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Journal of Cosmetic Dermatology Jul 2022Alopecia areata (AA) in its extensive and severe forms is treatment-challenging, especially in pediatrics. (Review)
Review
A systematic review on the treatment of pediatric severe alopecia areata by topical immunotherapy or Anthralin (contact sensitization) or low-level light/laser therapy (LLLT): focus on efficacy, safety, treatment duration, recurrence, and follow-up based on clinical studies.
INTRODUCTION
Alopecia areata (AA) in its extensive and severe forms is treatment-challenging, especially in pediatrics.
METHOD
A PRISMA-compliant systematic review of seven electronic databases was searched by the terms "alopecia areata," "pediatric," "topical immunotherapy," "Anthralin," and "light therapy" from inception until March 2021. All the alternative names of the disease and therapies have been included in the search terms. 790 articles went to title abstract review by two independent reviewers. In the subsequent level, a review of the full text of studies was conducted.
RESULTS
Finally, 10 relevant articles in terms of content structure, subject coverage, and purpose, were selected for further review. The highest percentages of complete hair regrowth were 79.6% and 63.61% by SADBE (topical immunotherapy) and laser therapy. By Anthralin (contact sensitization), the complete response rate was below 50% (between 30 and 35%). Regarding average response, the most effective methods were local immunotherapy (with an average effectiveness of 53.8%), laser therapy (52.55%), and the use of Anthralin-induced contact dermatitis (30.86%), respectively. However, recurrence rate-after treatment with induced contact dermatitis by topical medications like Anthralin (contact sensitization)-was lower (mean 43.53%) in comparison with local immunotherapy (57%). In topical immunotherapy, light base therapy, and contact sensitization, the highest percentage of complete hair regrowth and the average response rate were (63.61% and 52.55%), (79.6% and 53.8%) and (32% and 30.8%), respectively. These methods are considered safe in children.
CONCLUSION
A high and more than 50% efficacy in hair regrowth could be expected by topical immunotherapy and light/laser therapy method. No serious side effects have been observed by these methods that are well tolerated in children. Therefore, a combination of local immunotherapy and light/laser therapy could be suggested for the treatment of extensive AA in children. The use of Anthralin could be associated with a lower but more durable response. These points are important for patient selection in individualized situations.
Topics: Administration, Topical; Alopecia Areata; Anthralin; Child; Dermatitis, Contact; Duration of Therapy; Follow-Up Studies; Humans; Immunologic Factors; Immunotherapy; Low-Level Light Therapy; Treatment Outcome
PubMed: 34606676
DOI: 10.1111/jocd.14480 -
Heliyon Dec 2022The present study investigated the contamination of processed cereals such as bread, spaghetti, flour, and bran, with polycyclic aromatic hydrocarbons (PAHs).
BACKGROUND
The present study investigated the contamination of processed cereals such as bread, spaghetti, flour, and bran, with polycyclic aromatic hydrocarbons (PAHs).
SCOPE AND APPROACH
The databases such as PubMed, Scopus, and Science Direct were searched from 14/December/1972 to 25/May/2021.
KEY FINDINGS
We identified 639 articles and selected 18. The highest PAH concentrations found in bread, spaghetti, flour, and bran were related to anthracene, chrysene, fluorene, and naphthalene, respectively. On the other hand, the lowest PAH concentrations found in bread, spaghetti, flour, and bran were related to benzo[k]fluoranthene, benzo[a]pyrene, dibenz[a,h]anthracene, anthracene and dibenz[a,h]anthracene, respectively. Moreover, carcinogenetic and mutagenic risk assessment of the PAHs revealed a country-to-country variation. As a result, evaluation and control of PAHs in cereals should be done.
PubMed: 36536913
DOI: 10.1016/j.heliyon.2022.e12168 -
Gastroenterology Nursing : the Official...The quality of bowel preparation is an extremely important determinant of colonoscopy results. However, the efficacy of senna regimens in improving bowel cleanliness is... (Meta-Analysis)
Meta-Analysis
The quality of bowel preparation is an extremely important determinant of colonoscopy results. However, the efficacy of senna regimens in improving bowel cleanliness is uncertain. We conducted a systematic review and meta-analysis to synthesize data on whether using a senna bowel preparation regimen enhances the bowel cleanliness. We searched Web of Science Core Collection, MEDLINE, PubMed, Embase, Cochrane Library, and Scopus databases (from the inception to August 2021). The primary efficacy outcome was bowel cleanliness. Secondary outcomes included patient compliance, tolerance, and adverse events. Eleven trials fulfilled the inclusion criteria (3,343 patients. Overall, we found no significant differences in bowel cleanliness between the senna regimen and other bowel preparation regimens (odds ratio [95% confidence interval]: 1.02 [0.63, 1.67], p = 0.93). There was significant difference in tolerance (odds ratio [95% confidence interval]: 1.66 [1.08, 2.54], p = .02) and compliance (odds ratio [95% confidence interval]: 3.05 [1.42, 6.55], p = .004). The senna regimen yielded a significantly greater proportion of no nausea (odds ratio [95% confidence interval]: 1.84 [1.45, 2.32]) and vomiting (odds ratio [95% confidence interval]: 1.65 [0.81, 3.35]). Compared with other bowel preparation regimens, the senna regimen may be effective and safe in bowel cleaning before colonoscopy, with superior compliance and tolerance.
