scholarly journals Time of introducing solid food into infant’s diet and risk of Type I Diabetes: a systematic review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Giannakou ◽  
I Bolanou ◽  
S Chrysostomou
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Type I Diabetes ◽  
Exposure Period ◽  
Solid Food ◽  
Islet Autoimmunity ◽  
Publication Date ◽  
Type I ◽  
Early Exposure ◽  
Increased Risk

Abstract Background Type I Diabetes mellitus (DT1) is a multifactorial disease with various genetic and environmental factors involved in its pathophysiology. Several nutritional factors such as the timing of exposure to solid foods may increase the risk of DT1. The aim of this systematic review was to investigate the association between the time of introducing solid food into infant's nutrition during the first year of life and the risk of developing DT1. Methods PubMed and Science Direct were searched from inception to October 2019 for observational studies that investigated the above association. No restrictions on language or publication date were applied. Specific inclusion and exclusion criteria were set for the selection of articles. Title and abstract screening were performed by two independent researchers and data were extracted from shortlisted articles. Results In total, 76 studies were screened, and 7 articles met the inclusion criteria. The analysis shows that early exposure (before or during 3 or 4 months) and subsequent exposure (during or after 6 or 7 months) was associated with an increased risk of developing DT1 and/or pancreatic islet autoimmunity, compared to an intermediate exposure period (4-6 months, 4-5 months or 3-6 months). Conclusions The evidence suggests that an interim exposure period of genetically predisposed infants to DT1 from 4 to 5 months of age may reduce the risk of developing DT1 in later life as compared to early or later exposure. However, due to the limitations of the studies, further investigation is required to inform DT1 prevention practices. Key messages There is some evidence indicating that early exposure and later exposure to solid food may increase the risk of developing DT1 in children with a genetic predisposition. Due to the methodological heterogeneity across the studies included, more reliable data from large prospective studies and randomized clinical trials are needed.

scholarly journals Potential of biomarkers during pharmacological therapy setting for postmenopausal osteoporosis: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Filippo Migliorini ◽  
Nicola Maffulli ◽  
Filippo Spiezia ◽  
Giuseppe Maria Peretti ◽  
Markus Tingart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Postmenopausal Osteoporosis ◽  
Randomized Clinical Trials ◽  
Type I Collagen ◽  
Therapy Monitoring ◽  
Pharmacological Therapy ◽  
Type I ◽  
Gastrointestinal Adverse Events

Abstract Background Biochemical markers of bone turnover (BTMs), such as the bone alkaline phosphatase (bALP), procollagen type I N propeptide (PINP), serum cross-linked C-telopeptides of type I collagen (bCTx), and urinary cross-linked N-telopeptides of type I collagen (NTx), are used to manage therapy monitoring in osteoporotic patients. This systematic review analyzed the potential of these BMTs in predicting the clinical outcomes in terms of BMD, t-score, rate of fractures, and adverse events during the therapy setting in postmenopausal osteoporosis. Methods All randomized clinical trials (RCTs) reporting data on biomarkers for postmenopausal osteoporosis were accessed. Only articles reporting quantitative data on the level of biomarkers at baseline and on the outcomes of interest at the last follow-up were eligible. Results A total of 36,706 patients were retrieved. Greater values of bALP were associated with a greater rate of vertebral (P = 0.001) and non-vertebral fractures (P = 0.0001). Greater values of NTx at baseline were associated with a greater rate of adverse events at the last follow-up (P = 0.02). Greater values of CTx at baseline were associated with a greater rate of adverse events leading to discontinuation (P = 0.04), gastrointestinal adverse events (P = 0.0001), musculoskeletal adverse events (P = 0.04), and mortality (P = 0.04). Greater values of PINP at baseline were associated with greater rates of gastrointestinal adverse events (P = 0.02) at the last follow-up. Conclusion The present analysis supports the adoption of BMTs during pharmacological therapy setting of patients suffering from osteoporosis. Level of evidence I, systematic review of RCTs

scholarly journals Use of sodium-glucose cotransporter-2 inhibitors and urinary tract infections in type 2 diabetes patients: a systematic review

2019 ◽  
Vol 65 (2) ◽  
pp. 246-252 ◽  
Author(s):  
Izabela Rodrigues Figueiredo ◽  
Sara Cardoso Paes Rose ◽  
Nathália Bandeira Freire ◽  
Marina Stabile Patrocínio ◽  
Natália Pierdoná ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Randomized Clinical Trials ◽  
Oral Antidiabetic Agents ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk ◽  
Tract Infections

