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Annals of the Rheumatic Diseases May 2024To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).
OBJECTIVE
To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).
METHODS
A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting.
RESULTS
Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc.
CONCLUSIONS
The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes.
Topics: Humans; Scleroderma, Systemic; Lupus Erythematosus, Systemic; Evidence-Based Medicine; Patient Education as Topic; Rheumatology; Patient-Centered Care; Europe; Disease Management
PubMed: 37433575
DOI: 10.1136/ard-2023-224416 -
Journal of Dietary Supplements 2021Astaxanthin (AST), a naturally-occurring keto-carotenoid found in several species of bacteria and microalgae, has demonstrated diverse biological activities and . There...
Astaxanthin (AST), a naturally-occurring keto-carotenoid found in several species of bacteria and microalgae, has demonstrated diverse biological activities and . There is growing commercial interest in the application of astaxanthin in nutraceuticals and cosmeceuticals, due to its purported photoprotective, DNA repair, antioxidant, and anti-inflammatory benefits. This systematic review therefore aimed to summarize current clinical evidence on the effects of astaxanthin supplementation on skin health. Using the following combinations of broad Major Exploded Subject Headings (MesH) terms or text words [astaxanthin OR AST OR ASX OR carotenoid OR xanthophyll] AND [skin OR derm*], a comprehensive search of PubMed, EMBASE, Medline, Clinicaltrials.gov, and Google Scholar databases found a total of eleven clinical studies. There were six randomized, placebo-controlled, double-blind trials, while the rest were prospective, open-label studies. In many of the randomized, controlled trials reviewed, AST supplementation improved skin texture, appearance (wrinkles), and moisture content at the end of the study period. AST also appeared to protect against UV-induced skin damage. No serious adverse events were reported in any of the studies. However, most available studies had a relatively small sample size and were conducted on healthy Japanese females. Many of the studies were also funded by commercial entities, with potential conflicts of interests. This was difficult to account for in our analyses. Overall, there is some clinical data to support the benefits of astaxanthin supplementation (in the range of 3 to 6 mg/d) on skin health, especially for photoaged skin.
Topics: Dietary Supplements; Female; Humans; Prospective Studies; Randomized Controlled Trials as Topic; Skin; Xanthophylls
PubMed: 32202443
DOI: 10.1080/19390211.2020.1739187 -
Journal of Cosmetic Dermatology Nov 2022Excessive exposure to ultraviolet radiation has harmful effects on human skin. At present, synthetic and mineral types of sunscreens used to protect against these... (Review)
Review
BACKGROUND
Excessive exposure to ultraviolet radiation has harmful effects on human skin. At present, synthetic and mineral types of sunscreens used to protect against these harmful damages have been reported to cause negative health and environmental effects. The studies involving characterization and isolation of phytoconstituents from natural botanical sources are important to discover their potential beneficial effects on sunscreen development AIM: This systematic review provides specific and compiled information on the photoprotective properties of natural botanical sources for sunscreen development. The efforts in research and innovation are essential to ensure the safety and sustainability of plant-based sunscreen products.
METHODS
In this review, a total of 35 articles were selected using the Scopus database based on the inclusion and exclusion criteria RESULT: The significant correlation between total phenolic content, total flavonoid content, antioxidant activities, and sun protection factor were shown in these studies which confirmed the potential benefits of natural plants in sunscreen development.
CONCLUSIONS
In addition, natural botanical sources also exhibit excellent anti-tyrosinase, anti-aging, and anti-inflammatory activities. However, the biological activities of plants were dependent on the solvents used for extraction.
