scholarly journals Impact of Diet on Plasma Lipids in Individuals with Heterozygous Familial Hypercholesterolemia: A Systematic Review of Randomized Controlled Nutritional Studies

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 235
Author(s):  
Gabrielle Roy ◽  
Anykim Boucher ◽  
Patrick Couture ◽  
Jean-Philippe Drouin-Chartier
Keyword(s):  
Familial Hypercholesterolemia ◽  
Dietary Supplement ◽  
Guar Gum ◽  
Risk Of Bias ◽  
Omega 3 ◽  
Dietary Counseling ◽  
Randomized Controlled ◽  
Heterozygous Familial Hypercholesterolemia ◽  
Counseling Interventions ◽  
The Impact

Background: Conclusive data on the effectiveness of dietary interventions in heterozygous familial hypercholesterolemia (HeFH) management are unavailable. Whether this is due to a true lack of effects or biases in intervention designs remains unsettled. We systematically assessed the impact on LDL-C of published dietary randomized controlled trials (RCTs) conducted among individuals with HeFH in relation to their design and risk of bias. Methods: We systematically searched PubMed, Web of Science, and Embase in November 2020 to identify RCTs that assessed the impact of: (1) food-based interventions; (2) dietary counseling interventions; or (3) dietary supplements on LDL-C in individuals with HeFH. We evaluated the risk of bias of each study using the Cochrane Risk of Bias 2 method. Results: A total of 19 RCTs comprising 837 individuals with HeFH were included. Of those, five were food-based interventions, three were dietary counseling interventions and 12 were dietary supplement-based interventions (omega-3, n = 3; phytosterols, n = 7; guar gum, n = 1; policosanol, n = 1). One study qualified both as a food-based intervention and as a dietary supplement intervention due to its factorial design. A significant reduction in LDL-C levels was reported in 10 RCTs, including eight dietary supplement interventions (phytosterols, n = 6, omega-3, n = 1; guar gum, n = 1), one food-based intervention and one dietary counseling intervention. A total of 13 studies were judged to have some methodological biases in a way that substantially lowers confidence in the results. Studies at low risk of biases were more likely to report significant reductions in LDL-C concentrations, compared with studies at risk of bias (chi-square statistic: 5.49; p = 0.02). Conclusion: This systemic review shows that the apparent lack of effectiveness of diet manipulation in modulating plasma levels of LDL-C among individuals with HeFH is likely due to biases in study designs, rather than a true lack of effects. The likelihood of reporting significant reductions in LDL-C was associated with the concurrent risk of bias.

The impact of mobile applications on medication adherence: a systematic review

2019 ◽  
Author(s):  
Ricki Ng ◽  
Stephen R Carter ◽  
Sarira El-Den
Keyword(s):  
Medication Adherence ◽  
Clinical Outcome ◽  
Mobile Applications ◽  
Mobile Apps ◽  
Risk Of Bias ◽  
Randomized Controlled ◽  
Patient Related Outcome ◽  
Study Designs ◽  
High Degree ◽  
The Impact

AbstractIn 2008, Apple and Android launched their Application or “App” stores. Since then, there has been a growing interest in using mobile apps for improving medication adherence. However, research on the efficacy of apps, in terms of improved medication adherence and clinical outcome and/or patient-related outcome measures (PROMs) is scarce. The objective of this research was to systematically review the impact of apps on consumers’ medication adherence and to determine the effect on clinical outcome and/or PROM(s). A systematic literature search was conducted to identify publications aimed at improving medication adherence published from January 2008 to April 2018. All studies were assessed for risk of bias using either the Risk Of Bias In Non-randomized Studies-of Interventions or the revised tool for Risk of Bias in randomized trials tool, depending on study design. Eleven randomized controlled trials (RCTs) and 10 non-RCTs were included. All 11 RCTs showed improvements in adherence; however, only seven reported statistically significant improvements in at least one adherence measure. Nine RCTs also demonstrated improvements in clinical outcome/PROM(s), of which five were statistically significant, whereas two RCTs did not report on clinical outcome/PROM(s). Only two studies using non-RCT study designs showed statistically significant improvements in all measures of adherence and clinical outcome/PROM(s). The risk of bias was moderate or serious for all included studies. Even though the use of an app may improve adherence, it is difficult to draw conclusions regarding the impact of apps on medication adherence due to the high degree of heterogeneity across studies, from the methodological design to the features of the app and the measure of adherence.

