scholarly journals Vitamin K Supplementation for the Prevention of Cardiovascular Disease: Where Is the Evidence? A Systematic Review of Controlled Trials

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2909
Author(s):  
Caitlyn Vlasschaert ◽  
Chloe J. Goss ◽  
Nathan G. Pilkey ◽  
Sandra McKeown ◽  
Rachel M. Holden
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Cochrane Collaboration ◽  
Matrix Gla Protein ◽  
Arterial Calcification ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register

Matrix gla protein (MGP) is an important vitamin K-dependent inhibitor of vascular calcification. High levels of uncarboxylated, dephosphorylated MGP have been associated with vascular calcification and are responsive to vitamin K treatment. In this systematic review, we summarize the available evidence examining whether vitamin K supplementation improves surrogate measures of cardiovascular disease including artery and valve calcification, atherosclerosis and artery stiffening. Data from controlled trials of adults were obtained by searching Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and the Web of Science Core Collection. We identified nine randomized controlled trials for review, including trials of vitamin K1 or vitamin K2 supplementation, that assessed a surrogate measure of cardiovascular disease including arterial calcification, atherosclerosis or arterial stiffening. For each trial, the risk of bias was assessed applying Cochrane Collaboration methodology. The findings indicate that vitamin K does not consistently prevent progression of calcification, atherosclerosis or arterial stiffness. There may be some benefit in people with calcification at study entry. Studies were heterogenous, with relatively short follow-up and outcome measures were varied. While vitamin K supplementation clearly improves the carboxylation of dephosphoylated MGP, its role in mitigating vascular calcification is uncertain, based on current evidence.

Device and non-device-guided slow breathing to reduce blood pressure in hypertensive patients: a systematic review protocol. (Preprint)

2021 ◽  
Author(s):  
Kamila Shelry Gonçalves ◽  
Ana Carolina Queiroz Godoy Daniel ◽  
José Luiz Tatagiba Lamas ◽  
Henrique Ceretta Oliveira ◽  
Renata Cristina De Campos Pereira Silveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Systematic Review Protocol ◽  
Hypertensive Patients ◽  
Gray Literature ◽  
Review Protocol ◽  
Slow Breathing

UNSTRUCTURED Introduction: Physiotherapy can include both device-guided slow breathing and device-guided slow breathing in the treatment of systemic arterial hypertension. Methods: A systematic search of all published randomized controlled trials on the effects of device-guided and non-device-guided slow breathing on hypertensive patients, without language restriction, will be carried out until January 2020 in nine databases: Pubmed / MEDLINE (Medical Literature Analysis and Retrieval System Online), Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature ( CINAHL), Scopus, Web of Science, Livivo, as well as a search of clinical trial records databases, CT.GOV (Clinical trials.Gov), and bases for the Open Grey gray literature, Gray Literature Report, ProQuest Central (Citation, Abstract or Indexing and Dissertations and Theses). In all of these databases, potentially eligible studies including completed and ongoing ECAs were researched. The quality assessment of the included studies will be conducted using the Cochrane Risk of Bias Tool for Randomized Trials. The overall quality of the evidence for each outcome will be assessed using the Grading of Recommendations, Development and Evaluation (GRADE) system. Discussion: This systematic review will provide a summary of the current evidence on the effects of both device-guided slow breathing and device-guided slow breathing on blood pressure levels. This information can contribute to decision making by health professionals related to the use of these interventions in hypertensive patients. Following the guidelines, this systematic review protocol was registered with the Prospective International Register of Systematic Reviews (PROSPERO) number CRD42020147554.

scholarly journals Pharmacological and Nutritional Modulation of Vascular Calcification

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 100 ◽  
Author(s):  
Liv M. Vossen ◽  
Abraham A. Kroon ◽  
Leon J. Schurgers ◽  
Peter W. de Leeuw
Keyword(s):  
Cardiovascular Disease ◽  
Drug Therapy ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Vascular Function ◽  
Clinical Importance ◽  
Arterial Calcification ◽  
Channel Blockers ◽  
Cardiovascular Morbidity And Mortality ◽  
Prevention And Treatment