Topics: Humans; Sunscreening Agents; Ultraviolet Rays; Polyphenols; Skin; Skin Neoplasms
PubMed: 35723888
DOI: 10.1111/jocd.15170 -
The Journal of Maternal-fetal &... Jan 2022Retinopathy of prematurity (ROP) is a multifactorial retinal disorder characterized by an abnormal vascular development of the retina of the preterm infants. Carotenoids... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Retinopathy of prematurity (ROP) is a multifactorial retinal disorder characterized by an abnormal vascular development of the retina of the preterm infants. Carotenoids are natural pigments that are synthesized by all plants and some microorganisms where they play a role in photoprotection and coloration. Lutein and zeaxanthin (L/Z) are two carotenoids identified as the major components of the macular pigment. Recently it has been suggested that lutein and its isomer zeaxanthin may act as antioxidant agents and that they may prevent ROP.
OBJECTIVE
The primary objective of this study is to assess the safety and effectiveness of oral lutein in the prevention of retinopathy of prematurity in preterm neonates.
STUDY DESIGN
We conducted a systematic search for randomized or quasi-randomized controlled trials without any language or publication year restriction. The studies have to recruit preterm neonates ≤32 completed weeks of gestation and to compare the administration of oral L/Z at any dosage or duration, versus placebo in order to prevent ROP.
RESULT
Data from three RCT with a total of 406 participants failed to show any reduction in ROP incidence nor the risk of BPD, sepsis, NEC and mortality. It may reduce the number of transfusions but this result has to be assessed in a separate ad hoc trial.
Topics: Dietary Supplements; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Lutein; Retinopathy of Prematurity
PubMed: 32041442
DOI: 10.1080/14767058.2020.1712700 -
Rheumatology International May 2024We performed a systematic review to explore existing evidence regarding the efficacy of lifestyle interventions for the management of systemic lupus erythematosus (SLE)....
We performed a systematic review to explore existing evidence regarding the efficacy of lifestyle interventions for the management of systemic lupus erythematosus (SLE). The search was conducted on the 22nd of June 2021 for publications between 1st of January 2000 and the date of search. Additional articles within the aforementioned timeframe and until December 2023 were added by hand searching. Databases utilized were Medline, Embase, Web of Science, and Cinahl. Lifestyle interventions were defined as any intervention encompassing one or more of the following: physical exercise, diet and nutrition, mental health, harmful exposures, sleep, and social relations. The Joanna Briggs Institute critical appraisal tools were used for risk of bias assessment. The search yielded 11,274 unique records, we assessed the full text of 199 records, and finally included 102 studies. Overall, the quality of the evidence is limited, and there were multiple sources of heterogeneity. The two domains most extensively researched were mental health (40 records) and physical exercise (39 records). Psychological interventions had a positive effect on depressive symptoms, anxiety, and health-related quality of life (HRQoL), whereas physical exercise improved fatigue, depressive symptoms, aerobic capacity, and physical functioning. Studies on diet and nutrition (15 records) support that low fat intake and Mediterranean diet may be beneficial for reducing cardiovascular risk, but large interventional studies are lacking. Studies on harmful exposures (7 records) support photoprotection and use of sunscreen. While studies imply benefits regarding disease burden and drug efficacy in non-smokers and regarding HRQoL in normal-weight patients, more survey is needed on tobacco smoking and alcohol consumption, as well as weight control strategies. Studies on social relations (1 record) and sleep (no records) were sparse or non-existent. In conclusion, psychosocial interventions are viable for managing depressive symptoms, and exercise appears essential for reducing fatigue and improving aerobic capacity and physical function. Photoprotection should be recommended to all patients. Lifestyle interventions should be considered a complement, not a substitute, to pharmacotherapy.
Topics: Humans; Quality of Life; Life Style; Exercise; Lupus Erythematosus, Systemic; Fatigue
PubMed: 38451302
DOI: 10.1007/s00296-024-05548-x -
RMD Open Apr 2024This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations...
OBJECTIVE
This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE.
METHODS
Based on evidence from a systematic literature review and expert opinion, 3 overarching principles and 15 recommendations were agreed on by Delphi consensus.
