematic review of the following databases for inception: MEDLINE Pub Med, Cochrane EMBASE, and Web of Science electronic databases. The search strategy was comprised of all the observational studies with COVID-19 patients confirmed by PCR or serology who were infected by SARS-CoV-2 with no previous cognitive impairment. This review protocol was recorded on PROSPERO with registration number CRD 42023413454.
RESULTS
A total of 16 studies from 502 retrieved articles were included. COVID-19 could cause a decline in working memory ability, the results showed that 22.5-55% of the people suffered from working memory impairment in the acute phase (< 3 months) of COVID-19, at 6 months after SARS-CoV2 infection, the impairment of working memory caused by COVID-19 still existed, the prevalence was about 6.2-10%, and 41.1% of the patients had a slight decrease in working memory or a negative change in the boundary value. Moreover, concomitant symptoms could persist for a long time. To some extent, the performance of working memory was affected by age, the time after infection, and the severity of infection ( = -.132, <.001; = .098, <.001; = .075, = .003). The mechanism of working memory impairment after infection was mainly focused on the aspects of neuroinflammation and the nerve invasiveness of the virus; at the same time, we also noticed some changes of the brain parenchymal structure.
CONCLUSION
COVID-19 can cause a decline in working memory ability, accompanied by neurological symptoms. However, there is a lack of studies to identify the structural and functional changes in specific brain regions that relate to the impaired working memory.
Topics: Humans; Brain; COVID-19; Memory, Short-Term; SARS-CoV-2
PubMed: 38008952
DOI: 10.1080/03007995.2023.2286312 -
Nutrition Reviews Sep 2023Although some studies have examined the connection between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and preeclampsia (PE) risk, the results were... (Meta-Analysis)
Meta-Analysis
The association between circulating 25-hydroxyvitamin D levels and preeclampsia: a systematic review and dose-response meta-analysis of epidemiologic studies with GRADE assessment.
CONTEXT
Although some studies have examined the connection between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and preeclampsia (PE) risk, the results were inconsistent.
OBJECTIVE
A dose-response meta-analysis on epidemiologic investigations was conducted to evaluate the relation of 25(OH)D concentration and PE.
DATA SOURCE
Electronic databases, including Scopus, MEDLINE (PubMed), the Institute for Scientific Information, Embase, and Google Scholar, were comprehensively search until July 2021.
DATA EXTRACTION
A total of 65 observational studies evaluating the link between circulating 25(OH)D concentrations and PE were included. The body of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.
DATA ANALYSIS
Combining 32 effect sizes from 32 prospective studies with 76 394 participants revealed that highest vs lowest circulating 25(OH)D concentrations was significantly related to a 33% reduced risk of PE (relative risk [RR], 0.67; 95%CI, 0.54-0.83). Subgroup analysis by study design revealed that PE risk has significantly decreased in cohort and case-cohort studies (RR, 0.72; 95%CI, 0.61-0.85), and a slight decline was found in nested case-control studies (RR, 0.62; 95%CI, 0.38-1.02). Dose-response analysis in 27 prospective studies with 73 626 participants illustrated that each 10 ng/mL increment in circulating 25(OH)D concentration led to a 14% reduced incidence of PE (RR, 0.86; 95%CI, 0.83-0.90). A U-shaped significant association in nonlinear dose-response analysis was found between 25(OH)D and PE. A significant inverse association was also found between highest vs lowest circulating 25(OH)D concentration and PE in 32 nonprospective studies with 37 477 participants (odd ratio, 0.37; 95%CI, 0.27-0.52). This inverse association was significant in almost all subgroups, based on different covariates.
CONCLUSION
This meta-analysis of observational investigations showed blood 25(OH)D levels were negatively related to PE risk, in a dose-response manner.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42021267486.
