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Frontiers in Pharmacology 2024In recent years, diverse initiatives have been carried out to control the COVID-19 pandemic, ranging from measures restricting social activities to analyzing drugs and...
INTRODUCTION
In recent years, diverse initiatives have been carried out to control the COVID-19 pandemic, ranging from measures restricting social activities to analyzing drugs and vaccines. Studies on herbal medicines are also increasingly conducted in various countries as an adjuvant therapy or supplement. Therefore, this systematic review aimed to investigate the efficacy of herbal medicines analyzed from various countries through clinical trials with the randomized controlled trial method. The outcomes of Length of Stay (LOS), Negative Conversion Time (NCT), and Negative Conversion Rate (NCR) were the main focus.
METHODS
An extensive review of literature spanning from 2019 to 2023 was carried out using well-known databases including PubMed, Scopus, and Cochrane. The search included relevant keywords such as "randomized controlled trial," "COVID-19," and "herbal medicine."
RESULTS
A total of 8 articles were part of the inclusion criteria with outcomes of LOS, NCT, and NCR. In terms of LOS outcomes, all types of herbal medicines showed significant results, such as Persian Medicine Herbal (PM Herbal), Persian Barley Water (PBW), Jingyin Granules (JY granules), Reduning Injection, and (Amla). However, only JY granules showed significant results in NCR outcome, while JY granules and Reduning Injection showed significant results in reducing NCT.
CONCLUSION
These findings enrich our understanding of the potential benefits of herbal medicines in influencing LOS, NCR and NCT parameters in COVID-19 patients. Herbal medicines worked to treat COVID-19 through antiviral, anti-inflammatory, and immunomodulatory mechanisms.
PubMed: 38873430
DOI: 10.3389/fphar.2024.1383359 -
Frontiers in Neurology 2024To systematically review vagus nerve stimulation (VNS) studies to present data on the safety and efficacy on motor recovery following stroke, traumatic brain injury...
OBJECTIVE
To systematically review vagus nerve stimulation (VNS) studies to present data on the safety and efficacy on motor recovery following stroke, traumatic brain injury (TBI), and spinal cord injury (SCI).
METHODS
Data sources: PubMed, EMBASE, SCOPUS, and Cochrane.
STUDY SELECTION
Clinical trials of VNS in animal models and humans with TBI and SCI were included to evaluate the effects of pairing VNS with rehabilitation therapy on motor recovery.
DATA EXTRACTION
Two reviewers independently assessed articles according to the evaluation criteria and extracted relevant data electronically.
DATA SYNTHESIS
Twenty-nine studies were included; 11 were animal models of stroke, TBI, and SCI, and eight involved humans with stroke. While there was heterogeneity in methods of delivering VNS with respect to rehabilitation therapy in animal studies and human non-invasive studies, a similar methodology was used in all human-invasive VNS studies. In animal studies, pairing VNS with rehabilitation therapy consistently improved motor outcomes compared to controls. Except for one study, all human invasive and non-invasive studies with controls demonstrated a trend toward improvement in motor outcomes compared to sham controls post-intervention. However, compared to non-invasive, invasive VNS, studies reported severe adverse events such as vocal cord palsy, dysphagia, surgical site infection, and hoarseness of voice, which were found to be related to surgery.
CONCLUSION
Our review suggests that VNS (non-invasive or invasive) paired with rehabilitation can improve motor outcomes after stroke in humans. Hence, VNS human studies are needed in these populations (referring to SCI and TBI?) or just SCI. There are risks related to device implantation to deliver invasive VNS compared to non-invasive VNS. Future human comparison studies are required to study and quantify the efficacy vs. risks of paired VNS delivered via different methods with rehabilitation, which would allow patients to make an informed decision.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=330653.
PubMed: 38872818
DOI: 10.3389/fneur.2024.1390217 -
BMC Geriatrics Jun 2024Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at... (Meta-Analysis)
Meta-Analysis
Effectiveness of pedometer-based walking programmes in improving some modifiable risk factors of stroke among community-dwelling older adults: a systematic review, theoretical synthesis and meta-analysis.
