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United European Gastroenterology Journal Dec 2020Bowel preparation for colonoscopy is often poorly tolerated due to poor palatability and adverse effects. This can negatively impact on the patient experience and on the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Bowel preparation for colonoscopy is often poorly tolerated due to poor palatability and adverse effects. This can negatively impact on the patient experience and on the quality of bowel preparation. This systematic review and meta-analysis was carried out to assess whether adjuncts to bowel preparation affected palatability, tolerability and quality of bowel preparation (bowel cleanliness).
METHODS
A systematic search strategy was conducted on PubMed, MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews to identify studies evaluating adjunct use for colonoscopic bowel preparation. Studies comparing different regimens and volumes were excluded. Specific outcomes studied included palatability (taste), willingness to repeat bowel preparation, gastrointestinal adverse events and the quality of bowel preparation. Data across studies were pooled using a random-effects model and heterogeneity assessed using -statistics.
RESULTS
Of 467 studies screened, six were included for analysis (all single-blind randomised trials; = 1187 patients). Adjuncts comprised citrus reticulata peel, orange juice, menthol candy drops, simethicone, Coke Zero and sugar-free chewing gum. Overall, adjunct use was associated with improved palatability (mean difference 0.62, 95% confidence interval 0.29-0.96, < 0.001) on a scale of 0-5, acceptability of taste (odds ratio 2.75, 95% confidence interval: 1.52-4.95, < 0.001) and willingness to repeat bowel preparation (odds ratio 2.92, 95% confidence interval: 1.97-4.35, < 0.001). Patients in the adjunct group reported lower rates of bloating (odds ratio 0.48, 95% confidence interval: 0.29-0.77, = 0.003) and vomiting (odds ratio 0.47, 95% confidence interval 0.27-0.81, = 0.007), but no difference in nausea ( = 0.10) or abdominal pain ( = 0.62). Adjunct use resulted in superior bowel cleanliness (odds ratio 2.52, 95% confidence interval: 1.31-4.85, = 0.006). Heterogeneity varied across outcomes, ranging from 0% (vomiting) to 81% (palatability), without evidence of publication bias. The overall quality of evidence was rated moderate.
CONCLUSION
In this meta-analysis, the use of adjuncts was associated with better palatability, less vomiting and bloating, willingness to repeat bowel preparation and superior quality of bowel preparation. The addition of adjuncts to bowel preparation may improve outcomes of colonoscopy and the overall patient experience.
Topics: Colonoscopy; Humans; Laxatives; Patient Outcome Assessment; Patient Satisfaction; Pharmaceutic Aids; Preoperative Care; Randomized Controlled Trials as Topic; Taste; Treatment Outcome
PubMed: 32838693
DOI: 10.1177/2050640620953224 -
Frontiers in Physiology 2023An elevated core temperature (core) increases the risk of performance impairments and heat-related illness. Internal cooling (IC) has the potential to lower core when...
An elevated core temperature (core) increases the risk of performance impairments and heat-related illness. Internal cooling (IC) has the potential to lower core when exercising in the heat. The aim of the review was to systematically analyze the effects of IC on performance, physiological, and perceptional parameters. A systematic literature search was performed in the PubMed database on 17 December 2021. Intervention studies were included assessing the effects of IC on performance, physiological, or perceptional outcomes. Data extraction and quality assessment were conducted for the included literature. The standardized mean differences (SMD) and 95% Confidence Intervals (CI) were calculated using the inverse-variance method and a random-effects model. 47 intervention studies involving 486 active subjects (13.7% female; mean age 20-42 years) were included in the meta-analysis. IC resulted in significant positive effects on time to exhaustion [SMD (95% CI) 0.40 (0.13; 0.67), < 0.01]. IC significantly reduced core [-0.19 (22120.34; -0.05), < 0.05], sweat rate [-0.20 (-0.34; -0.06), < 0.01], thermal sensation [-0.17 (-0.33; -0.01), < 0.05], whereas no effects were found on skin temperature, blood lactate, and thermal comfort ( > 0.05). IC resulted in a significant reduction in time trial performance [0.31 (-0.60; -0.02), = 0.06], heart rate [-0.13 (-0.27; 0.01), = 0.06], rate of perceived exertion [-0.16 (-0.31; -0.00), = 0.05] and increased mean power output [0.22 (0.00; 0.44), = 0.05]. IC has the potential to affect endurance performance and selected physiological and perceptional parameters positively. However, its effectiveness depends on the method used and the time point of administration. Future research should confirm the laboratory-based results in the field setting and involve non-endurance activities and female athletes. https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022336623.