Topics: Pregnancy; Female; Humans; Prospective Studies; Pre-Eclampsia; GRADE Approach; Vitamin D; Calcifediol; Epidemiologic Studies; Observational Studies as Topic
PubMed: 36811334
DOI: 10.1093/nutrit/nuad006 -
Cureus Sep 2023Kidney stone formation is an intricate process that involves a disruption in the interplay of the multiple organs and systems involved in regulating the concentration of... (Review)
Review
Kidney stone formation is an intricate process that involves a disruption in the interplay of the multiple organs and systems involved in regulating the concentration of specific ions in the body. Women who have gone through menopause are susceptible to kidney stone disease. This systematic review aims to investigate the potential influence of estrogen on kidney function and oxalate homeostasis, notably through the anion transporter SLC26A6 (also known as putative anion transporter 1 or PAT1) in females. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist, a systematic search of online databases included Pubmed, ScienceDirect Journals, and Ingenta Connect Journals. Predetermined criteria to include and exclude papers, gathering articles published between 2012 and 2022, were determined. After a thorough analysis, eight articles (three cohorts, one case-control, one in vivo, one in vitro, and two cross-sectional studies) were identified for the final quality assessment review. The eight selected and quality-assessed articles provided evidence of a directly proportional connection between estrogen and kidney function. A correlation between serum estrogen levels and the development of kidney stone disease was confirmed. Administration of β-estradiol was shown to effectively inhibit the function of the anion transporter PAT1 in a tissue-specific manner. In the case of the kidney, estrogen was observed to down-regulate PAT1, which led to a reduction in oxalate transporting activity and, consequently, a decrease in kidney stone formation. Consensus suggests that serum estrogen levels and optimal kidney functioning are interrelated. Furthermore, analysis of the quality-assessed articles and a comprehensive literature review revealed estrogen's tissue-specific regulation of the PAT1 anion transporter aids in maintaining kidney function and anion homeostasis. Additional research is needed to solidify estrogen's role in kidney stone disease to determine its therapeutic value in clinical practice.
PubMed: 37881392
DOI: 10.7759/cureus.45839 -
Frontiers in Neurology 2023This study aims to identify blood and cerebrospinal fluid biomarkers that are correlated to the functional improvement of stroke patients after rehabilitation therapy,... (Review)
Review
OBJECTIVE
This study aims to identify blood and cerebrospinal fluid biomarkers that are correlated to the functional improvement of stroke patients after rehabilitation therapy, and provide ideas for the treatment and evaluation of stroke patients.
METHODS
The PubMed, Web of Science, and Embase databases were searched for articles published in the English language, from inception to December 8, 2022.
RESULTS
A total of 9,810 independent records generated 50 high-quality randomized controlled trials on 119 biomarkers. Among these records, 37 articles were included for the meta-analysis (with a total of 2,567 stroke patients), and 101 peripheral blood and cerebrospinal fluid biomarkers were included for the qualitative analysis. The quantitative analysis results revealed a moderate quality evidence that stroke rehabilitation significantly increased the level of brain-derived neurotrophic factor (BDNF) in serum. Furthermore, the low-quality evidence revealed that stroke rehabilitation significantly increased the concentration of serum noradrenaline (NE), peripheral blood superoxide dismutase (SOD), peripheral blood albumin (ALB), peripheral blood hemoglobin (HB), and peripheral blood catalase (CAT), but significantly decreased the concentration of serum endothelin (ET) and glutamate. In addition, the changes in concentration of these biomarkers were associated with significant improvements in post-stroke function. The serum BNDF suggests that this can be used as a biomarker for non-invasive brain stimulation (NIBS) therapy, and to predict the improvement of stroke patients.
CONCLUSION
The concentration of serum BNDF, NE, ET and glutamate, and peripheral blood SOD, ALB, HB and CAT may suggest the function improvement of stroke patients.
PubMed: 37731856
DOI: 10.3389/fneur.2023.1241521 -
Toxics Apr 2024Bisphenol A (BPA), an acknowledged endocrine disrupter, is easily exposed to humans via food packaging and container. However, a consensus has not been reached on the... (Review)
Review
Bisphenol A (BPA), an acknowledged endocrine disrupter, is easily exposed to humans via food packaging and container. However, a consensus has not been reached on the extent to which BPA exposure affects the reproductive system. We therefore conducted this systematic review and meta-analysis to elucidate the relationship between BPA exposure and male reproduction-related indicators. Up to October 2023, a comprehensive search was carried out in the PubMed, Embase, Cochrane and Web of Science, and 18 studies were ultimately included. β coefficients from multivariate linear regression analyses were pooled using a random effects model. The results showed that the urinary BPA concentration was negatively correlated with the sperm concentration (β coefficient = -0.03; 95% CI: -0.06 to -0.01; I = 0.0%, = 0.003) and total sperm count (β coefficient = -0.05; 95% CI: -0.08 to -0.02; I = 0.0%, < 0.001). In addition, BPA concentrations were associated with increased sex hormone-binding globulin (SHBG) levels, increased estradiol (E) levels, and reduced biologically active androgen levels. However, the relationship between an increased risk of below-reference sperm quality and BPA exposure was not robust. This systematic review revealed that BPA exposure disrupts reproductive hormones, reduces sperm counts and may ultimately adversely affect male reproduction.
PubMed: 38668517
DOI: 10.3390/toxics12040294