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Laryngoscope Investigative... Oct 2021Seasonal allergic rhinitis (SAR) is an exaggerated immunological reaction to allergens (pollen) in the air. In a small subgroup of patients, SAR can be difficult to... (Review)
Review
OBJECTIVE
Seasonal allergic rhinitis (SAR) is an exaggerated immunological reaction to allergens (pollen) in the air. In a small subgroup of patients, SAR can be difficult to control with first-line therapy. Intramuscular corticosteroid injections (IMCIs) are an additional treatment in this subgroup of SAR patients. The aim of this systematic review is to investigate the efficacy and safety of IMCIs in SAR.
METHODS
Titles and abstracts were independently screened, followed by full-text screening based on predefined criteria. Included articles were critically appraised using the Cochrane Risk of Bias 2 (RoB 2) tool. The primary outcome is reported as the final conclusion about efficacy that was stated in the included studies. The secondary outcome is the safety of IMCIs with regard to long lasting side-effects.
RESULTS
The search yielded 2139 records, of which 10 were relevant and valid for our clinical question. Critical appraisal showed high risk of bias, which was due to unclear description of methods. Four out of four placebo-controlled, randomized controlled trials reported a significant and relevant difference in efficacy in favor of IMCIs compared with placebo. The occurrence of side-effects was not different between IMCIs and placebo or oral corticosteroids (OCs).
CONCLUSION
The outcome of this systematic review on trials concerning intramuscular steroid injections, despite being based on individual studies claiming favorable outcome with their use, is "inconclusive." This is because of the epidemiological high risk of bias in these studies that were mostly executed more than 30 years ago. The "inconclusive" rating allows for a description as an "optional therapy" for severe cases in guideline formation.
PubMed: 34667833
DOI: 10.1002/lio2.645 -
The Science of the Total Environment Feb 2024Indoor air quality is important for the health of building occupants, and public interest in controlling indoor airborne pathogens increased dramatically with the... (Meta-Analysis)
Meta-Analysis Review
Indoor air quality is important for the health of building occupants, and public interest in controlling indoor airborne pathogens increased dramatically with the COVID-19 pandemic. Pollutant concentrations can be controlled locally using portable air cleaners (sometimes called air purifiers), which allow occupants to apply air cleaning technology to meet their needs in the location and times that they find appropriate. This paper provides a systematic review of scientific literature that describes field studies of the effectiveness of portable air cleaners. Over 500 papers were considered, and 148 were reviewed in detail, to extract 35 specific research results (e.g., particulate removal performance) or characteristics (e.g., type of building). These were aggregated to provide an overview of results and approaches to this type of research, and to provide meta-analyses of the results. The review includes: descriptions of the geographical location of the research; rate of publications over time; types of buildings and occupants in the field study; types of air cleaner technology being tested; pollutants being measured; resulting pollutant removal effectiveness; patterns of usage and potential barriers to usage by occupants; and the potential for by-product emissions in some air cleaner technologies. An example result is that 83 of the 148 papers measured reductions in fine particulates (PM) and found a mean reduction of 49 % with standard deviation of 20 %. The aggregated results were approximately normally distributed, ranging from finding no significant reduction up to a maximum above 90 % reduction. Sixteen of the 148 papers considered gaseous pollutants, such as volatile organic compounds, nitrogen dioxide, and ozone; 36 papers considered biological pollutants, such as bacteria, viruses, pollen, fungi, etc. An important challenge, common to several studies, is that occupants run the air cleaners for shorter periods and on low airflow rate settings, because of concerns about noise, drafts, and electricity cost, which significantly reduces air cleaning effectiveness.
