We conducted a meta-analysis to investigate the efficacy of ginseng supplements on fatigue reduction and physical performance enhancement as reported by randomized controlled trials (RCTs). RCTs that ...investigated the efficacy of ginseng supplements on fatigue reduction and physical performance enhancement compared with placebos were included. The main outcome measures were fatigue reduction and physical performance enhancement. Out of 155 articles meeting initial criteria, 12 RCTs involving 630 participants (311 participants in the intervention group and 319 participants in the placebo group) were included in the final analysis. In the fixed-effect meta-analysis of four RCTs, there was a statistically significant efficacy of ginseng supplements on fatigue reduction (standardized mean difference, SMD = 0.34; 95% confidence interval CI = 0.16 to 0.52). However, ginseng supplements were not associated with physical performance enhancement in the fixed-effect meta-analysis of eight RCTs (SMD = -0.01; 95% CI = -0.29 to 0.27). We found that there was insufficient clinical evidence to support the use of ginseng supplements on reducing fatigue and enhancing physical performance because only few RCTs with a small sample size have been published so far. Further lager RCTs are required to confirm the efficacy of ginseng supplements on fatigue reduction.
Although obesity is shown to be a risk factor for epithelial ovarian cancer, its role as a prognostic factor has been remained inconclusive. In this study, available evidences on this matter to date ...have been assembled for a meta-analysis to determine the effect of obesity on the survival of patients with epithelial ovarian cancer.
Eligible studies published up to December 2010 were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, and manual review of relevant bibliography to look for additional studies was done. Adjusted hazard ratios (HRs) from individual studies were pooled using a random-effects model.
Ten cohort studies of 331 screened articles were included in the final analysis. The meta-analysis showed overweight or obesity at early adulthood to be associated with higher mortality among patients with ovarian cancer (HR, 1.60; 95% confidence interval, 1.10-2.34). Among patients with advanced ovarian cancer, premorbid obesity was associated with worse prognosis (HR, 1.45; 95% confidence interval, 1.09-1.93). However, there was no significant relationship between prognosis and obesity around the time of diagnosis.
This study suggests a possible relationship between obesity at early adulthood and higher mortality among patients with ovarian cancer. Further studies are needed to elucidate the harmful effect of obesity on the survival of patients with ovarian cancer.
Abstract Purpose Previous studies have reported inconsistent findings regarding the association between the use of acid-suppressive drugs such as proton pump inhibitors (PPIs) and histamine 2 ...receptor antagonists (H2 RAs) and fracture risk. We investigated this association using meta-analysis. Methods We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library from inception through December 2010 using common key words. We included case-control, nested case-control, and cohort studies. Two evaluators independently reviewed and selected articles. We determined pooled effect estimates by using random-effects meta-analysis, because of heterogeneity. Results Of 1,809 articles meeting our initial inclusion criteria, 5 case-control studies, 3 nested case-control studies, and 3 cohort studies were included in the final analyses. The pooled odds ratio (OR) for fracture was 1.29 (95% confidence interval CI, 1.18–1.41) with use of PPIs and 1.10 (95% CI, 0.99–1.23) with use of H2 RAs when compared with nonuse of the respective medications. Long-term use of PPIs increased the risk of any fracture (adjusted OR = 1.30; 95% CI, 1.15–1.48) and hip fracture risk (adjusted OR = 1.34; 95% CI, 1.09–1.66), whereas long-term H2 RA use was not significantly associated with fracture risk. Conclusions We found possible evidence linking PPI use to an increased risk of fracture, but no association between H2 RA use and fracture risk. Widespread use of PPIs with the potential risk of fracture is of great importance to public health. Clinicians should carefully consider their decision to prescribe PPIs for patients already having an elevated risk of fracture because of age or other factors.