DIAGNOSTIC ALTERNATIVES TO ENDOCOSPIC ULTRASOUND IN SUBEPITHELIAL LESIONS: A SYSTEMATIC REVIEW

2021 ◽  
pp. 153-156
Author(s):  
Luiz Carlos Bertges ◽  
Ana Paula Ferreira ◽  
Klaus Ruback Bertges ◽  
Erika Ruback Bertges ◽  
Izabella Paiva Diogo Dornellas

Introduction: Subepithelial lesions are a challenge in clinical practice, often requiring a biopsy for a proper diagnosis. Currently, the gold standard is an endocospic ultrasound, which is rarely available. Objectives: Use a systematic review to check the effectiveness of the mucosal incision-assisted biopsy and assess whether it can be an alternative to endocospic ultrasound. Methods: The most relevant studies in the MedLine and SciELO databases were reviewed, and only randomized controlled clinical trials (RCT) and meta-analyses were considered. The search strategy used the following combinations of keywords: subepithelial lesion mucosal incision biopsy. The following terms were used to identify the study designs: clinical trials. Results: Seven articles that demonstrated the usefulness of the study technique and diagnostic efcacy were included in the scope of this review. This technique seems safe for biopsies. However, it is controversial for the resection of lesions. It has limitations, such as being more time-consuming. Conclusion: Mucosal incision-assisted biopsy can be considered useful in clinical practice and is still an effective technique and an alternative to endocospic ultrasound

Author(s):  
Seyed Reza Mirhafez ◽  
Mitra Hariri

Abstract. L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.


1997 ◽  
Vol 111 (7) ◽  
pp. 611-613 ◽  
Author(s):  
K. W. Ah-See ◽  
N. C. Molony ◽  
A. G. D. Maran

AbstractThere is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.


Author(s):  
Zeinab Yazdanpanah ◽  
Mandana Amiri ◽  
Azadeh Nadjarzadeh ◽  
Hadis Hooshmandi ◽  
Maryam Azadi-Yazdi

Introduction: Hypertension is a chronic condition that might lead to renal and cardiovascular diseases. The previous trials examining the effect of cinnamon supplementation on blood pressure have led to conflicting results. The present systematic review aimed to summarize the effect of cinnamon supplementation on blood pressure using a meta-analysis of published randomized controlled clinical trials. Methods: To identify the eligible articles, MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched from inception until September 2019 for relevant articles. The risk of bias assessment was performed using the Cochrane collaboration tool. A Random-effects model was applied to calculate the summary effects. Results: Totally, 11 trials with 686 participants were included in this systematic review and meta-analysis. The dose of cinnamon supplement consumption varied from 500 to 10000 mg/d. The meta-analysis revealed that cinnamon supplementation significantly decreases systolic blood pressure (SBP) [WMD (weighted mean difference)= -5.72 mmHg, 95% confidence interval (CI): -8.63 to -2.80; P<0.001, I2= 81.1)] and diastolic blood pressure (DBP) (WMD= -4.06 mmHg, 95% CI: -6.68 to -1.44; P= 0.002, I2 = 88.6). Subgroup analysis suggested no significant reduction of DBP in subjects with diabetes (WMD= -2.015 mmHg, 95% CI: -4.55 to 0.52; P= 0.12, I2 = 72.3) and prediabetes or metabolic syndrome (WMD= -4.8 mmHg, 95% CI: -10.06 to 0.44; P= 0.073, I2= 92.5). Conclusions: Cinnamon supplementation could be beneficial in lowering SBP and DBP in adults. Further studies with different doses are recommended to confirm the present findings.


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