BACKGROUND
Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at physical activity-related modifiable risk factors. The question arises: What is the effectiveness of pedometer-based walking program interventions in improving modifiable stroke risk factors among community-dwelling older adults?
METHOD
Eight databases were searched up to December 2, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects.
RESULTS
The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes.
CONCLUSION
Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals.
TRIAL REGISTRATION
Registration Number: INPLASY202230118.
Topics: Humans; Aged; Walking; Independent Living; Stroke; Risk Factors; Aged, 80 and over; Actigraphy; Health Promotion; Randomized Controlled Trials as Topic; Middle Aged
PubMed: 38872081
DOI: 10.1186/s12877-024-05069-z -
PloS One 2024There is a consistent association between exposure to air pollution and elevated rates of cardiopulmonary illnesses. As public health activities emphasize the paramount...
BACKGROUND
There is a consistent association between exposure to air pollution and elevated rates of cardiopulmonary illnesses. As public health activities emphasize the paramount need to reduce exposure, it is crucial to examine strategies like the antioxidant diet that could potentially protect individuals who are unavoidably exposed.
METHODS
A systematic search was performed in PubMed/Medline, EMBASE, CENTRAL, and ClinicalTrials.gov up to March 31, 2023, for clinical trials assessing dietary supplements against cardiovascular (blood pressure, heart rate, heart rate variability, brachial artery diameter, flow-mediated dilation, and lipid profile) or pulmonary outcomes (pulmonary function and airway inflammation) attributed to air pollution exposure.
RESULTS
After reviewing 4681 records, 18 studies were included. There were contradictory findings on the effects of fish oil and olive oil supplementations on cardiovascular outcomes. Although with limited evidence, fish oil offered protection against pulmonary dysfunction induced by pollutants. Most studies on vitamin C did not find protective cardiovascular effects; however, the combination of vitamin C and E offered protective effects against pulmonary dysfunction but showed conflicting results for cardiovascular outcomes. Other supplements like sulforaphane, L-arginine, n-acetylcysteine, and B vitamins showed potential beneficial effects but need further research due to the limited number of existing trials.
CONCLUSIONS
Although more research is needed to determine the efficacy and optimal dose of anti-inflammatory and antioxidant dietary supplements against air pollution toxicity, this low-cost preventative strategy has the potential to offer protection against outcomes of air pollution exposure.
Topics: Humans; Dietary Supplements; Air Pollution; Antioxidants; Cardiovascular Diseases; Clinical Trials as Topic; Fish Oils; Ascorbic Acid
PubMed: 38870164
DOI: 10.1371/journal.pone.0304402 -
PloS One 2024Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite numerous primary studies have been conducted to determine the prevalence of uncontrolled hypertension and identify its associated factors among hypertensive patients in Sub-Saharan Africa, these studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of uncontrolled hypertension and identify its associated factors.
METHODS
We have searched PubMed, Google Scholar, and Web of Science databases extensively for all relevant studies. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to compute the overall pooled prevalence of uncontrolled hypertension and the effect size of its associated factors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test.
RESULTS
A total of twenty-six primary studies with a sample size of 11,600 participants were included in the final meta-analysis. The pooled prevalence of uncontrolled hypertension was 50.29% (95% CI: 41.88, 58.69; I2 = 98.98%; P<0.001). Age of the patient [AOR = 1.57: 95% CI: 1.004, 2.44], duration of diagnosis [AOR = 2.57: 95% CI: 1.18, 5.57], non-adherence to physical activity [AOR = 2.13: 95% CI: 1.15, 3.95], khat chewing [AOR = 3.83: 95% CI: 1.59, 9.24] and habitual coffee consumption [AOR = 10.79: 95% CI: 1.84, 63.24] were significantly associated with uncontrolled hypertension among hypertensive patients.
CONCLUSIONS
The pooled prevalence of uncontrolled hypertension was considerably high. Older age, duration of diagnosis, non-adherence to physical activity, khat chewing and habitual coffee consumption were independent predictors of uncontrolled hypertension. Therefore, health professionals and other responsible stakeholders should encourage hypertensive patients to adhere to regular physical activity, and abstain from khat chewing and habitual coffee consumption. Early identification of hypertension and management of comorbidities is crucial, and it should be emphasized to control hypertension easily.
