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The Journal of Dermatological Treatment Dec 2023Isotretinoin is frequently used for treatment of severe nodulocystic and papulopustular acne, however use is limited by mucocutaneous, ocular, and systemic side... (Meta-Analysis)
Meta-Analysis
Isotretinoin is frequently used for treatment of severe nodulocystic and papulopustular acne, however use is limited by mucocutaneous, ocular, and systemic side effects. (1) provide a systematic meta-analysis of ocular side effects during isotretinoin use and their corresponding incidences; (2) provide a narrative summary of ocular side effects during isotretinoin use reported in case reports. A systematic database search using predefined search terms was performed in PubMed, EMBASE, and Scopus from inception to 5 March, 2021. Predetermined inclusion and exclusion criteria were used to select included studies. In total, 53 original studies qualified for meta-analysis, and 41 case reports/series qualified for narrative results. The studies included in the meta-analysis reported incidences of various ocular side effects including dry eye, eye sensitivity, vision changes, and ocular inflammatory conditions. Incidences across studies did vary, leading to considerable heterogeneity. The narrative results summarize more uncommon, but equally important, ocular side effects. Dry eye is the most commonly reported ocular side effect. Other less common, but more serious, ocular side effects including vision changes can occur. We recommend that isotretinoin prescribers monitor for dry eye. Limitations include the heterogeneity of reported incidences of ocular side effects between studies.
Topics: Humans; Acne Vulgaris; Dermatologic Agents; Drug-Related Side Effects and Adverse Reactions; Dry Eye Syndromes; Eye; Face; Isotretinoin
PubMed: 37248700
DOI: 10.1080/09546634.2023.2213364 -
Neuroepidemiology 2014Vitamin A and carotenoids are involved in signalling pathways regulating gene expression in many organs, including the brain. The dopaminergic system is a target of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Vitamin A and carotenoids are involved in signalling pathways regulating gene expression in many organs, including the brain. The dopaminergic system is a target of retinoic acid action in the central nervous system. The aim of this review is to assess the epidemiological evidence on the association between blood levels or dietary intakes of vitamin A and carotenoids and risk of Parkinson's disease (PD).
METHODS
PubMed and ISI Web of Science were searched for relevant papers from 1990 to April 2013. Data reported in epidemiological studies assessing the association between vitamin A and/or carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene, zeaxanthin and canthaxanthin) and PD were extracted for a narrative synthesis and meta-analysis.
RESULTS
Thirteen papers were included out of a total of 362 potentially relevant; of these, eight contributed to the meta-analysis. No statistically significant pooled estimate between micronutrient and PD was detected. Forest plots suggest possible non-significant inverse pooled estimates of α-carotene and β-carotene and risk of PD. A significant association between lutein intake and PD risk was detected in case-control studies only.
CONCLUSIONS
Data published to date are insufficient for drawing definite conclusions about the epidemiological evidence on the association between blood levels or dietary intakes of vitamin A and carotenoids and the risk of PD. Results should be interpreted particularly cautiously given the limitation of the present meta-analysis and the potential publication bias. Authors are urged to follow more closely the recommendations for reporting epidemiological studies in order to enhance the capacity for synthesising the evidence.
Topics: Animals; Carotenoids; Case-Control Studies; Humans; Parkinson Disease; Risk Factors; Vitamin A; beta Carotene
PubMed: 24356061
DOI: 10.1159/000355849 -
Advances in Nutrition (Bethesda, Md.) Oct 2022The global population is living longer; however, not everyone ages at the same rate with regard to their physical and cognitive abilities and their vulnerability to...
Contribution of Biological Age-Predictive Biomarkers to Nutrition Research: A Systematic Review of the Current Evidence and Implications for Future Research and Clinical Practice.
