scholarly journals Genetic and cellular techniques emerge as promising modalities for the treatment of diabetic foot syndrome

2014 ◽  
Vol 17 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Vladimir Iosifovich Konenkov ◽  
Vadim Valerievich Klimontov
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Autologous Transplantation ◽  
Limb Ischemia ◽  
Treatment Modalities ◽  
Optimal Dosage ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Patients With Diabetes ◽  
Clinical Potential

Two patient groups potentially to benefit most from these novel methods are patients with critical lower limb ischemia (CLLI) in whom angiosurgery is not indicated, and patients with trophic ulcers resistant to conventional therapy. A series of clinical trials has shown positive effects of transferring VEGF, HIF-1, FGF, PDGF, HGF and certain other growth factor genes to stimulate blood vessel formation and healing of diabetic ulcers. Autologous transplantation of mononuclear bone marrow and peripheral blood cells, endothelial progenitor cells, mesenchymal stem cells and stromal cell of the adipose tissue has also demonstrated its clinical potential in patients with diabetes mellitus and CLLI. Randomized clinical trials report beneficial effects of gene and cell therapy on such surrogate endpoints as ischemic index, rest pain and ulcer healing, though data on amputation rates is controversial. Further studies are necessary to determine optimal dosage and route of administration of biological agents and predictors of their efficacy, as well as long-term safety of these novel treatment modalities.

scholarly journals CITICOLINE EFFICIENCY ON COGNITIVE FUNCTION: A SYSTEMATIC REVIEW

2015 ◽  
pp. 1-12
Author(s):  
N. Cano-Cuenca ◽  
J. Solís-García del Pozo ◽  
J. Jordán
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Ischemic Stroke ◽  
Cognitive Function ◽  
Acute Ischemic Stroke ◽  
Daily Living ◽  
Randomized Clinical Trials ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Basic Activity

Background: Citicoline is considered an ingredient in particular foods in the USA and is available in pharmaceutical form in Europe and Japan. It has been postulated to render positive effects on the nervous system, either by increasing levels of neurotransmitters, or by affording neuroprotection. Methods: Several clinical trials have shown the efficacy and safety of this biomolecule in several neurodegenerative diseases and in acute ischemic stroke. Here, we have performed a systematic review to validate the effect of citicoline on MMSE, memory, attention, and basic activity of daily living. In electronic database searches, we found 14 randomized clinical trials reporting citicoline effects on cognitive function. Findings: A positive effect of citicoline on MMSE in acute ischemic stroke was found, which was not evidenced for Alzheimer disease or vascular dementia. On activities of daily living, citicoline failed to exert beneficial effects in patients with acute ischemic stroke or progressive cognitive impairment. Conclusions: Given the present data there is no evidence that supports advising patients with cognitive alterations to take chronic citicoline supplements.

scholarly journals EFFECTS OF POSTURAL EDUCATION IN ELEMENTARY SCHOOL CHILDREN: A SYSTEMATIC REVIEW

2021 ◽  
Vol 39 ◽  
Author(s):  
Paola Janeiro Valenciano ◽  
Fabíola Unbehaun Cibinello ◽  
Jessica Caroliny de Jesus Neves ◽  
Dirce Shizuko Fujisawa
Keyword(s):  
Clinical Trials ◽  
Elementary School ◽  
High Risk ◽  
School Children ◽  
Elementary School Children ◽  
Randomized Clinical Trials ◽  
Outcome Data ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Positive Effects

ABSTRACT Objective: To determine the effect of postural education on the learning and postural habits of elementary school children without physical intervention. Methods: We searched PubMed, Lilacs, SciELO, Cochrane, and Science Direct data bases and reference lists of studies in February 2020. The eligibility criteria were randomized clinical trials related to the effect of postural education in children aged between 6 and 12 years old. Two authors independently assessed trials for inclusion and risk of bias: randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selection of the reported result. Data were extracted in standardized tables including information on author, publication year, country, sample size, age, sex, intervention characteristics, outcome measurements and results. Results: We found seven clinical trials (involving 2,568 children) for the review. The studies were conducted between 2000 and 2018: four in Belgium, two in Spain, and one in Germany. All seven included trials underwent evaluation: only one had a clear process of randomization and allocation concealment. All included studies were judged as having high risk of bias in at least one domain or have concerns for multiple domains. Conclusions: The positive effects of acquired knowledge and postural habits found in the studies cannot be used to reliably support postural education in elementary school children due to a high risk of bias in the evaluated studies.