Topics: Hypertension; Humans; Africa South of the Sahara; Prevalence; Risk Factors
PubMed: 38870163
DOI: 10.1371/journal.pone.0301547 -
Frontiers in Cellular and Infection... 2024Gestational diabetes mellitus (GDM) is a form of gestational diabetes mellitus characterized by insulin resistance and abnormal function of pancreatic beta cells. In...
INTRODUCTION
Gestational diabetes mellitus (GDM) is a form of gestational diabetes mellitus characterized by insulin resistance and abnormal function of pancreatic beta cells. In recent years, genomic association studies have revealed risk and susceptibility genes associated with genetic susceptibility to GDM. However, genetic predisposition cannot explain the rising global incidence of GDM, which may be related to the increased influence of environmental factors, especially the gut microbiome. Studies have shown that gut microbiota is closely related to the occurrence and development of GDM. This paper reviews the relationship between gut microbiota and the pathological mechanism of GDM, in order to better understand the role of gut microbiota in GDM, and to provide a theoretical basis for clinical application of gut microbiota in the treatment of related diseases.
METHODS
The current research results on the interaction between GDM and gut microbiota were collected and analyzed through literature review. Keywords such as "GDM", "gut microbiota" and "insulin resistance" were used for literature search, and the methodology, findings and potential impact on the pathophysiology of GDM were systematically evaluated.
RESULTS
It was found that the composition and diversity of gut microbiota were significantly associated with the occurrence and development of GDM. Specifically, the abundance of certain gut bacteria is associated with an increased risk of GDM, while other changes in the microbiome may be associated with improved insulin sensitivity. In addition, alterations in the gut microbiota may affect blood glucose control through a variety of mechanisms, including the production of short-chain fatty acids, activation of inflammatory pathways, and metabolism of the B vitamin group.
DISCUSSION
The results of this paper highlight the importance of gut microbiota in the pathogenesis of GDM. The regulation of the gut microbiota may provide new directions for the treatment of GDM, including improving insulin sensitivity and blood sugar control through the use of probiotics and prebiotics. However, more research is needed to confirm the generality and exact mechanisms of these findings and to explore potential clinical applications of the gut microbiota in the management of gestational diabetes. In addition, future studies should consider the interaction between environmental and genetic factors and how together they affect the risk of GDM.
Topics: Diabetes, Gestational; Gastrointestinal Microbiome; Humans; Pregnancy; Female; Insulin Resistance; Probiotics; Bacteria
PubMed: 38868299
DOI: 10.3389/fcimb.2024.1364545 -
PCN Reports : Psychiatry and Clinical... Jun 2023The current systematic review and meta-analysis aimed to explore the evidence base to date for exercise interventions/interventions that aim to increase physical... (Review)
Review
BACKGROUND
The current systematic review and meta-analysis aimed to explore the evidence base to date for exercise interventions/interventions that aim to increase physical activity using a modality that can be accessed from home (i.e., online or video-based programs), and its effects on anxiety and depression in children and adolescents.
METHODS
A broad search was conducted using six databases (PubMed, Web of Science, CINAHL, PsychINFO, ERIC and Scopus) on February 23, 2022. Studies with children or adolescents between the ages 5 and 18 years were included. Of the 2527 records that were identified, nine studies met the full-inclusion criteria. Their quality was assessed by two independent researchers using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Meta analyses were conducted for studies that specifically assessed anxiety and depression.
RESULTS
The overall results indicated that there is some evidence suggesting the positive effects of exercise interventions delivered online in reducing children's and adolescents' anxiety ( = -0.99, 95% confidence interval [CI]: -1.12 to -0.86). Meanwhile, there seems to be insufficient evidence for its efficacy in reducing low mood ( = -0.42; 95% CI: -0.84 to 0.01). Motivational and coaching based interventions to increase levels of physical activity may be limited in their efficacy, whilst having children exercise along with a video or live sessions online appears promising.
