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Hepatology (Baltimore, Md.) Oct 2021Animal models of human disease are a key component of translational hepatology research, yet there is no consensus on which model is optimal for NAFLD.
BACKGROUND AND AIMS
Animal models of human disease are a key component of translational hepatology research, yet there is no consensus on which model is optimal for NAFLD.
APPROACH AND RESULTS
We generated a database of 3,920 rodent models of NAFLD. Study designs were highly heterogeneous, and therefore, few models had been cited more than once. Analysis of genetic models supported the current evidence for the role of adipose dysfunction and suggested a role for innate immunity in the progression of NAFLD. We identified that high-fat, high-fructose diets most closely recapitulate the human phenotype of NAFLD. There was substantial variability in the nomenclature of animal models: a consensus on terminology of specialist diets is needed. More broadly, this analysis demonstrates the variability in preclinical study design, which has wider implications for the reproducibility of in vivo experiments both in the field of hepatology and beyond.
CONCLUSIONS
This systematic analysis provides a framework for phenotypic assessment of NAFLD models and highlights the need for increased standardization and replication.
Topics: Animals; Animals, Genetically Modified; Cholesterol, Dietary; Diet; Diet, High-Fat; Dietary Sucrose; Dietary Sugars; Disease Models, Animal; Dyslipidemias; Female; Fructose; Humans; Liver; Male; Metabolic Syndrome; Mice; Non-alcoholic Fatty Liver Disease; Obesity; Rats; Reproducibility of Results
PubMed: 33973269
DOI: 10.1002/hep.31897 -
Journal of Wound Care Apr 2021Management of chronic wounds remains one of the major challenges for health professionals and patients. An evidence-based decision is important to ensure that patients...
OBJECTIVE
Management of chronic wounds remains one of the major challenges for health professionals and patients. An evidence-based decision is important to ensure that patients are receiving the best treatment proven to reduce healing time and improve outcomes, including economic benefits and patients' health-related quality of life (HRQoL). Due to recent restrictions because of the COVID-19 pandemic, including closure of wound care centres within hospitals and a drop in patient volume, chronic wound management needs simple-to-use dressings which are still effective and evidence-based solutions. This systematic review was conducted to identify the clinical evidence available on a sucrose octasulfate dressing (TLC-NOSF, UrgoStart dressing range, Laboratoires Urgo, France) to explore its efficacy in the management of chronic wounds, particularly lower limb ulcers, diabetic foot ulcers and pressure ulcers.
METHOD
A literature search of PubMed, Cochrane Library and Google Scholar was conducted based on the PICO model (patient/population, intervention, comparison and outcomes) to retrieve publications of different levels of evidence in order to evaluate outcomes of the use of TLC-NOSF dressings.
RESULTS
A total of 21 publications of different levels, ranging from double-blind randomised control trials to case reports, involving over 12,000 patients, were identified through PubMed, with a further eight publications through Google Scholar and two publications through Cochrane Library. A total of seven results were omitted due to the lack of relevance or repetition.
CONCLUSION
All the evidence provided suggest that these dressings provide clinicians with an evidence-based option for the management of chronic wounds; that the TLC-NOSF dressings are beneficial in promoting the healing process, reducing healing times, enhancing patients' HRQoL, and in allowing a more cost-effective procedure.
Topics: Adult; Aged; Aged, 80 and over; Bandages, Hydrocolloid; Chronic Disease; Diabetic Foot; Double-Blind Method; Female; France; Humans; Male; Middle Aged; Pressure Ulcer; Sucrose; Wound Healing
PubMed: 33856929
DOI: 10.12968/jowc.2021.30.Sup4.S42 -
ESC Heart Failure Dec 2020Intravenous ferric carboxymaltose (FCM) has been shown to improve functional capacity and quality of life in iron deficient heart failure patients. However, FCM's effect... (Meta-Analysis)
Meta-Analysis
AIMS
Intravenous ferric carboxymaltose (FCM) has been shown to improve functional capacity and quality of life in iron deficient heart failure patients. However, FCM's effect on hospitalizations and mortality remains unclear as previous randomized controlled trials (RCTs) and their meta-analyses have been underpowered to detect significant differences. We sought to conduct an updated meta-analysis using recently published RCT data.