RESULTS
The overarching principles highlight the importance of shared decision-making and the need to explain the benefits of physical activity to persons living with SLE and other healthcare providers. The 15 specific recommendations state that physical activity is generally recommended for all people with SLE, but in some instances, a medical evaluation may be needed to rule out contraindications. Pertaining to outdoor activity, photoprotection is necessary. Both aerobic and resistance training programmes are recommended, with a gradual increase in frequency and intensity, which should be adapted for each individual, and ideally supervised by qualified professionals.
CONCLUSION
In summary, the consensus reached by the international task force provides a valuable framework for the integration of physical activity and exercise into the management of SLE, offering a tailored evidence-based and eminence-based approach to enhance the well-being of individuals living with this challenging autoimmune condition.
Topics: Humans; Consensus; Lupus Erythematosus, Systemic; Exercise; Advisory Committees
PubMed: 38580348
DOI: 10.1136/rmdopen-2024-004171 -
Heliyon Feb 2021Reactive oxygen species (ROS) are produced as a result of various environmental factors and cellular metabolism reactions creating oxidative stress. The reversible... (Review)
Review
Reactive oxygen species (ROS) are produced as a result of various environmental factors and cellular metabolism reactions creating oxidative stress. The reversible oxidative modification on proteins such as cysteine oxidation may be useful and can play positive role. ROS generated offer some benefits such as cellular signalling and tissue repair when present in low concentration. However, most of the times, these reactive species cause detrimental effects to cell components which leads to various pathological conditions which causes or aggravates diseases due to oxidative stress. The degenerative diseases due to oxidative stress are diabetes, cardiovascular diseases, epilepsy, cancer and aging. Antioxidants are the compounds which scavenge these free radicals and hence neutralize their effects. Research has enabled the use of natural antioxidants as therapeutic agent in the treatment of diseases. Safranal is one such natural agent which is a major volatile component of saffron. Saffron, is the most expensive spice found in limited region of the planet and is also reported to be used in traditional systems of medicine. Chemically, safranal is a monoterpene aldehyde possessing a sweet fragrance. While exploring for the photoprotective properties of safranal, we learnt about the immense antioxidant potential of safranal. Investigation by various research groups established safranal as an anti-inflammatory, antidepressant, anxiolytic, antiasthamatic, antihypertensive, anticonvulsant, anticancer and antitussive and antigenotoxic agent. It has brought researchers over the world to explore the antioxidant benefits of saffron for human health. In the present paper, potential of safranal and its related molecules as radical scavenger in combating oxidative stress, diseased conditions is collated and the underlying mechanisms have been explained. Various cell lines and animal models used for study of Safranal have been discussed.
PubMed: 33615006
DOI: 10.1016/j.heliyon.2021.e06117 -
International Journal of Environmental... Aug 2022People who practice outdoor sports have an increased risk of skin cancer as they are exposed to high doses of ultraviolet (UV) radiation. Recent studies have shown that...
People who practice outdoor sports have an increased risk of skin cancer as they are exposed to high doses of ultraviolet (UV) radiation. Recent studies have shown that in many athletes, sun protection behaviours are inadequate, with the risk that this entails. The aim of this review is to collect the information published to date about the knowledge, attitudes and habits of athletes in relation to sun exposure and its risks. A systematic review was conducted using PubMed and Embase with the search algorithm "(skin cancer OR melanoma) AND (exercise OR sport OR athletes)". All studies analysing the knowledge, attitudes and habits of photoprotection in athletes were included. A total of 2,365 publications were found, of which 23 were selected, including a total of 10,445 sportspeople. The majority of participants declared their voluntary intention to tan and stated that the sun made them feel better, although they also showed concern about possible damage associated with UV radiation. In most studies, less than half of the participants made adequate use of photoprotective measures. In general, most athletes had a high level of knowledge regarding the risk of skin cancer associated with sun exposure. In conclusion, most athletes are aware of the risks associated with UV radiation but do not make adequate use of photoprotective cream. New training programs on photoprotection could help improve athletes' photoprotective behaviour, reducing the incidence of skin cancer and precancerous lesions in this population.