Vascular calcification is an independent predictor of cardiovascular disease, and therefore, inhibition or regression of this processes is of clinical importance. The standard care regarding prevention and treatment of cardiovascular disease at this moment mainly depends on drug therapy. In animal and preclinical studies, various forms of cardiovascular drug therapy seem to have a positive effect on vascular calcification. In particular, calcium channel blockers and inhibitors of the renin–angiotensin–aldosteron system slowed down arterial calcification in experimental animals. In humans, the results of trials with these drugs are far less pronounced and often contradictory. There is limited evidence that the development of new atherosclerotic lesions may be retarded in patients with coronary artery disease, but existing lesions can hardly be influenced. Although statin therapy has a proven role in the prevention and treatment of cardiovascular morbidity and mortality, it is associated with both regression and acceleration of the vascular calcification process. Recently, nutritional supplements have been recognized as a potential tool to reduce calcification. This is particularly true for vitamin K, which acts as an inhibitor of vascular calcification. In addition to vitamin K, other dietary supplements may also modulate vascular function. In this narrative review, we discuss the current state of knowledge regarding the pharmacological and nutritional possibilities to prevent the development and progression of vascular calcification.

scholarly journals Effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain: a protocol of a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Naiane Teixeira Bastos de Oliveira ◽  
Irlei dos Santos ◽  
Gisela Cristiane Miyamoto ◽  
Cristina Maria Nunes Cabral
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Aerobic Exercise ◽  
Musculoskeletal Pain ◽  
Included Study ◽  
Chronic Musculoskeletal Pain ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
And Function

Abstract Background Chronic musculoskeletal pain affects the quality of life of older adults by interfering in their ability to perform activities of daily living. Aerobic exercise programs have been used in the treatment of various health conditions, including musculoskeletal disorders. However, there is still little evidence on the effects of aerobic exercise for the treatment of older adults with chronic musculoskeletal pain. Thus, the objective of this study is to assess the effects of aerobic exercise in improving pain and function of older adults with chronic pain as a consequence of different chronic musculoskeletal conditions. Methods The databases to be used in the search are PubMed, EMBASE, CINAHL, PEDro, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials that used aerobic exercise in the treatment of older adults with chronic musculoskeletal pain will be included. Primary outcomes will be pain and function. We will use the PEDro scale to evaluate the methodological quality and statistical description of each included study, and the strength of the recommendations will be summarized using GRADE. Discussion The results of this systematic review will provide a synthesis of the current evidence on the effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. In addition, this information can help health professionals in decision-making about the use of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. Ethics and dissemination This systematic review was recorded prospectively, and the results will be part of a doctoral thesis to be published in a peer-reviewed international journal and possibly presented at international conferences. Systematic review registration PROSPERO, CRD42019118903.

Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 026921552095193
Author(s):  
Alberto Saavedra-García ◽  
Jose A Moral-Munoz ◽  
David Lucena-Anton
Keyword(s):  
Systematic Review ◽  
Electrical Stimulation ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Mean Difference ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Mirror Therapy

Objective: To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated. Data sources: Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020. Review methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence. Results: Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence). Conclusion: Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

Efficacy of fish oil and its components in the management of psoriasis: a systematic review of 18 randomized controlled trials

2020 ◽  
Vol 78 (10) ◽  
pp. 827-840 ◽  
Author(s):  
Xi Chen ◽  
Seokgyeong Hong ◽  
Xiaoying Sun ◽  
Wenbin Xu ◽  
Hongjin Li ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Fish Oil ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Lesion Area ◽  
Randomized Controlled ◽  
Pasi Score

Abstract Context Fish oil and omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have anti-inflammatory properties, but their effect on psoriasis and its comorbidities remains inconclusive. Objective The aim of this quantitative systematic review was to evaluate the efficacy and safety of fish oil and its components in the treatment of psoriasis and its comorbidities. Data Sources PubMed, Embase, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases were searched from inception to March 30, 2019. Study Selection Randomized controlled trials were eligible for inclusion if they measured the effect of fish oil and its components in the treatment of patients with psoriasis. Data Extraction Eighteen randomized controlled trials involving 927 study participants were included. Results Monotherapy with fish oil or ω-3 PUFAs had no effect on the Psoriasis Area and Severity Index (PASI) score (P = 0.47), lesion area (P = 0.34), or pruritus (P = 0.62). Fish oil or ω-3 PUFAs combined with conventional treatments, however, resulted in a decreased PASI score (mean difference [MD], −3.92; 95%CI, −6.15 to −1.69; P = 0.0006) and lesion area (MD, −30.00; 95%CI, −33.82 to −26.18; P < 0.0001). Safety evaluation suggested no between-group differences. Fish oil and its components reduced certain risk factors for obesity, cardiovascular disease, and metabolic disease in patients with psoriasis and also regulated several inflammatory mediators. Conclusions Overall, when combined with conventional treatments, fish oil and its components may have beneficial effects on psoriasis and its comorbidities, including obesity, cardiovascular disease, and metabolic disease. Systematic Review Registration PROSPERO registration number CRD42019128631.

