-
Diabetes & Metabolic Syndrome Oct 2023Glycemic control is of utmost importance both as a preventive measure in individuals at risk of diabetes and in the management of patients with disturbed glycemia.... (Meta-Analysis)
Meta-Analysis Review
Effects of curcumin/turmeric supplementation on glycemic indices in adults: A grade-assessed systematic review and dose-response meta-analysis of randomized controlled trials.
INTRODUCTION
Glycemic control is of utmost importance both as a preventive measure in individuals at risk of diabetes and in the management of patients with disturbed glycemia. Turmeric/curcumin has been extensively studied in this field. In the present systematic review and meta-analysis, we aimed at investigating the impact of turmeric/curcumin supplementation on glycemic control.
METHODS
Major online databases (PubMed, Scopus, Web of Science, Cochrane Library and Google Scholar) were systematically searched from inception up to October 2022. Relevant randomized controlled trials (RCTs) meeting our eligible criteria were included. Weighted mean differences (WMDs) with confidence intervals (CIs) were expressed using a random-effect model. Subgroup analyses were conducted to find the sources of heterogeneities. To detect risk of bias in the included studies, we used the Cochrane risk-of-bias tool. The registration number was CRD42022374874.
RESULTS
Out of 4182 articles retrieved from the initial search, 59 RCTs were included. Our findings suggested that turmeric/curcumin supplementation was significantly effective in improving fasting blood sugar (WMD: 4.60 mg/dl; 95% CI: 5.55, -3.66), fasting insulin levels (WMD: 0.87 μIU/ml; 95% CI: 1.46, -0.27), hemoglobin A1c (HbA1c) (WMD: 0.32%; 95% CI: 0.45, -0.19), and homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: 0.33; 95% CI: 0.43, -0.22).
CONCLUSION
Our results indicate that turmeric/curcumin supplementation can be considered as a complementary method in the management of disturbed glycemia.
Topics: Humans; Adult; Glycemic Index; Curcumin; Curcuma; Randomized Controlled Trials as Topic; Dietary Supplements; Blood Glucose; Insulin Resistance
PubMed: 37748368
DOI: 10.1016/j.dsx.2023.102855 -
Indian Journal of Dental Research :... 2020To systematically review the association between black stains and early childhood caries. (Review)
Review
OBJECTIVE
To systematically review the association between black stains and early childhood caries.
METHODS
Seven electronic databases and hand search were carried out using keywords on black stains and early childhood caries. Articles published in English from January 1947 to January 2020 were included. A total of 38,686 articles were retrieved, and 38,645 duplicate and irrelevant records were removed. Among the 41 articles obtained, 21 articles were excluded after screening the title and abstracts. Fifteen articles were excluded after analyzing the full text. Finally, five articles with cross-sectional study designs were included in this review. Quality analysis was carried out using a modified Newcastle-Ottawa scale.
RESULTS
All the five articles included in this review had a low risk of bias. Two articles showed a significant negative association and one article showed a significant positive association between black stains and early childhood caries.
CONCLUSION
Cross-sectional design and heterogeneity of the included articles provide an ambiguous opinion on the association between black stains and early childhood caries. More of longitudinal studies following rigid methodology is needed to establish the association between black stains and early childhood caries.
Topics: Child; Child, Preschool; Coloring Agents; Cross-Sectional Studies; Dental Caries; Dental Caries Susceptibility; Humans
PubMed: 33753668
DOI: 10.4103/ijdr.IJDR_327_20 -
Journal of Laparoendoscopic & Advanced... Aug 2013Evolutions in minimally invasive surgical techniques and advances in sentinel node navigation surgery (SNNS) have had considerable impact on current insights into... (Review)
Review
Evolutions in minimally invasive surgical techniques and advances in sentinel node navigation surgery (SNNS) have had considerable impact on current insights into surgical treatment of gastric cancer. Extensive data on this method of surgical application have accumulated but have been principally derived from single-institute studies. Isosulfan blue and patent blue violet have been the most frequently used dye tracers in the past; however, indocyanine green has now is increasingly popular. The double-tracer method, where dye and radioisotope tracers are used together, seems to be more effective than any single tracer. Among newly emerging adjunct techniques and promising alternative in particular are infrared ray electronic endoscopy, florescence imaging, nanoparticles, and near-infrared technology. Hematoxylin and eosin (H&E) staining is still the method of choice for the detection of sentinel lymph node (SLN) metastases. Immunohistochemical staining can be used to support H&E findings, but the equipment costs of ultrarapid processing systems are currently slowing down their worldwide spread. We believe minimally invasive function-preserving resection of the stomach, together with lymphatic basin dissection navigated by SLNs, can represent the ideal approach for SNNS to detect clinically node-negative early gastric cancer, although this remains to be elucidated. Patients with cT3 or more advanced disease should still be treated by means of standard D2 dissection.
