Página 30 dos resultados de 95517 itens digitais encontrados em 0.152 segundos

‣ Mental Health and Physical Activity in Women with Polycystic Ovary Syndrome: A Brief Review

Conte, Francesca; Banting, Lauren; Teede, Helena J.; Stepto, Nigel K.
Fonte: Springer International Publishing Publicador: Springer International Publishing
Tipo: Artigo de Revista Científica
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This review was designed to consider the available literature concerning mental health and physical activity in women with polycystic ovary syndrome (PCOS). A systematic approach was taken and two electronic databases (PubMed and EBSCO Research articles published between 1970 and 2013) were searched in 2013 to inform a narrative review. Inclusion criteria encompassed requirements for the research to involve a physical activity intervention and assessment of mental health outcomes in women with PCOS. Seven articles considered mental health outcomes and physical activity interventions for women with PCOS. The results demonstrated positive outcomes following physical activity intervention for health-related quality of life, depression, and anxiety. Only one paper reported the independent effects of physical activity on mental health. All other interventions included multi-factor lifestyle interventions or did not establish a control group. Physical activity is likely to be beneficial to the mental health of women with PCOS; however, more research is required to establish the nature of the relationship between physical activity and mental health outcomes.

‣ Pandanus odoratissimus (Kewda): A Review on Ethnopharmacology, Phytochemistry, and Nutritional Aspects

Adkar, Prafulla P.; Bhaskar, V. H.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
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Pandanus odoratissimus Linn. (family: Pandanaceae) is traditionally recommended by the Indian Ayurvedic medicines for treatment of headache, rheumatism, spasm, cold/flu, epilepsy, wounds, boils, scabies, leucoderma, ulcers, colic, hepatitis, smallpox, leprosy, syphilis, and cancer and as a cardiotonic, antioxidant, dysuric, and aphrodisiac. It contains phytochemicals, namely, lignans and isoflavones, coumestrol, alkaloids, steroids, carbohydrates, phenolic compounds, glycosides, proteins, amino acids as well as vitamins and nutrients, and so forth. It is having immense importance in nutrition. A 100 g edible Pandanus pericarp is mainly comprised of water and carbohydrates (80 and 17 g, resp.) and protein (1.3 mg), fat (0.7 mg), and fiber (3.5 g). Pandanus fruits paste provides 321 kilocalories, protein (2.2 g), calcium (134 mg), phosphorus (108 mg), iron (5.7 mg), thiamin (0.04 mg), vitamin C (5 mg), and beta-carotene (19 to 19,000 μg) (a carotenoid that is a precursor to vitamin A). Pandanus fruit is an important source of vitamins C, B1, B2, B3, and so forth, usually prepared as a Pandanus floured drink. Traditional claims were scientifically evaluated by the various authors and the phytochemical profile of plant parts was well established. The methods for analytical estimations were developed. However...

‣ Epidemiology of Adverse Drug Reactions in Europe: A Review of Recent Observational Studies

Bouvy, Jacoline C.; De Bruin, Marie L.; Koopmanschap, Marc A.
Fonte: Springer International Publishing Publicador: Springer International Publishing
Tipo: Artigo de Revista Científica
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Adverse drug reactions (ADRs) cause considerable mortality and morbidity but no recent reviews are currently available for the European region. Therefore, we performed a review of all epidemiological studies quantifying ADRs in a European setting that were published between 1 January 2000 and 3 September 2014. Included studies assessed the number of patients who were admitted to hospital due to an ADR, studies that assessed the number of patients who developed an ADR during hospitalization, and studies that measured ADRs in the outpatient setting. In total, 47 articles were included in the final review. The median percentage of hospital admissions due to an ADR was 3.5 %, based on 22 studies, and the median percentage of patients who experienced an ADR during hospitalization was 10.1 %, based on 13 studies. Only five studies were found that assessed ADRs occurring in the outpatient setting. These results indicate that the occurrence of ADRs in the European hospital setting—both ADRs that result in hospitalization and ADRs that occur during the hospital stay—is significant. Furthermore, the limited number of studies that were performed in the outpatient setting identify a lack of information regarding the epidemiology of ADRs in this setting.