scholarly journals Lumbar Fusion for Degenerative Disease: A Systematic Review and Meta-Analysis

Neurosurgery ◽  
2017 ◽  
Vol 80 (5) ◽  
pp. 701-715 ◽  
Author(s):  
Daniel Yavin ◽  
Steven Casha ◽  
Samuel Wiebe ◽  
Thomas E Feasby ◽  
Callie Clark ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Spinal Stenosis ◽  
Lumbar Fusion ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Safety And Efficacy ◽  
Relative Safety

Abstract BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016). Comparative studies reporting validated measures of safety or efficacy were included. Treatment effects were calculated through DerSimonian and Laird random effects models. RESULTS: The literature search yielded 65 studies (19 randomized controlled trials, 16 prospective cohort studies, 15 retrospective cohort studies, and 15 registries) enrolling a total of 302 620 patients. Disability, pain, and patient satisfaction following fusion, decompression-alone, or nonoperative care were dependent on surgical indications and study methodology. Relative to decompression-alone, the risk of reoperation following fusion was increased for spinal stenosis (relative risk [RR] 1.17, 95% confidence interval [CI] 1.06-1.28) and decreased for spondylolisthesis (RR 0.75, 95% CI 0.68-0.83). Among patients with spinal stenosis, complications were more frequent following fusion (RR 1.87, 95% CI 1.18-2.96). Mortality was not significantly associated with any treatment modality. CONCLUSION: Positive clinical change was greatest in patients undergoing fusion for spondylolisthesis while complications and the risk of reoperation limited the benefit of fusion for spinal stenosis. The relative safety and efficacy of fusion for chronic low back pain suggests careful patient selection is required (PROSPERO International Prospective Register of Systematic Reviews number, CRD42015020153).

scholarly journals The effect of menaquinone-7 supplementation on vascular calcification in patients with diabetes: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Vol 110 (4) ◽  
pp. 883-890 ◽  
Author(s):  
S R Zwakenberg ◽  
P A de Jong ◽  
J W Bartstra ◽  
R van Asperen ◽  
J Westerink ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Controlled Trial ◽  
Matrix Gla Protein ◽  
Arterial Calcification ◽  
Secondary Outcome ◽  
Double Blind

ABSTRACT Background Vitamin K occurs in the diet as phylloquinone and menaquinones. Observational studies have shown that both phylloquinone and menaquinone intake might reduce cardiovascular disease (CVD) risk. However, the effect of vitamin K on vascular calcification is unknown. Objectives The aim of this study was to assess if menaquinone supplementation, compared to placebo, decreases vascular calcification in people with type 2 diabetes and known CVD. Methods In this double-blind, randomized, placebo-controlled trial, we randomly assigned men and women with type 2 diabetes and CVD to 360 µg/d menaquinone-7 (MK-7) or placebo for 6 mo. Femoral arterial calcification at baseline and 6 mo was measured with 18sodium fluoride positron emission tomography (18F-NaF PET) scans as target-to-background ratios (TBRs), a promising technique to detect active calcification. Calcification mass on conventional computed tomography (CT) scan was measured as secondary outcome. Dephosphorylated–uncarboxylated matrix Gla protein (dp-ucMGP) concentrations were measured to assess compliance. Linear regression analyses were performed with either TBR or CT calcification at follow-up as the dependent variable, and treatment and baseline TBR or CT calcification as independent variables. Results We randomly assigned 35 patients to the MK-7 group (33 completed follow-up) and 33 to the placebo group (27 completed follow-up). After the 6-mo intervention, TBR tended to increase in the MK-7 group compared with placebo (0.25; 95% CI: −0.02, 0.51; P = 0.06), although this was not significant. Log-transformed CT calcification mass did not increase in the intervention group compared with placebo (0.50; 95% CI: −0.23, 1.36; P = 0.18). MK-7 supplementation significantly reduced dp-ucMGP compared with placebo (−205.6 pmol/L; 95% CI: −255.8, −155.3 pmol/L). No adverse events were reported. Conclusion MK-7 supplementation tended to increase active calcification measured with 18F-NaF PET activity compared with placebo, but no effect was found on conventional CT. Additional research investigating the interpretation of 18F-NaF PET activity is necessary. This trial was registered at clinicaltrials.gov as NCT02839044.

scholarly journals Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101032 ◽  
Author(s):  
Emma Pearce ◽  
Kate Jolly ◽  
Laura L Jones ◽  
Gemma Matthewman ◽  
Mandana Zanganeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Premenstrual Syndrome ◽  
Randomised Controlled Trials ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions ◽  
Randomised Controlled

BackgroundExercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.AimTo systematically review the evidence for the effectiveness of exercise as a treatment for PMS.Design & settingThis systematic review searched eight major databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), and two trial registries from inception until April 2019.MethodRandomised controlled trials (RCTs) comparing exercise interventions of a minimum of 8-weeks duration with non-exercise comparator groups in women with PMS were included. Mean change scores for any continuous PMS outcome measure were extracted from eligible trials and standardised mean differences (SMDs) were calculated where possible. Random-effects meta-analysis of the effect of exercise on global PMS symptoms was the primary outcome. Secondary analyses examined the effects of exercise on predetermined clusters of psychological, physical, and behavioural symptoms.ResultsA total of 436 non-duplicate returns were screened, with 15 RCTs eligible for inclusion (n = 717). Seven trials contributed data to the primary outcome meta-analysis (n = 265); participants randomised to an exercise intervention reported reduced global PMS symptom scores (SMD = -1.08; 95% confidence interval [CI] = -1.88 to -0.29) versus comparator, but with substantial heterogeneity (I2 = 87%). Secondary results for psychological (SMD = -1.67; 95% CI = -2.38 to -0.96), physical (SMD = -1.62; 95% CI = -2.41 to -0.83) and behavioural (SMD = -1.94; 95% CI = -2.45 to -1.44) symptom groupings displayed similar findings. Most trials (87%) were considered at high risk of bias.ConclusionBased on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.

scholarly journals Effect of Warm-Needling Acupuncture in Overweight and Obese Adults: Protocol for a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Junpeng YAO ◽  
Liping Chen ◽  
Hui Zheng ◽  
Lin Zhang ◽  
Ying Li
Keyword(s):  
Systematic Review ◽  
Evaluation System ◽  
Grey Literature ◽  
Overweight And Obesity ◽  
Biomedical Literature ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Academic Degree ◽  
Warm Needling

Abstract Background: Overweight and obesity are chronic metabolic diseases characterized by abnormal or excessive fat accumulation that presents a risk to health. Warm-needling acupuncture (WNA), which combines the characteristics of acupuncture and moxibustion, has been commonly used to manage obesity with reasonable weight control in recent years. Therefore, our objective is to systematically appraise the efficacy and safety of WNA for overweight and obesity.Methods: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), Excerpt Medica Database (EMBASE), ALT HealthWatch, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), the Chinese Biomedical Literature Database (CBM), Wanfang Data, and grey literature (trial registries, conference proceedings and academic degree dissertations) will be searched for the identification of articles. All randomized controlled trials (RCTs) involving WNA independently or as an adjunct to other active therapies, compared with the same therapies alone, will be included. The principal outcome will be the difference in BMI from baseline to the end of studies. Secondary outcomes include the change of weight, waist circumference, percentage of body fat, serum lipid before and after treatment. The severity and incidence of adverse events will be measured as the safety assessment. Study selection, data extraction, and assessment of risk of bias will be performed independently by two reviewers. A third reviewer will resolve and determine disagreements. The Review Manager software (V.5.3.5) and Stata software (V.14.0) will be used for data synthesis. Furthermore, the quality of the evidence for the results will be described according to the Grading of Recommendations Assessment, Development and Evaluation system (GRADE) with GRADEprofiler software (V.3.6.1).Discussion: This is the first systematic review to evaluate the effect of WNA in the management of obesity. This program will provide a high-quality synthesis of the current evidence to identify whether WNA is an effective therapeutic approach for overweight and obesity.Systematic review registration: PROSPERO CRD42019146380.

scholarly journals Statins in Healthy Adults: A Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 585
Author(s):  
Lee Sandwith ◽  
Patrice Forget
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Meta Analysis ◽  
Health Conditions ◽  
Current Evidence ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

Background and Objectives: In this paper, we investigated the efficacy of statin therapy on cardiovascular disease (CVD) reduction in adults with no known underlying health conditions by undertaking a meta-analysis and systematic review of the current evidence. Materials and Methods: We performed a systematic search to identify Primary Prevention Randomized Controlled Trials (RCTs) that compared statins with a control group where CVD events or mortality were the primary end point. Identified RCTs were evaluated and classified into categories depending on relevance in order to determine which type of meta-analysis would be feasible. Results: No differences were observed between categories with the exception of relative risk for all CVD events combined which showed a 12% statistically significant difference favouring studies which were known to include participants without underlying health conditions. Strong negative correlations between number-need-to-treat (NNT) and LDL-C reduction were observed for all Coronary Heart Disease (CHD) outcomes combined and all CVD outcomes combined. Conclusions: This project highlights the need for further research on the effects of statins on participants who do not suffer from underlying health conditions, given that no such studies have been conducted.

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