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Pharmacological Research Jan 2024Short-chain fatty acids (SCFAs), the main metabolites of gut microbiota, have been associated with lower blood glucose and lipid levels in diabetic mice. However, a... (Meta-Analysis)
Meta-Analysis
Short-chain fatty acids (SCFAs), the main metabolites of gut microbiota, have been associated with lower blood glucose and lipid levels in diabetic mice. However, a comprehensive summary and comparison of the effects of different SCFA interventions on blood glucose and lipid levels in diabetic mice is currently unavailable. This study aims to compare and rank the effects of different types of SCFAs on blood glucose and lipid levels by collecting relevant animal research. A systematic search through PubMed, Embase, Cochrane Library, and Web of Science database was conducted to identify relevant studies from inception to March 17, 2023. Both pairwise meta-analysis and Bayesian network meta-analysis were used for statistical analyses. In total, 18 relevant studies involving 5 interventions were included after screening 3793 citations and 53 full-text articles. Notably, butyrate therapy (mean difference [MD] = -4.52, 95% confidence interval [-6.29, -2.75]), acetate therapy (MD = -3.12, 95% confidence interval [-5.79, -0.46]), and propionate therapy (MD = -2.96, 95% confidence interval [-5.66, -0.26]) significantly reduced the fasting blood glucose levels compared to the control group; butyrate therapy was probably the most effective intervention, with a surface under the cumulative ranking curve (SUCRA) value of 85.5%. Additionally, acetate plus propionate therapy was probably the most effective intervention for reducing total cholesterol (SUCRA = 85.8%) or triglyceride levels (SUCRA = 88.1%). These findings underscore the potential therapeutic implications of SCFAs for addressing metabolic disorders, particularly in type 2 diabetes mellitus.
Topics: Animals; Mice; Acetates; Bayes Theorem; Blood Glucose; Butyrates; Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 2; Fatty Acids, Volatile; Network Meta-Analysis; Propionates
PubMed: 38128856
DOI: 10.1016/j.phrs.2023.107041 -
Pain May 2024Recent literature suggests that the withdrawal of remifentanil (RF) infusion can be associated with hyperalgesia in clinical and nonclinical settings. We performed a... (Meta-Analysis)
Meta-Analysis
Recent literature suggests that the withdrawal of remifentanil (RF) infusion can be associated with hyperalgesia in clinical and nonclinical settings. We performed a systematic review and a meta-analysis of randomized controlled trials with cross-over design, to assess the effect of discontinuing RF infusion on pain intensity and areas of hyperalgesia and allodynia in healthy volunteers. Nine studies were included. The intervention treatment consisted in RF infusion that was compared with placebo (saline solution). The primary outcome was pain intensity assessment at 30 ± 15 minutes after RF or placebo discontinuation, assessed by any pain scale and using any quantitative sensory testing. Moreover, postwithdrawal pain scores were compared with baseline scores in each treatment. Secondary outcomes included the areas (% of basal values) of hyperalgesia and allodynia. Subjects during RF treatment reported higher pain scores after discontinuation than during treatment with placebo [standardized mean difference (SMD): 0.50, 95% confidence interval (CI): 0.03-0.97; P = 0.04, I 2 = 71%]. A significant decrease in pain scores, compared with baseline values, was found in the placebo treatment (SMD: -0.87, 95% CI: -1.61 to -0.13; P = 0.02, I 2 = 87%), but not in the RF treatment (SMD: -0.28, 95% CI: -1.18 to 0.62; P = 0.54, I 2 = 91%). The area of hyperalgesia was larger after RF withdrawal (SMD: 0.55; 95% CI: 0.27-0.84; P = 0.001; I 2 = 0%). The area of allodynia did not vary between treatments. These findings suggest that the withdrawal of RF induces a mild but nonclinically relevant degree of hyperalgesia in HVs, likely linked to a reduced pain threshold.