METHODS AND RESULTS
Online databases were searched from inception until November 2020 for RCTs evaluating the effects of FCM on clinical outcomes in iron-deficient heart failure patients. Outcomes of interest included heart failure hospitalizations, all-cause mortality, and cardiovascular mortality. Meta-analysis was performed using a fixed-effect model and estimates were reported as odds ratios (ORs), hazard ratios, or rate ratios (RRs) along with corresponding 95% confidence intervals (CIs). A total of 1947 patients (n = 1062 in the FCM group; n = 885 in the placebo group) were included. FCM, compared with placebo, significantly reduced the risk of the composite endpoint of time to first heart failure hospitalization or cardiovascular death (hazard ratio = 0.76; 95% CI = 0.63-0.90; I = 55%). FCM also significantly reduced the risk of recurrent heart failure hospitalizations (RR = 0.68; 95% CI = 0.54-0.85; I = 71%) and recurrent cardiovascular hospitalizations (RR = 0.71; 95% CI = 0.59-0.86; I = 56%). However, FCM had no significant effect on the risk of all-cause (OR = 0.97; 95% CI = 0.73-1.28; I = 0%) or cardiovascular mortality (OR = 0.93; 95% CI = 0.69-1.27; I = 0%).
CONCLUSIONS
Ferric carboxymaltose reduces heart failure hospitalizations and cardiovascular hospitalizations with no beneficial effect on all-cause and cardiovascular mortality in iron-deficient heart failure patients. These findings reinforce the role of FCM as a therapeutic option in heart failure patients.
Topics: Ferric Compounds; Heart Failure; Humans; Iron; Maltose
PubMed: 33586856
DOI: 10.1002/ehf2.13146 -
ANZ Journal of Surgery Jan 2020Post-operative ileus (POI) and delayed return of gastrointestinal (GI) function are common complications after colorectal surgery. There is a lack of uniformity in...
BACKGROUND
Post-operative ileus (POI) and delayed return of gastrointestinal (GI) function are common complications after colorectal surgery. There is a lack of uniformity in enhanced recovery protocols (ERPs) with regards to interventions used to target these complications. This systematic review aims to categorize and summarize management recommendations available from published ERPs.
METHODS
A systematic search of Ovid MEDLINE, Embase, Cochrane Library and PubMed databases was performed from January 1990 to May 2018. All studies publishing enhanced recovery or fast-track or multimodal pathway protocols for colorectal surgery in their full-text were included. Data on interventions aimed at reducing the duration of POI were extracted, as well as references quoted to support specific interventions.
RESULTS
Of 481 manuscripts screened, 37 published ERPs were identified from 37 studies (18 cohort, seven historical-control, five guidelines, four randomized controlled trials, one randomized controlled trial protocol, one case series and one narrative review). The most commonly recommended interventions were magnesium-based laxatives (18 of 37, 48.6%), chewing gum (13 of 37, 35.1%), Alvimopan (6 of 37, 16.2%), lactulose (4 of 37, 10.8%), neostigmine (2 of 37, 5.4%) and bisacodyl (2 of 37, 5.4%). Geographical trends were noted for the various interventions, but high-quality evidence was only referenced to support the use of Alvimopan.
CONCLUSION
ERP recommendations specific to interventions targeting POI and return of GI function are varied. While laxatives are the most commonly recommended intervention, there is only weak evidence reported to support this practice.