CONCLUSION
The current preliminary review revealed potential benefits of at-home interventions that had children and adolescents exercise along with a video in improving anxiety.
PubMed: 38868129
DOI: 10.1002/pcn5.103 -
IET Nanobiotechnology 2024Foodborne disease outbreaks due to bacterial pathogens and their toxins have become a serious concern for global public health and security. Finding novel antibacterial... (Review)
Review
Foodborne disease outbreaks due to bacterial pathogens and their toxins have become a serious concern for global public health and security. Finding novel antibacterial agents with unique mechanisms of action against the current spoilage and foodborne bacterial pathogens is a central strategy to overcome antibiotic resistance. This study examined the antibacterial activities and mechanisms of action of inorganic nanoparticles (NPs) against foodborne bacterial pathogens. The articles written in English were recovered from registers and databases (PubMed, ScienceDirect, Web of Science, Google Scholar, and Directory of Open Access Journals) and other sources (websites, organizations, and citation searching). "Nanoparticles," "Inorganic Nanoparticles," "Metal Nanoparticles," "Metal-Oxide Nanoparticles," "Antimicrobial Activity," "Antibacterial Activity," "Foodborne Bacterial Pathogens," "Mechanisms of Action," and "Foodborne Diseases" were the search terms used to retrieve the articles. The PRISMA-2020 checklist was applied for the article search strategy, article selection, data extraction, and result reporting for the review process. A total of 27 original research articles were included from a total of 3,575 articles obtained from the different search strategies. All studies demonstrated the antibacterial effectiveness of inorganic NPs and highlighted their different mechanisms of action against foodborne bacterial pathogens. In the present study, small-sized, spherical-shaped, engineered, capped, low-dissolution with water, high-concentration NPs, and in Gram-negative bacterial types had high antibacterial activity as compared to their counterparts. Cell wall interaction and membrane penetration, reactive oxygen species production, DNA damage, and protein synthesis inhibition were some of the generalized mechanisms recognized in the current study. Therefore, this study recommends the proper use of nontoxic inorganic nanoparticle products for food processing industries to ensure the quality and safety of food while minimizing antibiotic resistance among foodborne bacterial pathogens.
Topics: Anti-Bacterial Agents; Foodborne Diseases; Nanoparticles; Food Microbiology; Microbial Sensitivity Tests; Metal Nanoparticles; Bacteria; Humans
PubMed: 38863967
DOI: 10.1049/2024/5417924 -
European Journal of Physical and... Jun 2024Fibromyalgia is characterized by chronic widespread pain accompanied by reduced levels of physical activity and associated comorbidities such as overweight and obesity...
INTRODUCTION
Fibromyalgia is characterized by chronic widespread pain accompanied by reduced levels of physical activity and associated comorbidities such as overweight and obesity which have been associated to sarcopenia development. The aim of this systematic review is to ascertain whether Europeans with fibromyalgia show a reduction in sarcopenia determinants compared to apparently-healthy controls and to determine the risk of sarcopenia and its possible risk factors (PROSPERO: CRD42023439839).
EVIDENCE ACQUISITION
Systematic searches were conducted on six databases (Academic-Search-Ultimate, CENTRAL, PubMed, SciELO, WOS-Core Collection, and ClinicalTrials.gov last-search February-2024) looking for original studies developed in European countries which assessed any of the sarcopenia determinants proposed by the EWGSOP2-guidelines (handgrip strength, five sit-to-stand, appendicular skeletal mass [ASM], skeletal muscle index [SMI]) and included fibromyalgia and healthy-control individuals. Studies mixing fibromyalgia with other diagnoses were excluded. Random-effects meta-analyses and meta-regressions were used to analyze possible differences and associated risk factors. The risk of bias was assessed using the Cochrane-Rob tool and the Quality Assessment Tool for Observational Studies, and the certainty of the evidence using GRADE-approach.