Topics: Humans; Cathartics; Colonoscopy; Sennosides; Patient Compliance; Polyethylene Glycols
PubMed: 35758925
DOI: 10.1097/SGA.0000000000000664 -
Clinical Lymphoma, Myeloma & Leukemia Jan 2021To investigate the effects of mitoxantrone and daunorubicin in induced chemotherapy on complete remission (CR), death during induction therapy, overall survival (OS),... (Meta-Analysis)
Meta-Analysis
PURPOSE
To investigate the effects of mitoxantrone and daunorubicin in induced chemotherapy on complete remission (CR), death during induction therapy, overall survival (OS), disease-free survival (DFS), and relapse in patients of all ages with acute myeloid leukemia (AML).
METHODS
We searched published reports at the Medline, Embase, and Cochrane Databases as well as other databases from inception through July 2019. There was no restriction on date of publication or language (PROSPERO registration CRD42018095843).
RESULTS
We enrolled 12 randomized controlled trials that included data of 4583 AML patients whose disease was untreated or relapsed/refractory, and compared the CR, death during induction therapy, DFS, and OS between mitoxantrone and daunorubicin. Mitoxantrone significantly increased the CR rate (relative risk = 1.07; 95% confidence interval [CI], 1.01, 1.14; P = .03) and DFS (hazard ratio = 0.87; 95% CI, 0.79, 0.96; P = .005) compared to daunorubicin. However, there was no significant difference in death during induction therapy (relative risk = 1.00; 95% CI, 0.81, 1.24; P = .99) and OS (hazard ratio = 0.94; 95% CI, 0.87, 1.01; P = .077) between the two drugs.
CONCLUSION
Although more studies are needed to compare mitoxantrone with higher-dose daunorubicin, the results showed that compared to daunorubicin, mitoxantrone can significantly improve CR and DFS in patients of all ages. These findings suggest that mitoxantrone may be a better choice than daunorubicin as an induction chemotherapy agent for AML patients, especially in developing countries.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Daunorubicin; Female; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Mitoxantrone; Randomized Controlled Trials as Topic
PubMed: 32863193
DOI: 10.1016/j.clml.2020.08.001 -
Biomedicine & Pharmacotherapy =... May 2023The morbidity and mortality of cardiovascular diseases (CVDs) are increasing in recent years, and atherosclerosis (AS), a major CVD, becomes a disorder that afflicts... (Review)
Review
The morbidity and mortality of cardiovascular diseases (CVDs) are increasing in recent years, and atherosclerosis (AS), a major CVD, becomes a disorder that afflicts human beings severely, especially the elders. AS is recognized as the primary cause and pathological basis of some other CVDs. The active constituents of Chinese herbal medicines have garnered increasing interest in recent researches owing to their influence on AS and other CVDs. Emodin (1,3,8-trihydroxy-6-methylanthraquinone) is a naturally occurring anthraquinone derivative found in some Chinese herbal medicines such as Rhei radix et rhizome, Polygoni cuspidati rhizoma et radix and Polygoni multiflori root. In this paper, we first review the latest researches about emodin's pharmacology, metabolism and toxicity. Meanwhile, it has been shown to be effective in treating CVDs caused by AS in dozens of previous studies. Therefore, we systematically reviewed the mechanisms by which emodin treats AS. In summary, these mechanisms include anti-inflammatory activity, lipid metabolism regulation, anti-oxidative stress, anti-apoptosis and vascular protection. The mechanisms of emodin in other CVDs are also discussed, such as vasodilation, inhibition of myocardial fibrosis, inhibition of cardiac valve calcification and antiviral properties. We have further summarized the potential clinical applications of emodin. Through this review, we hope to provide guidance for clinical and preclinical drug development.
Topics: Humans; Aged; Emodin; Drugs, Chinese Herbal; Cardiovascular Diseases; Plant Extracts; Atherosclerosis; Phytochemicals
PubMed: 36933375
DOI: 10.1016/j.biopha.2023.114539 -
Marine Pollution Bulletin Jan 2024This study was conducted on the concentrations of PAHs, including benzo[a]pyrene and the sum of four PAHs (benz[a]anthracene, chryseno, benzo[b]fluoranthene, and...