Topics: Health Knowledge, Attitudes, Practice; Humans; Melanoma; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents; Ultraviolet Rays
PubMed: 36011808
DOI: 10.3390/ijerph191610175 -
Journal of Cutaneous Medicine and... 2021College and university students are a group known for excessive sun exposure and indoor tanning. Health education campaigns for avoidance of ultraviolet (UV) radiation...
College and university students are a group known for excessive sun exposure and indoor tanning. Health education campaigns for avoidance of ultraviolet (UV) radiation have been relatively unsuccessful in this population. This systematic review examines interventions aimed at post-secondary school young adults on college and university campuses for skin cancer awareness, photoprotection, and change in UV-exposure-related behavior. Fifty-nine studies were identified for inclusion according to predetermined criteria. Study heterogeneity was high; methods of intervention were individual or group-based, and were mostly visually delivered and/or passive learning. Most interventions occurred at a single time point. Intervention success was assessed by evaluating subject behavior, intention, attitudes, knowledge, and emotion. Multicomponent interventions, generally consisting of UV photography and a passively delivered educational component, may be more effective than a single component alone. Overall, study quality was poor. Sample size of the majority of studies was <150 subjects. Most studies used self-report of behavior and had a short follow-up time. Generalizability of findings may be impacted as women, particularly white/Caucasian women, were overrepresented in the studies identified by this systematic review. For this specific target population, themes arising from the review include the importance of self-relevance and message framing. Self-affirmation was identified as a potential challenge in designing interventions for this target group, which can lead to defensiveness and a negative reaction to the health message. The findings of this systematic review may inform future research in this field, as well as guide planning of effective interventions in this target population.
Topics: Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Male; Schools; Skin Neoplasms; Sunburn; Ultraviolet Rays; Young Adult
PubMed: 33566702
DOI: 10.1177/1203475420988863 -
Critical Reviews in Food Science and... Jun 2024Lycopene as a natural antioxidant that have been studied for ultraviolet radiation (UVR) photo protection and is one of the most effective carotenoids to scavenge... (Meta-Analysis)
Meta-Analysis
The effect of tomato and lycopene on clinical characteristics and molecular markers of UV-induced skin deterioration: A systematic review and meta-analysis of intervention trials.
Lycopene as a natural antioxidant that have been studied for ultraviolet radiation (UVR) photo protection and is one of the most effective carotenoids to scavenge reactive oxygen species (ROS). This review aims to summarize the protective effect of tomato and lycopene on skin photo damage and skin photoaging in healthy subjects by reviewing the existing population intervention experiments. A total of five electronic databases including PubMed, Scopus, EBSCO, Web of Science and Cochrane Library were searched from inceptions to January 2021 without any restriction. Out of 19336 publications identified, 21 fulfilled the inclusion criteria and were meta-analysis. Overall, interventions supplementing tomato and lycopene were associated with significant reductions in Δa*, MMP-1, ICAM-1 and skin pigmentation; while tomato and lycopene supplementation were associated with significant increase in MED, skin thickness and skin density. Based on the results of this systematic review and meta-analysis, supplementation with tomato and lycopene could reduce skin erythema formation and improve the appearance and pigmentation of the skin, thereby preventing light-induced skin photodamage and skin photoaging. Lycopene-rich products could be used as endogenous sun protection and may be a potential nutraceutical for sun protection.
Topics: Lycopene; Humans; Ultraviolet Rays; Solanum lycopersicum; Skin; Skin Aging; Antioxidants; Dietary Supplements; Skin Pigmentation; Matrix Metalloproteinase 1; Biomarkers; Carotenoids; Erythema; Intercellular Adhesion Molecule-1
PubMed: 36606553
DOI: 10.1080/10408398.2022.2164557