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Previous systematic reviews and meta-analyses of randomized controlled trials have reported controversial findings regarding the effects of melatonin on pain reduction. The aim of this study was to ...evaluate the efficacy of melatonin on pain among adults using a meta-analysis of randomized, double-blind, placebo-controlled trials (RDBPCTs). PubMed, EMBASE, the Cochrane Library, and the bibliographies of relevant articles were searched up to February 2020. Two of the authors independently evaluated eligibility of the studies based on the pre-determined criteria and extracted data. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) for the pain score change were calculated using a random-effects meta-analysis. Out of 463 that met the initial criteria, a total of 30 trials, which involved 1967 participants with 983 in an intervention group and 984 in a control group, were included in the final analysis. In a random-effects meta-analysis, the use of melatonin reduced chronic pain in all the trials (5 studies, SMD -0.65, 95% CI -0.96 to -0.34,
57.2%) and high-quality trials (4 studies, SMD -0.62, 95% CI -1.01 to -0.23,
49.3%). Moreover, the use of melatonin significantly reduced acute postoperative pain (11 studies, SMD -0.82, 95% CI -1.40 to -0.25,
93.0%). However, the subgroup meta-analysis of high-quality RDBPCTs showed no significant association between them (6 studies, SMD -0.21, 95 % CI -0.66 to 0.24,
82.4%). The current study suggests that melatonin might be used in treatment of chronic pain, while there is no sufficient evidence for acute postoperative or procedural pain. Further trials are warranted to confirm its analgesic effect.
Omega‐3 fatty acid supplements have been used to treat dyslipidemia. However, there is no comprehensive meta‐analysis of randomized, double‐blind, placebo‐controlled trials that encompasses a broad ...range of populations with or without underlying diseases regarding their efficacy. PubMed, EMBASE, and Cochrane Library were searched for trials in June 2016. A pooled weighted mean difference with its 95% confidence interval (CI) was calculated using a random‐effect meta‐analysis. A total of 58 trials were included in the final analysis. Compared with placebos, omega‐3 fatty acid supplements significantly reduced triglyceride (TG) levels by 38.59 mg dL−1 (95%CI, −47.16 to −30.02 mg dL−1; n = 53). In the subgroup meta‐analysis, the beneficial effects on TG levels were dose‐dependent up to 3.9 g of omega‐3 fatty acid supplements daily and were greater at higher baseline TG levels. However, there existed substantial heterogeneity in the main and subgroup meta‐analyses, overall methodological quality of included trials were low, and about 70% of the included trials had a small sample size less than 100 participants. The current meta‐analysis of randomized, double‐blind, placebo‐controlled trials suggests that there is no sufficient clinical evidence to support the use of omega‐3 fatty acid supplements for the prevention or treatment of dyslipidemia. Practical Applications: Further large, high‐quality randomized, double‐blind, placebo‐controlled trials with a long‐term follow‐up are warranted to confirm the clinical efficacy of omega‐3 fatty acid supplements on lipid profiles management.
The meta‐analysis of 53 randomized, double‐blind, placebo‐controlled trials shows a beneficial effect of omega‐3 fatty acid supplements such as EPA and DHA on triglyceride levels. However, there exists substantial heterogeneity in the main and subgroup meta‐analyses, overall methodological quality of includes trials was low, and about 70% of the include trials has a small sample size less than 100 participants. WMD, weighted mean difference; CI, confidence interval.
The meta‐analysis of 53 randomized, double‐blind, placebo‐controlled trials shows a beneficial effect of omega‐3 fatty acid supplements such as EPA and DHA on triglyceride levels. However, there exists substantial heterogeneity in the main and subgroup meta‐analyses, overall methodological quality of includes trials was low, and about 70% of the include trials has a small sample size less than 100 participants. WMD, weighted mean difference; CI, confidence interval.