Topics: Humans; Remifentanil; Hyperalgesia; Analgesics, Opioid; Piperidines; Randomized Controlled Trials as Topic; Pain
PubMed: 38047761
DOI: 10.1097/j.pain.0000000000003119 -
Journal of Dairy Science Jan 2024To investigate the effects of supplemental monensin administration on the metabolic responses of dairy cows, a systematic review and dose-response meta-analysis were... (Meta-Analysis)
Meta-Analysis
Effects of monensin supplementation on rumen fermentation, methane emissions, nitrogen balance, and metabolic responses of dairy cows: A systematic review and dose-response meta-analysis.
To investigate the effects of supplemental monensin administration on the metabolic responses of dairy cows, a systematic review and dose-response meta-analysis were conducted. Initially, 604 studies were identified through comprehensive database searches, including Google Scholar, Scopus, Science Direct, and PubMed, using key words related to dairy cows, monensin, and metabolic outcomes. After a 2-stage screening process, 51 articles with a total of 60 experiments were selected for meta-analysis based on criteria such as study implementation date between 2001 and 2022, presence of a control group that did not receive monensin supplementation, reporting of at least 1 outcome variable, and presentation of means and corresponding errors. The meta-analysis used the 1-stage random-effects method, and sensitivity analyses were performed to assess the robustness of the results. The results showed that the administration of monensin at a dosage of 19 to 26 mg/kg was inversely related to methane emissions and that the administration of monensin at a dosage of 18 to 50 mg/kg resulted in a significant decrease in dry matter intake. Administration of monensin at doses of 13 to 28 and 15 to 24 mg/kg also resulted in a significant decrease in ruminal acetate proportion and an increase in propionate proportion, respectively, with no effects on ruminal butyrate, NH, or pH levels. We found no effects on blood parameters or nitrogen retention, but a significant negative correlation was observed between monensin supplementation and fecal nitrogen excretion. Based on the analysis of all variables evaluated, the optimal dose range of monensin was estimated to be 19 to 24 mg/kg.
Topics: Female; Cattle; Animals; Monensin; Milk; Fermentation; Methane; Rumen; Nitrogen; Dietary Supplements; Diet; Lactation
PubMed: 37709041
DOI: 10.3168/jds.2023-23441 -
International Wound Journal Jan 2024Caesarean section (C-section) is a prevalent obstetric surgical procedure, with the choice of analgesic agents playing a pivotal role in postoperative recovery. This... (Meta-Analysis)
Meta-Analysis
Caesarean section (C-section) is a prevalent obstetric surgical procedure, with the choice of analgesic agents playing a pivotal role in postoperative recovery. This systematic meta-analysis aimed to compare the effects of sufentanil (ST) and remifentanil (RT) on postoperative wound healing in caesarean section primiparas undergoing epidural anaesthesia. A comprehensive search was conducted across multiple databases, adhering to PRISMA guidelines, yielding eight randomized controlled trials (RCTs) for inclusion. The primary outcome was wound healing assessment using the REEDA (redness, edema, ecchymosis, discharge, approximation) scale on the third, fifth and tenth postoperative days. The meta-analysis encompassed 691 primiparas. A significant difference in wound healing was observed between ST and RT on the third (I = 99%; Random: SMD: 6.75, 95% CIs: 3.11-10.39, p < 0.01) and fifth days (I = 99%; Random: SMD: 3.63, 95% CIs: 1.56-5.70, p < 0.01) postcaesarean section. However, no significant difference was noted on the tenth day (I = 5%; Random: SMD: 0.00, 95% CIs: -0.45-0.45, p = 0.35). Sufentanil and remifentanil exhibit differential effects on early postoperative wound healing in caesarean section primiparas undergoing epidural anaesthesia. While both opioids are effective analgesics, sufentanil demonstrates a more pronounced impact on wound healing during the immediate postoperative days. Clinicians should consider these findings when selecting an opioid for pain management in this patient population.
Topics: Female; Humans; Pregnancy; Analgesics, Opioid; Anesthesia, Epidural; Cesarean Section; Remifentanil; Sufentanil; Wound Healing; Randomized Controlled Trials as Topic
PubMed: 37697689
DOI: 10.1111/iwj.14377 -
Nutrition Reviews Jan 2024There is substantial evidence that reduced short-chain fatty acids (SCFAs) in the gut are associated with obesity and type 2 diabetes, although findings from clinical... (Meta-Analysis)
Meta-Analysis
CONTEXT
There is substantial evidence that reduced short-chain fatty acids (SCFAs) in the gut are associated with obesity and type 2 diabetes, although findings from clinical interventions that can increase SCFAs are inconsistent.
