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Primary Care Diabetes Feb 2019Several studies have been published about the effect of garlic on lipid profile and blood glucose in diabetic patients. Which, the results mostly contradict with each... (Meta-Analysis)
Meta-Analysis
PURPOSE
Several studies have been published about the effect of garlic on lipid profile and blood glucose in diabetic patients. Which, the results mostly contradict with each other. This study aimed to investigate the effect of garlic on lipid profile and serum glucose levels in diabetic patients using a systematic review and meta-analysis.
METHODS
This study was a systematic review and meta-analysis of articles published between 1988 and 2016. For this purpose, two independent researchers searched SID medical information databases including MagIran, Irandoc, Medlib, Iran Medex, Science Direct, Scopus, Google and PubMed using keywords. Data were analyzed using STATA software.
RESULTS
After the initial search, 23,000 articles were found, of which 33 had the required criteria for the meta-analysis. In the present study, the total sample under review was 1273 individuals, with a mean of 39 samples per study. Overall, the garlic was more influential than placebo in reducing the levels of lipid parameters including triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), and fasting blood sugar (FBS) and HbA. In the meta-analysis, the concentration of serum TC, LDL, TG, and HDL in the group receiving garlic compared with the placebo showed a significant decreased for 16.87mg/dl (95% CI, -21.01, -12.73) (P=0.001), 9.65mg/dl (95% CI, -15.07, -4.23) (P=0.001), 12.44mg/dl (95% CI, -18.19, -6.69) (P=0.001), and increased for 3.19mg/dl (95% CI, 1.85, 4.53) (P=0.001), respectively. Also, the concentration of serum FBS and HbA serum showed a significant decreased for 10.90mg/dl (95% CI, -16.40, -5.40) (P=0.001) and 0.60mg/dl (95% CI, -0.98, -0.22) (P=0.001), respectively.
CONCLUSION
Garlic can reduce lipid profile as well as glucose parameters and be therapeutically effective in patients suffering from cardiovascular diseases and diabetes.
Topics: Adolescent; Adult; Aged; Biomarkers; Blood Glucose; Child; Diabetes Mellitus; Female; Garlic; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Hypolipidemic Agents; Lipids; Male; Middle Aged; Plant Extracts; Plant Roots; Treatment Outcome; Young Adult
PubMed: 30049636
DOI: 10.1016/j.pcd.2018.07.007 -
Journal of Chromatography. B,... Jul 2017Aloe arborescens Miller (Family Asphodelaceae) is a member of genus Aloe, which is used in traditional medicine to cure various diseases. The extracts of the plant have... (Review)
Review
Aloe arborescens Miller (Family Asphodelaceae) is a member of genus Aloe, which is used in traditional medicine to cure various diseases. The extracts of the plant have been reported to possess anticancer, immunomodulator, antidiabetic, anti-inflammatory and antioxidant activities. The phytochemical investigations have revealed diverse chemical constituents, including phenolics [anthraquinones, anthrones, pyrones, chromones and coumarins], polysaccharides [arborans [(1-4) linked glucomannans, polysaccharide (A, B and C): (A: a linear (1-6)-O-α-glucan, B: a branching (1-2)-O-l-arabinose with (1-2)-O-d-galactose linkages and C: (1-4)-O-β-mannan with 18% acetyl group)]], glycoproteins and carboxypeptidase enzyme. There are many reports, describing the different methodologies developed to perform chemical analysis as well as, separation, detection and identification of these constituents. Different chromatographic techniques were applied such as gas chromatography (GC), high-performance liquid chromatography (HPLC), liquid chromatography-electrospray ionization coupled with mass spectroscopy (LC-ESI/MS/MS) and gel filtration chromatography. Also the isolated compounds were identified based on the spectroscopic analysis; ultraviolet-visible spectroscopy (UV-vis), infra-red spectroscopy (IR), mass spectroscopy (MS) and nuclear-magnetic resonance (NMR). This study aims to pinpoint the active components besides finding out new structural leads for future drugs. Therefore, the review is targeted to provide evidence reported in the relevant literature on qualitative and quantitative research to assist scientists in isolation and characterization of bioactive compounds in A. arborescens.