EVIDENCE SYNTHESIS
A total of 25 studies (6393 individuals; 97% women; 20-65 years) were included. Fibromyalgia individuals showed reduced muscle strength ([handgrip] SMD: -1.16 [-1.29, -1.03]; high-certainty; [five sit-to-stand] not-assessed) and muscle quantity ([ASM] mean-difference: -0.83 kg [-1.41, -0.37]; [SMI] mean-difference: -0.26 kg/m [-0.41, -0.10]; both low-certainty) compared to healthy-controls. Fibromyalgia individuals had nine-times greater risk for probable sarcopenia (OR: 9.23 [6.85, 12.45]; high-certainty), but not for confirmed sarcopenia ([ASM] OR: 0.91 [0.49, 1.67]; [SMI] OR: 0.67 [0.19, 2.33]; both low-certainty) according to the EWGSOP2 cut-off points. Reduced muscle strength was strongly associated to fibromyalgia-severity (β=-0.953 [-0.069, -0.038]). Studies were rated as high-risk of bias overall because did not account for some potential confounders (physical activity, sedentary time, Body Mass Index) which could influence the estimated effect.
CONCLUSIONS
Europeans with fibromyalgia have a large reduction in muscle strength and may have a reduction in muscle quantity. The risk of probable sarcopenia according to the EWGSOP2 cut-off points was nine-times higher, but may have no difference in risk of reduced muscle quantity relative to healthy-controls. Muscle strength was strongly associated to disease severity.
PubMed: 38860694
DOI: 10.23736/S1973-9087.24.08348-5 -
BMC Geriatrics Jun 2024Depression is a prevalent issue among older adults, affecting their quality of life and overall well-being. Exercise is an effective means of relieving depressive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Depression is a prevalent issue among older adults, affecting their quality of life and overall well-being. Exercise is an effective means of relieving depressive symptoms in older adults, but the optimal dose for different exercise types remains unclear. As such, the aim of this meta-analysis was to examine the dose-response relationship between overall and specific types of exercise with depression symptoms in older adults.
METHODS
This systematic review and network meta-analysis included a search of PubMed, Medline, Embase, PsycINFO, Cochrane library, and Web of Science for randomized controlled trials of exercise in older adults with depression symptoms from inception to 15 July 2023. Comprehensive data extraction covered dose, treatment regimen, demographics and study duration. Dosage metrics, encompassing METs-min/week, were scrutinized in correlation with the Minimal Clinically Importance Difference (MCID).
RESULTS
A total of 47 studies involving 2895 participants and 7 kinds of exercise were included in the review. Without considering the dose, the results of our network meta-analysis indicated that Walking was the most effective in alleviating depression in older adults, in addition to Aerobic exercise (AE), Yoga, Qigong, Resistance training (RT), and Tai Chi (TC), which were equally effective. However, the results of the dose-response analysis found that Aerobic exercise was most effective at a dose of 1000 METs-min/week. It is noteworthy that Walking is significantly effective in alleviating depressive symptoms in older adults at very low doses. In terms of clinical benefits, we found that overall exercise doses in the range of 600 ~ 970 METs-min/week were clinically effective. Considering the specific types of exercise, Aerobic exercise, Resistance training, Walking, and Yoga were found to be effective at doses ranging from 820 ~ 1000 METs-min/week, 520 ~ 1000 METs-min/week, 650 ~ 1000 METs-min/week, 680 ~ 1000 METs-min/week, respectively. At the same time, we found that when the age exceeded 81 years, even when participating in exercise, it did not achieve the effect of alleviating depressive symptoms in older adults.
CONCLUSIONS
In conclusion, including Walking, AE, Yoga, Qigong, RT, and TC, effectively alleviate depressive symptoms in older adults. Furthermore, we established statistically and clinically significant threshold doses for various exercise types. Early initiation of exercise is beneficial, but its efficacy diminishes from the age of 80, and beyond 81, exercise no longer significantly alleviates depressive symptoms.
Topics: Humans; Aged; Depression; Network Meta-Analysis; Exercise Therapy; Exercise; Randomized Controlled Trials as Topic
PubMed: 38849780
DOI: 10.1186/s12877-024-05118-7