scholarly journals β-(1→3,1→6)-D-glucans in disease prevention and health promotion - a systematic review of randomized controlled trials

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Marigoula Vlassopoulou ◽  
Adamantini Kyriacou ◽  
Vasiliki Pletsa ◽  
George Zervakis ◽  
Mary Yiannakoulia
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Abdominal Circumference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Wide Range ◽  
Tract Infections ◽  
The Impact

AbstractIntroductionβ-Glucans comprise a heterogeneous group of polysaccharides exhibiting a wide range of biological properties. They are categorized as dietary fibers due to their ability to reach the large intestine undigested and undergo fermentation by gut microbiota, with potential beneficial effects for the host. Aim of this systematic review is to assess the effects of consumption of β-(1→3,1→6)-D-glucans, naturally found in the cell walls of fungi, on health outcomes.MethodsA comprehensive literature search was performed on PubMed, Cochrane Library and Web of Science in order to retrieve studies that investigated the impact of exclusively oral administration of β-(1→3,1→6)-D-glucans to healthy individuals and/or patients in any form, at any dosage. Only randomized controlled trials (RCTs) were considered.ResultsTwenty-five RCTs, of the 48 clinical studies retrieved in total, met the eligibility criteria and are included in the present review. The sources of β-(1→3,1→6)-D-glucans were Saccharomyces cerevisiae, Aureobasidium pullulans, Pleurotus ostreatus and Lentinula edodes and the dosage of supplementation ranged from 2.5 to 3000 mg daily for up to 6 months. The main physiological outcome for the majority of the interventions was immunomodulation, which resulted in a) strengthened immune defence that reduces the incidence and symptoms of cold, flu and upper respiratory tract infections in general and b) alleviation of allergic symptoms. However, findings on the induction of immune response alterations were inconsistent at a cellular and molecular level. Another aspect is psychological wellbeing, as the cohorts that received the polysaccharides of interest reported improvement of mood state as well as amelioration of the wellbeing overall, while co-administration with chemotherapeutic drugs enhanced cancer patients’ quality of life and prolonged their survival. Furthermore, supplements containing β-(1→3,1→6)-D-glucan induced beneficial changes in body fat mass and abdominal circumference in overweight adults. Notably, no adverse event causally related to the glucans was recorded in any of the trials.ConclusionsSupplementation with β-(1→3,1→6)-D-glucans is well-tolerated and health-promoting properties are manifested primarily through the potentiation of the immune system. More studies are required in order to confirm additional beneficial effects, establish the optimal dose and reveal the underlying molecular mechanisms.

scholarly journals Systematic Review of Fire Needling or Warm Needling Treatment for Ankle Sprain

2020 ◽  
Vol 37 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Hong Je Ko ◽  
Jae Hee Yoo ◽  
Min Wook Kim ◽  
Jeong Cheol Shin
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Ankle Sprain ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Ankle Sprains ◽  
Control Groups ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Warm Needling

The effectiveness of fire needling or warm needling treatment in clinical studies for the treatment of ankle sprains was reviewed using 4 international (PubMed, Cochrane library, EMBASE, CNKI) and 5 Korean databases (NDSL, RISS, KISS, OASIS, KTKP). Randomized controlled trials, that performed fire needling or warm needling treatment for ankle sprains until October, 2018 were retrieved (<i>n</i> = 8). All studies were performed in China, and 7 out of 8 studies were published within the last 5 years. There were 4 studies that used fire needling treatment, 3 studies used warm needling treatment, and 1 study used fire and warm needling treatment. The ashi-points and gallbladder meridian were the most frequently selected acupoint and meridian each. All intervention groups in the 8 studies showed statistically significant beneficial effects compared with control groups. The results of this study could provide preliminary data as the basis for welldesigned randomized controlled trials on fire needling or warm needling treatment for ankle sprains.

The Effect of Probiotics/synbiotics Supplementation on Renal and Liver Biomarkers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

2021 ◽  
pp. 1-31
Author(s):  
Shima Abdollahi ◽  
Fatemeh Meshkini ◽  
Cain C. T. Clark ◽  
Javad Heshmati ◽  
Sepideh Soltani
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Beneficial Effects ◽  
Randomized Controlled