scholarly journals 804 The Role of Kono-S Anastomosis and Mesenteric Resection in Reducing Recurrence After Surgery for Crohn’s Disease: A Systematic Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Alshantti
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Poor Grade ◽  
Randomized Controlled ◽  
Surgical Recurrence ◽  
Mesenteric Excision ◽  
The Impact

Abstract Aim Recurrence after surgery for Crohn’s disease is common. Anastomotic configuration may influence recurrence and the mesentery may be key.The Kono-S anastomosis and radical mesenteric excision have been proposed as methods of reducing recurrence. We analysed the literature pertaining to these novel techniques. Method We searched MEDLINE, Embase and the Cochrane Library for, studies evaluating Kono-S anastomosis and/or radical mesenteric excision in Crohn’s disease. We assessed methodological quality and risk of bias using the Cochrane tool for randomized controlled trials and the JBI tool for nonrandomized trials. A narrative synthesis was used to summarize the findings. Results Nine studies (896 patients) were identified. Apart from one randomized controlled trial with a low risk of bias the overall level of evidence was poor (Grade IV). The Kono-S anastomosis was associated with a lower incidence of endoscopic and surgical recurrence (0%–3.4% vs 15%–24.4% respectively). Complications, particularly anastomotic leak rate, were also lower (1.8% vs 9.3% respectively). Evidence from a single poor-quality study suggested that mesenteric excision may reduce surgical recurrence rates compared with mesentery preservation. Conclusions The existing literature suggests that the Kono-S anastomosis is safe and may reduce endoscopic and surgical recurrence, but level of evidence is mainly poor. One element of the Kono-S technique, preservation of the mesentery, may be detrimental to recurrence. Further, higher quality, studies are required to investigate these techniques. Such studies should consider the impact of the degree of mesenteric resection in addition to the anastomosis on disease recurrence.

The impact of ezetimibe and high-dose of statin treatment on LDL levels in patients with heterozygous familial hypercholesterolemia

2009 ◽  
Vol 134 (2) ◽  
pp. 280-281 ◽  
Author(s):  
Christos Pitsavos ◽  
Ioannis Skoumas ◽  
Dimitris Tousoulis ◽  
George Metalinos ◽  
Constantina Masoura ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Statin Treatment ◽  
High Dose ◽  
Heterozygous Familial Hypercholesterolemia ◽  
The Impact

scholarly journals VISCERAL MOBILIZATION AS MANAGEMENT OPTION FOR LOW BACK PAIN - A SYSTEMATIC REVIEW

2020 ◽  
Vol 9 (2) ◽  
pp. 4-10
Author(s):  
Mirza M. Zeeshan Saeed ◽  
Nabeel Baig ◽  
Muhammad Ather Hashmi
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Risk Of Bias ◽  
Qualitative Assessment ◽  
P Value ◽  
Low Back ◽  
Pubmed Central ◽  
Randomized Controlled ◽  
The Impact

OBJECTIVE This systematic review is to evaluate the impact of visceral mobilization or manipulation in improving low back pain via standard protocols. MATERIALS AND METHODS Literature was searched electronically on various databases such as PEDro, PubMed Central, Google Scholar, BioMed Central, MEDLINE, EMBASE and Science Direct considering duration of 2011 to 2019. Randomized Controlled Trials investigating effectiveness of visceral manipulation or mobilization, either, in the comparison with different modalities or with sham/placebo were included. Data was extracted and studies were reviewed on standardized qualitative assessment criteria. Cochrane guidelines were followed to find out the risk of bias among the included studies. RESULTS All the studies provided moderate to high quality evidence in favor of visceral mobilization or manipulation being effective on low back pain in terms of risk of bias and quality assessment with significant results (p-value <0.05). CONCLUSION The available studies provided the significant and strong effectiveness of visceral manipulation and mobilization. However, scarcity of literature in domain raises an inevitable need for further studies to be conducted in future.