Topics: Aloe; Chromatography, Gas; Chromatography, High Pressure Liquid; Glycoproteins; Phenols; Plant Extracts; Spectrometry, Mass, Electrospray Ionization; Tandem Mass Spectrometry
PubMed: 28535423
DOI: 10.1016/j.jchromb.2017.04.044 -
Infection, Genetics and Evolution :... Dec 2019Apoptosis is a universal cellular defense mechanism against senescent, damaged, genetically mutated, or virally-infected cells. It also is critical for the maintenance... (Meta-Analysis)
Meta-Analysis
Apoptosis is a universal cellular defense mechanism against senescent, damaged, genetically mutated, or virally-infected cells. It also is critical for the maintenance of liver health. Fas and FasL system act as a major death pathway that triggers apoptosis cascade in the liver. In this systematic review and meta-analysis, we aimed to investigate the relationship between four major polymorphisms of Fas and FasL genes with susceptibility to or clearance of HBV infection. All the eligible studies were extracted from PubMed and Scopus with no date and language restriction. ORs with 95% CIs were used to evaluate the strength of the association based on the following genetic models: (1) the allelic, (2) the homozygote, (3) the dominant, and (4) the recessive models. Totally 7 related articles were included in this meta-analysis; 5 studies of 7 related articles investigated FasL -844C/T (rs763110) polymorphism, 4 studies investigated FasL IVS2nt-124, 6 studies investigated Fas -670 A/G (rs1800682), and 4 studies investigated Fas -1377 A/G (rs2234767) polymorphism. This meta-analysis showed that there is no statistically significant association between the risk or clearance of HBV infection and four studied Fas and FasL polymorphisms in their allelic comparison or genetic models. Fas -670, Fas -1377, FasL -124, and FasL -844 polymorphisms did not show any significant association with the clearance or risk of HBV infection. Therefore, it seems that susceptibility to HBV infection or clearance of it is not affected by Fas and FasL genetic polymorphisms. But, to reach a definitive conclusion, further studies with a larger sample size of different ethnicity are still needed.
Topics: Fas Ligand Protein; Genetic Predisposition to Disease; Hepatitis B; Hepatitis B virus; Homozygote; Humans; Odds Ratio; Polymorphism, Single Nucleotide; Promoter Regions, Genetic; fas Receptor
PubMed: 31425784
DOI: 10.1016/j.meegid.2019.104003 -
Malaria Journal Apr 2017Parasite resistance to anti-malarials represents a great obstacle for malaria elimination. The majority of studies have investigated the association between... (Review)
Review
Assessment of copy number variation in genes related to drug resistance in Plasmodium vivax and Plasmodium falciparum isolates from the Brazilian Amazon and a systematic review of the literature.
BACKGROUND
Parasite resistance to anti-malarials represents a great obstacle for malaria elimination. The majority of studies have investigated the association between single-nucleotide polymorphisms (SNPs) and drug resistance; however, it is becoming clear that the copy number variation (CNV) is also associated with this parasite phenotype. To provide a baseline for molecular surveillance of anti-malarial drug resistance in the Brazilian Amazon, the present study characterized the genetic profile of both markers in the most common genes associated with drug resistance in Plasmodium falciparum and Plasmodium vivax isolates. Additionally, these data were compared to data published elsewhere applying a systematic review of the literature published over a 20-year time period.
METHODS
The genomic DNA of 67 patients infected by P. falciparum and P. vivax from three Brazilian States was obtained between 2002 and 2012. CNV in P. falciparum multidrug resistance gene-1 (pfmdr1), GTP cyclohydrolase 1 (pfgch1) and P. vivax multidrug resistance gene-1 (pvmdr1) were assessed by real-time PCR assays. SNPs in the pfmdr1 and pfcrt genes were assessed by PCR-RFLP. A literature search for studies that analysed CNP in the same genes of P. falciparum and P. vivax was conducted between May 2014 and March 2017 across four databases.