Topics: Bisacodyl; Chewing Gum; Colonic Diseases; Humans; Ileus; Lactulose; Neostigmine; Piperidines; Postoperative Complications; Recovery of Function; Rectal Diseases
PubMed: 31272135
DOI: 10.1111/ans.15319 -
The American Journal of Clinical... Jan 2020There is controversy on the relevance of dietary sugar intake for cardiometabolic health. (Meta-Analysis)
Meta-Analysis
BACKGROUND
There is controversy on the relevance of dietary sugar intake for cardiometabolic health.
OBJECTIVE
The aim of this network meta-analysis (NMA) was to assess how isocaloric substitutions of dietary sugar with other carbohydrates affect cardiometabolic risk factors, comparing different intervention studies.
METHODS
We included randomized controlled trials (RCTs) investigating the isocaloric effect of substituting dietary sugars (fructose, glucose, sucrose) with other sugars or starch on cardiometabolic risk markers, including LDL cholesterol, triacylglycerol (TG), fasting glucose (FG), glycated hemoglobin (HbA1c), insulin resistance (HOMA-IR), uric acid, C-reactive protein (CRP), alanine transaminase (ALT), aspartate transaminase (AST), and liver fat content. To identify the most beneficial intervention for each outcome, random-effects NMA was conducted by calculating pooled mean differences (MDs) with 95% CIs, and by ranking the surface under the cumulative ranking curves (SUCRAs). The certainty of evidence was evaluated using the Confidence In Network Meta-Analysis tool.
RESULTS
Thirty-eight RCTs, including 1383 participants, were identified. A reduction in LDL-cholesterol concentrations was shown for the exchange of sucrose with starch (MD: -0.23 mmol/L; 95% CI: -0.38, -0.07 mmol/L) or fructose with starch (MD: -0.22 mmol/L; 95% CI: -0.39, -0.05 mmol/L; SUCRAstarch: 98%). FG concentrations were also lower for the exchange of sucrose with starch (MD: -0.14 mmol/L; 95% CI: -0.29, 0.01 mmol/L; SUCRAstarch: 91%). Replacing fructose with an equivalent energy amount of glucose reduced HOMA-IR (MD: -0.36; 95% CI: -0.71, -0.02; SUCRAglucose: 74%) and uric acid (MD: -23.77 µmol/L; 95% CI: -44.21, -3.32 µmol/L; SUCRAglucose: 93%). The certainty of evidence was rated very low to moderate. No significant effects were observed for TG, HbA1c, CRP, ALT, and AST.
CONCLUSIONS
Our findings indicate that substitution of sucrose and fructose with starch yielded lower LDL cholesterol. Insulin resistance and uric acid concentrations were beneficially affected by replacement of fructose with glucose. Our findings are limited by the very low to moderate certainty of evidence. This review was registered at www.crd.york.ac.uk/prospero as CRD42018080297.
Topics: Blood Glucose; C-Reactive Protein; Cardiovascular Diseases; Cholesterol, LDL; Dietary Sugars; Fructose; Glucose; Glycated Hemoglobin; Humans; Insulin Resistance; Randomized Controlled Trials as Topic; Starch; Sucrose; Triglycerides; Uric Acid
PubMed: 31711109
DOI: 10.1093/ajcn/nqz273 -
BMC Pregnancy and Childbirth Feb 2022The objective of the FeminFER project was to assess the value of ferric carboxymaltose following a multicriteria decision analysis in obstetrics and gynaecology in Spain.
BACKGROUND
The objective of the FeminFER project was to assess the value of ferric carboxymaltose following a multicriteria decision analysis in obstetrics and gynaecology in Spain.
METHODS
Ferric carboxymaltose (FCM) and ferrous sulphate were evaluated using the EVIDEM framework. Ten stakeholders participated to collect different perspectives. The framework was adapted considering evidence retrieved with a PICO-S search strategy and grey literature. Criteria/subcriteria were weighted by level of relevance and an evidence-based decision-making exercise was developed in each criterion; weights and scores were combined to obtain the value of intervention relative to each criterion/subcriterion, that were further combined into the Modulated Relative Benefit-Risk Balance (MRBRB).