The global population is living longer; however, not everyone ages at the same rate with regard to their physical and cognitive abilities and their vulnerability to certain diseases and death. This review aimed to synthesize the contribution of biological age-predictive biomarkers to nutrition research and highlight the implications for future research and clinical practice. MEDLINE, CINAHL, and Cochrane CENTRAL were systematically searched on 30 September 2021 for randomized controlled trials and cross-sectional studies examining the association between nutrition and biological age in older adults reporting on genetic, clinical, or molecular biomarkers of biological aging. Cochrane's ROB 2 and ROBINS-I were used to assess the quality of included studies. Synthesis was undertaken narratively. Of 1245 records identified from the search, 13 studies from 8 countries and territories, involving 5043 participants, were included. Seven studies assessed associations between nutrient food intake and telomere attrition, reporting protective effects for branched-chain amino acids, calcium and vitamin D, and a diet of a lower inflammatory index; whereas they found shorter telomeres in people consuming more processed foods and arachidonic acid and other proinflammatory compounds. Five studies examined the associations between plasma nutrition biomarkers and cognitive function, and found a protective effect for HDL cholesterol, lycopene, carotenoids, ω-3 and ω-6 fatty acids, and vitamins B, C, D, and E; whereas trans fatty acids and fibrinogen correlated with a decline in cognitive function. One study used Horvath's clock and reported the epigenetic rejuvenation effect of a Mediterranean diet. In conclusion, biological aging was negatively associated with an anti-inflammatory diet. However, a few studies did not control for the confounding effect of other lifestyle factors. Future research should address this and also assess the synergistic effect of different nutrients, their combinations, and evaluate their dose-response relations. Nutrition practice can incorporate updated screening procedures for older people that include relevant biological aging nutrition markers, leading to anti-aging precision nutrition therapy. The methodology of this systematic review was registered in PROSPERO (CRD42021288122).
Topics: Aged; Aging; Amino Acids, Branched-Chain; Arachidonic Acids; Biomarkers; Calcium; Carotenoids; Cholesterol, HDL; Cross-Sectional Studies; Diet, Mediterranean; Fatty Acids, Omega-6; Fibrinogen; Humans; Lycopene; Trans Fatty Acids; Vitamin B Complex; Vitamin D
PubMed: 35612976
DOI: 10.1093/advances/nmac060 -
Asian Pacific Journal of Cancer... Feb 2023Tacrolimus is a powerful macrolide calcineurin inhibitor that has low adverse effects which lead to a rapid response in the control of signs and symptoms in comparison... (Meta-Analysis)
Meta-Analysis
Efficacy and Safety of Topical Tacrolimus in Comparison with Topical Corticosteroids, Calcineurin Inhibitors, Retinoids and Placebo in Oral Lichen Planus: An Updated Systematic Review and Meta-Analysis.
BACKGROUND
Tacrolimus is a powerful macrolide calcineurin inhibitor that has low adverse effects which lead to a rapid response in the control of signs and symptoms in comparison to that of corticosteroids in Oral Lichen Planus(OLP). There have been increasing number of studies establishing the use of topical tacrolimus in oral lichen planus. Still, there is a need to find evidence of the successful use of tacrolimus in comparison to other drugs used in the treatment of OLP, by means of a systematic review and meta-analysis, so that an informed and accurate approach can be utilized.
METHODS
A comprehensive literature review was performed, including PubMed, the Cochrane Library, published up to and including December 2021. There were no restrictions on date of publication. Articles available in English language were included. Using the Cochrane Collaboration tool, we assessed the risk of bias for randomized controlled trials. A meta-analysis was performed on the relevant studies.
RESULTS
A total of 11 RCTs evaluating the effects of tacrolimus were included in this study after application of inclusion and exclusion criteria. Seven studies revealed a low bias risk, three presented a moderate risk and one had a high risk of bias. The results revealed no significant difference in clinical resolution and adverse effects between tacrolimus and corticosteroids. The pooled data from our meta-analysis shows that there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other topical corticosteroids.