OBJECTIVE
This systematic review and meta-analysis aimed to assess the effect of SCFA interventions on fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR).
DATA SOURCES
Relevant articles published up to July 28, 2022, were extracted from PubMed and Embase using the MeSH (Medical Subject Headings) terms of the defined keywords [(short-chain fatty acids) AND (obesity OR diabetes OR insulin sensitivity)] and their synonyms. Data analyses were performed independently by two researchers who used the Cochrane meta-analysis checklist and the PRISMA guidelines.
DATA EXTRACTION
Clinical studies and trials that measured SCFAs and reported glucose homeostasis parameters were included in the analysis. Standardized mean differences (SMDs) with 95%CIs were calculated using a random-effects model in the data extraction tool Review Manager version 5.4 (RevMan 5.4). The risk-of-bias assessment was performed following the Cochrane checklist for randomized and crossover studies.
DATA ANALYSIS
In total, 6040 nonduplicate studies were identified, 23 of which met the defined criteria, reported fasting insulin, fasting glucose, or HOMA-IR values, and reported change in SCFA concentrations post intervention. Meta-analyses of these studies indicated that fasting insulin concentrations were significantly reduced (overall effect: SMD = -0.15; 95%CI = -0.29 to -0.01, P = 0.04) in treatment groups, relative to placebo groups, at the end of the intervention. Studies with a confirmed increase in SCFAs at the end of intervention also had a significant effect on lowering fasting insulin (P = 0.008). Elevated levels of SCFAs, compared with baseline levels, were associated with beneficial effects on HOMA-IR (P < 0.00001). There was no significant change in fasting glucose concentrations.
CONCLUSION
Increased postintervention levels of SCFAs are associated with lower fasting insulin concentrations, offering a beneficial effect on insulin sensitivity.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration number CRD42021257248.
Topics: Humans; Insulin Resistance; Diabetes Mellitus, Type 2; Insulin; Obesity; Glucose; Fatty Acids, Volatile; Blood Glucose
PubMed: 37290429
DOI: 10.1093/nutrit/nuad042 -
Frontiers in Pharmacology 2023No evidence shows that one intranasal corticosteroid (INCS) is better than another for treating moderate-to-severe allergic rhinitis (AR). This network meta-analysis... (Review)
Review
Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis.
No evidence shows that one intranasal corticosteroid (INCS) is better than another for treating moderate-to-severe allergic rhinitis (AR). This network meta-analysis assessed the comparative efficacy and acceptability of licensed dose aqueous INCSs. PubMed/MEDLINE, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 31 March 2022. Eligible studies included randomized controlled trials comparing INCSs with placebo or other types of INCSs in patients with moderate-to-severe allergic rhinitis. Two reviewers independently screened and extracted data following the Preferred Reporting Items in Systematic Reviews and Meta-analysis guideline. A random-effects model was used for data pooling. Continuous outcomes were expressed as standardized mean difference (SMD). The primary outcomes were the efficacy in improving total nasal symptom score (TNSS) and treatment acceptability (the study dropout). We included 26 studies, 13 with 5,134 seasonal AR patients and 13 with 4,393 perennial AR patients. Most placebo-controlled studies had a moderate quality of evidence. In seasonal AR, mometasone furoate (MF) was ranked the highest efficacy, followed by fluticasone furoate (FF), ciclesonide (CIC), fluticasone propionate and triamcinolone acetonide (TAA) (SMD -0.47, 95% CI: -0.63 to -0.31; -0.46, 95% CI: -0.59 to -0.33; -0.44, 95% CI: -0.75 to -0.13; -0.42, 95% CI: -0.67 to -0.17 and -0.41, 95% CI: -0.81 to -0.00), In perennial AR, budesonide was ranked the highest efficacy, followed by FF, TAA, CIC, and MF (SMD -0.43, 95% CI: -0.75 to -0.11; -0.36, 95% CI: -0.53 to -0.19; -0.32, 95% CI: -0.54 to -0.10; -0.29, 95% CI: -0.48 to -0.11; and -0.28, 95% CI: -0.55 to -0.01). The acceptability of all included INCSs was not inferior to the placebo. According to our indirect comparison, some INCSs have superior efficacy to others with moderate quality of evidence in most placebo-controlled studies for treating moderate-to-severe AR.