Abstract Despite the apparent beneficial effects of probiotics/synbiotics on glucose hemostasis, lipid profile, and inflammatory responses, it is not clear whether these beneficial effects also impact renal and hepatic function in diabetes. Therefore, we sought to assess the effect of probiotics/synbiotics supplementation on renal and liver biomarkers in adults with type 2 diabetes (T2DM) using a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched, up to February 2021. The pooled weighted mean difference (WMD) was estimated using a random-effect model. The methodological quality of studies, as well as certainty of evidence, was assessed using standard scales. Fifteen related trials were identified. Meta-analysis of six trials, involving 426 participants, indicated that probiotics/synbiotics supplementation reduced serum levels of creatinine (WMD= −0.10 mg/dl, 95% CI: −0.20, −0.00; P= 0.01; I 2 = 87.7%; P-heterogeneity<0.001), without any significant effect on blood urea nitrogen (BUN), glomerular filtration rate, or microalbuminuria. No significant improvement was found on liver biomarkers following probiotics/synbiotics supplementation. The subgroup analysis showed a significant improvement in BUN when follow-up duration lasted for 12 weeks or more (WMD= −1.215 mg/dl, 95% CI: −1.933, −0.496 ; P= 0.001), and in creatinine levels in patients with renal dysfunction (WMD= −0.209 mg/dl, 95% CI: −0.322, −0.096; P<0.001). Our results are insufficient to advocate the use of probiotics/synbiotics for improving renal or liver function in patients with T2DM. Indeed, due to the low certainty of evidence, these findings need to be affirmed in further high-quality RCTs.

scholarly journals Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Curative Intent ◽  
Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

scholarly journals A Review of Marital Intimacy-Enhancing Interventions among Married Individuals

2015 ◽  
Vol 8 (8) ◽  
pp. 74 ◽  
Author(s):  
Maryam Kardan-Souraki ◽  
Zeinab Hamzehgardeshi ◽  
Ismail Asadpour ◽  
Reza Ali Mohammadpour ◽  
Soghra Khani
Keyword(s):  
Clinical Trials ◽  
Randomized Controlled Trials ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Main Concern ◽  
Care Providers ◽  
Marital Intimacy ◽  
Randomized Controlled ◽  
The Impact

<p><strong>BACKGROUND:</strong> Lack of intimacy is currently the main concern rather than main concern of the experts in psychology and counseling. It is considered as one of the most important causes for divorce and as such to improve marital intimacy a great number of interventions have been proposed in the literature. Intimacy training and counseling make the couples take effective and successful steps to increase marital intimacy. No study has reviewed the interventions promoting marital intimacy after marriage. Thus, this review study aimed to classify the articles investigating the impact of interventional programs on marital intimacy after marriage.</p><p><strong>SEARCH METHODS:</strong> In April 2015, we performed a general search in Google Scholar search engines, and then we did an advanced search the databases of Science Direct, ProQuest, SID, Magiran, Irandoc, Pubmed, Scopus, <a href="http://www.cochranelibrary.com/">Cochrane Library</a>, and Psych info; Cumulative Index to Nursing and Allied Health Literature (CINAHL). Also, lists of the references of the relevant articles were reviewed for additional citations. Using Medical Subject Headings (MESH) keywords: Intervention (Clinical Trials, Non-Randomized Controlled Trials, Randomized Controlled Trials, Education), intimacy, marital (Marriage) and selected related articles to the study objective were from 1995 to April 2015. Clinical trials that evaluated one or more behavioral interventions to improve marital intimacy were reviewed in the study.</p><p><strong>MAIN RESULTS:</strong> 39 trials met the inclusion criteria. Eleven interventions had follow-up, and 28 interventions lacked follow-up. The quality evidence for 22 interventions was low, for 15 interventions moderate, and for one intervention was considered high. Findings from studies were categorized in 11 categories as the intimacy promoting interventions in dimensions of emotional, psychological, physical, sexual, temporal, communicational, social and recreational, aesthetic, spiritual, intellectual intimacy, and total intimacy.</p><p><strong>AUTHORS’ CONCLUSIONS:</strong> Improving and promoting communication, problem solving, self-disclosure and empathic response skills and sexual education and counseling in the form of cognitive-behavioral techniques and based on religious and cultural context of each society, an effective step can be taken to enhance marital intimacy and strengthen family bonds and stability. Health care providers should consider which interventions are appropriate to the couple characteristics and their relationships.</p>

scholarly journals Impact of Ramadan Diurnal Intermittent Fasting on Hypoglycemic Events in Patients With Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies

2021 ◽  
Vol 12 ◽  
Author(s):  
Dana Abdelrahim ◽  
MoezAlIslam E. Faris ◽  
Mohamed Hassanein ◽  
Ayman Z. Shakir ◽  
Ayesha M. Yusuf ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Randomized Controlled Trials ◽  
Observational Studies ◽  
Dietary Behaviors ◽  
Controlled Trials ◽  
Ramadan Fasting ◽  
Randomized Controlled ◽  
The Impact