Characteristics and effects of physical exercise programs for older cancer survivors: A scoping review (Características y efectos de los programas de ejercicio físico para personas mayores sobrevivientes de cáncer: Una revisión de alcance)

Retos ◽  
2021 ◽  
Vol 44 ◽  
pp. 370-385
Author(s):  
Igor Cigarroa ◽  
Estefanía Díaz ◽  
Constanza Ortiz ◽  
Raquel Otero ◽  
Irene Cantarero ◽  
...  
Keyword(s):  
Physical Activity ◽  
Clinical Trials ◽  
Physical Exercise ◽  
Cancer Survivors ◽  
Scoping Review ◽  
Randomized Clinical Trials ◽  
Exercise Interventions ◽  
Positive Effects ◽  
Calidad De Vida

There is a discrepancy about the characteristics and effects of exercise-based programs in older cancer survivors (OCS). Therefore, this scoping review aimed to identify the characteristics and effects of physical activity programs in OCS health. This scoping review followed the PRISMA guidelines and included randomized clinical trials and clinical trials from MEDLINE by PubMed, Scopus, Scielo, and PEDro, published between 2010 and 2020. Results suggest that physical programs were carried out in health centers (54.2%) and were based on physical exercise (74.4%). The length of the exercise interventions was between 3–6 months (87.5%) was performed 2–3 times per week (73.1%) with a duration between 20–60 minutes (78.2%) and was run by health professionals (94.4%). The health outcomes with the most positive effects were physical activity, depression, and quality of life. In conclusion, physical programs for OCS based on aerobic exercises are safe and could be a therapeutic strategy to improve different health markers in OCS.  Resumen. En la literatura existe discrepancia sobre las características y los efectos de los programas basados en el ejercicio físico en sobrevivientes de cáncer (SC) de edad avanzada. Por lo tanto, esta revisión de alcance tuvo como objetivo identificar las características y los efectos de los programas de actividad física en la salud de personas SC de edad avanzada. Esta revisión de ensayos clínicos aleatorizados y ensayos clínicos, se realizó considerando las siguientes bases de datos: MEDLINE (de Pubmed), Scopus, Scielo y PEDro, entre los años 2010 y 2020. Los resultados indican que los programas de ejercicio se realizaron en centros de salud (54.2%), y se basaron en ejercicio físico principalmente (74.4%). La extensión de las intervenciones físicas fue entre 3–6 meses (87.5%), se realizaron 2–3 veces por semana (73.1%) con una duración entre 20–60 minutos, y fueron dirigidas por profesionales de salud (94.4%). El impacto sobre la salud con mayores efectos positivos fueron la actividad física, la depresión y la calidad de vida. En conclusión, los programas de ejercitación física para personas SC en edad avanzada, basados en ejercicios aeróbicos son seguros y podrían ser una estrategia terapéutica para mejorar diferentes variables de salud en este grupo de personas.

Exercise training and cognitive performance in persons with multiple sclerosis: A systematic review and multilevel meta-analysis of clinical trials

2020 ◽  
pp. 135245852091793 ◽  
Author(s):  
Reza Gharakhanlou ◽  
Leonie Wesselmann ◽  
Annette Rademacher ◽  
Amit Lampit ◽  
Raoof Negaresh ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Exercise Training ◽  
Cognitive Performance ◽  
Randomized Clinical Trials ◽  
Selection Process ◽  
Meta Analysis ◽  
Training Dose ◽  
Domain Specific ◽  
Positive Effects

Background: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. Objective: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. Methods: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). Results: The pooled effect of exercise training on the global cognitive performance was null ( g = 0.04, 95% confidence interval (CI): –0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null ([Formula: see text]= 0.0%) and between studies was low ([Formula: see text]= 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10−5, [Formula: see text] = 100%, [Formula: see text] = 52.34%). Conclusion: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.