‣ The Immunomodulatory Effect of Acupoint Application for Childhood Asthma: A Systematic Review and Meta-Analysis

Yang, Xiao Cun; Yin, Tao; Gao, Qian; Kong, Ling Jun
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
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Objective. To evaluate the evidence on the immunomodulatory effect of acupoint application for childhood asthma. Methods. Five electronic databases through October 2014 were searched. The risk of bias in eligible studies was assessed using the Cochrane Collaboration tool. Standardised mean difference (SMD) and 95% confidence intervals (CI) of random-effects model were calculated. And heterogeneity was assessed using the Cochran Q statistic and quantified with the I2 index. Results. Six studies were included in our review. The aggregated results suggested that acupoint application showed the beneficial effect for childhood asthma in improving IgA (SMD, −0.83; 95% CI −1.14 to −0.52; P < 0.00001), IgE (SMD, −0.52; 95% CI −0.76 to −0.29; P < 0.001), IgG (SMD, −1.17; 95% CI −1.61 to −0.74; P < 0.0001), IL-4 (SMD, −0.57; 95% CI −0.91 to −0.23; P = 0.0009), and IFN-γ (SMD, −0.38; 95% CI −0.71 to −0.04; P = 0.03) but not IgM (SMD, −0.40; 95% CI −0.98 to 0.18; P = 0.18). And the effective dose of acupoint application may be 2–6 hours/time and a total of 3 times within 4 weeks. Conclusions. This review showed the positive evidence that acupoint application had the favorable immunomodulatory effect for childhood asthma. However...

‣ Cognitive impairment in COPD: a systematic review*

Torres-Sánchez, Irene; Rodríguez-Alzueta, Elisabeth; Cabrera-Martos, Irene; López-Torres, Isabel; Moreno-Ramírez, Maria Paz; Valenza, Marie Carmen
Fonte: Sociedade Brasileira de Pneumologia e Tisiologia Publicador: Sociedade Brasileira de Pneumologia e Tisiologia
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

‣ An Updated Review of Interventions that Include Promotion of Physical Activity for Adult Men

Bottorff, Joan L.; Seaton, Cherisse L.; Johnson, Steve T.; Caperchione, Cristina M.; Oliffe, John L.; More, Kimberly; Jaffer-Hirji, Haleema; Tillotson, Sherri M.
Fonte: Springer International Publishing Publicador: Springer International Publishing
Tipo: Artigo de Revista Científica
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The marked disparity in life expectancy between men and women suggests men are a vulnerable group requiring targeted health promotion programs. As such, there is an increasing need for health promotion strategies that effectively engage men with their health and/or illness management. Programs that promote physical activity could significantly improve the health of men. Although George et al. (Sports Med 42(3):281, 30) reviewed physical activity programs involving adult males published between 1990 and 2010, developments in men’s health have prompted the emergence of new sex- and gender-specific approaches targeting men. The purpose of this review was to: (1) extend and update the review undertaken by George et al. (Sports Med 42(3):281, 30) concerning the effectiveness of physical activity programs in males, and (2) evaluate the integration of gender-specific influences in the content, design, and delivery of men’s health promotion programs. A search of MEDLINE, CINAHL, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and the SPORTDiscus databases for articles published between January 2010 and August 2014 was conducted. In total, 35 studies, involving evaluations of 31 programs, were identified. Findings revealed that a variety of techniques and modes of delivery could effectively promote physical activity among men. Though the majority of programs were offered exclusively to men...

‣ Neighborhood-Level Stress and Circadian Cortisol: A Systematic Review and Meta-Analysis

HOSSEINI, Fatemeh; ADHA, Nikmatul; ZAINOL, Rosilawati; ISAHAK, Marzuki; NEMATI, Nahid
Fonte: Tehran University of Medical Sciences Publicador: Tehran University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em /10/2014 Português
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The main objective was to find association between basal cortisol and neighborhood-level stress. Systematic searches, including electronic and hand searches, were conducted. The most recent date of the search was July 26, 2013. Primary observational studies included if they considered stress related outcomes in the neighborhood context. Using the EndNote X7 advanced search option; the authors examined the abstracts and titles of the 18,092 articles to exclude obviously irrelevant studies, gray literature, discussion papers, reviews and, studies with no complete data. Two authors independently extracted data from the original reports into pre-designed data extraction forms based on the Data Extraction Template of the Cochrane Consumer and Communication Review Group (CCCRG). Ten studies with a total of 2,134 participants were synthesized and analyzed. Two studies out of ten received expanded meta-analysis. The overall effect size (95% CI) for cortisol level for residents in neighborhoods with lower stress compared to inhabitants from higher was 0.12 (0.01, 0.23). This review is demonstrating a link between psychosocial or physical stress and cortisol obtained from saliva. However, living in high disorder neighborhoods results in higher level of cortisol. This represents a biological indicator of psychosocial/physical stress exposure (i.e....