scholarly journals Effects of Nutrition on Cognitive Function in Adults with or without Cognitive Impairment: A Systematic Review of Randomized Controlled Clinical Trials

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3728
Author(s):  
Laia Gutierrez ◽  
Alexandre Folch ◽  
Melina Rojas ◽  
José Luis Cantero ◽  
Mercedes Atienza ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Dietary Supplements ◽  
Specific Protein ◽  
Dietary Interventions ◽  
Dietary Counseling ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
The Impact

New dietary approaches for the prevention of cognitive impairment are being investigated. However, evidence from dietary interventions is mainly from food and nutrient supplement interventions, with inconsistent results and high heterogeneity between trials. We conducted a comprehensive systematic search of randomized controlled trials (RCTs) published in MEDLINE-PubMed, from January 2018 to July 2021, investigating the impact of dietary counseling, as well as food-based and dietary supplement interventions on cognitive function in adults with or without cognitive impairment. Based on the search strategy, 197 eligible publications were used for data abstraction. Finally, 61 articles were included in the analysis. There was reasonable evidence that dietary patterns, as well as food and dietary supplements improved cognitive domains or measures of brain integrity. The Mediterranean diet showed promising results, whereas the role of the DASH diet was not clear. Healthy food consumption improved cognitive function, although the quality of these studies was relatively low. The role of dietary supplements was mixed, with strong evidence of the benefits of polyphenols and combinations of nutrients, but with low evidence for PUFAs, vitamin D, specific protein, amino acids, and other types of supplements. Further well-designed RCTs are needed to guide the development of dietary approaches for the prevention of cognitive impairment.

scholarly journals Effect of Omega-3 Supplementation in Patients With Smell Dysfunction Following Endoscopic Sellar and Parasellar Tumor Resection: A Multicenter Prospective Randomized Controlled Trial

Neurosurgery ◽  
2020 ◽  
Vol 87 (2) ◽  
pp. E91-E98 ◽  
Author(s):  
Carol H Yan ◽  
Aakanksha Rathor ◽  
Kaelyn Krook ◽  
Yifei Ma ◽  
Melissa R Rotella ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Endoscopic Resection ◽  
Controlled Trial ◽  
Tumor Resection ◽  
Skull Base Tumor ◽  
Omega 3 ◽  
Randomized Controlled ◽  
Olfactory Loss ◽  
Prospective Randomized Controlled Trial ◽  
The Impact

Abstract BACKGROUND Endoscopic endonasal approaches pose the potential risk of olfactory loss. Loss of olfaction and potentially taste can be permanent and greatly affect patients’ quality of life. Treatments for olfactory loss have had limited success. Omega-3 supplementation may be a therapeutic option with its effect on wound healing and nerve regeneration. OBJECTIVE To evaluate the impact on olfaction in patients treated with omega-3 supplementation following endoscopic skull base tumor resection. METHODS In this multi-institutional, prospective, randomized controlled trial, 110 patients with sellar or parasellar tumors undergoing endoscopic resection were randomized to nasal saline irrigations or nasal saline irrigations plus omega-3 supplementation. The University of Pennsylvania Smell Identification Test (UPSIT) was administered preoperatively and at 6 wk, 3 mo, and 6 mo postoperatively. RESULTS Eighty-seven patients completed all 6 mo of follow-up (41 control arm, 46 omega-3 arm). At 6 wk postoperatively, 25% of patients in both groups experienced a clinically significant loss in olfaction. At 3 and 6 mo, patients receiving omega-3 demonstrated significantly less persistent olfactory loss compared to patients without supplementation (P = .02 and P = .01, respectively). After controlling for multiple confounding variables, omega-3 supplementation was found to be protective against olfactory loss (odds ratio [OR] 0.05, 95% CI 0.003-0.81, P = .03). Tumor functionality was a significant independent predictor for olfactory loss (OR 32.7, 95% CI 1.15-929.5, P = .04). CONCLUSION Omega-3 supplementation appears to be protective for the olfactory system during the healing period in patients who undergo endoscopic resection of sellar and parasellar masses.