Topics: Forecasting; Humans; Lymph Nodes; Lymphatic Metastasis; Patient Selection; Sentinel Lymph Node Biopsy; Stomach Neoplasms
PubMed: 23755853
DOI: 10.1089/lap.2012.0311 -
Minimally Invasive Therapy & Allied... Oct 2023In Asia, particularly, robotic gastrectomy has grown in popularity as a treatment for stomach cancer. Indocyanine green (ICG) and near-infrared (NIR) fluorescent imaging... (Meta-Analysis)
Meta-Analysis Review
Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph node dissection during robotic gastrectomy for gastric cancer: a systematic review and meta-analysis.
BACKGROUND
In Asia, particularly, robotic gastrectomy has grown in popularity as a treatment for stomach cancer. Indocyanine green (ICG) and near-infrared (NIR) fluorescent imaging technology has been reported for robotic gastrectomy. However, the clinical value still should be further evaluated. In this meta-analysis, we investigated the safety and efficacy of ICG near-infrared fluorescent imaging-guided lymph node (LN) dissection during robotic gastrectomy.
MATERIAL AND METHODS
Through July 2022, systematic searches of PubMed, Embase, Web of Science, and the Cochrane Library were conducted to find studies comparing ICG fluorescence imaging with conventional treatment in patients with gastric cancer. The current meta-analysis was performed according to the preferred reporting items for systematic review and meta-analysis guidelines. A pooled analysis was performed for the available data regarding the number of lymph node dissections, other operative outcomes and postoperative complications. R studio software 4.2.2 was used for this meta-analysis.
RESULTS
This analysis includes five studies with a total of 312 gastric cancer patients (128 in the ICG group and 184 in the non-ICG group). In this meta-analysis, the number of retrieved LNs in the ICG group was significantly higher (weighted mean difference [WMD] = 8.80, 95% confidence intervals [CI]: 4.37-13.22, < 0.05) than that in the non-ICG group with moderate heterogeneity ( < 0.0001, I=53.3%). Intraoperative blood loss and postoperative complications were all comparable and without significant heterogeneity. Additionally, ICG near-infrared fluorescent imaging was associated with a reduced operative time (WMD= -11.85, 95% CI: -22.40 to -1.30, < 0.05) with low heterogeneity ( = 0.027, I= 2.1%).
CONCLUSIONS
ICG near-infrared fluorescent imaging-guided lymphadenectomy was considered to be safe and effective in robotic gastrectomy. ICG was used to increase the number of LNs harvested while reducing operative time without increasing intraoperative blood loss or postoperative complications.
Topics: Humans; Indocyanine Green; Stomach Neoplasms; Robotic Surgical Procedures; Blood Loss, Surgical; Lymph Node Excision; Coloring Agents; Gastrectomy; Postoperative Complications; Lymph Nodes
PubMed: 36639136
DOI: 10.1080/13645706.2023.2165415 -
Phytotherapy Research : PTR May 2019The aim of this study was to evaluate the effects of turmeric and curcumin in the management of oral mucositis in cancer patients undergoing chemo and/or radiotherapy....
The aim of this study was to evaluate the effects of turmeric and curcumin in the management of oral mucositis in cancer patients undergoing chemo and/or radiotherapy. The systematic review was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The search was performed in the following database: Cochrane Library, LILACS, LIVIVO, PubMed, Scopus, and Web of Science. A gray literature search was undertaken using Google Scholar, Open Grey, and ProQuest. The methodology of included studies was evaluated by the Meta-Analysis of Statistics Assessment and Review Instrument. After a two-step selection process, four randomized and one nonrandomized clinical trials were included in the analysis. Two studies were categorized as low and three as moderate risk of bias. Turmeric/curcumin was applied topically as a gel or as a mouthwash. Patients treated with turmeric/curcumin experienced reduced grade of mucositis, pain, erythema intensity, and ulcerative area. Current evidence suggests that topical application of turmeric or curcumin is effective in controlling signs and symptoms of oral mucositis. Thus, further investigation is required to confirm the promising effect of turmeric and curcumin in oral inflammatory lesions.