Topics: Air Filters; Air Pollutants; Air Pollution, Indoor; Environmental Pollutants; Pandemics; Particulate Matter
PubMed: 38008326
DOI: 10.1016/j.scitotenv.2023.168786 -
International Journal of Environmental... Jun 2022The burden of asthma readmission for children and adolescents is approximately 10% worldwide. Research has been synthesised for behavioural and indoor impacts; however,... (Review)
Review
The burden of asthma readmission for children and adolescents is approximately 10% worldwide. Research has been synthesised for behavioural and indoor impacts; however, no such synthesis has been conducted for outdoor environmental exposures. This systematic review aims to evaluate and synthesise the impact the outdoor environment has on readmission rates for children or adolescents with asthma. We conducted a systematic search of seven databases and hand searched reference lists of articles published up until 18 January 2021. There were 12 out of 392 studies eligible for inclusion. Overall, most studies showed that outdoor environments impact on readmission; however, the strength of association is seen to be stronger in a particular subpopulation of each study depending on the exposure investigated. The evidence for the association between outdoor environmental exposure and readmission rates for children or adolescents with asthma is increasing; however, it is complicated by potential confounders such as socioeconomic factors, ethnicity, indoor air pollutants, and other behavioural factors. Further research is required to differentiate between them. Additionally, further studies need to be undertaken in further countries other than the United States of America to understand the full relationship.
Topics: Adolescent; Air Pollutants; Air Pollution; Air Pollution, Indoor; Asthma; Child; Environmental Exposure; Humans; Patient Readmission; Socioeconomic Factors
PubMed: 35742711
DOI: 10.3390/ijerph19127457 -
Sustainable Cities and Society Jun 2022COVID-19 is deemed as the most critical world health calamity of the 21st century, leading to dramatic life loss. There is a pressing need to understand the multi-stage... (Review)
Review
COVID-19 is deemed as the most critical world health calamity of the 21st century, leading to dramatic life loss. There is a pressing need to understand the multi-stage dynamics, including transmission routes of the virus and environmental conditions due to the possibility of multiple waves of COVID-19 in the future. In this paper, a systematic examination of the literature is conducted associating the virus-laden-aerosol and transmission of these microparticles into the multimedia environment, including built environments. Particularly, this paper provides a critical review of state-of-the-art modelling tools apt for COVID-19 spread and transmission pathways. GIS-based, risk-based, and artificial intelligence-based tools are discussed for their application in the surveillance and forecasting of COVID-19. Primary environmental factors that act as simulators for the spread of the virus include meteorological variation, low air quality, pollen abundance, and spatial-temporal variation. However, the influence of these environmental factors on COVID-19 spread is still equivocal because of other non-pharmaceutical factors. The limitations of different modelling methods suggest the need for a multidisciplinary approach, including the 'One-Health' concept. Extended One-Health-based decision tools would assist policymakers in making informed decisions such as social gatherings, indoor environment improvement, and COVID-19 risk mitigation by adapting the control measurements.
PubMed: 35317188
DOI: 10.1016/j.scs.2022.103840 -
JMIR MHealth and UHealth Jul 2019With the large amount of material that is readily available on the internet, there are endless opportunities for electronic health-literate patients to obtain and learn... (Meta-Analysis)
Meta-Analysis
BACKGROUND
With the large amount of material that is readily available on the internet, there are endless opportunities for electronic health-literate patients to obtain and learn new information. Although novel, a Web- or mobile-based program can be a powerful way to engage adolescents and young adults (AYAs). The ongoing engagement of AYAs with chronic disease is vital not only to empower them but also to ensure a smooth transition from pediatric to adult health care.
OBJECTIVE
This study aimed to evaluate the current evidence on Web- or mobile-based interventions designed for AYAs.
METHODS
This review was registered with PROSPERO: CRD42018096487. A systematic search of MEDLINE Complete, EMBASE, and CINAHL Complete was conducted on April 10, 2019, for studies that examined the perspectives of transition-age patients about technology-based interventions, the process involved in intervention development, or the evaluation of intervention efficacy. For each study, the comprehensiveness of reporting was appraised. The Downs and Black checklist was used for intervention efficacy trials, the Standards for Reporting Qualitative Research checklist was used for qualitative work, and a 16-item tool developed by Tong et al was used for questionnaire research.