RESULTS
All analysed samples of P. falciparum carried only one copy of pfmdr1 or pfgch1. Although the pfcrt K76T polymorphism, a determinant of CQ resistance, was present in all samples genotyped, the pfmdr1 N86Y was absent. For P. vivax isolates, an amplification rate of 20% was found for the pvmdr1 gene. The results of the study are in agreement with the low amplification rates for pfmdr1 gene evidenced in the Americas and Africa, while higher rates have been described in Southeast Asia. For P. vivax, very low rates of amplification for pvmdr1 have been described worldwide, with exceptions in French Guiana, Cambodia, Thailand and Brazil.
CONCLUSIONS
The present study was the first to evaluate gch1 CNV in P. falciparum isolates from Brazil, showing an absence of amplification of this gene more than 20 years after the withdrawal of the Brazilian antifolates therapeutic scheme. Furthermore, the rate of pvmdr1 amplification was significantly higher than that previously reported for isolates circulating in Northern Brazil.
Topics: Adult; Brazil; Drug Resistance; Female; Gene Dosage; Gene Frequency; Humans; Male; Middle Aged; Plasmodium falciparum; Plasmodium vivax; Polymorphism, Restriction Fragment Length; Polymorphism, Single Nucleotide; Protozoan Proteins; Real-Time Polymerase Chain Reaction
PubMed: 28420389
DOI: 10.1186/s12936-017-1806-z -
Antimicrobial Agents and Chemotherapy Jan 2015Recently, there has been a renewed interest in the development of new drugs for the treatment of leishmaniasis. This has spurred the need for pharmacodynamic markers to... (Review)
Review
Recently, there has been a renewed interest in the development of new drugs for the treatment of leishmaniasis. This has spurred the need for pharmacodynamic markers to monitor and compare therapies specifically for visceral leishmaniasis, in which the primary recrudescence of parasites is a particularly long-term event that remains difficult to predict. We performed a systematic review of studies evaluating biomarkers in human patients with visceral, cutaneous, and post-kala-azar dermal leishmaniasis, which yielded a total of 170 studies in which 53 potential pharmacodynamic biomarkers were identified. In conclusion, the large majority of these biomarkers constituted universal indirect markers of activation and subsequent waning of cellular immunity and therefore lacked specificity. Macrophage-related markers demonstrate favorable sensitivity and times to normalcy, but more evidence is required to establish a link between these markers and clinical outcome. Most promising are the markers directly related to the parasite burden, but future effort should be focused on optimization of molecular or antigenic targets to increase the sensitivity of these markers. In general, future research should focus on the longitudinal evaluation of the pharmacodynamic biomarkers during treatment, with an emphasis on the correlation of studied biomarkers and clinical parameters.
Topics: Acute-Phase Proteins; Adenosine Deaminase; Antibodies, Protozoan; Antigens, Protozoan; Biomarkers; Cytokines; Humans; Immunity, Cellular; Leishmania donovani; Leishmaniasis, Cutaneous; Leishmaniasis, Visceral; Macrophages; Membrane Proteins; Treatment Outcome
PubMed: 25367913
DOI: 10.1128/AAC.04298-14 -
Journal of Medical Microbiology Apr 2018Approximately one-third of the world's population has Toxoplasma gondii infection, and one of the main routes of transmission is organ transplantation. The aim of this... (Review)
Review
PURPOSE
Approximately one-third of the world's population has Toxoplasma gondii infection, and one of the main routes of transmission is organ transplantation. The aim of this study was to evaluate the impact of Toxoplasma infection on liver transplantation patients.
METHODOLOGY
We searched PubMed, Lilacs, Medline, Science direct, Scielo, Ebsco, Springer, Wiley, Ovid and Google Scholar for reports published up to June 2017, and a systematic review was performed.
RESULTS
Twenty cases were analysed before and after liver transplantation. Primary and reactivated infections were investigated. Before transplantation, positive IgG antibodies were the predominant serological markers in donors and recipients: 40 % (D+/R-), 20 % (D+/R+) and 20 % (D-/R+). IgM was present in only 5 % of the donors (D+/R-). In four cases, the serological markers were not specified or were negative (D?/R? or D?/R-). After transplantation, IgM anti-Toxoplasma antibodies were found in 30 % of the recipients, and in 67 % of the seronegative recipients the presence of Toxoplasma DNA or tachyzoites was reported, suggesting a primary infection. Clinical symptoms were meningitis, massive cerebral oedema, encephalitis and seizures. Treatment was administered in 70 % of the patients, and 40 % died after presenting symptoms associated with Toxoplasma infection.