Topics: Curcuma; Curcumin; Humans; Neoplasms; Stomatitis
PubMed: 30838707
DOI: 10.1002/ptr.6326 -
International Journal For Vitamin and... Oct 2022This systematic review and meta-analysis examined the effects of selected root plants (curcumin, ginseng, ginger and garlic) on markers of muscle damage and muscular... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis examined the effects of selected root plants (curcumin, ginseng, ginger and garlic) on markers of muscle damage and muscular performance measures following muscle-damaging protocols. We included 25 studies (parallel and crossover design) with 353 participants and used the PEDro scale to appraise each study. Forest plots were generated to report on standardised mean differences (SMD) and p-values at 24 and 48 hours following the muscle-damaging protocols. The meta-analysis showed that the supplemental (SUPP) condition showed significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) and muscle soreness at 24 hours and 48 hours (p < 0.01) than the placebo (PLA) condition. The inflammatory markers were significantly lower for the SUPP condition than the PLA condition at 24 hours (p = 0.02), although no differences were identified at 48 hours (p = 0.40). There were no significant differences in muscular performance measures between the SUPP and PLA conditions at 24 hours and 48 hours (p > 0.05) post-exercise. According to our qualitative data, a number of studies reported a reduction in oxidative stress (e.g., malondialdehyde, superoxide dismutase) with a concomitant upregulation of anti-oxidant status, although other studies showed no effects. Accordingly, selected root plants minimised the level of several biomarkers of muscle damage, inflammation and muscle soreness during periods of exercise-induced muscle damage. However, the benefits of these supplements in ameliorating oxidative stress, increasing anti-oxidant status and accelerating recovery of muscular performance appears equivocal, warranting further research in these outcome measures.
Topics: Antioxidants; Biomarkers; Creatine Kinase; Curcumin; Dietary Supplements; Exercise; Humans; Lactate Dehydrogenases; Malondialdehyde; Muscle, Skeletal; Myalgia; Myoglobin; Superoxide Dismutase
PubMed: 33196371
DOI: 10.1024/0300-9831/a000689 -
Journal of Affective Disorders Mar 2021Curcumin, a potential natural substance is a promising complementary and alternative therapeutic intervention for depression or depressive symptoms. We undertook a... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Curcumin, a potential natural substance is a promising complementary and alternative therapeutic intervention for depression or depressive symptoms. We undertook a systematic review and meta-analysis to evaluate the efficacy and acceptability.
METHODS
PubMed, EMBASE, PsycInfo, Web of Science, Cochrane Library and ClinicalTrials.gov were searched from the inception up until March 4, 2020. The Outcomes were depressive symptoms, response rates, drop-out rates, and adverse effects.
RESULTS
A total of 594 patients from ten trials were subjected to meta-analysis. Three trials were judged to be at high risk of bias, four at unclear risk of bias and three at low risk of bias. Most of the domains for risk of bias were at low risk or unclear risks and three domains at high risks. The pooling results suggested a significant difference in depression or depressive symptoms(SMD= -0.32, 95% CI: -0.50 to -0.13, I=15%, n=594) and response rates (OR=3.20, 95% CI: 1.28-7.99, I=35%, n=271). However, there was no difference between drop-out rates (OR=1.06, 95% CI: 0.58-1.93, I=0%, n=594), digestive symptoms (OR=1.27, 95% CI: 0.69-2.32, I=0%, n=284) and neurological symptoms (OR=1.08, 95% CI: 0.49-2.36, I=0%, n=284). Subgroup analysis showed depression was associated with a reduction(SMD= -0.35, 95% CI: -0.56 to -0.15, I=7%, n=432) but depressive symptoms were not (SMD= -0.17, 95% CI: -0.61 to 0.26, I=40%, n=162).
CONCLUSIONS
The evidence quality is low, indicating that there is great uncertainty about the efficacy and acceptability of curcumin for the treatment of depression or depressive symptoms.
Topics: Curcumin; Depression; Humans
PubMed: 33418373
DOI: 10.1016/j.jad.2020.12.158 -
European Journal of Surgical Oncology :... Nov 2020Sentinel node procedures (SNP) are performed with the use of tracer-agents, mainly radio-colloid and/or blue dye. Fluorescent agents have emerged as a new tracer-agent... (Meta-Analysis)
Meta-Analysis
Sentinel node procedures (SNP) are performed with the use of tracer-agents, mainly radio-colloid and/or blue dye. Fluorescent agents have emerged as a new tracer-agent to identify the SLN intra-operatively with near-infrared imaging. Our aim is to compare the detection rate of fluorescent agents to current "golden standards" (blue dye and/or radio-colloid) for the SNP by means of a systematic review and meta-analysis without any restrictions based on tumor type. A systematic search in PubMed, Embase and The Cochrane Library was performed. Articles that compared the detection rates of fluorescent agents with radio-colloid and/or blue dye were included. Meta-analyses were performed for breast, gynecological and dermatological cancer using a random effects model. In total 6195 articles were screened which resulted in a final inclusion of 55 articles. All studies used indocyanine green (ICG) as fluorescent agent. Meta-analyses comparing ICG with blue dye showed a significant and clinically relevant difference in detection rate in favor of ICG, for both breast, dermatological and gynecological cancer. Meta-analyses comparing ICG with radio-colloid did not show any significant differences, with the exception of ICG versus radio-colloid + blue dye for the bilateral SLN detection in gynecological cancer. Near-infrared fluorescence imaging using ICG provides a higher detection rate compared to blue dye for the SNP in a range of different tumor types. SLN detection rates of ICG are comparable to radio-colloid. Due to their complementary characteristics in terms of spatial resolution and transdermal sensitivity, we suggest to use a combination of both ICG and a radio-colloid.