PubMed: 37288109
DOI: 10.3389/fphar.2023.1184552 -
International Journal of Obstetric... May 2023External cephalic version (ECV) is a moderately painful procedure used to turn a fetus from a non-vertex to cephalic position. This systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
External cephalic version (ECV) is a moderately painful procedure used to turn a fetus from a non-vertex to cephalic position. This systematic review and meta-analysis compared intravenous remifentanil with other analgesia or no analgesia or placebo on the success rate and associated pain of ECV.
METHODS
Systematic searches for randomised controlled trials using remifentanil during ECV for non-cephalic term singleton pregnancies were conducted in EMBASE, MEDLINE and the Cochrane Library to October 2021. The primary outcomes were successful ECV and maternal pain; secondary outcomes included mode of delivery and adverse effects. The Cochrane Risk of Bias tool was used and meta-analysis undertaken if there were ≥2 comparable studies.
RESULTS
Four trials were identified, three placebo-controlled and one vs no analgesia, totalling 482 participants. Comparisons against nitrous oxide or neuraxial anaesthesia were not analysed. Two studies had a low overall risk of bias, and two had some concern for bias. Remifentanil compared with placebo increased the success of ECV by 43% (risk ratio [RR] 1.43; 95% confidence interval [CI] 1.14 to 1.78). Pain scores (0-10) were lower (mean difference -1.97; 95% CI -2.49 to -1.46) whilst there was no impact on caesarean delivery rate (RR 0.97; 95% CI 0.81 to 1.17). Adverse events were rare, with fetal bradycardia observed less often with remifentanil than placebo.
CONCLUSIONS
Remifentanil increases the procedural success of ECV and reduces pain compared with placebo. Trials were at low risk of bias and contained a sufficient number of participants to have reasonable confidence in this finding.
Topics: Pregnancy; Female; Humans; Remifentanil; Version, Fetal; Breech Presentation; Pregnancy Trimester, Third; Pain
PubMed: 36989876
DOI: 10.1016/j.ijoa.2023.103649 -
HPB : the Official Journal of the... Jun 2023Spleen preserving distal pancreatectomy (SPDP) represents a widely adopted procedure in the presence of benign or low-grade malignant tumors. Splenic vessels... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Spleen preserving distal pancreatectomy (SPDP) represents a widely adopted procedure in the presence of benign or low-grade malignant tumors. Splenic vessels preservation and resection (Kimura and Warshaw techniques respectively) represent the two main surgical modalities to avoid splenic resection. Each one is characterized by strengths and drawbacks. The aim of the present study is to systematically review the current high-quality evidence regarding these two techniques and analyze their short-term outcomes.
METHODS
A systematic review was conducted according to PRISMA, AMSTAR II and MOOSE guidelines. The primary endpoint was to assess the incidence of splenic infarction and splenic infarction leading to splenectomy. As secondary endpoints, specific intraoperative variables and postoperative complications were explored. Metaregression analysis was conducted to evaluate the effect of general variables on specific outcomes.
RESULTS
Seventeen high-quality studies were included in quantitative analysis. A significantly lower risk of splenic infarction for patients undergoing Kimura SPDP (OR = 0.14; p < 0.0001). Similarly, splenic vessel preservation was associated with a reduced risk of gastric varices (OR = 0.1; 95% p < 0.0001). Regarding all secondary outcome variables, no differences between the two techniques were noticed. Metaregression analysis failed to identify independent predictors of splenic infarction, blood loss, and operative time among general variables.
CONCLUSIONS
Although Kimura and Warshaw SPDP have been demonstrated comparable for most of postoperative outcomes, the former resulted superior compared to the latter in reducing the risk of splenic infarction and gastric varices. For benign pancreatic tumors and low-grade malignancies Kimura SPDP may be preferred.