SUMMARY Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are drugs that act by maintaining glycosuria. Recent studies have shown promising effects of these in the treatment of type 2 diabetes mellitus (DM2). However, there may be an increased risk of developing urinary tract infections (UTIs) in patients treated with these. Our study aims to analyze the association between the risk of UTI in patients treated with SGLT2i. A systematic review of the literature was carried out by randomized clinical trials, totalizing at the end of the selection 23 articles that were statistically evaluated. The incidence of UTI was generally demonstrated in articles and in different subgroups: patients on SGLT2i monotherapy or on combination therapy; according to specific comorbidities of each sample or according to the drug used. They noticed an increase in the chance of UTI in the SGLT2i groups compared to the control groups on placebo or other oral antidiabetic agents. This increased chance was found predominantly with the use of Dapagliflozin, Canagliflozin, and Tofogliflozin, regardless of the dosing. Lastly, stands out that the dimension of UTI chances for DM2 patients who use SGLT2i remains to be more strictly determined.

scholarly journals Platelet Activation and Platelet–Leukocyte Aggregates in Type I Diabetes Mellitus

2018 ◽  
Vol 24 (9_suppl) ◽  
pp. 230S-239S ◽  
Author(s):  
Asmaa M. Zahran ◽  
Omnia El-Badawy ◽  
Ismail L. Mohamad ◽  
Deiaaeldin M. Tamer ◽  
Safwat M. Abdel-Aziz ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Type I Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Control Group ◽  
Type I ◽  
Platelet Activity ◽  
Increased Risk

Hyperglycemia alone may not explain the increased risk of cardiovascular diseases (CVDs) in patients with type 1 diabetes (T1D) compared with type 2. This study emphases on the evaluation of some platelet activity markers in patients with T1D, with relevance to some metabolic disorders as hyperlipidemia and hyperglycemia. This study was performed on 35 patients with T1D and 20 healthy controls. All participants were subjected to full history taking, clinical examination and assay of glycated hemoglobin (HbA1c), and lipid profile. The expression of CD62P and CD36 on platelets and the frequency of platelet–monocyte, and platelet–neutrophil aggregates were assessed by flow cytometry. Patients showed significantly higher expression of CD62P and CD36 than the control group. Platelets aggregates with monocytes were also higher among patients than the control group. Levels of CD36+ platelets, CD62P+ platelets, and platelet–monocyte aggregates revealed significant correlations with the levels of HbA1c, total cholesterol, low-density lipoprotein, and triglycerides. Hyperlipidemia and hyperglycemia accompanying T1D have a stimulatory effect on platelet activation which probably makes those patients vulnerable to CVD than nondiabetics.

scholarly journals Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (17) ◽  
pp. 6401
Author(s):  
Juan Vega-Escaño ◽  
Ana María Porcel-Gálvez ◽  
Rocío de Diego-Cordero ◽  
José Manuel Romero-Sánchez ◽  
Manuel Romero-Saldaña ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Publication Date ◽  
The Impact

The aim of this systematic review and meta-analysis was to identify and evaluate the impact of interventions to improve or reduce insomnia in the workforce through randomized clinical trials. Following the recommendations of the PRISMA and MARS statement, a systematic literature search was carried out on the PubMed, Web of Science, CINHAL, and PsycINFO databases, with no restrictions on the language or publication date. For the meta-analysis, a random-effects model and the Insomnia Severity Index were used as outcome measures. To assess the risk of bias and the quality of evidence, the Cochrane Collaboration tool and the GRADE method were used, respectively. Twenty-two studies were included in the systematic review and 12 studies in the meta-analysis, making a total of 14 intervention groups with a sample of 827 workers. Cognitive behavioral therapy was the most widely used intervention. According to the estimated difference between the means, a moderate effect for the reduction of insomnia symptoms after the intervention (MD −2.08, CI 95%: [−2.68, −1.47]) and a non-significant degree of heterogeneity were obtained (p = 0.64; I2 = 0%). The quality of the evidence and the risk of bias were moderate. The results suggest that interventions on insomnia in the workplace are effective for improving workers’ health, and that improvements in the quality of sleep and a decrease in the symptoms of insomnia are produced, thanks to an increase in weekly sleeping hours and a reduction in latency at sleep onset. As regards work, they also led to improvements in productivity, presenteeism, and job burnout.

scholarly journals Effects of dual blockade in heart failure and renal dysfunction: Systematic review and meta-analysis

2019 ◽  
Vol 20 (4) ◽  
pp. 147032031988265
Author(s):  
Alessandra Rodrigues Silva ◽  
Alexandre Goes Martini ◽  
Graziela De Luca Canto ◽  
Eliete Neves da Silva Guerra ◽  
Francisco de Assis Rocha Neves
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Adverse Events ◽  
Renal Dysfunction ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Renin Angiotensin System ◽  
Ras Inhibition ◽  
Increased Risk ◽  
Dual Blockade