CONCLUSION
According to the current systematic study and meta-analysis, there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other drugs. Uniform trials are required with larger sample sizes and standardized methodology are required for a better analysis.
Topics: Humans; Calcineurin Inhibitors; Tacrolimus; Retinoids; Lichen Planus, Oral; Macrolides; Drug-Related Side Effects and Adverse Reactions
PubMed: 36853285
DOI: 10.31557/APJCP.2023.24.2.389 -
Advances in Nutrition (Bethesda, Md.) Jan 2024Carotenoids appear to have anticancer effects. Prospective evidence for the relation between serum carotenoids and breast cancer is controversial. The present systematic... (Meta-Analysis)
Meta-Analysis Review
Carotenoids appear to have anticancer effects. Prospective evidence for the relation between serum carotenoids and breast cancer is controversial. The present systematic review and meta-analysis aimed to investigate the link between circulating carotenoids and the risk of breast cancer. We performed a systematic search of PubMed, Scopus, and Web of Science up to 30 November, 2022. Prospective studies on adults aged ≥18 y that have reported risk estimates for the association between circulating carotenoids and breast cancer risk were considered. Study quality was assessed using the Newcastle-Ottawa Scale. A random-effects model was used for combining studies' risk estimates. Dose-response relations were explored through a 1-stage random-effects model. Fifteen publications (17 nested case-control studies and 1 cohort study) with 20,188 participants and 7608 cases were included. We observed an inverse association between the highest level of circulating total carotenoids (relative risk [RR]: 0.76; 95% confidence interval [CI]: 0.62, 0.93; n = 8), α-carotene (RR: 0.77; 95% CI: 0.68, 0.87; n = 13), β-carotene (RR: 0.80; 95% CI: 0.65, 0.98; n = 15), β-cryptoxanthin (RR: 0.85; 95% CI: 0.74, 0.96; n = 11), lycopene (RR: 0.86; 95% CI: 0.76, 0.98; n = 13), and lutein (RR: 0.70; 95% CI: 0.52, 0.93; n = 6) and the risk of breast cancer compared with the lowest level. Additionally, each 10 μg/dL of total carotenoids, α-carotene, β-carotene, and β-cryptoxanthin was associated with 2%, 22%, 4%, and 10% lower risk of breast cancer, respectively. This relationship was stronger at lower levels of total carotenoids and β-cryptoxanthin. The certainty of evidence was rated from very low to low. Most studies were performed among Western nations, which should be acknowledged for extrapolation of findings. Total circulating carotenoids, α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein seem to be related to a decreased risk of breast cancer. Our findings could have practical importance for public health. This study was registered at PROSPERO as CRD42023434983.
Topics: Adult; Female; Humans; beta Carotene; Beta-Cryptoxanthin; Breast Neoplasms; Carotenoids; Lutein; Lycopene
PubMed: 38436219
DOI: 10.1016/j.advnut.2023.10.007 -
Nutrition Reviews Aug 2022Dietary carotenoid intake is associated with vitamin A status and healthy visual and cognitive function in early life. To date, however, only limited population-level...
CONTEXT
Dietary carotenoid intake is associated with vitamin A status and healthy visual and cognitive function in early life. To date, however, only limited population-level data on the concentrations of carotenoids in human milk or infant blood have been available to assess the dietary exposure of infants to carotenoids.
OBJECTIVE
This systematic review seeks to define worldwide carotenoid concentrations in human milk and infant blood.
DATA SOURCES
The PubMed, Embase, and Web of Science databases were searched for original research articles published before February 2021.
DATA EXTRACTION
Dietary carotenoid concentrations in human milk and in blood plasma or serum from healthy infants (≤1 year of age), along with study location, infant age, and lactation stage, were extracted. Means and 95%CIs were analyzed within and across variables.