RESULTS
The search uncovered 29 relevant studies, which included qualitative studies (n=14), intervention efficacy studies (n=7), questionnaire studies (n=4), mixed qualitative and questionnaire studies (n=2), and a mixed qualitative and pilot randomized controlled trial study (n=1). The reporting comprehensiveness score of questionnaires was rated considerably lower (n=6, 13%-57% [2/16-8/14]) than the scores of intervention efficacy trials (n=8, 48%-85% [13/27-23/27]) and qualitative research (n=17, 40%-93% [8.5/21-19.5/21]). AYAs were receptive to obtaining information via a website or mobile app. An intervention was more likely to be perceived as useful by AYAs when there was a concerted effort to involve AYAs and subject matter experts in the process of intervention design, as opposed to relying solely on the AYAs or the experts alone. The preferred medium of intervention delivery varied greatly for AYAs, ranging from static text to audiovisual materials. However, AYAs considered being concise was the most important aspect. Across different conditions, AYAs were interested in receiving information on diverse topics, such as anxiety and stress management, dealing with insurance, and having social relationships. Patients also requested for disease-specific information, such as weather forecasts and pollen levels for patients with asthma and information related to the pretransplant period for organ transplant recipients. Meta-analyses showed no significant group differences across time on quality of life, self-efficacy, and self-management.
CONCLUSIONS
Owing to the lack of intervention efficacy trials, no conclusion can be drawn if an intervention delivered via a mobile app is better than that delivered via a website. However, through this systematic review, it is confirmed that AYAs were receptive to receiving medical information electronically.
Topics: Access to Information; Adolescent; Adult; Anxiety; Child; Child, Preschool; Chronic Disease; Female; Humans; Internet; Internet-Based Intervention; Learning; Male; Mobile Applications; Qualitative Research; Quality of Life; Randomized Controlled Trials as Topic; Self Efficacy; Self-Management; Stress, Psychological; Surveys and Questionnaires; Technology; Young Adult
PubMed: 31322129
DOI: 10.2196/12042 -
Allergologia Et Immunopathologia 2022To determine whether the levels of T-helper (T) 2 cytokines (interleukin (IL)-4 and IL-5) in allergic reactions are allergen dependent and evaluate the impact of various... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To determine whether the levels of T-helper (T) 2 cytokines (interleukin (IL)-4 and IL-5) in allergic reactions are allergen dependent and evaluate the impact of various treatment strategies on the levels of these cytokines.
METHODS
The PubMed search engine was used from inception until January 2021. The random-effects residual maximum likelihood model was performed, and effect sizes were estimated using the Hedge's statistic. All data analysis was performed using STATA 16.0 (StataCorp LP, TX, USA).
RESULTS
Fourteen studies reporting on 794 participants were included in this study. House dust mite was associated with eliciting a stronger immune response mediated by both IL-4 and IL-5 when compared to pollen. Whereas a mixture of house dust mite and pollen was associated with IL-4-weighted inflammation. Comparisons of IL-4 and IL-5 levels amongst the allergens showed significant differences. The treatment with anti-corticosteroids or allergen-specific immunotherapy was effective in normalising the T2 responses and alleviating allergy symptoms.
CONCLUSION
T2-mediated inflammation in allergic reactions is allergen-dependent. Therefore, the type of allergen should be considered when using cytokine-targeting biologics in allergic reactions.
Topics: Allergens; Animals; Cytokines; Dermatophagoides pteronyssinus; Humans; Hypersensitivity; Inflammation; Interleukin-4; Interleukin-5; Pyroglyphidae; Th2 Cells
PubMed: 34873895
DOI: 10.15586/aei.v50i1.470 -
American Journal of Rhinology & Allergy Jul 2020Pharmacotherapy for allergic rhinitis (AR) still remains unsatisfying regarding its effect and safety. Barrier protection measures may be a good choice for the patients... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pharmacotherapy for allergic rhinitis (AR) still remains unsatisfying regarding its effect and safety. Barrier protection measures may be a good choice for the patients with AR.
OBJECTIVE
To assess the efficacy and safety of barrier protection measures in the treatment of AR.