Ramadan is the 9th month of the lunar calendar during which Muslims abstain from food and drink between dawn and sunset for 30 consecutive days. Ramadan fasting is observed by all healthy Muslim adults, as well many Muslims with type 2 diabetes (T2DM). Hypoglycemic events (HE) are a serious complication associated with diabetes management and are associated with increased cardiovascular disease risk. Conflicting results have been reported concerning the incidence of HE among people with T2DM observing Ramadan fasting. This review summarizes available scientific evidence on the occurrence of HE and the effects of different moderators on the incidence of HE among patients with T2DM during Ramadan. We conducted a systematic review of available observational studies and randomized controlled trials (RCTs) for patients with T2DM who fasted during Ramadan, with HE as the primary outcome. Ten databases were searched for relevant studies from inception until October 31, 2020. In total, 68 studies (35 RCTs and 33 observational studies) met the inclusion criteria. Non-sulfonylureas hypoglycemic medications showed superior effects in lowering the incidence of HE over sulfonylureas hypoglycemic medications. Variable moderators were associated with experiencing HE during Ramadan in both observational studies and RCTs, including sex, geographical location, body anthropometric indicators, season, dietary behaviors, fasting duration, time since diagnosis, and pre-fasting education. This comprehensive systematic review covered the largest number of observational and clinical studies investigating the impact of Ramadan on HE among patients with T2DM. The study highlights the significance of different moderators that influence the effect of Ramadan fasting on HE, including dietary behaviors, fasting time duration, sex, season, country, pre-fasting education, age, and time since diagnosis. The study also highlighted the impact of different hypoglycemic medications on HE and noted the superiority of non-sulfonylureas over sulfonylureas hypoglycemic medications in lowering the risk for hypoglycemia in people with T2DM during Ramadan fasting.

scholarly journals The Long-Lasting Effects of “Placebo Injections” in Knee Osteoarthritis: A Meta-Analysis

Cartilage ◽  
2020 ◽  
pp. 194760352090659 ◽  
Author(s):  
Davide Previtali ◽  
Giulia Merli ◽  
Giorgio Di Laura Frattura ◽  
Christian Candrian ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Placebo Effect ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
The Impact

Objectives To quantify the placebo effect of intraarticular injections for knee osteoarthritis in terms of pain, function, and objective outcomes. Factors influencing placebo effect were investigated. Design Meta-analysis of randomized controlled trials; Level of evidence, 2. PubMed, Web of Science, Cochrane Library, and grey literature databases were searched on January 8, 2020, using the string: (knee) AND (osteoarthritis OR OA) AND (injections OR intra-articular) AND (saline OR placebo). The following inclusion criteria were used: double-blind, randomized controlled trials on knee osteoarthritis, including a placebo arm on saline injections. The primary outcome was pain variation. Risk of bias was assessed using the RoB 2.0 tool, and quality of evidence was graded following the GRADE (Grading of Recommendations Assessment, Development and Evaluation) guidelines. Results Out of 2,363 records, 50 articles on 4,076 patients were included. The meta-analysis showed significant improvements up to the 6-month follow-up: Visual Analogue Scale (VAS)-pain −13.4 mean difference (MD) (95% confidence interval [CI]: −21.7/−5.1; P < 0.001), Western Ontario and McMaster Osteoarthritis Index (WOMAC)-pain −3.3 MD (95% CI: −3.9/−2.7; P < 0.001). Other significant improvements were WOMAC-stiffness −1.1 MD (95% CI: −1.6/−0.6; P < 0.001), WOMAC-function −10.1 MD (95% CI: −12.2/−8.0; P < 0.001), and Evaluator Global Assessment −21.4 MD (95% CI: −29.2/−13.6; P < 0.001). The responder rate was 52% (95% CI: 40% to 63%). Improvements were greater than the “minimal clinically important difference” for all outcomes (except 6-month VAS-pain). The level of evidence was moderate for almost all outcomes. Conclusions The placebo effect of knee injections is significant, with functional improvements lasting even longer than those reported for pain perception. The high, long-lasting, and heterogeneous effects on the scales commonly used in clinical trials further highlight that the impact of placebo should not be overlooked in the research on and management of knee osteoarthritis.

scholarly journals Improving Cardiovascular Health through Nudging Healthier Food Choices: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2520 ◽  
Author(s):  
Christine Tørris ◽  
Hilde Mobekk
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Dietary Habits ◽  
Negative Impact ◽  
Experimental Studies ◽  
Food Choices ◽  
Overweight And Obesity ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Obesity and metabolic syndrome are considered major public health problems, and their negative impact on cardiovascular disease (CVD) and diabetes mellitus type 2 (DM2) is profound. Targeting modifiable risk factors such as dietary habits is therefore of great importance. Many of today’s health challenges with overweight and obesity may have behavioral roots, and traditional methods such as regulations and campaigns are often insufficient to improve dietary choices. Nudging or choice architecture might be a viable tool to influence people’s everyday choices and behaviors to better outcomes. This paper reviews the current state of the rapidly expanding number of experimental field studies that investigate the effects/associations of nudging on healthy food choices. A systematic literature search was conducted in PubMed, where 142 citations were identified. Based on selection criteria, six randomized controlled trials and 15 non-randomized controlled trials were ultimately included. The results of this systematic review show that many of the studies included traffic-light labeling, which may be a promising strategy. The reviewed findings, however, also highlight the challenges that confront experimental studies examining the impact of nudging on diet.

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