Systematic review and meta-analysis of randomized controlled trials assessing the impact of Baduanjin exercise on cognition and memory in patients with mild cognitive impairment

2020 ◽  
pp. 026921552096966
Author(s):  
Liqiang Yu ◽  
Fang Liu ◽  
Pingying Nie ◽  
Cuiling Shen ◽  
Junying Chen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Conventional Therapy ◽  
Verbal Learning ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Objective: To determine the effectiveness of Baduanjin exercise in improving cognition and memory in patients with mild cognitive impairment. Data sources: Relevant English- and Chinese-language studies published until 15th September 2020 were retrieved from the PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, OVID, National Knowledge Infrastructure, WANFANG DATA, VIP Information, and SinoMed databases. Review methods: Randomized controlled trials assessing Baduanjin exercise in patients with mild cognitive impairment were included. Two researchers independently identified eligible studies and extracted data. Risk-of-bias assessment was performed using the Cochrane Risk of Bias Tool. Results: This study included 16 randomized controlled trials (1054 participants) from China that used Chinese versions of standardized tests. Most studies had no significant bias, and only one study had a high risk of bias in the random allocation category. Compared with conventional therapy alone, Baduanjin plus conventional therapy significantly improved the Montreal Cognitive Assessment and Mini-Mental State Examination scores after 6 months of treatment ( P < 0.00001 for both), significantly decreased the tau/Aβ1–42 ratio in the cerebrospinal fluid ( P < 0.00001), and significantly improved some dimensional scores on the Wechsler Memory Scale and the auditory verbal learning test scores at 6 months ( P < 0.05 for all). Conclusion: Compared with conventional therapy, Baduanjin plus conventional therapy significantly improved cognitive and memory function in patients with mild cognitive impairment.

scholarly journals The impact of worksite nutrition and physical activity interventions on productivity, work performance and workability: A Systematic Review

2019 ◽  
Author(s):  
Aikaterini Grimani ◽  
Emmanuel Aboagye ◽  
Lydia Kwak
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Work Performance ◽  
Risk Of Bias ◽  
Work Related ◽  
Randomized Controlled ◽  
Physical Activity Interventions ◽  
Randomized Controlled Studies ◽  
Nutrition And Physical Activity ◽  
The Impact

Abstract Background Healthy lifestyles play an important role in the prevention of premature death, chronic diseases, productivity loss and other social and economic concerns. However, worksite interventions to address issues of fitness and nutrition which include work-related outcomes are complex and thus challenging to implement and appropriately measure the effectiveness of. This systematic review investigated the impact of worksite nutrition and physical activity interventions, which include components aimed at worksite’s physical environment and organizational structure, on employees’ productivity, work performance and workability. Methods A systematic review that included randomized controlled trials and or non-randomized controlled studies was conducted. Medline, EMBASE.com, Cochrane Library and Scopus were searched until September 2016. Productivity, absenteeism, presenteeism, work performance and workability were the primary outcomes of our interest, while sedentary behavior and changes in other health-related behaviors were considered as secondary outcomes. Two reviewers independently screened abstracts and full-texts for study eligibility, extracted the data and performed a quality assessment using the Cochrane Collaboration Risk-of-Bias Tool for randomized trials and the Risk-of-Bias in non-randomized studies of interventions. Findings were narratively synthesized. Results Thirty-nine randomized control trials and non-randomized controlled studies were included. Nearly 28% of the included studies were of high quality, while 56% were of medium quality. The studies covered a broad range of multi-level and environmental-level interventions. Fourteen worksite nutrition and physical activity intervention studies yielded statistically significant changes on absenteeism (n=7), work performance (n=2), workability (n=3), productivity (n=1) and on both workability and productivity (n=1). Two studies showed effects on absenteeism only between subgroups. Conclusions The scientific evidence shows that it is possible to influence work-related outcomes, especially sickness absence, positively through health promotion efforts that include components aimed at the workplace’s physical work environment and organizational structure. In order to draw further conclusions regarding work-related outcomes in controlled high-quality studies, long-term follow-up using objective outcomes and/or quality assured questionnaires are required. Registration number PROSPERO CRD42017081837

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