PubMed: 37113693
DOI: 10.3389/fphys.2023.1125969 -
Biomedicine & Pharmacotherapy =... Jul 2021Ketoprofen (K) was synthesized in 1968. K belongs to nonsteroidal anti-inflammatory drugs (NSAIDs) and has analgesic, anti-inflammatory and antipyretic properties. K is...
INTRODUCTION
Ketoprofen (K) was synthesized in 1968. K belongs to nonsteroidal anti-inflammatory drugs (NSAIDs) and has analgesic, anti-inflammatory and antipyretic properties. K is commonly used due to rapid absorption, simple metabolism, high antinociceptive activity and fast blood brain barrier crossing. However, this substance causes various side effects which are the major factors affecting its' popularity. Many researchers have modified this drug to discover an improved and safe NSAID.
AIM
The aim of the review was to find in recent publications data bout future prospects of K of improved safety for the gastric mucosa after oral administration.
METHOD
Systematic literature review was conducted in March 2021 (2015 onwards). We selected 22 articles from PubMed, Google Scholar, Medline Complete databases.
RESULTS AND DISCUSSION
Many studies aimed at obtaining K with lower ulcerogenic properties. This article describes K with lysine, new K delivery systems, K in form of hydrogels, prodrugs and codrugs of K, K as ATB-352, K with zinc, K encapsulated as proliposomal powders and several substances that reduce the gastric side effects of K described after 2015.
CONCLUSION
Our review confirms that modifications of K maintain its' desirable actions and decrease ulcer producing side effect. Some new forms of K were also found to have better activity profile compared to the parent drug.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Gastric Mucosa; Humans; Ketoprofen; Stomach Ulcer
PubMed: 33932737
DOI: 10.1016/j.biopha.2021.111608 -
Scandinavian Journal of Medicine &... Nov 2019Hyperthermia during exercise induces central and peripheral fatigue and impairs physical performance. To facilitate heat loss and optimize performance, athletes can... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Hyperthermia during exercise induces central and peripheral fatigue and impairs physical performance. To facilitate heat loss and optimize performance, athletes can hasten body cooling prior (pre-cooling) or during (per-cooling) exercise. However, it is unclear whether per-cooling effect is the same on 'aerobic' and 'anaerobic' types of exercise (duration <75 and >76 seconds, respectively, according to Gastin [Sports Med 2001;31:725-741]) and whether the body area that is cooled makes a difference.
METHODS
A literature search led to the identification of 1582 potential studies. Included studies had to include physical exercise with sufficient details on the type, duration, intensity, and provide valid performance measures and a cooling intervention administered during exercise with sufficient details on the type and site of application.
RESULTS
Forty-five studies were included. Per-cooling provides a performance benefit during 'aerobic' (standardized mean difference (SMD) of 0.60, P < .001) and 'anaerobic' exercises (SMD = 0.27, P < .02). The effects were greater during aerobic compared to anaerobic exercises (P < .01). Internal cooling (cold fluid ingestion such as cold water and ice slurry/menthol beverage) and external cooling (face, neck, and torso) provide the greatest performance benefit for 'aerobic' performance with a moderate to large effect (0.46 < SMD < 1.24). For 'anaerobic' exercises, wearing a whole-body cooling garment is the best way to enhance exercise performance (SMD = 0.39, P < .01).
CONCLUSION
Per-cooling improves 'aerobic' and 'anaerobic' exercise performance with a greater benefit for 'aerobic' exercise. The magnitude of the effect depends on the type and site of the cooling application.
Topics: Administration, Topical; Athletic Performance; Beverages; Body Temperature Regulation; Cold Temperature; Drinking; Exercise; Humans
PubMed: 31340407
DOI: 10.1111/sms.13521 -
Dimensions of Critical Care Nursing :...The aim of this study was to review the scope and quality of evidence for thirst treatment in adult acute care. (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this study was to review the scope and quality of evidence for thirst treatment in adult acute care.
