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

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Sarah Mousavi ◽  
Mandana Moradi ◽  
Tina Khorshidahmad ◽  
Maryam Motamedi
Keyword(s):  
Systematic Review ◽  
Clinical Setting ◽  
Randomized Clinical Trials ◽  
Jadad Score ◽  
Inflammatory Agent ◽  
Mesh Terms ◽  
Single Target ◽  
Quasi Experimental ◽  
Anti Inflammatory ◽  
Quality Assessments

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, heparin seems to be a safe and effective anti-inflammatory agent; although it is shown that heparin can decrease the level of inflammatory biomarkers and improves patient conditions, still more data from larger rigorously designed studies are needed to support use of heparin as an anti-inflammatory agent in clinical setting. However, because of the association between inflammation, atherogenesis, thrombogenesis, and cell proliferation, heparin and related compounds with pleiotropic effects may have greater therapeutic efficacy than compounds acting against a single target.

Beyond its anti‐migraine properties, sumatriptan is an anti‐inflammatory agent: A systematic review

2021 ◽  
Author(s):  
Moein Ala ◽  
Mehdi Ghasemi ◽  
Razieh Mohammad Jafari ◽  
Ahmad Reza Dehpour
Keyword(s):  
Systematic Review ◽  
Inflammatory Agent ◽  
Anti Inflammatory

scholarly journals Efficacy of Modern Diabetes Treatments- Dpp-4i, Sglt-2i, Glp-1ra- in White and Asian Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Sushrima Gan1 ◽  
Adem Y Dawed ◽  
Louise A Donnelly ◽  
ATN Nair ◽  
Colin NA Palmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Asian Ethnicity ◽  
Mesh Terms ◽  
Oral Agents ◽  
The Impact

<b><i><u>Background and Purpose:</u></i></b>The pathophysiology of Type 2 diabetes differs markedly by ethnicity. A systematic review and meta-analysis was conducted to assess the impact of ethnicity on the glucose lowering efficacy of the newer oral agents, SGLT-2is, GLP-1RAs and DPP-4is, using evidence from randomized clinical trials (RCTs). <p><b><i><u>Data Sources:</u></i></b>A literature search was conducted in PubMed of all randomized, placebo-controlled trials of DPP-4 inhibitors, SGLT-2 inhibitors and GLP-1RA. The search strategy was developed based on medical subject sub-headings (MeSH) terms and keywords.</p> <p><b><i><u>Study selection :</u></i></b> 64 studies qualified for meta-analysis after full-text review based on pre-defined inclusion and exclusion criteria. RCTs with at least 50 patients in each arm; >70% of population from Asian or White group; duration>=24 weeks; published up to March 2019 were selected for systematic review and meta-analysis.</p> <p><b><i><u>Data extraction:</u></i></b>Data extraction was done for aggregated study-level data , by two independent researchers. Absolute changes in HbA1c (%) from baseline to 24 weeks between the drug and placebo was considered as the primary endpoint of the study.</p> <p><b><i><u>Data synthesis: </u></i></b>Change in HbA1c was evaluated by computing mean differences (MDs) and 95% confidence intervals (CI) between treatment and placebo arms. </p> <p><b><i><u>Limitations: </u></i></b> Study is based on summarized data and could not be separated based on East Asians and South Asians.</p> <p><b><i><u>Conclusion : </u></i></b>The glucose lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared to studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA.</p>

scholarly journals Efficacy of Modern Diabetes Treatments- Dpp-4i, Sglt-2i, Glp-1ra- in White and Asian Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Sushrima Gan1 ◽  
Adem Y Dawed ◽  
Louise A Donnelly ◽  
ATN Nair ◽  
Colin NA Palmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Asian Ethnicity ◽  
Mesh Terms ◽  
Oral Agents ◽  
The Impact