Topics: Humans; Esophageal and Gastric Varices; Pancreatectomy; Pancreatic Neoplasms; Postoperative Complications; Retrospective Studies; Splenic Artery; Splenic Infarction; Treatment Outcome
PubMed: 36941150
DOI: 10.1016/j.hpb.2023.02.009 -
Frontiers in Veterinary Science 2023The objective of this study was to evaluate the effects of dietary supplementation with flavonoids (FLAs) on animal performance, diet digestibility, antioxidant status...
The objective of this study was to evaluate the effects of dietary supplementation with flavonoids (FLAs) on animal performance, diet digestibility, antioxidant status in blood serum, rumen parameters, meat quality, and milk composition in beef and dairy cattle through a meta-analysis. Thirty-six peer-reviewed publications were included in the data set. The weighted mean differences (WMD) between the FLAs treatments and the control treatment were used to assess the effect size. Dietary supplementation with FLAs decreased feed conversion ratio (WMD = -0.340 kg/kg; = 0.050) and increased ( < 0.05) dry matter intake (WMD = 0.191 kg/d), dry matter digestibility (WMD = 15.283 g/kg of DM), and daily weight gain (WMD = 0.061 kg/d). In blood serum, FLAs supplementation decreased the serum concentration of malondialdehyde (WMD = -0.779 nmol/mL; < 0.001) and increased ( < 0.01) the serum concentration of superoxide dismutase (WMD = 8.516 U/mL), glutathione peroxidase (WMD = 12.400 U/mL) and total antioxidant capacity (WMD = 0.771 U/mL). A higher ruminal propionate concentration (WMD = 0.926 mol/100 mol; = 008) was observed in response to FLAs supplementation. In meat, the dietary inclusion of FLAs decreased ( < 0.05) shear force (WMD = -1.018 kgf/cm), malondialdehyde content (WMD = -0.080 mg/kg of meat), and yellowness (WMD = -0.460). Supplementation with FLAs decreased milk somatic cell count (WMD = -0.251 × 103 cells/mL; < 0.001) and increased ( < 0.01) milk production (WMD = 1.348 kg/d), milk protein content (WMD = 0.080/100 g) and milk fat content (WMD = 0.142/100 g). In conclusion, dietary supplementation with FLAs improves animal performance and nutrient digestibility in cattle. In addition, FLAs improve the antioxidant status in blood serum and the quality of meat and milk.
PubMed: 36876000
DOI: 10.3389/fvets.2023.1134925 -
Scientific Reports Jan 2023Researchers discovered that diets rich in anthocyanin-rich fruits and vegetables significantly impacted gut flora. To conclude, large-scale randomized controlled... (Meta-Analysis)
Meta-Analysis
Researchers discovered that diets rich in anthocyanin-rich fruits and vegetables significantly impacted gut flora. To conclude, large-scale randomized controlled clinical trials are challenging to conduct; therefore, merging data from multiple small studies may aid. A systematic review collects and analyses all research on a particular subject and design. This comprehensive review and meta-analysis examined the influence of dietary anthocyanins on Firmicutes/Bacteroide (Fir/Bac) and short-chain fatty acids (SCFAs) content. The current meta-analysis followed the guidelines of PRISMA-the preferred reporting items for systematic reviews and meta-analyses. Diets high in anthocyanins substantially reduced the Fir/Bac ratio in the assessed trials. Among three SCFAs, the highest impact was observed on acetic acid, followed by propionic acid, and then butanoic acid. The meta-analysis results also obtained sufficient heterogeneity, as indicated by I values. There is strong evidence that anthocyanin supplementation improves rodent gut health biomarkers (Fir/Bac and SCFAs), reducing obesity-induced gut dysbiosis, as revealed in this systematic review/meta-analysis. Anthocyanin intervention duration and dosage significantly influenced the Fir/Bac ratio and SCFA. Anthocyanin-rich diets were more effective when consumed over an extended period and at a high dosage.
Topics: Anthocyanins; Fatty Acids, Volatile; Acetic Acid; Bacteroidetes; Firmicutes
PubMed: 36720989
DOI: 10.1038/s41598-023-28764-0