scholarly journals Possible Involvement of Vitamin C in Periodontal Disease-Diabetes Mellitus Association

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 553
Author(s):  
Maria Bogdan ◽  
Andreea Daniela Meca ◽  
Mihail Virgil Boldeanu ◽  
Dorin Nicolae Gheorghe ◽  
Adina Turcu-Stiolica ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trials ◽  
Ascorbic Acid ◽  
Vitamin C ◽  
Periodontal Disease ◽  
Fruits And Vegetables ◽  
Water Soluble ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Water Soluble Vitamin

Ascorbic acid (vitamin C) is an important water-soluble vitamin found in many fruits and vegetables. It has well-documented beneficial effects on the human body and is used as a supplement, alone or in combination with other vitamins and minerals. Over recent years, research has focused on possible new therapeutic actions in chronic conditions including periodontal disease (PD). We conducted a systematic review on clinical trials from four databases (PubMed, Clinical Trials, Cochrane, Web of Science) which measured plasmatic/salivary levels of ascorbic acid in PD–diabetes mellitus (DM) association. Six studies were included in our review, three of them analyzing patients with different grades of PD and DM who received vitamin C as a treatment (500 mg vitamin C/day for 2 months and 450 mg/day for 2 weeks) or as part of their alimentation (guava fruits), in combination with standard therapies and procedures. Decreased levels of vitamin C were observed in PD patients with DM but data about efficacy of vitamin C administration are inconclusive. Given the important bidirectional relationship between PD and DM, there is a strong need for more research to assess the positive effects of ascorbic acid supplementation in individuals suffering from both diseases and also its proper regimen for these patients.

Supplementation of Probiotics and Its Effects on Physically Active Individuals and Athletes: Systematic Review

2019 ◽  
Vol 29 (5) ◽  
pp. 481-492 ◽  
Author(s):  
Gabriella Berwig Möller ◽  
Maria Júlia Vieira da Cunha Goulart ◽  
Bruna Bellincanta Nicoletto ◽  
Fernanda Donner Alves ◽  
Cláudia Dornelles Schneider
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Small Sample Size ◽  
Gastrointestinal Symptoms ◽  
Small Sample ◽  
Control Group ◽  
Probiotic Supplementation ◽  
Physically Active ◽  
Positive Effects

The aim of this study was to conduct a systematic review of the effects of probiotic supplementation on physically active individuals. The participants, interventions, comparisons, outcome and study design inclusion criteria were (a) studies involving healthy adults or older subjects of both sexes who did physical exercise (including athletes and physically active individuals), (b) interventions with probiotics, (c) inclusion of a control group, (d) outcomes not previously defined, and (e) clinical trials and randomized clinical trials, with no language or date restrictions. The search was conducted in the following scientific databases: MEDLINE, Embase, SciELO, Scopus, and Lilacs. Search terms were “Probiotics” OR “Prebiotics” OR “Microbiota” AND “Exercise” OR “Athletes.” The articles were first screened by title and abstract by two independent reviewers and disagreements resolved by a third reviewer. Data were extracted independently by the same two reviewers; results were extracted in duplicate and then compared to avoid errors. A total of 544 articles were retrieved and 24 were included. A total of 1,680 patients were included, most of them being male (n = 1,134, 67.5%), with a mean age of 30.9 ± 6.1 years. Following probiotic supplementation, positive effects have been reported for several outcomes including respiratory tract infection, immunologic markers, and gastrointestinal symptoms in both athletes and nonathletes. However, published studies have distinct protocols and measured outcomes, and some of them have small sample size and failed to prove beneficial effect on probiotic supplementation, leading to inconclusive results for standardized supplementation protocols.

scholarly journals Hormonal suppression for fertility preservation in males and females

Reproduction ◽  
2008 ◽  
Vol 136 (6) ◽  
pp. 691-701 ◽  
Author(s):  
Marvin L Meistrich ◽  
Gunapala Shetty
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Ovarian Function ◽  
Follicular Development ◽  
Primordial Follicle ◽  
Cytotoxic Agents ◽  
Cytotoxic Therapy ◽  
Primordial Follicles ◽  
Beneficial Effects ◽  
Gnrh Analogs