METHODS
A systematic review was completed by 2 independent reviewers using MEDLINE, PubMed, BNI, EMBASE, EMCARE, and CINAHL databases and additional hand searching in June 2020. Interventions to relieve thirst for inpatients receiving acute care were included. Evidence was appraised against the levels of evidence for therapeutic studies, and a risk-of-bias assessment was completed for included studies. Outcomes are presented via narrative synthesis. Meta-analysis was planned.
RESULTS
Four studies (out of 844) were eligible reporting thirst outcomes from 611 critical care patients. Meta-analysis could not be completed because a priori criteria were not met. Two randomized controlled trials represented the highest level of evidence. Thirst assessment was completed via a self-reported scale in all reviewed works. Interventions included cold water sprays or swabs, menthol lip moisturizer, and use of humidification. Three works demonstrate reduced thirst scores; all interventions in these studies exploit cooling effects to the oropharynx with the aim of preabsorptive satiation of thirst. A humidified oxygen circuit showed a neutral response when compared with a nonhumidified circuit.
CONCLUSIONS
There is a limited but growing evidence base related to thirst treatment in the acute setting. Studies using a "bundle" of topical interventions incorporating cooling and menthol treatments showed positive effects in reducing symptom burden. Work to explore the scope of application for thirst treatment for patients unable to self-report, consideration of sustained effects, and a study of individual versus combined effects of bundle elements would be welcomed as the evidence base continues to develop.
Topics: Adult; Critical Care; Humans; Thirst
PubMed: 35099156
DOI: 10.1097/DCC.0000000000000511 -
Phytotherapy Research : PTR Jan 2024Inflammation, a type of the body's defense against injury or infection, causes many chronic disorders including diabetes, cardiovascular disease, and cancer. Therefore,... (Review)
Review
Inflammation, a type of the body's defense against injury or infection, causes many chronic disorders including diabetes, cardiovascular disease, and cancer. Therefore, discovering natural compounds with numerous biological activities for the management of inflammation is highly recommended. Out of natural compounds, peppermint and its main component, menthol, has been suggested to possess antiinflammatory potential. Four databases including Web of Sciences, PubMed, Scopus, and Embase were searched to identify articles about peppermint and its antiinflammatory effects up to March 2023. Out of 3805 records screened, 14 articles met the study criteria. The evidence reviewed here proposed peppermint as an antiinflammatory agent. Peppermint may suppress inflammation by activating the AMP-activated protein kinase/unc-51 like kinase 1/nuclear factor-E2 associated factor 2 autophagy pathway, downregulating extracellular signal-regulated kinase-nuclear factor kappa B and mitogen activated protein kinases pathways, attenuating oxidative stress, suppressing the production of pro-inflammatory mediators and nitric oxide, and inducing the production of antiinflammatory prostaglandins. Due to the promising antiinflammatory effects of peppermint and the lack of human studies in this regard, future randomized clinical trials examining the effects of peppermint on inflammation and its related maladies are warranted.
Topics: Animals; Humans; Mice; Rats; Anti-Inflammatory Agents; Extracellular Signal-Regulated MAP Kinases; Inflammation; Lipopolysaccharides; Mentha piperita; Monocytes; NF-kappa B; Plant Extracts; In Vitro Techniques
PubMed: 37850332
DOI: 10.1002/ptr.8041 -
Nicotine & Tobacco Research : Official... Sep 2019E-liquids are available in a high variety of flavors. A systematic classification of e-liquid flavors is necessary to increase comparability of research results. In the...
INTRODUCTION
E-liquids are available in a high variety of flavors. A systematic classification of e-liquid flavors is necessary to increase comparability of research results. In the food, alcohol, and fragrance industry, flavors are classified using flavor wheels. We systematically reviewed literature on flavors related to electronic cigarette use, to investigate how e-liquid flavors have been classified in research, and propose an e-liquid flavor wheel to classify e-liquids based on marketing descriptions.
METHODS
The search was conducted in May 2017 using PubMed and Embase databases. Keywords included terms associated with electronic cigarette, flavors, liking, learning, and wanting in articles. Results were independently screened and reviewed. Flavor categories used in the articles reviewed were extracted.