<b><i><u>Background and Purpose:</u></i></b>The pathophysiology of Type 2 diabetes differs markedly by ethnicity. A systematic review and meta-analysis was conducted to assess the impact of ethnicity on the glucose lowering efficacy of the newer oral agents, SGLT-2is, GLP-1RAs and DPP-4is, using evidence from randomized clinical trials (RCTs). <p><b><i><u>Data Sources:</u></i></b>A literature search was conducted in PubMed of all randomized, placebo-controlled trials of DPP-4 inhibitors, SGLT-2 inhibitors and GLP-1RA. The search strategy was developed based on medical subject sub-headings (MeSH) terms and keywords.</p> <p><b><i><u>Study selection :</u></i></b> 64 studies qualified for meta-analysis after full-text review based on pre-defined inclusion and exclusion criteria. RCTs with at least 50 patients in each arm; >70% of population from Asian or White group; duration>=24 weeks; published up to March 2019 were selected for systematic review and meta-analysis.</p> <p><b><i><u>Data extraction:</u></i></b>Data extraction was done for aggregated study-level data , by two independent researchers. Absolute changes in HbA1c (%) from baseline to 24 weeks between the drug and placebo was considered as the primary endpoint of the study.</p> <p><b><i><u>Data synthesis: </u></i></b>Change in HbA1c was evaluated by computing mean differences (MDs) and 95% confidence intervals (CI) between treatment and placebo arms. </p> <p><b><i><u>Limitations: </u></i></b> Study is based on summarized data and could not be separated based on East Asians and South Asians.</p> <p><b><i><u>Conclusion : </u></i></b>The glucose lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared to studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA.</p>

scholarly journals Hydroxychloroquine Versus COVID-19: A Rapid Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Amir Shamshirian ◽  
Amirhossein Hessami ◽  
Keyvan Heydari ◽  
Reza Alizadeh-Navaei ◽  
Mohammad Ali Ebrahimzadeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Adverse Effects ◽  
Comparative Studies ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Control Group ◽  
Mesh Terms

AbstractBackgroundCoronavirus Disease 2019 (COVID-19) has become a major global issue with rising the number of infected individuals and mortality in recent months. Among all therapeutic approaches, arguments have raised about hydroxychloroquine (HCQ) efficacy in the treatment of COVID-19. We aimed to overcome the controversies regarding the effectiveness of hydroxychloroquine in the treatment of COVID-19, using a systematic review and meta-analysis.MethodsA systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, Web of Science, Google Scholar and medRxiv pre-print database using all available MeSH terms for COVID-19 and hydroxychloroquine. Two authors selected and assessed the quality of studies independently using related checklists. Data have been extracted from included studies and analyzed using CMA v. 2.2.064. heterogeneity was also assessed using the I-squared test. We also conducted different sensitivity analyses to examine the effect of studies that greatly influence the results.ResultsOut of 14 studies entered into our systematic review, 12 studies including seven comparative studies with control group and five observational studies containing 3,428 participants have entered into the study. The results of the meta-analysis on comparative studies indicated no significant clinical effectiveness (negative in RT-PCR evaluation) for HCQ regimen in the treatment of COVID-19 in comparison to control group (RR: 1.04, 95% CI, 0.83-1.31). The same result was observed for the combination of HCQ+azithromycin (RR: 2.15, 95% CI, 0.31-14.77). Approximately 1.7 times higher mortality rate was observed among the HCQ regimen group in comparison to control group (RR: 1.73, 95% CI, 1.06-2.81), which was not related to the age differences according to meta-regression analysis (P=0.305). No substantial difference was observed for disease exacerbation (RR: 1.87, 95% CI, 0.28-12.36) between HCQ group and controls. Also, radiological findings significantly improved in the HCQ group (OR: 0.32, 95% CI, 0.11-0.98). Odds of known HCQ adverse effects (diarrhea, vomiting, blurred vision, rash, headache, etc.) occurred in the HCQ regimen group was approximately 3.5 times of control group (OR: 3.55, 95% CI, 1.61-7.82), but no substantial differences were found regarding intubation odds between HCQ group and control group (OR: 2.11, 95% CI, 0.31-14.03).ConclusionThis systematic review and meta-analysis not only indicated no clinical benefits regarding HCQ treatment with/without azithromycin for COVID-19 patients, but the higher mortality rate and frequency of known HCQ adverse effects were observed for the HCQ regimen group. However, due to that most of the studies were non-randomized and results were not homogenous, selection bias was unavoidable and further large randomized clinical trials following comprehensive meta-analysis should be taken into account in order to achieve more reliable findings.