DATA ANALYSIS
Publications on carotenoid concentrations in infant blood (47 publications, n = 4553 unique individuals) and human milk (65 publications, n = 2871 unique individuals) described populations from 22 and 31 countries, respectively. Carotenoid species concentrations ranged from 0.3 to 20 µg/dL in blood and from 0.1 to 30 µg/dL in human milk, with carotenoid concentrations generally decreasing in milk across lactation stages and increasing in blood with infant age.
CONCLUSION
Concentrations of the major dietary carotenoids-β-carotene, lycopene, lutein, β-cryptoxanthin, zeaxanthin, and α-carotene-have been reported in both infant blood and human milk across infant ages and lactation stages, with β-carotene, lutein, and lycopene tending to be more abundant than other carotenoids. Despite heterogeneous amounts of data available for each outcome, infants worldwide are exposed to a variety of dietary carotenoids. The estimates of dietary carotenoids in human milk and infant blood can facilitate the interpretation of future studies and the design of nutritionally relevant experiments on dietary carotenoids and infant health.
Topics: Carotenoids; Female; Humans; Infant; Lutein; Lycopene; Milk, Human; Zeaxanthins; beta Carotene
PubMed: 35389473
DOI: 10.1093/nutrit/nuac018 -
Nutrients Apr 2024This review aims to evaluate the efficacy of any vitamin administration(s) in preventing and managing COVID-19 and/or long-COVID. Databases were searched up to May 2023... (Meta-Analysis)
Meta-Analysis Review
The Efficacy of Multivitamin, Vitamin A, Vitamin B, Vitamin C, and Vitamin D Supplements in the Prevention and Management of COVID-19 and Long-COVID: An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials.
This review aims to evaluate the efficacy of any vitamin administration(s) in preventing and managing COVID-19 and/or long-COVID. Databases were searched up to May 2023 to identify randomized clinical trials comparing data on the effects of vitamin supplementation(s) versus placebo or standard of care on the two conditions of interest. Inverse-variance random-effects meta-analyses were conducted to estimate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for all-cause mortality between supplemented and non-supplemented individuals. Overall, 37 articles were included: two regarded COVID-19 and long-COVID prevention and 35 records the COVID-19 management. The effects of vitamin D in preventing COVID-19 and long-COVID were contrasting. Similarly, no conclusion could be drawn on the efficacy of multivitamins, vitamin A, and vitamin B in COVID-19 management. A few positive findings were reported in some vitamin C trials but results were inconsistent in most outcomes, excluding all-cause mortality (RR = 0.84; 95% CI: 0.72-0.97). Vitamin D results were mixed in most aspects, including mortality, in which benefits were observed in regular administrations only (RR = 0.67; 95% CI: 0.49-0.91). Despite some benefits, results were mostly contradictory. Variety in recruitment and treatment protocols might explain this heterogeneity. Better-designed studies are needed to clarify these vitamins' potential effects against SARS-CoV-2.
Topics: Humans; Dietary Supplements; COVID-19; Vitamins; Vitamin D; Randomized Controlled Trials as Topic; Ascorbic Acid; SARS-CoV-2; Vitamin A; COVID-19 Drug Treatment; Vitamin B Complex
PubMed: 38732592
DOI: 10.3390/nu16091345 -
Clinical Orthopaedics and Related... Aug 2011Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis... (Review)
Review
BACKGROUND
Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective.
QUESTIONS/PURPOSES
Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty.
METHODS
PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.
RESULTS
Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean two-dimensional linear penetration rate of 0.042 mm/year based on 28 studies (n=1503 hips) and 0.137 mm/year based on 18 studies (n=695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes.