Objective: The effect of dual renin–angiotensin system (RAS) inhibition in heart failure (HF) is still controversial. Systematic reviews have shown that dual RAS blockade may reduce mortality and hospitalizations, yet it has been associated with the increased risk of renal dysfunction (RD). Surprisingly, although RD in patients with HF is frequent, the effect of combining RAS inhibitors in HF patients with RD has never been studied in a meta-analysis. Methods: A systematic review and meta-analysis of randomized clinical trials involving HF patients with RD who received dual blockade analyzing death, cardiovascular (CV) death or HF hospitalization, and adverse events. Results: Out of 2258 screened articles, 12 studies were included (34,131 patients). Compared with monotherapy, dual RAS inhibition reduced hazard ratio of death to 0.94 ( p=0.07) and significantly reduced CV death or HF hospitalization to 0.89 ( p=0.0006) in all individuals, and to 0.86 ( p=0.005) in patients with RD and to 0.91 ( p=0.04) without RD. Nevertheless, dual RAS blockade significantly increased the risk of renal impairment (40%), hyperkalemia (44%), and hypotension (42%), although discontinuation of treatment occurs only in 3.68% versus 2.19% ( p=0.00001). Conclusions: Dual RAS inhibition therapy reduces the risk of CV death or HF hospitalization. However, cautions monitoring for specific adverse events may be warranted.

Child Abuse in Natural Disasters and Conflicts: A Systematic Review

2019 ◽  
Vol 22 (1) ◽  
pp. 176-185 ◽  
Author(s):  
Hamed Seddighi ◽  
Ibrahim Salmani ◽  
Mohhamad Hossein Javadi ◽  
Saeideh Seddighi
Keyword(s):  
Systematic Review ◽  
Child Abuse ◽  
Natural Disasters ◽  
Child Labor ◽  
Child Protection ◽  
Physical Violence ◽  
Geographical Area ◽  
Publication Date ◽  
Violence Against Children ◽  
Increased Risk

Violence against children affects a significant portion of youth around the world. Emergencies and natural disasters escalate the risk due to weakened child protection systems and disruption of preventative mechanisms. In this systematic review, 692 related papers were searched in various databases in the initial search. After review, 11 papers were finally selected for full review. These papers were selected based on publication date, relevance to emergencies, their geographical area type of violence, age of subjects, and their gender. Most families affected by natural disasters, especially those in lower socioeconomic status, face greater social and economic pressures. The families that are more vulnerable to loss of food and shelter commit violence against children more frequently. On the other hand, while the rate of violence increases in emergencies, the reported rate of violence is less than the actual rate due to lack of required infrastructure and reporting mechanisms. The emergency housing increased risk of some types of child abuse. The history of exposure to violence, parental substance abuse, poverty, and child labor were predictors of increased violence against children in emergency situations. Sexual violence against girls after conflicts and physical violence against boys after emergencies are common forms of violence. Poverty as another predictor exposes children to more violence due to limited family economic resources and support. Given the identified predictors of violence, humanitarian organizations can come closer to providing appropriate plans to reduce the risk during and postdisaster.

On the clinical importance of thyroid microsomal and thyroglobulin antibody determination

1987 ◽  
Vol 116 (1_Suppl) ◽  
pp. S325-S329 ◽  
Author(s):  
W. A. Scherbaum
Keyword(s):  
Autoimmune Thyroiditis ◽  
Type I Diabetes ◽  
Post Partum ◽  
Thyroid Autoimmunity ◽  
Elevated Serum ◽  
Clinical Importance ◽  
Overt Hypothyroidism ◽  
Type I ◽  
Increased Risk ◽  
Antibody Determination

Abstract. Among the various autoantibody tests applied in research and clinical practice, the determination of thyroid microsomal (TMAb) and thyroglobulin antibodies (TgAb) still retains its strong value in the screening for thyroid autoimmunity. The presence in the serum of TMAb is almost invariably associated with thyroid autoimmune disease or focal thyroiditis. The appearance of TMAb together with elevated serum-TSH in subclinical autoimmune thyroiditis strongly suggests progression to overt hypothyroidism. Pregnant women with positive TMAb and/or TgAb run an increased risk for post-partum painless thyroiditis with transient thyrotoxicosis and subsequent hypothyroidism. After delivery also a relapse of previously unrecognized Graves' thyrotoxicosis may occur. Thyroid antibody determination is not a valuable tool to discriminate autoimmune thyroiditis from thyroid malignancies. TMAb and TgAb determination helps to recognize individuals with thyroid autoimmunity among patients with non-thyroid autoimmune diseases such as Addison's disease and Type I diabetes mellitus.

