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Advances in Nutrition (Bethesda, Md.) Sep 2019Dyslipidemia is a global health problem and a high risk factor for atherosclerosis, which can lead to serious cardiovascular disease (CVD). Existing studies have shown... (Meta-Analysis)
Meta-Analysis
Dyslipidemia is a global health problem and a high risk factor for atherosclerosis, which can lead to serious cardiovascular disease (CVD). Existing studies have shown inconsistent effects of turmeric and curcuminoids on blood lipids in adults. We performed this systematic review and meta-analysis to evaluate the effects of turmeric and curcuminoids on blood triglycerides (TG), total cholesterol (TC), LDL cholesterol, and HDL cholesterol. We searched the English databases of the Web of Science, PubMed, Ovid (including EMBASE and MEDLINE), Scopus, and the Cochrane Library and 2 Chinese databases, Wanfang Data and China National Knowledge Infrastructure, for randomized controlled trials (RCTs) that studied the effects of turmeric and curcuminoids on blood TG, TC, LDL cholesterol, and HDL cholesterol in subjects with metabolic diseases. With random-effects models, separate meta-analyses were conducted by using inverse-variance. The results are presented as the mean difference with 95% CIs. Evidence from 12 RCTs for TG, 14 RCTs for TC, 13 RCTs for LDL cholesterol, and 16 RCTs for HDL cholesterol showed that turmeric and curcuminoids could lower blood TG by -19.1 mg/dL (95% CI: -31.7, -6.46 mg/dL; P = 0.003), TC by -11.4 mg/dL (95% CI: -17.1, -5.74 mg/dL; P < 0.0001), and LDL cholesterol by -9.83 mg/dL (95% CI: -15.9, -3.74 mg/dL; P = 0.002), and increase HDL cholesterol by 1.9 mg/dL (95% CI: 0.31, 3.49 mg/dL; P = 0.02). In conclusion, turmeric and curcuminoids can significantly modulate blood lipids in adults with metabolic diseases. However, these findings should be interpreted cautiously because of the significant heterogeneity between included studies (I2 > 50%). There is a need for further RCTs in future.
Topics: Adult; Cardiovascular Diseases; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Curcuma; Diarylheptanoids; Dietary Supplements; Dyslipidemias; Female; Humans; Lipids; Male; Metabolic Diseases; Middle Aged; Randomized Controlled Trials as Topic; Triglycerides
PubMed: 31212316
DOI: 10.1093/advances/nmz021 -
The Cochrane Database of Systematic... Oct 2007Trials have assessed bile acids for patients with viral hepatitis, but no consensus has been reached regarding their usefulness. (Review)
Review
BACKGROUND
Trials have assessed bile acids for patients with viral hepatitis, but no consensus has been reached regarding their usefulness.
OBJECTIVES
To assess the beneficial and harmful effects of bile acids for viral hepatitis.
SEARCH STRATEGY
Searches were performed in The Cochrane Hepato-Biliary Group Controlled Trials Register (July 2007), The Cochrane Library (Issue 1, 2007), MEDLINE (July 2007), EMBASE (July 2007), Science Citation Index Expanded (July 2007), and Chinese Biomedical Database (July 2007).
SELECTION CRITERIA
Randomised clinical trials comparing any dose or duration of bile acids versus placebo or no intervention for viral hepatitis were included, irrespective of language, publication status, or blinding. Co-interventions were allowed in the included randomised clinical trials.
DATA COLLECTION AND ANALYSIS
Two authors extracted the data independently. The methodological quality of the trials was evaluated with respect to generation of the allocation sequence, allocation concealment, double blinding, and follow-up. The outcomes were presented as relative risks (RR) or weighted mean differences (WMD) with 95% confidence intervals (CI).