CONCLUSIONS
HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter (>32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Cross-Linking Reagents; Femur Head; Hip Prosthesis; Humans; Knee Prosthesis; Materials Testing; Osteolysis; Polyethylenes; Prosthesis Design; Prosthesis Failure
PubMed: 21431461
DOI: 10.1007/s11999-011-1872-4 -
Nutrients Oct 2022: Age-related macular degeneration (AMD) is a neurodegenerative ophthalmic disease. The purpose of this systematic review (SR) and meta-analysis was to evaluate if... (Meta-Analysis)
Meta-Analysis Review
: Age-related macular degeneration (AMD) is a neurodegenerative ophthalmic disease. The purpose of this systematic review (SR) and meta-analysis was to evaluate if dietary supplementation alone or in combinations might delay the progression of any of the stages of AMD. A SR and meta-analysis identifying cohort studies and randomized controlled trials (RCTs) evaluating the effect of supplements in patients diagnosed with AMD. PubMed, Scopus, Web of Science, CINAHL, and Cochrane were searched through 8th October 2021. Twenty studies, examining 5634 participants ranging from 55 to 80 years, were included in the SR. Eight studies were selected for meta-analysis (414 and 216 subjects in the intervention and control groups). Lutein and zeaxanthin plus -3 long-chain polyunsaturated fatty acids (-3 LC-PUFA) supplementation showed significant improvements in best-corrected visual acuity (BCVA) (SMD: -1.99, 95% CI: -3.33, -0.65) compared to the control group. Multifocal electroretinogram results (mfERG) were significantly improved overall (SMD: 4.59, 95% CI: 1.75, 7.43) after lutein plus zeaxanthin supplementation. Combinations of lutein and zeaxanthin with -3 LC-PUFA might be beneficial in preventing AMD progression and deterioration of visual function. Our results encourage initiating further studies with combinations of -3 LC-PUFA, lutein, and zeaxanthin especially in early AMD patients.
Topics: Humans; Zeaxanthins; Lutein; Xanthophylls; Visual Acuity; Double-Blind Method; Macular Degeneration; Dietary Supplements; Fatty Acids, Omega-3
PubMed: 36296956
DOI: 10.3390/nu14204273 -
Advances in Nutrition (Bethesda, Md.) Jun 2021Vitamin A (VA) is an essential nutrient often lacking in the diets of people in developing countries. Accurate biomarkers of VA status are vital to inform public health... (Meta-Analysis)
Meta-Analysis
Vitamin A (VA) is an essential nutrient often lacking in the diets of people in developing countries. Accurate biomarkers of VA status are vital to inform public health policy and monitor interventions. The relative dose-response (RDR) and modified-RDR (MRDR) tests are semi-quantitative screening tests for VA deficiency that have been used in Demographic and Health Surveys and VA intervention studies. A systematic review and meta-analysis of sensitivity and specificity were conducted to summarize the physiological evidence to support the RDR tests as methods to assess VA status and investigate the impact of different pathological and physiological states on the tests. A total of 190 studies were screened for inclusion, with 21 studies comparing the RDR tests with the gold-standard biomarker, liver VA concentration (68% and 80% sensitivity and 85% and 69% specificity for the RDR and MRDR, respectively). Nearly all studies with VA interventions in VA-deficient populations demonstrated a response of the tests to VA intake that would be expected to improve VA status. The impacts of chronic liver disease, protein malnutrition, age, pregnancy and lactation, infection and inflammation, and various other conditions were examined in 51 studies. The RDR and MRDR tests were reported to have been used in 39 observational studies, and the MRDR has been used in at least 6 national micronutrient surveys. The RDR and MRDR are sensitive tests for determining population VA status and assessing VA interventions. Although they are robust to most physiological and pathological states, caution may be warranted when using the tests in neonates, individuals with chronic liver disease, and those with protein or iron malnutrition. Research on further improvements to the tests to increase accessibility, such as sampling breast milk instead of blood or using intramuscular doses in subjects with malabsorption, will allow wider adoption. This review was registered with PROSPERO as CRD42019124180.
Topics: Breast Feeding; Dose-Response Relationship, Drug; Female; Humans; Infant, Newborn; Lactation; Milk, Human; Nutritional Status; Vitamin A; Vitamin A Deficiency
PubMed: 33130884
DOI: 10.1093/advances/nmaa136