RESULTS
The most important criterion favouring FCM was Compared Efficacy/Effectiveness (0.183 ± 0.07), followed by Patient Preferences (0.059 ± 0.10). Only Direct medical costs criterion favoured FS (-0.003 ± 0.03). MRBRB favoured FCM; 0.45 ± 0.19; in a scale from -1 to + 1.
CONCLUSIONS
In conclusion, considering the several criteria involved in the decision-making process, participants agreed with the use of FCM according to its MRBRB.
Topics: Anemia, Iron-Deficiency; Decision Support Techniques; Female; Ferric Compounds; Ferrous Compounds; Humans; Maltose; Pregnancy; Pregnancy Complications, Hematologic; Risk Assessment; Spain; Stakeholder Participation
PubMed: 35216553
DOI: 10.1186/s12884-022-04481-w -
Journal of Neuroscience Methods Jul 2023Exposing rats to repeated unpredictable stressors is a popular method for modelling depression. The sucrose preference test is used to assess the validity of this...
BACKGROUND
Exposing rats to repeated unpredictable stressors is a popular method for modelling depression. The sucrose preference test is used to assess the validity of this method, as it measures a rat´s preference for a sweet solution as an indicator of its ability to experience pleasure. Typically, if stressed rats show a lower preference compared to unstressed rats, it is concluded they are experiencing stress-induced anhedonia.
METHODS
While conducting a systematic review, we identified 18 studies that used thresholds to define anhedonia and to distinguish "susceptible" from "resilient" individuals. Based on their definitions, researchers either excluded "resilient" animals from further analyses or treated them as a separate cohort. We performed a descriptive analysis to understand the rationale behind these criteria.
RESULTS
we found that the methods used for characterizing the stressed rats were largely unsupported. Many authors failed to justify their choices or relied exclusively on referencing previous studies. When tracing back the method to its origins, we converged on a pioneering article that, although employed as a universal evidence-based justification, cannot be regarded as such. What is more, through a simulation study, we provided evidence that removing or splitting data, based on an arbitrary threshold, introduces statistical bias by overestimating the effect of stress.
CONCLUSION
Caution must be exercised when implementing a predefined cut-off for anhedonia. Researchers should be aware of potential biases introduced by their data treatment strategies and strive for transparent reporting of methodological decisions.
Topics: Rats; Animals; Anhedonia; Sucrose; Depression; Food Preferences; Stress, Psychological; Disease Models, Animal
PubMed: 37394102
DOI: 10.1016/j.jneumeth.2023.109910 -
Clinical Oncology (Royal College of... May 2024Pelvic radiotherapy can induce gastrointestinal injury and symptoms, which can affect quality of life. We assessed interventions for managing these symptoms. (Meta-Analysis)
Meta-Analysis
AIMS
Pelvic radiotherapy can induce gastrointestinal injury and symptoms, which can affect quality of life. We assessed interventions for managing these symptoms.
MATERIALS AND METHODS
A review of randomised controlled trials published between January 1990 and June 2023 from databases including MEDLINE, EMBASE, CENTRAL, CINAHL, clinicaltrials.gov, ISRCTN and grey literature sources was conducted. Meta-analyses were carried out using the DerSimonian and Laird random effects model to produce overall treatment differences with 95% confidence intervals.
RESULTS
Twenty-eight studies (2392 participants) of varying methodological quality were included. 4% formalin was superior to sucralfate for improving gastrointestinal symptom score (standardised mean difference [SMD] -1.07, 95% confidence interval -1.48 to -0.65). Argon plasma coagulation (APC) was inferior to sucralfate (SMD 1.22, 95% confidence interval 0.84 to 1.59). Counselling positively influenced symptom score (SMD -0.53, 95% confidence interval -0.76 to -0.29), whereas hyperbaric oxygen therapy showed conflicting results. Sucralfate combined with APC increased endoscopic markers of moderate-severe bleeding versus APC alone (risk ratio 2.26, 95% confidence interval 1.12 to 4.55). No definite conclusions on pain, incontinence, diarrhoea, tenesmus or quality of life interventions were confirmed.