CONCLUSIONS
Although we review Toxoplasma infection and liver transplantation cases, problems associated with the parasite may be greater than identified. Hence, follow-up studies on Toxoplasma infection in liver transplantation patients are recommended.
Topics: Antibodies, Protozoan; Humans; Liver Transplantation; Postoperative Complications; Toxoplasma; Toxoplasmosis
PubMed: 29458555
DOI: 10.1099/jmm.0.000694 -
Therapeutic Apheresis and Dialysis :... Apr 2022The aim of this study was to delve into whether beta-2 microglobulin could assess all-cause mortality in patients with chronic kidney disease. PubMed and Embase were... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to delve into whether beta-2 microglobulin could assess all-cause mortality in patients with chronic kidney disease. PubMed and Embase were systematically searched. Hazard risk and 95% CI were pooled using random-effect models. A total of eight studies were involved according to the inclusion and exclusion criterions. By meta-analysis, each 1 mg/L increase in beta-2 microglobulin displayed positive relationships to the risk of all-cause mortality (hazard risk 1.03, 95% CI = 1.02-1.03) and cardiovascular events (hazard risk 1.04, 95% CI = 1.00-1.08) in patients with dialysis. However, the relationship between elevated level of serum beta-2 microglobulin as a categorical variable and mortality was not significant. The prognostic value of elevated beta-2 microglobulin might be significant in ESRD patients with dialysis and a proper cutoff value to predict mortality should be determined in the future.
Topics: Cardiovascular Diseases; Cause of Death; Humans; Kidney Failure, Chronic; Prognosis; Renal Dialysis; Renal Insufficiency, Chronic; beta 2-Microglobulin
PubMed: 34459115
DOI: 10.1111/1744-9987.13729 -
Journal of Global Antimicrobial... Jun 2020Carbapenem-resistant Enterobacteriaceae (CRE) are a major public-health threat. The most important mechanism of carbapenem resistance in CRE is carbapenemase production.... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Carbapenem-resistant Enterobacteriaceae (CRE) are a major public-health threat. The most important mechanism of carbapenem resistance in CRE is carbapenemase production. Early identification of carbapenemase-producing Enterobacteriaceae (CPE) leads to improved clinical outcomes. This systematic review aimed to assess the accuracy and applicability of the modified Hodge test (MHT), the carbapenemase Nordmann-Poirel (Carba NP) test, the modified carbapenem inactivation method (mCIM) and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS) for CPE detection.
METHODS
The meta-analysis included pooled sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic (SROC) curve and area under the curve (AUC).
RESULTS
A total of 67 studies were included in the analysis. Pooled effect sizes (95% confidence interval) of the MHT, Carba NP, mCIM and MALDI-TOF/MS, respectively, were as follows: sensitivity, 92% (87-95%), 97% (94-98%), 99% (99-100%) and 99% (96-100%); specificity, 93% (86-97%), 100% (99-100%), 99% (96-100%) and 99% (96-100%); diagnostic odds ratio, 98.156 (48.175-199.995), 1277.710 (751.391-2172.692), 3597.352 (1287.575-10000) and 1781.360 (651.827-4868.228); and AUC, 0.97, 1, 1 and 1.
CONCLUSION
Carba NP, mCIM and MALDI-TOF/MS all demonstrated high accuracy in CPE detection, whereas the MHT is not recommended owing to some clear drawbacks. We recommend the selection of carbapenemase detection tests in the order of mCIM, Carba NP and MALDI-TOF/MS according to their simplicity, cost, and equipment and skills involved.