‣ A Review of Pioneer Physicians’ Work on Maternal Health in Pregnancy in Ancient Iran; Narrative Systematic Review

JAFARI-DEHKORDI, Effat; MOKABERINEJAD, Roshanak; MINAEI, Bagher; SOHRABVAND, Farnaz; NAZEM, Esmaeil; HASHEM DABAGHIAN, Fataneh; ALIASL, Jale
Fonte: Tehran University of Medical Sciences Publicador: Tehran University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em /12/2013 Português
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Background Maternal lifestyle and behaviors during pregnancy have been associated with future health outcomes for mothers and babies. Iranian Traditional medicine, which is a holistically-oriented medical discipline, has special attitudes towards pregnancy. The purpose of the study is the investigation of maternal health in medical books of ancient Iran. This study is a systematic review scrutinizing issues concerning lifestyle during pregnancy based on “Avicenna’s Canon medicine” and “Rhazes Al-Havi” and for complete discussion, other reliable sources in traditional medicine which was conducted following the categorization and analysis of the gleaned data. Based on approaches by Iranian Traditional Medicine, the most important topics in lifestyle habits during pregnancy are divided into four main groups: Nutrition, physical exercise, sexual activity and psychological stress. Then special recommendations are suggested which include a regimen to facilitate labor. Eating behaviors and other lifestyle habits have a major role in optimizing the health of women in pregnancy. Regarding to traditional medicine viewpoints paying special attention to correcting diet, life style and preventive attitude with effective and simple therapeutic procedures...

‣ Anti-Inflammatory Effects of Heparin and Its Derivatives: A Systematic Review

Mousavi, Sarah; Moradi, Mandana; Khorshidahmad, Tina; Motamedi, Maryam
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
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Background. Heparin, used clinically as an anticoagulant, also has anti-inflammatory properties. The purpose of this systematic review was to provide a comprehensive review regarding the efficacy and safety of heparin and its derivatives as anti-inflammatory agents. Methods. We searched the following databases up to March 2012: Pub Med, Scopus, Web of Science, Ovid, Elsevier, and Google Scholar using combination of Mesh terms. Randomized Clinical Trials (RCTs) and trials with quasi-experimental design in clinical setting published in English were included. Quality assessments of RCTs were performed using Jadad score and Consolidated Standards of Reporting Trials (CONSORT) checklist. Results. A total of 280 relevant studies were reviewed and 57 studies met the inclusion criteria. Among them 48 studies were RCTs. About 65% of articles had score of 3 and higher according to Jadad score. Twelve studies had a quality score > 40% according to CONSORT items. Asthma (n = 7), inflammatory bowel disease (n = 5), cardiopulmonary bypass (n = 8), and cataract surgery (n = 6) were the most studied disease condition. Forty studies use unfractionated heparin (UFH) for intervention; the remaining studies use low molecular weight heparin (LMWH). Conclusion. Despite the conflicting results...

‣ Association between myasthenia gravis and cognitive function: A systematic review and meta-analysis

Mao, Zhifeng; Yin, Junjie; Lu, Zhengqi; Hu, Xueqiang
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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The course of myasthenia gravis (MG) is complicated by increased reports of cognitive defects in both human and animal models, which suggests potential central nervous system (CNS) damage. We conducted a systematic review of the relationships between MG and cognitive function. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Major databases were searched to examine the neuropsychological studies of adults with MG. Weighted effect sizes were pooled by cognitive domain. Eight studies representing 300 subjects were included. Eight cognitive domain categories were identified: (i) Mini-Mental State Examination (MMSE), (ii) language, (iii) processing speed, (iv) verbal learning and memory, (v) visual learning and memory, (vi) attention span, (vii) response fluency, and (viii) motor performance. Nine (cognitive domain categories, MMSE, language, processing speed, verbal learning and memory (except for delayed recall memory), and motor performance) of 16 cognitive tasks revealed significant moderate effect sizes. Verbal logical-delayed memory, finger tapping with the preferred hand, and the Symbol Digit Modalities Test showed a greater magnitude relationship to cognitive function than did other specific cognitive domains. Verbal learning and memory seems to be the most significant affected according to cognitive domain categories. For MG...