METHODS
We selected relevant randomized controlled trials published between January 1, 1990, and February 20, 2019, by searching Embase, PubMed, Cochrane, Web of Knowledge, and ClinicalTrials.gov. The primary outcome for this analysis was rhinitis symptom scores, overall quality of life, nasal peak inspiratory flow (NPIF), and adverse events. Differences were expressed as weighted mean difference (WMD) with 95% confidence intervals (CIs) for continuous outcomes. Statistical heterogeneity across trials was assessed with the statistic ( < .1) and the statistic.
RESULTS
Fifteen RCTs (with data for 1154 participants) satisfied our inclusion criteria. The types of barrier protection measures comprised cellulose, pollen blocker cream, microemulsion, and nasal filter. To reduce the potential risk of bias and heterogeneity, we carried out subgroup analysis according to different types of barrier protection measures (cellulose: WMD = -2.18, 95% CI, -3.01 to -1.35, < .00001; pollen blocker cream: WMD = -4.55, 95% CI, -6.10 to -3.00, < .00001; microemulsion: WMD = -0.22, 95% CI, -0.42 to -0.03, = .03). Findings from our meta-analysis show that, compared with placebo, barrier protection measures can yield improved symptomatic control for AR, with no increase in adverse events. Furthermore, barrier protection measures can improve the quality of life and NPIF.
CONCLUSION
Although further studies are still needed, our findings clearly lend support to barrier protection measures as a safe and efficacious option for the treatment of AR patients.
Topics: Administration, Intranasal; Allergens; Antigens, Plant; Humans; N95 Respirators; Pollen; Quality of Life; Randomized Controlled Trials as Topic; Rhinitis, Allergic, Seasonal; Severity of Illness Index; Skin Cream
PubMed: 32178523
DOI: 10.1177/1945892420912370 -
Journal of Ethnopharmacology Feb 2023Diabetic retinopathy (DR) is a general complication of diabetes, which has become a serious threat to human health worldwide. However, the best treatment is still under... (Review)
Review
ETHNOPHARMACOLOGY RELEVANCE
Diabetic retinopathy (DR) is a general complication of diabetes, which has become a serious threat to human health worldwide. However, the best treatment is still under development. Qiming (QM) granules are mainly composed of Astragalus membranaceus, Pueraria lobata, Rehmannia Glutinosa, Lycium barbarum, Cassiae Semen, Fructus Leonuri, Pollen Typhae, and Leech, which are beneficial to qi, nourish liver and kidney, and clear collaterals and eyes. The treatment of DR is a comprehensive application based on the above traditional Chinese medicine. In recent years, satisfactory results have been achieved for DR.
AIM OF THE STUDY
Through the traditional application analysis, network pharmacology analysis and clinical research summary of QM granules, to review the effectiveness and advantages of QM granules in the treatment of DR comprehensively.
MATERIALS AND METHODS
Analysis of main active components of QM granules by network pharmacology and prediction of mechanism of action of QM granules on DR. Further, PubMed, Web of Science, and China National Knowledge Infrastructure were used to search literature, using the keywords of "Qiming granules", "diabetic retinopathy", "clinical research" and their combinations, mainly from 1999 to 2022.
RESULTS
Traditional pharmacological analysis, Network pharmacological analysis, animal experiments, and clinical studies have confirmed that QM granules plays a role in the treatment of DR through multiple components, multiple targets, and multiple channels.
CONCLUSIONS
This systematic review for the first time provides meaningful information for the further study of the pharmacodynamic material basis and pharmacological mechanism of QM granules, and also provides a basis for further study of quality markers and quality control of QM granules.
Topics: Animals; Humans; Network Pharmacology; Drugs, Chinese Herbal; Diabetic Retinopathy; Medicine, Chinese Traditional; Diabetes Mellitus
PubMed: 36332761
DOI: 10.1016/j.jep.2022.115861 -
Frontiers in Plant Science 2022Vegetables are a distinct collection of plant-based foods that vary in nutritional diversity and form an important part of the healthy diet of the human being. Besides...