This study was conducted on the concentrations of PAHs, including benzo[a]pyrene and the sum of four PAHs (benz[a]anthracene, chryseno, benzo[b]fluoranthene, and benzo[a]pyrene), in unsmoked fish tissues. The values were related to the time period, locality (country and region), living habits, eating habits, and types of environments of the fish species. The data obtained has been also compared with the limits established by the United States Environmental Protection Agency (U.S. EPA) and European Union (E.U.) legislation. The data were collected through a PRISMA systematic review (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) from 1982 to 2020. Only documents that presented the PAHs concentration values were selected. China, Nigeria, and Iran had the highest number of studies. The species Coptodon zillii, Siganus punctatus, and Liza abu were the most commonly used bioindicators. Fish inhabiting demersal and pelagic environments showed the highest concentrations of PAHs. The majority of PAH concentrations of the analyzed documents fell within permissible limits for human consumption, representing a total percentage of 79.49 % for benzo[a]pyrene and 82.86 % for the sum of the 4 PAHs. Although some studies identified concentrations of benzo[a]pyrene alone and benzo[a]pyrene, benz[a]anthracene, chryseno, benzo[b]fluoranthene above the legislation limits, in most of them, the concentrations reported in fish tissue were below the limits defined by European Legislation for human consumption.
Topics: Humans; Animals; Polycyclic Aromatic Hydrocarbons; Benzo(a)pyrene; Fluorenes; Anthracenes
PubMed: 38016205
DOI: 10.1016/j.marpolbul.2023.115778 -
Current Medicinal Chemistry 2021A systematic review and meta-analysis of clinical trials were undertaken to evaluate the effect of diacerein intake on cardiometabolic profiles in patients with type 2... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A systematic review and meta-analysis of clinical trials were undertaken to evaluate the effect of diacerein intake on cardiometabolic profiles in patients with type 2 diabetes mellitus (T2DM).
METHODS
Electronic databases such as PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Cochrane Central Register of Controlled Trials were searched from inception to 31 July 2019. Statistical heterogeneity was evaluated using Cochran's Q test and I-square (I) statistic. Data were pooled using random-effects models and weighted mean difference (WMD).
RESULTS
From 1,733 citations, seven clinical trials were eligible for inclusion and meta-analysis. A significant reduction in hemoglobin A1c (HbA1c) (WMD -0.73; 95%CI -1.25 to -0.21; P= 0.006; I2= 72.2%) and body mass index (BMI) (WMD -0.55; 95%CI -1.03 to -0.07; P= 0.026; I= 9.5%) was identified. However, no significant effect of diacerein intake was identified on fasting blood sugar (FBS) (WMD -9.00; 95%CI -22.57 to 4.57; P= 0.194; I2= 60.5%), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD 0.39; 95%CI -0.95 to 1.73; P= 0.569; I= 2.2%), body weight (WMD - 0.54; 95%CI -1.10 to 0.02; P= 0.059), triglycerides (WMD -0.56; 95%CI -24.16 to 23.03; P= 0.963; I= 0.0%), total-cholesterol (WMD -0.21; 95%CI -12.19 to 11.78; P= 0.973; I= 0.0%), HDL-cholesterol (WMD -0.96; 95%CI -2.85 to 0.93; P= 0.321; I= 0.0%), and LDL-cholesterol levels (WMD -0.09; 95%CI -8.43 to 8.25; P= 0.983; I= 37.8%).
CONCLUSION
Diacerein intake may reduce HbA1c and BMI; however, no evidence of the effect was observed for FBS, HOMA-IR, body weight, triglycerides, total cholesterol, HDL-cholesterol or LDLcholesterol.
Topics: Anthraquinones; Blood Glucose; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Humans; Triglycerides
PubMed: 32723228
DOI: 10.2174/0929867327666200728134755 -
Regulatory Toxicology and Pharmacology... Feb 2021Aloe products are increasingly valued as ingredients in food supplements and flavoring agents. In early March 2020, the European Commission drafted a ban on the use of...
Aloe products are increasingly valued as ingredients in food supplements and flavoring agents. In early March 2020, the European Commission drafted a ban on the use of Aloe products that contain hydroxyanthracene derivatives (HADs) in food, following the opinion on concerns about the toxicity of vegetable extracts containing HADs carried out by the European Food Safety Authority (EFSA). Aloe gel preparation is characterized by minimal amounts of HADs, only present as contaminants during extraction, compared to other sold Aloe preparations such as Aloe latex and Aloe whole leaf extract. This review provides a comprehensive account of the toxicological aspects of Aloe gel, and briefly discusses the chemical profile of other Aloe preparations. Unlike these other preparations, pure Aloe gel shows no toxic effects. However, further toxicological studies remain necessary to establish the maximum permissible limit of HAD contaminants in Aloe gel, considering daily doses and maximum duration of treatments. Finally, officially validated analytical methods for determination of HADs are required, in the form of tools for use by Companies and Competent Authorities to ensure the absence of HAD contamination in raw materials or in finished products.