MAIN RESULTS
We identified 29 randomised trials of bile acids for hepatitis B or C; none were of high methodological quality. We were unable to extract data from two trials. In one trial, ursodeoxycholic acid (UDCA) versus placebo for acute hepatitis B significantly reduced the risk of hepatitis B surface antigen positivity at the end of treatment and serum HBV DNA level at the end of follow-up. In another trial, UDCA versus no intervention for chronic hepatitis B significantly reduced the risk of having abnormal serum transaminase activities at the end of treatment. Twenty-five trials compared bile acids (21 trials UDCA; four trials tauro-UDCA) versus placebo or no intervention with or without co-interventions for chronic hepatitis C. Bile acids did not significantly reduce the risk of having detectable serum HCV RNA (RR 0.99, 95% CI 0.91 to 1.07), cirrhosis, or portal and periportal inflammation score at the end of treatment. Bile acids significantly decreased the risk of having abnormal serum alanine aminotransferase activity at the end of treatment (RR 0.82, 95% CI 0.76 to 0.90) and follow-up (RR 0.91, 95% CI 0.85 to 0.98). Bile acids significantly increased the Knodell score (WMD 0.20, 95% CI 0.08 to 0.31) at the end of treatment. No severe adverse events were reported. We did not identify trials including patients with hepatitis A, acute hepatitis C, hepatitis D, or hepatitis E.
AUTHORS' CONCLUSIONS
Bile acids lead to a significant improvement in serum transaminase activities in hepatitis B and C but have no effects on the clearance of virus. There is insufficient evidence either to support or to refute effects on long-term outcomes including hepatocellular carcinoma, hepatic decompensation, and liver related mortality. Randomised trials with high methodological quality are required before clinical use is considered.
Topics: Antiviral Agents; Hepatitis B, Chronic; Hepatitis C, Chronic; Hepatitis, Viral, Human; Humans; Randomized Controlled Trials as Topic; Taurochenodeoxycholic Acid; Ursodeoxycholic Acid
PubMed: 17943781
DOI: 10.1002/14651858.CD003181.pub2 -
European Review For Medical and... Feb 2023This systematic review and meta-analysis aimed to address the effect of antioxidant supplementation on oxidative stress and proinflammatory biomarkers in patients with... (Meta-Analysis)
Meta-Analysis
The effect of antioxidants supplementation on oxidative stress and proinflammatory biomarkers in patients with chronic kidney disease: a systematic review and meta-analysis.
OBJECTIVE
This systematic review and meta-analysis aimed to address the effect of antioxidant supplementation on oxidative stress and proinflammatory biomarkers in patients with Chronic Kidney Disease (CKD).
MATERIALS AND METHODS
Systematic literature searches from the date of inception up to September 16th, 2022, were performed on PubMed, SCOPUS, and the Cochrane Central Register of Controlled Trials using relevant keywords, i.e., "Chronic Kidney Disease" and "antioxidants", and "supplementation". All studies relevant to the selection criteria were included in the analysis, focusing on any type of oxidative stress and proinflammatory biomarkers. A meta-analysis of included literature was conducted if sufficient data was obtained.
RESULTS
This systematic review involved 32 published studies, with most having a Jadad score of ≥ 3 (65.6%). Only studies on antioxidants, i.e., polyphenols (n=5) and vitamin E (n=6) in curcumin/turmeric, were sufficient to be included in a meta-analysis. Curcumin/turmeric supplementation was found to significantly reduce the serum c-reative protein (CRP) [standardized mean difference (SMD) -0.5238 (95% CI: -1.0495, 0.0019); p = 0.05; I2 = 78%; p = 0.001]. Similarly, vitamin E supplementation was found to significantly reduce the serum CRP [SMD -0.37 (95% CI: -0.711, -0.029); p = 0.03; I2= 53%; p = 0.06] , but not serum interleukin-6 (IL-6) [SMD -0.26 (95% CI: -0.68, 0.16); p = 0.22; I2 = 43%; p = 0.17] and malondialdehyde (MDA) content [SMD -0.94 (95% CI: -1.92, 0.04); p = 0.06; I2= 87%; p = 0.0005].