Vegetables are a distinct collection of plant-based foods that vary in nutritional diversity and form an important part of the healthy diet of the human being. Besides providing basic nutrition, they have great potential for boosting human health. The balanced consumption of vegetables is highly recommended for supplementing the human body with better nutrition density, dietary fiber, minerals, vitamins, and bioactive compounds. However, the production and quality of fresh vegetables are influenced directly or indirectly by exposure to high temperatures or heat stress (HS). A decline in quality traits and harvestable yield are the most common effects of HS among vegetable crops. Heat-induced morphological damage, such as poor vegetative growth, leaf tip burning, and rib discoloration in leafy vegetables and sunburn, decreased fruit size, fruit/pod abortion, and unfilled fruit/pods in beans, are common, often rendering vegetable cultivation unprofitable. Further studies to trace down the possible physiological and biochemical effects associated with crop failure reveal that the key factors include membrane damage, photosynthetic inhibition, oxidative stress, and damage to reproductive tissues, which may be the key factors governing heat-induced crop failure. The reproductive stage of plants has extensively been studied for HS-induced abnormalities. Plant reproduction is more sensitive to HS than the vegetative stages, and affects various reproductive processes like pollen germination, pollen load, pollen tube growth, stigma receptivity, ovule fertility and, seed filling, resulting in poorer yields. Hence, sound and robust adaptation and mitigation strategies are needed to overcome the adverse impacts of HS at the morphological, physiological, and biochemical levels to ensure the productivity and quality of vegetable crops. Physiological traits such as the stay-green trait, canopy temperature depression, cell membrane thermostability, chlorophyll fluorescence, relative water content, increased reproductive fertility, fruit numbers, and fruit size are important for developing better yielding heat-tolerant varieties/cultivars. Moreover, various molecular approaches such as omics, molecular breeding, and transgenics, have been proved to be useful in enhancing/incorporating tolerance and can be potential tools for developing heat-tolerant varieties/cultivars. Further, these approaches will provide insights into the physiological and molecular mechanisms that govern thermotolerance and pave the way for engineering "designer" vegetable crops for better health and nutritional security. Besides these approaches, agronomic methods are also important for adaptation, escape and mitigation of HS protect and improve yields.
PubMed: 35837452
DOI: 10.3389/fpls.2022.878498 -
Critical Reviews in Food Science and... Apr 2023Appraised for being one of the oldest staple nutritive foods mainly in the Arabian Peninsula, the date palm tree ( L.), is a crop native to the subtropical and tropical...
Appraised for being one of the oldest staple nutritive foods mainly in the Arabian Peninsula, the date palm tree ( L.), is a crop native to the subtropical and tropical regions of Southern Asia and Africa. Different parts of the date tree have been extensively studied for their nutritional and therapeutic properties. Despite an array of publications on the date tree, there has been no attempt to compile in a single study the traditional uses, nutritive value, phytochemical profile, the medicinal properties as well as the potential of the different plant parts as a functional food. Therefore, this review endeavors to systematically review the scientific literature to highlight the traditional uses of date fruit and parts around the world, the nutritional profile of several parts and the medicinal properties. A total of 215 studies was retrieved (traditional uses (n = 26), nutritional (n = 52), and medicinal (n = 84)). Scientific articles were further categorized as in vitro (n = 33), in vivo (n = 35), and clinical (n = 16) evidences. Date seeds were found to be effective against and . Aqueous date pollen was used to manage hormonal problems and boost fertility. Palm leaves showed anti-hyperglycemic effects inhibition of α-amylase and α-glucosidase. Unlike previous studies, this study highlighted the functional roles of all the plant parts of the palm tree and provided insights into the various mechanism of action of their bioactive compounds. Although scientific shreds of evidence have been growing over the years, there is still a dearth of studies concerning the clinical validation of the date fruit and other plant parts to provide strong evidence on their medicinal uses. In conclusion, can be regarded as a potent medicinal plant with prophylactic potential and should be further explored to alleviate the burden of both communicable and non-communicable diseases.
PubMed: 37070182
DOI: 10.1080/10408398.2023.2191285