Increased length of stay and hospital charges in adolescents with type 1 diabetes and psychiatric illness

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fernando A. Munoz ◽  
Cindy Chin ◽  
Samantha A. Kops ◽  
Katie Kowalek ◽  
Michael D. Seckeler
Keyword(s):  
Length Of Stay ◽  
Healthcare Utilization ◽  
Type I Diabetes ◽  
Hospital Charges ◽  
Type I ◽  
Bonferroni Correction ◽  
Psychiatric Illnesses ◽  
Severe Diabetes ◽  
Increased Risk

AbstractObjectivesType I diabetes mellitus (T1DM) is one of the most common chronic diseases of childhood. Diabetic ketoacidosis (DKA) in this population contributes to significant healthcare utilization, including emergency room visits, hospitalizations, and ICU care. Comorbid psychiatric illnesses (CPI) are additional risks for increased healthcare utilization. While CPI increased risk for DKA hospitalization and readmission, there are no data evaluating the relationship between CPI and hospital outcomes. We hypothesized that adolescents with T1DM and CPI admitted for DKA have increased length of stay (LOS) and higher charges compared to those without CPI.MethodsRetrospective review of 2000–2012 Healthcare Cost and Utilization Project’s (HCUP) Kids’ Inpatient Databases (KID). Patients 10–21 years old admitted with ICD-9 codes for DKA or severe diabetes (250.1–250.33) with and without ICD-9 codes for depression (296–296.99, 311) and anxiety (300–300.9). Comparisons of LOS, mortality, and charges between groups (No CPI, Depression and Anxiety) were made with one way ANOVA with Bonferroni correction, independent samples Kruskal-Wallis test with Bonferroni correction and χ2.ResultsThere were 79,673 admissions during the study period: 68,573 (86%) No CPI, 8,590 (10.7%) Depression and 12,510 (15.7%) Anxiety. Female patients comprised 58.2% (n=46,343) of total admissions, 66% of the Depression group, and 71% of the Anxiety group. Patients with depression or anxiety were older and had longer LOS and higher mean charges (p<0.001 for both).ConclusionComorbid depression or anxiety are associated with significantly longer LOS and higher charges in adolescents with T1DM hospitalized for DKA. This study adds to the prior findings of worse outcomes for patients with both T1DM and CPI, emphasizing the importance of identifying and treating these comorbid conditions.

scholarly journals Hidradenitis Suppurativa and Comorbid Disorder Biomarkers, Druggable Genes, New Drugs and Drug Repurposing—A Molecular Meta-Analysis

Pharmaceutics ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 44
Author(s):  
Viktor A. Zouboulis ◽  
Konstantin C. Zouboulis ◽  
Christos C. Zouboulis
Keyword(s):  
Systematic Review ◽  
Clinical Studies ◽  
Hidradenitis Suppurativa ◽  
Type I Diabetes ◽  
Meta Analysis ◽  
Drug Repurposing ◽  
Epithelial Differentiation ◽  
New Drugs ◽  
Acne Inversa ◽  
Type I

Chronic inflammation and dysregulated epithelial differentiation, especially of hair follicle keratinocytes, have been suggested as the major pathogenetic pathways of hidradenitis suppurativa/acne inversa (HS). On the other hand, obesity and metabolic syndrome have additionally been considered as an important risk factor. With adalimumab, a drug has already been approved and numerous other compounds are in advanced-stage clinical studies. A systematic review was conducted to detect and corroborate HS pathogenetic mechanisms at the molecular level and identify HS molecular markers. The obtained data were used to confirm studied and off-label administered drugs and to identify additional compounds for drug repurposing. A robust, strongly associated group of HS biomarkers was detected. The triad of HS pathogenesis, namely upregulated inflammation, altered epithelial differentiation and dysregulated metabolism/hormone signaling was confirmed, the molecular association of HS with certain comorbid disorders, such as inflammatory bowel disease, arthritis, type I diabetes mellitus and lipids/atherosclerosis/adipogenesis was verified and common biomarkers were identified. The molecular suitability of compounds in clinical studies was confirmed and 31 potential HS repurposing drugs, among them 10 drugs already launched for other disorders, were detected. This systematic review provides evidence for the importance of molecular studies to advance the knowledge regarding pathogenesis, future treatment and biomarker-supported clinical course follow-up in HS.

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