CONCLUSIONS
Our review suggests that curcumin/turmeric and vitamin E supplements effectively lower serum CRP levels in CKD patients, particularly those undergoing chronic dialysis (CKD-5D). Higher scales of randomized controlled trials (RCTs) are still needed for other antioxidants due to inconclusive and contradicting results.
Topics: Humans; Antioxidants; Curcumin; Oxidative Stress; Vitamin E; Renal Insufficiency, Chronic; Biomarkers
PubMed: 36876681
DOI: 10.26355/eurrev_202302_31379 -
Hematology/oncology and Stem Cell... 2011Cyclophosphamide plus total body irradiation (CYTBI) and oral busulfan plus cyclophosphamide (BUCY) are commonly used conditioning regimens prior to allogeneic... (Comparative Study)
Comparative Study Meta-Analysis Review
Cyclophosphamide plus total body irradiation compared with busulfan plus cyclophosphamide as a conditioning regimen prior to hematopoietic stem cell transplantation in patients with leukemia: a systematic review and meta-analysis.
BACKGROUND AND OBJECTIVES
Cyclophosphamide plus total body irradiation (CYTBI) and oral busulfan plus cyclophosphamide (BUCY) are commonly used conditioning regimens prior to allogeneic hematopoietic stem cell transplantation (HSCT) in patients with leukemia. However, there is conflicting data on the superiority of one regimen over the other. Our aim was to critically appraise and synthesize available evidence regarding the efficacy and safety of CYTBI compared to BUCY as a conditioning regimen.
DESIGN AND SETTING
Systematic review and meta-analysis of randomized, controlled trials (RCTs) comparing BUCY with CYTBI.
METHODS
We did a systematic search of the indexed medical literature using appropriate keywords to identify potentially relevant articles. The primary outcome of interest was efficacy measured by overall survival (OS) and disease-free survival (DFS). Acute and late toxicity were secondary endpoints. Meta-analysis was attempted only on RCTs. A relative risk or risk ratio (RR) and 95% confidence interval (CI) was calculated for each outcome in the meta-analysis.
RESULTS
Fifteen non-randomized comparative studies involving 6280 patients were included in a narrative review without attempting a pooled analysis, in view of the potential for significant bias. Outcome data from seven RCTs involving 730 patients randomly assigned to either CYTBI or BUCY was pooled using meta-analytic methods. CYTBI was associated with a modest but non-significant reduction in all cause mortality (RR=0.82, 95%CI: 0.64-1.05; P=.12) and relapse of leukemia (RR=0.89, 95%CI: 0.72-1.10; P=.28). Transplant-related mortality (TRM) was significantly lesser with CYTBI compared to oral BUCY (RR-0.53, 95%CI: 0.31-0.90; P=.02). The cumulative incidence of major complications was not significantly different between the two regimens, but specific complications varied according to the conditioning regimen. TBI-based regimens were associated with more severe late effects on growth and development in children.
CONCLUSION
This analysis represents the largest comparative analyses of CYTBI with BUCY as a conditioning regimen prior to HSCT in the indexed medical literature. Conditioning regimen and disease (type and setting) can significantly affect outcomes. TRM is significantly lesser with CYTBI, but this does not translate into a significant survival benefit. There remain valid concerns regarding the late effects of TBI, particularly in children. Although not overly superior, the weight of evidence favors CYTBI over BUCY as a first choice-conditioning regimen in patients with leukemia.
Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Busulfan; Cyclophosphamide; Databases as Topic; Disease-Free Survival; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Leukemia; Randomized Controlled Trials as Topic; Registries; Transplantation Conditioning; Treatment Outcome; Whole-Body Irradiation
PubMed: 21460603
DOI: 10.5144/1658-3876.2011.17 -
Toxins Mar 2023This study seeks a comprehensive meta-analysis of mycotoxin contaminants in animal feed consumed in the Middle East and North Africa (MENA) region. The obtained articles... (Meta-Analysis)
Meta-Analysis Review
This study seeks a comprehensive meta-analysis of mycotoxin contaminants in animal feed consumed in the Middle East and North Africa (MENA) region. The obtained articles were reviewed, and 49 articles that investigated the contamination of mycotoxins including aflatoxins (AFs), deoxynivalenol (DON), zearalenone (ZEA), T-2 toxin, fumonisins (FUM), and ochratoxin A (OTA), in feed samples or components of animal feed in the MENA region were selected. The titles of the final articles included in the study were meta-analyzed. Necessary information was extracted and categorized from the articles, and a meta-analysis was performed using Stata software. The highest contamination was in dry bread (80%), and Algeria was the most contaminated country (87% of animal feed), with the most mycotoxins contaminating AFs (47%) and FUM (47%). The highest concentration of mycotoxins in animal feed is related to FUM (1240.01 μg/kg). Climate change, economic situation, agricultural and processing methods, the nature of the animal feed, and improper use of food waste in animal feed are among the most critical factors that are effective in the occurrence of mycotoxin contamination in animal feed in MENA. Control of influential factors in the occurrence of contaminations and rapid screening with accurate identification methods to prevent the occurrence and spread of mycotoxin contamination of animal feed seem important.
Topics: Animals; Mycotoxins; Prevalence; Food Contamination; Refuse Disposal; Aflatoxins; Fumonisins; Middle East; Africa, Northern; Animal Feed
PubMed: 36977105
DOI: 10.3390/toxins15030214 -
International Journal of Molecular... Jul 2019The aim of this study was to perform a systematic review of the literature followed by a meta-analysis about the efficacy of photodynamic therapy (PDT) on the... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to perform a systematic review of the literature followed by a meta-analysis about the efficacy of photodynamic therapy (PDT) on the microorganisms responsible for dental caries. The research question and the keywords were constructed according to the PICO strategy. The article search was done in Embase, Lilacs, Scielo, Medline, Scopus, Cochrane Library, Web of Science, Science Direct, and Pubmed databases. Randomized clinical trials and in vitro studies were selected in the review. The study was conducted according the PRISMA guideline for systematic review. A total of 34 articles were included in the qualitative analysis and four articles were divided into two subgroups to perform the meta-analysis. Few studies have achieved an effective microbial reduction in microorganisms associated with the pathogenesis of dental caries. The results highlight that there is no consensus about the study protocols for PDT against cariogenic microorganisms, although the results showed the PDT could be a good alternative for the treatment of dental caries.
Topics: Bacteroidaceae Infections; Biofilms; Candida; Candidiasis; Curcumin; Dental Caries; Humans; Methylene Blue; Photochemotherapy; Photosensitizing Agents; Porphyromonas gingivalis; Rosaniline Dyes; Streptococcal Infections; Streptococcus; Tolonium Chloride; Treatment Outcome
PubMed: 31340425
DOI: 10.3390/ijms20143585 -
Frontiers in Endocrinology 2021Per- or polyfluoroalkyl substances (PFAS), a family of synthetic polyfluorinated compounds, are widely used in consumer products. Ubiquitous exposures to PFAS, in...