RESULTS
Searches yielded 386 unique articles of which 28 were included. Forty-three main flavor categories were reported in these articles (eg, tobacco, menthol, mint, fruit, bakery/dessert, alcohol, nuts, spice, candy, coffee/tea, beverages, chocolate, sweet flavors, vanilla, and unflavored). Flavor classifications of e-liquids in literature showed similarities and differences across studies. Our proposed e-liquid flavor wheel contains 13 main categories and 90 subcategories, which summarize flavor categories from literature to find a shared vocabulary. For classification of e-liquids using our flavor wheel, marketing descriptions should be used.
CONCLUSIONS
We have proposed a flavor wheel for classification of e-liquids. Further research is needed to test the flavor wheels' empirical value. Consistently classifying e-liquid flavors using our flavor wheel in research (eg, experimental, marketing, or qualitative studies) minimizes interpretation differences and increases comparability of results.
IMPLICATIONS
We reviewed e-liquid flavors and flavor categories used in research. A large variation in the naming of flavor categories was found and e-liquid flavors were not consistently classified. We developed an e-liquid flavor wheel and provided a guideline for systematic classification of e-liquids based on marketing descriptions. Our flavor wheel summarizes e-liquid flavors and categories used in literature in order to create a shared vocabulary. Applying our flavor wheel in research on e-liquids will improve data interpretation, increase comparability across studies, and support policy makers in developing rules for regulation of e-liquid flavors.
Topics: Biomedical Research; Electronic Nicotine Delivery Systems; Flavoring Agents; Humans; Terminology as Topic; Vaping
PubMed: 29788484
DOI: 10.1093/ntr/nty101 -
PloS One 2024The recommendation for Chlorhexidine (CHX) as a traditional oral care solution is decreasing, and herbal oral care products are being considered as a potential... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The recommendation for Chlorhexidine (CHX) as a traditional oral care solution is decreasing, and herbal oral care products are being considered as a potential alternative. This network meta-analysis aims to determine if herbal oral care products for oral care in mechanically ventilated patients are superior to CHX and provide direction for future research by comparing the effectiveness of herbal oral care products currently available.
MATERIALS AND METHODS
We searched for English-language published and grey literature sources of randomized clinical trials involving herbal oral care solutions in intensive care unit (ICU) oral care (until September 2023). The primary outcome was the incidence of ventilator-associated pneumonia (VAP); the secondary outcome was the oral microbiota quantity. Data were pooled by pairwise meta-analysis and Bayesian network meta-analysis. The risk of bias was assessed using the Cochrane risk of bias tool, and the certainty of evidence was evaluated using the GRADE framework.
RESULTS
Our network meta-analysis included 29 studies, and the results showed that Chinese herb (OR: 0.39, 95% CI: 0.2-0.75) and Miswak (OR: 0.27, 95% CI: 0.07-0.91) were more effective in reducing VAP incidence than CHX. In terms of reducing bacterial counts, Chinese herb (OR: 0.3, 95% CI: 0.19-0.48) was superior to CHX, and all herbal oral care products, including Persica® (alcoholic extract of S. persica, Achillea millefolium, and Mentha spicata), Matrica® (Chamomile extract), and Listerine® (main components include Menthol, Thymol, and Eucalyptol), were better than saline in all aspects but without significant differences.
CONCLUSION
Based on our network meta-analysis, we have observed that Chinese herbal medicine and Miswak are superior to CHX in reducing the incidence of VAP. However, the safety and feasibility of traditional Chinese herbal medicine require further high-quality research for validation. Simultaneously, Matrica® demonstrates a significant reduction in microbial counts but does not exhibit a significant advantage in lowering the incidence of VAP. This observation aligns with the results of clinical double-blind trials. Therefore, we identify Miswak and Matrica® as promising herbal oral care products with the potential to replace CHX. It is essential to emphasize that our study provides guidance for future research rather than conclusive determinations.
REGISTRATION
PROSPERO no. CRD42023398022.
Topics: Pneumonia, Ventilator-Associated; Humans; Randomized Controlled Trials as Topic; Network Meta-Analysis; Chlorhexidine; Mouthwashes; Bayes Theorem; Intensive Care Units
PubMed: 38848351
DOI: 10.1371/journal.pone.0304583