CONCLUSIONS
Small study sizes, methodological quality and heterogeneity limit support of any individual intervention. APC and 4% formalin seem to be promising interventions, with further larger randomised controlled trials now warranted.
Topics: Humans; Sucralfate; Quality of Life; Gastrointestinal Tract; Rectum; Formaldehyde
PubMed: 38431427
DOI: 10.1016/j.clon.2024.02.011 -
Paediatric Drugs Mar 2022Parenteral iron is generally considered safe in adults, and severe adverse events are extremely rare. Ferric carboxymaltose (FCM), a third-generation parenteral iron...
BACKGROUND
Parenteral iron is generally considered safe in adults, and severe adverse events are extremely rare. Ferric carboxymaltose (FCM), a third-generation parenteral iron product, is not licensed for pediatric use.
OBJECTIVE
The aim of this study was to present our data on the safety of FCM in children with iron deficiency (ID) and/or iron deficiency anemia (IDA) and to investigate through a systematic literature review articles reporting on the safety of FCM use in children with ID/IDA.
PATIENTS AND METHODS
Safety data regarding children treated with FCM for ID/IDA from four pediatric departments in Greece over a 26-month period are presented. Additionally, a literature search was performed in PubMed, Scopus, and Google Scholar on December 4, 2021 for articles reporting on the use of FCM in children with ID/IDA. Review articles, guidelines, case reports/case series, and reports on the use of FCM for conditions other than ID/IDA were excluded. Identified articles were screened for all reported adverse events (AE) that were graded according to the Common Terminology Criteria for Adverse Events, version 5.0.
RESULTS
In our cohort, 37 children with ID/IDA received 41 FCM infusions. All infusions were tolerated well. In addition, 11 articles reporting 1231 infusions of FCM in 866 children were identified in the literature. Among them, 52 (6%) children developed AE that were graded as mild or moderate (grades I-III).
CONCLUSIONS
Our patient cohort and this literature review provide further evidence for the good safety profile of FCM in children, although well-designed prospective clinical trials with appropriate safety endpoints are still required.
Topics: Adult; Child; Ferric Compounds; Greece; Humans; Maltose; Prospective Studies
PubMed: 35083718
DOI: 10.1007/s40272-022-00491-5 -
Critical Reviews in Food Science and... 2024Dairy powder, with abundant chemical components such as protein, fat, and lactose possessing diverse physical and chemical structures, can exhibit a surface composition...
Dairy powder, with abundant chemical components such as protein, fat, and lactose possessing diverse physical and chemical structures, can exhibit a surface composition distinct from its bulk content during the conversion of liquid milk into dry powder. Surface chemical composition is a significant parameter in the dairy industry, as it is directly associated with the techno-functional properties of dairy powder products. The current work provides an overview of the factors influencing the surface composition of dairy powders such as the bulk composition of raw milk (animal source and formulation), liquid dairy processing (homogenization, thermal treatment, and evaporation), the drying process (drying methods as well as operating conditions during the most commonly used spray drying), and storage conditions (temperature, relative humidity, and duration). The underlying mechanisms involved in the variations of particle surface composition include the mechanical properties of emulsion, milk fat globules redistribution caused by mechanical forces, adsorption competition and interactions of ingredients at the water/air interface, dehydration-induced alterations in particle structure, corresponding solid/solutes segregation differentiation during spray drying, and lactose crystallization-induced increase in surface fat during storage. Additionally, future research is suggested to explore the effects of emerging processing technologies on the surface composition modification of dairy powders.
Topics: Animals; Powders; Lactose; Milk; Desiccation; Crystallization; Particle Size
PubMed: 35916834
DOI: 10.1080/10408398.2022.2105803