Per- or polyfluoroalkyl substances (PFAS), a family of synthetic polyfluorinated compounds, are widely used in consumer products. Ubiquitous exposures to PFAS, in consideration of their persistence, bioaccumulation potential, and toxicities have led to concerns regarding possible harmful effects during critical periods of development in early-life and long-term consequences on health. The potential effects of PFAS depend on various factors including the type of PFAS and the timing and level of exposure. We performed a systematic review of the epidemiologic literature to assess the effects of early-life PFAS exposure on prenatal and postnatal growth, adiposity, and puberty in children and adolescents. For birth size, most studies indicated that prenatal PFAS exposure, in particular long-chain PFAS, may impair fetal growth, albeit some reports of null associations with maternal PFAS. For growth within 2 years of age, prenatal PFAS exposure showed no associations with height and either null or negative associations with weight. However, postnatal PFAS exposures were inversely related to height and weight at 2 years in a cross-sectional study. For postnatal adiposity, prenatal PFAS may mostly have negative associations with body mass index in the first 2 years of life, but positive relationships with adiposity in childhood and adolescence, although some studies showed null associations. For puberty, the evidence for associations between early-life PFAS exposure and pubertal development or sex hormone levels were limited and inconclusive. From experimental studies, plausible mechanisms through which PFAS may affect early-life growth and puberty include PFAS-induced activation of peroxisome proliferator-activated receptor, alterations of thyroid or steroid hormone synthesis and metabolism, and their weak estrogenic or anti-androgenic properties. Although the published literature suggests possible effects of PFAS exposures on early-life growth, adiposity, and puberty, current human evidence is limited in establishing PFAS-induced effects on early-life physical development. Further investigation is warranted to clarify PFAS-induced effects on growth and physical development in consideration of the critical time-window of exposure, concomitant exposure to chemical mixtures including various PFAS types, and possible non-monotonic dose-response relationship for growth and adiposity trajectories.
Topics: Adiposity; Alkanesulfonic Acids; Carboxylic Acids; Child; Child Development; Environmental Exposure; Environmental Pollutants; Fetal Development; Fluorocarbons; Gonadal Steroid Hormones; Humans; Puberty
PubMed: 34566884
DOI: 10.3389/fendo.2021.683297 -
Environment International Apr 2022Human exposure to per- and polyfluoroalkyl substances (PFAS) has been primarily attributed to contaminated food and drinking water. There is information indicating other...
BACKGROUND
Human exposure to per- and polyfluoroalkyl substances (PFAS) has been primarily attributed to contaminated food and drinking water. There is information indicating other sources and pathways of exposure in residential environments, but few studies report relationships between these indoor media and human biomonitoring measurements.
METHODS
This study adapts existing systematic review tools and methodologies to synthesize evidence for PFAS exposure pathways from indoor environment media including consumer products, household articles, cleaning products, personal care products, and indoor air and dust. Studies were identified using innovative machine learning approaches and pathway-specific search strings to reduce time needed for literature search and screening. The included studies and systematic review were evaluated using tools modified specifically for exposure studies. The systematic review was conducted following a previously published protocol (DeLuca et al., 2021) that describes the systematic review methodology used in detail.
RESULTS
Only 7 studies were identified that measured the targeted subset of 8 PFAS chemicals in concordant household media (primarily house dust) and participant serum. Data extracted from the included studies were used to calculate exposure intake rates and estimate a percentage of occupant serum concentrations that could be attributed to the indoor exposure pathways. These calculations showed that exposure to PFOA, PFOS, PFNA, and PFHxS from contaminated house dust could account for 13%, 3%, 7%, and 25% of serum concentrations, respectively. Inhalation of PFAS in indoor air could account for less than 4% of serum PFOA concentrations and less than 2% of serum PFOS and PFNA concentrations. A risk of bias was identified due to participant profiles in most of the studies being skewed towards white, female, and higher socioeconomic status.
CONCLUSIONS
Along with synthesizing evidence for estimated contributions to serum PFAS levels from indoor exposure media, this systematic review also identifies a consistent risk of bias across exposure study populations that should be considered in future studies. It highlights a major research gap and need for studies that measure concordant data from both indoor exposure media and participant serum and the need for continued research on exposure modeling parameters for many PFAS chemicals.