‣ Recessive Dystrophic Epidermolysis Bullosa: A Review of Disease Pathogenesis and Update on Future Therapies

Soro, Luis; Bartus, Cynthia; Purcell, Stephen
Fonte: Matrix Medical Communications Publicador: Matrix Medical Communications
Tipo: Artigo de Revista Científica
Publicado em /05/2015 Português
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Objective: Review the pathogenesis of recessive dystrophic epidermolysis bullosa and provide an update on research currently underway that is aimed at treating and potentially curing this severe skin disorder. Design: Review article. Setting: Private practice and large teaching hospital. Participants: None. Measurements: N/A. Results: Currently, patients with recessive dystrophic epidermolysis bullosa are managed with only supportive care. However, there are several promising new treatment avenues that may help patients in the future. These include gene therapy, cell therapy, and protein-based therapy. Each approach offers distinct advantages and disadvantages. Conclusions: The advances in understanding the molecular basis for epidermolysis bullosa over the last few decades has led to significant progress in devising new treatment options. Though many of these approaches remain several years away from regular implementation, it is an exciting time for research in the field.

‣ A critical review of pharmacological significance of Hydrogen Sulfide in hypertension

Ahmad, Ashfaq; Sattar, Munavvar A.; Rathore, Hassaan A.; Khan, Safia Akhtar; Lazhari, M. I.; Afzal, Sheryar; Hashmi, F.; Abdullah, Nor A.; Johns, Edward J.
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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In the family of gas transmitters, hydrogen sulfide (H2S) is yet not adequately researched. Known for its rotten egg smell and adverse effects on the brain, lungs, and kidneys for more than 300 years, the vasorelaxant effects of H2S on blood vessel was first observed in 1997. Since then, research continued to explore the possible therapeutic effects of H2S in hypertension, inflammation, pancreatitis, different types of shock, diabetes, and heart failure. However, a considerable amount of efforts are yet needed to elucidate the mechanisms involved in the therapeutic effects of H2S, such as nitric oxide-dependent or independent vasodilation in hypertension and regression of left ventricular hypertrophy. More than a decade of good repute among researchers, H2S research has certain results that need to be clarified or reevaluated. H2S produces its response by multiple modes of action, such as opening the ATP-sensitive potassium channel, angiotensin-converting enzyme inhibition, and calcium channel blockade. H2S is endogenously produced from two sulfur-containing amino acids L-cysteine and L-methionine by the two enzymes cystathionine γ lyase and cystathionine β synthase. Recently, the third enzyme, 3-mercaptopyruvate sulfur transferase...

‣ The Influence and Role of Microbial Factors in Autoimmune Kidney Diseases: A Systematic Review

Kronbichler, Andreas; Kerschbaum, Julia; Mayer, Gert
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
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A better understanding of the pathophysiology of autoimmune disorders is desired to allow tailored interventions. Despite increased scientific interest a direct pathogenic factor in autoimmune renal disease has been described only in a minority like membranous nephropathy or ANCA-associated vasculitis. Nonetheless the initial step leading to the formation of these antibodies is still obscure. In this review we will focus on the possible role of microbial factors in this context. Staphylococcus aureus may be a direct pathogenetic factor in granulomatosis with polyangiitis (GPA). Chronic bacterial colonization or chronic infections of the upper respiratory tract have been proposed as trigger of IgA vasculitis and IgA nephropathy. Interventions to remove major lymphoid organs, such as tonsillectomy, have shown conflicting results but may be an option in IgA vasculitis. Interestingly no clear clinical benefit despite similar local colonization with bacterial strains has been detected in patients with IgA nephropathy. In systemic lupus erythematosus injection of bacterial lipopolysaccharide induced progressive lupus nephritis in mouse models. The aim of this review is to discuss and summarize the knowledge of microbial antigens in autoimmune renal disease. Novel methods may provide insight into the involvement of microbial antigens in the onset...

‣ Spatial and temporal trends of the Stockholm Convention POPs in mothers’ milk — a global review

Fång, Johan; Nyberg, Elisabeth; Winnberg, Ulrika; Bignert, Anders; Bergman, Åke
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
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Persistent organic pollutants (POPs) have been of environmental and health concern for more than half a century and have their own intergovernmental regulation through the Stockholm Convention, from 2001. One major concern is the nursing child’s exposure to POPs, a concern that has led to a very large number of scientific studies on POPs in mothers’ milk. The present review is a report on the assessment on worldwide spatial distributions of POPs and of their temporal trends. The data presented herein is a compilation based on scientific publications between 1995 and 2011. It is evident that the concentrations in mothers’ milk depend on the use of pesticides and industrial chemicals defined as POPs. Polychlorinated biphenyls (PCBs) and “dioxins” are higher in the more industrialized areas, Europe and Northern America, whereas pesticides are higher in Africa and Asia and polybrominated diphenyl ethers (PBDEs) are reported in higher concentrations in the USA. POPs are consequently distributed to women in all parts of the world and are thus delivered to the nursing child. The review points out several major problems in the reporting of data, which are crucial to enable high quality comparisons. Even though the data set is large...