Topics: Breast Neoplasms; Coloring Agents; Female; Fluorescent Dyes; Genital Neoplasms, Female; Humans; Indocyanine Green; Optical Imaging; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Skin Neoplasms
PubMed: 32826112
DOI: 10.1016/j.ejso.2020.07.012 -
Complementary Therapies in Medicine Jun 2023Liver conditions are major burdens upon health systems around the world. Turmeric /curcumin is believed to possess therapeutic features in ameliorating various metabolic... (Meta-Analysis)
Meta-Analysis Review
Effects of curcumin/turmeric supplementation on liver function in adults: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.
INTRODUCTION
Liver conditions are major burdens upon health systems around the world. Turmeric /curcumin is believed to possess therapeutic features in ameliorating various metabolic disorders. In this systematic review and meta-analysis of the randomized controlled trials (RCTs), we examined the effect of turmeric/curcumin supplementation on some liver function tests (LFTs).
METHODS
We comprehensively searched online databases (i.e. PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar) from inception up to October 2022. Final outcomes included aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT). Weighted mean differences (WMDs) were reported. In case of between-study heterogeneity, subgroup analysis was conducted. Non-linear dose-response analysis was carried out to detect the potential effect of dosage and duration. The registration code is CRD42022374871.
RESULTS
Thirty-one RCTs were included in the meta-analysis. Turmeric/curcumin supplementation significantly reduced blood levels of ALT (WMD = -4.09 U/L; 95 % CI = -6.49, -1.70) and AST (WMD = -3.81 U/L; 95 % CI = -5.71, -1.91), but not GGT (WMD: -12.78 U/L; 95 % CI: -28.20, 2.64). These improvements, though statistically significant, do not ensure clinical effectiveness.
CONCLUSION
It seems that turmeric/curcumin supplementation might be effective in improving AST and ALT levels. However, further clinical trials are needed to examine its effect on GGT. Quality of the evidence across the studies was low for AST and ALT and very low for GGT. Therefore, more studies with high quality are needed to assess this intervention on hepatic health.
Topics: Humans; Adult; Curcumin; Curcuma; Randomized Controlled Trials as Topic; Liver; gamma-Glutamyltransferase; Dietary Supplements
PubMed: 37178581
DOI: 10.1016/j.ctim.2023.102952 -
Neurosurgical Review Dec 2023Intradural spinal tumors present significant challenges due to involvement of critical motor and sensory tracts. Achieving maximal resection while preserving functional... (Meta-Analysis)
Meta-Analysis Review
Intradural spinal tumors present significant challenges due to involvement of critical motor and sensory tracts. Achieving maximal resection while preserving functional tissue is therefore crucial. Fluorescence-guided surgery aims to improve resection accuracy and is well studied for brain tumors, but its efficacy has not been fully assessed for spinal tumors. This meta-analysis aims to delineate the efficacy of fluorescence guidance in intradural spinal tumor resection. The authors performed a systematic review in four databases. We included studies that have utilized fluorescence agents, 5-aminolevulinic acid (5-ALA) or sodium fluorescein, for the resection of intradural spinal tumors. A meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 12 studies involving 552 patients undergoing fluorescence-guided intradural spinal tumor resection were included. Meningiomas demonstrated a 98% fluorescence rate and were associated with a homogenous florescence pattern; however, astrocytomas had variable fluorescence rate with pooled proportion of 70%. There was no significant difference in gross total resection (GTR) rates between fluorescein and 5-ALA (94% vs 84%, p = .22). Pre-operative contrast enhancement was significantly associated with intraoperative fluorescence with fluorescein. Intramedullary tumors with positive intraoperative fluorescence were significantly associated with higher GTR rates (96% vs 73%, p = .03). Utilizing fluorescence guidance during intradural spinal tumor resection holds promise of improving intraoperative visualization for specific intradural spinal tumors. Meningiomas and ependymomas have the highest fluorescence rates especially with sodium fluorescein; on the other hand, astrocytomas have variable fluorescence rates with no superiority of either agent. Positive fluorescence of intramedullary tumors is associated with a higher degree of resection.
Topics: Humans; Spinal Neoplasms; Fluorescein; Fluorescence; Meningioma; Spinal Cord Neoplasms; Astrocytoma; Aminolevulinic Acid; Meningeal Neoplasms
PubMed: 38085385
DOI: 10.1007/s10143-023-02230-x