Topics: Bacterial Proteins; Bacteriological Techniques; Carbapenem-Resistant Enterobacteriaceae; Enterobacteriaceae Infections; Humans; Phenotype; Public Health; Sensitivity and Specificity; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; beta-Lactamases
PubMed: 31639543
DOI: 10.1016/j.jgar.2019.10.010 -
Blood Purification 2012Attempts at achieving cytokine homeostasis include blood purification to deliver cytokine removal. Assessment of ex vivo studies for optimal operating conditions is a... (Review)
Review
BACKGROUND AND AIMS
Attempts at achieving cytokine homeostasis include blood purification to deliver cytokine removal. Assessment of ex vivo studies for optimal operating conditions is a vital step.
METHODS
We conducted a systematic search for ex vivo studies on cytokine removal using known modalities of extracorporeal circulation. We selected 29 articles and analyzed data according to clearance, sieving coefficient, ultrafiltrate concentration and percentage removal.
RESULTS
We identified four main techniques for cytokine removal: standard techniques, high cut-off (HCO) techniques, adsorption techniques and combined plasma filtration adsorption. HCO hemofiltration (HCO/HF) showed greatest consistency in cytokine removal among all approaches. Mean albumin clearance with HCO filters was 3.74 ml/min.
CONCLUSION
Ex vivo data support the view that HCO/HF is the most consistently effective approach in terms of sieving and clearance. Further investigation of HCO/HF in randomized controlled trials in animal models and humans seems desirable.
Topics: Adsorption; Animals; Cytokines; Hemofiltration; Humans; Plasma Exchange; Plasmapheresis; Renal Replacement Therapy
PubMed: 22248671
DOI: 10.1159/000333845 -
Antimicrobial Resistance and Infection... 2018Mupirocin is widely used for nasal decolonization of to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mupirocin is widely used for nasal decolonization of to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and unrestricted use has led to the emergence of mupirocin-resistant (mupR) . The aim of this systematic review was to investigate the prevalence, phenotypic and molecular characteristics, and geographic spread of mupR in Africa.
METHODS
We examined five electronic databases (EBSCOhost, Google Scholar, ISI Web of Science, MEDLINE, and Scopus) for relevant English articles on screening for mupR from various samples in Africa. In addition, we performed random effects meta-analysis of proportions to determine the pooled prevalence of mupR in Africa. The search was conducted until 3 August 2016.
RESULTS
We identified 43 eligible studies of which 11 (26%) were obtained only through Google Scholar. Most of the eligible studies (28/43; 65%) were conducted in Nigeria (10/43; 23%), Egypt (7/43; 16%), South Africa (6/43; 14%) and Tunisia (5/43; 12%). Overall, screening for mupR was described in only 12 of 54 (22%) African countries. The disk diffusion method was the widely used technique (67%; 29/43) for the detection of mupR in Africa. The -positive isolates were identified in five studies conducted in Egypt ( = 2), South Africa ( = 2), and Nigeria ( = 1). Low-level resistance (LmupR) and high-level resistance (HmupR) were both reported in six human studies from South Africa ( = 3), Egypt ( = 2) and Libya ( = 1). Data on mupR-MRSA was available in 11 studies from five countries, including Egypt, Ghana, Libya, Nigeria and South Africa. The pooled prevalence (based on 11 human studies) of mupR in Africa was 14% (95% CI =6.8 to 23.2%). The proportion of -positive in Africa ranged between 0.5 and 8%. Furthermore, the frequency of isolates that exhibited LmupR, HmupR and mupR-MRSA in Africa were 4 and 47%, 0.5 and 38%, 5 and 50%, respectively.
CONCLUSIONS
The prevalence of mupR in Africa (14%) is worrisome and there is a need for data on administration and use of mupirocin. The disk diffusion method which is widely utilized in Africa could be an important method for the screening and identification of mupR . Moreover, we advocate for surveillance studies with appropriate guidelines for screening mupR in Africa.
Topics: Africa; Animals; Anti-Bacterial Agents; Bacterial Proteins; Cattle; Cattle Diseases; Databases, Bibliographic; Drug Resistance, Bacterial; Humans; Mupirocin; Sheep; Sheep Diseases; Staphylococcal Infections; Staphylococcus aureus
PubMed: 30147868
DOI: 10.1186/s13756-018-0382-5