‣ Absorbable and nonabsorbable packing after functional endoscopic sinus surgery: systematic review and meta-analysis of outcomes

Wang, Tang-Chuan; Tai, Chih-Jaan; Tsou, Yung-An; Tsai, Li-Tai; Li, Yu-Fen; Tsai, Ming-Hsui
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
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The purpose of the study was to perform a systematic review and meta-analysis of the literature to compare the efficacy (and other postoperative outcomes) of nonabsorbable versus absorbable nasal packing after functional endoscopic sinus surgery (FESS) for the treatment of chronic rhinosinusitis. Studies were considered for inclusion if they were published in English language, were randomized clinical trials, and reported on outcomes following postoperative synechia. The primary outcome for meta-analysis was the incidence of postoperative synechia; pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using fixed-effects models. Five studies, involving 241 nasal cavities in each treatment group, were included in the systematic review. The prevalence of synechia ranged from 4.6 to 8.0 % in the absorbable groups and from 8.0 to 35.7 % in the nonabsorbable groups. Postoperative bleeding was lower in the absorbable groups, whereas there was no clear finding regarding postoperative pain. Postoperative edema was generally similar between groups. There were no consistent findings regarding bleeding and pain on packing removal. Two studies using the same type of packing material were included in the meta-analysis. The combined OR (0.33...

‣ A Review on Automatic Mammographic Density and Parenchymal Segmentation

He, Wenda; Juette, Arne; Denton, Erika R. E.; Oliver, Arnau; Martí, Robert; Zwiggelaar, Reyer
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
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Breast cancer is the most frequently diagnosed cancer in women. However, the exact cause(s) of breast cancer still remains unknown. Early detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the most effective way to tackle breast cancer. There are more than 70 common genetic susceptibility factors included in the current non-image-based risk prediction models (e.g., the Gail and the Tyrer-Cuzick models). Image-based risk factors, such as mammographic densities and parenchymal patterns, have been established as biomarkers but have not been fully incorporated in the risk prediction models used for risk stratification in screening and/or measuring responsiveness to preventive approaches. Within computer aided mammography, automatic mammographic tissue segmentation methods have been developed for estimation of breast tissue composition to facilitate mammographic risk assessment. This paper presents a comprehensive review of automatic mammographic tissue segmentation methodologies developed over the past two decades and the evidence for risk assessment/density classification using segmentation. The aim of this review is to analyse how engineering advances have progressed and the impact automatic mammographic tissue segmentation has in a clinical environment...

‣ Eye Acupuncture Treatment for Stroke: A Systematic Review and Meta-Analysis

Bai, Zeng-Hua; Zhang, Zhi-Xing; Li, Chun-Ri; Wang, Mei; Kim, Meong-Ju; Guo, Hui; Wang, Chun-Yan; Xiao, Tong-Wu; Chi, Yuan; Ren, Lu; Gu, Zhong-Yue; Xu, Ran
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
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There were applications of eye acupuncture for stroke patients. Unfortunately, similar to many other Traditional Chinese Medicine (TCM) treatments, it lacks comprehensive evaluation and system review for its effect and safety. Objective. This study is a systematic review to appraise the safety and effectiveness of eye acupuncture for stroke. Methods. “Eye acupuncture therapy” in eleven databases was searched by randomized controlled trials and quasi-randomized controlled trials. The search activity was ended in April 2014. The data were extracted and assessed by three independent authors. Rev Man 5.0 software was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval. Results. Sixteen trials (1120 patients) were involved with generally poor methodological quality. The study indicated that when eye acupuncture was combined with western medicine compared to western medicine, there was a significant difference in the areas of mental state, swallow function, and NDS. When eye acupuncture was combined with western medicine and rehabilitation compared to western medicine and rehabilitation, there was significant difference in the changes of SSS, FMA, and constipation symptoms evaluation. No adverse events or side effects have been reported. Conclusions. The current evidence is insufficient and the rigorously designed trials are warranted.