Topics: Aloe; Animals; Anthracenes; Dietary Supplements; European Union; Food Safety; Gels; Government Regulation; Humans; Plant Extracts
PubMed: 33221425
DOI: 10.1016/j.yrtph.2020.104818 -
Medicine Nov 2022Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of diacerein in the treatment of osteoarthritis is controversial. We systematically reviewed the efficacy, safety, and residual effectiveness of diacerein.
OBJECTIVES
To estimate the symptomatic efficacy, residual effect and safety of diacerein in the treatment of knee osteoarthritis, using a meta-analysis of published randomized controlled trials (RCTs).
METHODS
On December 1, 2021, we searched PubMed Medline, Web of Science, Cochrane Library databases, Wan Fang Medical Database, and National Knowledge Infrastructure. This study followed the inclusion criteria of the principle P(Population), I(Intervention), C(Comparison), O(Outcome), S (Study design) principle. All studies were randomized controlled trials of knee osteoarthritis. Cochrane bias risk assessment tool was used to assess the risk of bias. Meta-analyses were performed using a random-effects model. To explore sources of heterogeneity, subgroup analysis, sensitivity analysis, regression analysis and publication bias analysis were performed. Drug side effects with complete data were extracted from the included articles and then a combined analysis of these data was performed.
RESULTS
Eight studies were eligible and were included in our analysis (N = 1277 participants). All studies were randomized controlled trials of knee osteoarthritis. There was no significant difference in reduction of joint pain and improvement of function between diacerein and the control group. However, subgroup analysis suggested, compared with the placebo group, diacerein treatment yielded an improved mean reduction in visual analogue scale score of-0.44% (95% confidence interval [CI]-0.79 to 0.09), an improved the western Ontario and McMaster universities (physical function) score of -0.44% (95% CI-0.72 to -0.12). Follow-up analysis after discontinuation showed that diacerein treatment had a significant residual effect (95% CI-0.81 to- 0.24). Data on drug side effects described in the included articles were extracted for statistical analysis. There was an increased risk of diarrhea with diacerein (Risk Ratio [RR] = 1.95 [1.03 to 2.47]) and withdrawal event from therapy (RR = 0.93 [0.75 to 1.15]).
CONCLUSION
Diacerein might be considered an effective drug for the treatment of patients with KOA, showing short-term residual effectiveness. Although it is associated with an increased risk of diarrhea, the adverse event is mostly tolerable.
Topics: Humans; Aged; Osteoarthritis, Knee; Anthraquinones; Disease Progression; Drug-Related Side Effects and Adverse Reactions; Diarrhea; Randomized Controlled Trials as Topic
PubMed: 36401382
DOI: 10.1097/MD.0000000000031700 -
Journal of Diabetes Research 2020To figure out the effect of diacerein supplementation on type 2 diabetes mellitus (T2DM). (Meta-Analysis)
Meta-Analysis
AIMS
To figure out the effect of diacerein supplementation on type 2 diabetes mellitus (T2DM).
METHODS
An electronic search was processed on Pubmed, Embase, and Cochrane library for randomized controlled trials (RCTs) comparing the efficacy of diacerein with placebo on T2DM. The primary outcome was fasting blood glucose (FBG). Trial sequential analysis (TSA) was used to test the reliability of this pooled outcome. Secondary outcomes were glycosylated hemoglobin A1c (HbA1c), body mass index (BMI), lipid profiles, hematological indexes including hematocrit and platelet count, and systematic inflammatory level expressed as a C-reactive protein (CRP) level. Safety outcome was the rate of complications. The difference in continuous data was measured by mean difference (MD) and 95% confidence interval (CI), while the difference of dichotomous data was calculated by relative risk (RR) and 95% CI. A two-tailed < 0.05 was regarded as statistically significant.
RESULTS
Five RCTs with 278 participants were included. Compared with control, diacerein provided significant improvement on FBG (MD -0.52; 95% CI (-0.89~-0.14); < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant.
CONCLUSION
Based on the current analysis, diacerein as an add-on treatment provided better glycemic control for T2DM but this benefit requires more verification. Compared with control, additional diacerein also lowered body weight and CRP level in T2DM, but increased the rate of gastrointestinal syndromes.
Topics: Anthraquinones; Blood Glucose; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Randomized Controlled Trials as Topic; Reproducibility of Results; Treatment Outcome
PubMed: 32104712
DOI: 10.1155/2020/2593792