scholarly journals The effect of intermittent fasting on cancer prevention: a systematic review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Giannakou ◽  
C Papakonstantinou ◽  
S Chrysostomou ◽  
D Lamnisos
Keyword(s):  
Systematic Review ◽  
Cancer Prevention ◽  
Randomized Clinical Trials ◽  
Animal Experiments ◽  
Developed Countries ◽  
Intermittent Fasting ◽  
Preclinical Studies ◽  
Mesh Terms ◽  
Prevention Of Cancer ◽  
Clinical Experiments

Abstract Background Cancer consists of a large group of diseases and is considered one of the key health problems in developed countries as it negatively affects patients' life expectancy and quality of life. At the forefront of research is the prevention of cancer through diet. The aim of this study is to examine the effect of intermittent fasting on cancer prevention. Methods A systematic review was performed in PubMed and EMBASE from inception to December 2019 to identify relevant preclinical studies examining the above association. The search strategy included a combination of search and MESH terms related to intermittent fasting and cancer. Specific inclusion and exclusion criteria were set for the selection of articles. Two researchers systematically screened articles and data were extracted from shortlisted articles. Qualitative data was synthesised thematically, and a narrative synthesis was produced. Results 307 reports were assessed, but only 6 preclinical studies met the inclusion criteria. Most studies concluded that intermittent fasting had a positive effect in the appearance of tumours, either by slowing down the cancer incidence through the reduction of the number of lesions and inflammation of the tissues, or by reducing the risk of certain types of cancer. Conclusions Intermittent fasting with calorie restriction appeared to have an anticancer effect in animal experiments. However, due to the limitations of the studies included, future well-designed randomized clinical trials should examine the effect of intermittent fasting over longer periods of time, parallel forms of cancer and different patient populations. Key messages Animal experiments indicate a possible preventive effect of intermittent fasting on certain types of cancers. Due to the methodological shortcomings and heterogeneity across the studies included, more clinical experiments are strongly needed.

scholarly journals Laser Effects on the Prevention and Treatment of Dentinal Hypersensitivity: A Systematic Review

2018 ◽  
Vol 10 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Fahimeh Rezazadeh ◽  
Paria Dehghanian ◽  
Dana Jafarpour
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Yttrium Aluminum Garnet ◽  
New Technology ◽  
Dentinal Tubules ◽  
Significant Difference ◽  
Prevention And Treatment ◽  
Reduction Methods ◽  
Quality Assessments ◽  
Dentinal Hypersensitivity

Introduction: Dentinal hypersensitivity (DH) is an acute intensive tooth pain which can lead to dental annoyances during eating and drinking. Stimulating exposed dentinal tubules by either kind of thermal, tactile, chemical and/or osmotic stimuli is believed to be the cause of this pain. It is hypothesized that dentinal tubules’ orifice occlusion (DOO) can help relieve such dental irritations. Thus, this systematic review was conducted to evaluate the effectiveness of laser application as a prevention and treatment modality on DH reduction. Methods: Electronic databases (MEDLINE, SCOPUS) were searched among randomized clinical trials from January 2007 to December 2016. The extraction of data and quality assessments were carried out by different independent observers. Results: A total of 499 items were found of which3 9 relevant articles were extracted. The profound findings proved lasers’ effectiveness as a treatment of DH. Although some of the researches reported no significant difference between laser and other desensitizing agents, most of the studies suggested that better results (both rapid and long-lasting) were obtained in combined modalities. Furthermore, the preventive role of this new technology has been emphasized as well. Nd-YAG (neodymium-doped yttrium aluminum garnet) and diode lasers reduce DH after bleaching. Lasers can also protect cervical restorations from DH due to tubular occlusion. Moreover, it is suggested to apply lasers in relief of DH following scaling and root planning. Nevertheless, a few researchers dispute its beneficence as a result of placebo effect. Conclusion: The results obtained from several studies in the present review revealed that the application of lasers is effective not only in terms of treatment of DH, but also in the prevention of this intensive tooth pain. Among various types of lasers, the application of Nd:YAG laser has shown the best results in DH treatment.

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