‣ Efficacy of Laparoscopic Mini Gastric Bypass for Obesity and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Quan, Yingjun; Huang, Ao; Ye, Min; Xu, Ming; Zhuang, Biao; Zhang, Peng; Yu, Bo; Min, Zhijun
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
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Background. Controversies on the utility of laparoscopic mini gastric bypass (LMGB) in weight loss and type 2 diabetes mellitus (T2DM) control still exist. Methods. We conducted a comprehensive literature search of PubMed, EMBASE, and Cochrane Library. Review Manager was used to perform the meta-analysis and the weighted mean difference (WMD) and/or odds ratio with 95% confidence interval (95% CI) were used to evaluate the overall size effect. Results. The literature search identified 16 studies for systematic review and 15 articles for meta-analysis. Compared with LAGB, LSG, and LRYGB, LMGB showed significant weight loss [WMD, −6.58 (95% CI, −9.37, −3.79), P < 0.01 (LAGB); 2.86 (95% CI, 1.40, 5.83), P = 0.004 (LSG); 10.33 (95% CI, 4.30, 16.36), P < 0.01 (LRYGB)] and comparable/higher T2DM remission results [86.2% versus 55.6%, P = 0.06 (LAGB); 89.1% versus 76.3%, P = 0.004 (LAGB); 93.4% versus 77.6%, P = 0.006 (LAGB)]; LMGB also had shorter learning curve and less operation time than LRYGB [WMD, −35.2 (95% CI, −46.94, −23.46)]. Conclusions. LMGB appeared to be effective in weight loss and T2DM remission and noninferior to other bariatric surgeries. However, clinical utility of LMGB needs to be further validated by future prospective randomized controlled trials.

‣ Helicobacter pylori and gastric cancer: a state of the art review

Ishaq, Sauid; Nunn, Lois
Fonte: Shaheed Beheshti University of Medical Sciences Publicador: Shaheed Beheshti University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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Gastric cancer is the third most common cause of cancer-related death in the world. It is now well- established that Helicobacter pylori infection predispose individuals toward gastric adenocarcinoma later in life. It has since been classified as a class I carcinogen by the World Health Organization. Research suggests that the oncogenic effects of Helicobacter pylori can occur through a variety of mechanisms, including the indirect inflammatory effects of Helicobacter pylori on the gastric mucosa and the direct epigenetic effects of Helicobacter pylori on individual cells. Whilst infected with Helicobacter pylori, a combination of environmental and host-dependent factors determines the likelihood of developing gastric cancer. Controversy remains regarding the effects of eradication of Helicobacter pylori on the prevention of further progression of gastric lesions and the possibility for regression of atrophic gastritis. The aim of this review is to synthesis different elements that contribute to the step-wise progression of normal gastric mucosa to gastric adenocarcinoma. This review helps clinicians to better identify those infected individuals who are at high risk of developing gastric cancer and implement the necessary investigations and treatment.

‣ Vitamin D & its analogues in type 2 diabetic nephropathy: a systematic review

Chokhandre, Mrunalini K; Mahmoud, Mahmoud I; Hakami, Tahir; Jafer, Mohammed; Inamdar, Aadil S
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 15/07/2015 Português
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Nephropathy is one of the major complications of diabetes often leading to chronic kidney disease (CKD). Inflammation and oxidative stress are associated with pathogenesis of diabetic nephropathy (DN) and found to be regulated by nuclear receptors such as vitamin D receptors (VDR). Vitamin D and its analogues have been effectively used in patients with CKD. The review attempts to summarize the available evidence on the role of vitamin D in DN. Electronic databases (MEDLINE, EMBASE, and Cochrane Library) were searched for studies assessing the role of vitamin D or its analogues on kidney function in type 2 diabetic patients. Studies evaluating kidney functions (urinary albumin/protein creatinine ratio, albuminuria and eGFR) were included and quality and risk of bias assessment performed. Additionally effect on 25 (OH) vitamin D, calcium and HbA1c were evaluated. The mean or its % change along with their standard deviation (SD) was used for reporting our results. RevMan (V5.2) was used for data analysis. Six studies included in this review evaluated the role of cholecalciferol, calcitriol and paricalcitol in patients with DN. Study designs differed (three randomized, one non-randomized and two uncontrolled trials) with varying degree of quality and risk of biases. Vitamin D analogues showed significant improvement in kidney function in two randomized studies. None of the studies reported significant incidences of hypercalcemia. Vitamin D analogues show significant improvement of kidney function in DN. Randomized controlled trials with longer duration...