Topics: Alkanesulfonic Acids; Biological Monitoring; Culture Media; Drinking Water; Dust; Environmental Pollutants; Female; Fluorocarbons; Humans
PubMed: 35240384
DOI: 10.1016/j.envint.2022.107149 -
Alimentary Pharmacology & Therapeutics Aug 2014Up to 88% of patients with hepatic cirrhosis experience painful muscle cramps resulting in sleep deprivation and impaired quality of life. Management is often based on... (Review)
Review
BACKGROUND
Up to 88% of patients with hepatic cirrhosis experience painful muscle cramps resulting in sleep deprivation and impaired quality of life. Management is often based on poor evidence with varying degrees of success in controlling the frequency and severity of muscle cramps in this group.
AIM
To review systematically the treatment options for muscle cramps in cirrhosis.
METHODS
A systematic review of the relevant databases to identify treatments for muscle cramps in patients with hepatic cirrhosis was performed. Studies meeting the selection criteria were reviewed and quality of the papers was rated using a validated quality rating scale. The results for each treatment are reported.
RESULTS
Eighteen publications were identified as eligible for inclusion in this systematic review. The majority (n = 15) of these were treatment/intervention reports. Only three randomised-control studies were identified. A wide range of treatments were identified including zinc, 1-α-hydroxy vitamin D, vitamin E, branched chain amino acids, taurine, l-carnitine, nuiche-shen-qi-wen, eperisone hydrochloride, intravenous albumin and quinidine. There were some reported improvements in muscle cramps with most interventions with the exception of vitamin E but the evidence predominantly relies on case study reports. There is a lack of randomised-controlled clinical studies to support using these interventions.
CONCLUSIONS
There appear to be a number of promising treatments for muscle cramps in cirrhosis. However, there remains a need for further double-blinded, randomised, controlled clinical investigations to support routine use of these interventions to treat muscle cramps in patients with hepatic cirrhosis.
Topics: Albumins; Amino Acids, Branched-Chain; Carnitine; Humans; Liver Cirrhosis; Muscle Cramp; Propiophenones; Quinidine; Taurine; Vitamin D; Zinc
PubMed: 24942957
DOI: 10.1111/apt.12827 -
Journal of Healthcare Engineering 2022To observe the therapeutic effect and the incidence of adverse reactions of total body irradiation plus cyclophosphamide (TBI/CY) and busulfan plus cyclophosphamide... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To observe the therapeutic effect and the incidence of adverse reactions of total body irradiation plus cyclophosphamide (TBI/CY) and busulfan plus cyclophosphamide (BU/CY) in the treatment of pediatric hematopoietic stem cell transplantation.
METHODS
By searching the Cochrane Library, PubMed, Web of Knowledge, Embase, Chinese Biomedical Literature Database (CBM), and screening randomized controlled trials (RCTs), quality evaluation and data extraction were performed for the included literature, and meta-analysis was performed for RCTs included at using Review Manager 5.2 software.
RESULTS
A total of 10160 patients were enrolled in 15 RCTs, including 5211 patients in the TBI/CY group and 4949 patients in the BU/CY group. Meta-analysis showed that there was a statistical difference in transplant failure rate (OR = 1.56, 95% CI (1.23, 1.97), = 0.0002, = 56%, = 3.69), transplant mortality (OR = 1.45, 95% CI (1.24, 1.68), < 0.00001, = 76%, = 4.80), transplantation long-term disease-free survival rate (OR = 1.52, 95% CI (1.09, 2.12), = 0.01, = 0%, = 2.50), and transplantation adverse reactions (OR = 1.28, 95% CI (1.08, 1.52), = 0.004, = 0%, = 2.85).
CONCLUSION
Meta-analysis showed that TBI/CY combined pretreatment regimen was more effective than BU/CY regimen alone in the treatment of pediatric hematologic transplantation, with a lower incidence of adverse reactions and significant long-term survival efficacy.
Topics: Busulfan; Child; Cyclophosphamide; Humans; Leukemia; Transplantation Conditioning; Treatment Outcome
PubMed: 35340233
DOI: 10.1155/2022/2825712