The recommended dietary allowance (RDA) for vitamin C differs greatly (40–110 mg/d) across countries. In addition, vitamin D deficiency is, effectively, a pandemic, with a prevalence of approximately ...25% to 80% across countries according to the findings in the recent scientific literature. However, these phenomena are attributable to a serious error in the concept and definition of RDA, which was developed in 1941. The current definition of RDA is the average daily dietary nutrient intake level that is deemed sufficient to meet the nutrient requirements of almost all (97–98%) healthy individuals. This is an extremely high intake level for a specific nutrient affecting only a few individuals (the upper 2.5%) of the generally healthy population. The RDA should be redefined by investigating at which intake level of a specific nutrient the incidence of a specific disease or mortality increases or decreases based on prospective cohort studies.
Background
A meta-analysis regarding bone loss after bariatric surgery, designed to compare surgical and nonsurgical groups, has not yet been performed. Therefore, we performed a meta-analysis to ...compare the differences between bariatric surgical groups and nonoperated controls with regard to bone mineral density.
Methods
In March 2015, we performed a review of the literature using PubMed, EMBASE, and the Cochrane Library. The search focused on retrospective and prospective studies, including but not limited to randomized studies published in English.
Results
Among 1299 studies that were initially screened, ten met the selection criteria. For all types of bariatric surgery, bone density at the femoral neck was lower in the surgical group than in the nonsurgical control group (mean difference MD −0.05 g/cm
2
; 95 % confidence interval CI, −0.07 to −0.02;
p
= 0.001); no difference in bone density was found between the two groups at the lumbar spine (MD −0.01 g/cm
2
; 95 % CI −0.07 to 0.05;
p
= 0.661). The analysis of Roux-en-Y gastric bypass showed similar results.
Conclusion
Bone density at the femoral neck decreased after bariatric surgery, compared to that in nonsurgical controls, whereas bone density at the lumbar spine did not show a difference between groups. Further larger scale studies with comparative nonsurgical controls are warranted to overcome the heterogeneity among studies in this analysis and to add evidence of possible bone loss subsequent to bariatric surgical procedures.
Lysyl oxidase-like 2 (LOXL2) is associated with invasiveness and metastasis in breast cancer. We analyzed the prognostic impact of LOXL2 for breast cancer patients and investigated the role of LOXL2 ...in breast cancer cell lines. Immunohistochemical study of LOXL2 expression was done in samples from 309 patients. Survival analysis was performed using log-rank test and Cox regression hazard model. After identification of LOXL2 expression in breast cancer cell lines, we performed matrigel invasion and wound-healing assays with LOXL2-silenced cell lines. In the human study, LOXL2 was expressed in 16.2 % of patients. Comparing the LOXL2-positive versus negative groups, there was a significantly higher proportion of estrogen receptor-negative patients (54.0 vs. 37.0 %, respectively;
p
= 0.029) and triple-negative patients (34.0 vs. 18.0 %;
p
= 0.022) in the positive group. In multivariate analysis for overall survival and metastasis-free survival, positive LOXL2 was demonstrated as a poor prognostic factor (HR 2.27 and 2.10, respectively). In vitro study indicated that LOXL2 silencing induces a mesenchymal–epithelial transition-like process in basal cell lines (MDA-MB-231 and BT549) associated with decreased invasive and migratory properties. These clinical and preclinical data confirm that higher LOXL2 expression is associated with invasiveness of basal-like breast cancer cells and lower survival of breast cancer patients. Our results suggest the clinical value of LOXL2 as a therapeutic target in breast cancer.
According to the 'Table 1' showing the findings from the meta-analyses on alcohol consumption and cancer risk at different intakes 2, significant increased risks were observed in oropharyneal cancer ...(relative risk, RR=2.55; 95% confidence interval, CI: 2.15-3.02) 3, oesophageal cancer (RR=1.32; 95% CI: 0.90-1.60), colorectal cancer (RR=1.21; 95% CI: 1.13-1.28) 4, liver cancer (RR=1.19; 95% CI: 1.12-1.27) 5, and female breast cancer (RR=1.05; 95% CI: 1.02-1.08) 6 among light drinkers (described as <=1 drink/day or 12.5g/day in oropharynx cancer, colorectal cancer, and female breast cancer; <=25g/day in liver cancer).
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