Methods to restore fertility of men and women sterilized by medical treatments and environmental toxicant exposures are under investigation. Rendering spermatogenesis and ovarian follicular development kinetically quiescent by suppression of gonadotropins has been proposed to protect them from damage by cytotoxic therapy. Although the method fails to protect the fertility of male mice and monkeys, gonadotropin and testosterone suppression in rats before or after cytotoxic therapy do enhance the recovery of spermatogenesis. However, the mechanism involves not the induction of quiescence but rather the reversal, by suppression of testosterone, of a block in differentiation of surviving spermatogonia caused by damage to the somatic environment. In men, only one of eight clinical trials was successful in protecting or restoring spermatogenesis after cytotoxic therapy. In women, protection of primordial follicles in several species from damage by cytotoxic agents using GnRH analogs has been claimed; however, only two studies in mice appear convincing. The protection cannot involve the induction of quiescence in the already dormant primordial follicle but may involve direct effects of GnRH analogs or indirect effects of gonadotropin suppression on the whole ovary. Although numerous studies in female patients undergoing chemotherapy indicate that GnRH analogs might be protective of ovarian function, none of the studies showing protection were prospective randomized clinical trials and thus they are inconclusive. Considering interspecies differences and similarities in the gonadal sensitivity to cytotoxic agents and hormones, mechanistic studies are needed to identify the specific beneficial effects of hormonal suppression in select animal models that may be applicable to humans.

scholarly journals Probiotics in the treatment of chronic kidney disease: a systematic review

2018 ◽  
Vol 40 (3) ◽  
pp. 278-286 ◽  
Author(s):  
Raquel Aparecida Bandeira Fagundes ◽  
Taís Fátima Soder ◽  
Kamila Castro Grokoski ◽  
Fábia Benetti ◽  
Roberta Hack Mendes
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Clinical Trials ◽  
Renal Function ◽  
Kidney Disease ◽  
Sample Size ◽  
Randomized Clinical Trials ◽  
Inclusion Criteria ◽  
Progressive Reduction ◽  
Positive Effects

ABSTRACT Chronic kidney disease (CKD) is a syndrome caused by the progressive reduction of renal function. This study aimed to systematically examine the effects of supplementation with probiotics in the treatment of CKD. Searches were carried out on databases MEDLINE (PubMed), SciELO, Cochrane, and Clinical Trials. Two independent reviewers selected the studies from which data was extracted. The search included papers written in English and Portuguese published in the 2012-2016 period describing randomized clinical trials. Eight of the 82 eligible articles met the inclusion criteria. Sample size ranged from 18 to 101 individuals with CKD. The duration of the included studies varied from four to 24 weeks. Most of the included articles reported positive effects in renal function and decreased levels of urea, blood urea nitrogen, ammonia, plasma p-cresol, p-cresyl sulfate, and indoxyl sulfate.

scholarly journals Management of Darier disease: A review of the literature and update

2021 ◽  
Vol 87 ◽  
pp. 14-21
Author(s):  
Roger N. Haber ◽  
Nicole G. Dib
Keyword(s):  
Clinical Trials ◽  
Therapeutic Approach ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Case Series ◽  
Small Sample ◽  
Treatment Modalities ◽  
Published Data ◽  
Clinical Images ◽  
Darier Disease

Darier disease (DD) is a rare type of inherited keratinizing disorder with no definitive therapeutic approach. The objective of this study is to provide a detailed literature review of all the available treatment modalities of Darier disease, including those that are both surgical and non surgical, to compare their efficacies and to propose a novel therapeutic approach. A complete search of the literature for all articles describing the different treatments of Darier disease, with no restrictions on patients’ ages, gender or nationalities, was performed with the use of PubMed. A total of 68 articles were included in the study: 3 prospective studies, 44 case reports/case series and 21 letters/correspondences/clinical images. The treatments described were topical, oral or physical. Retinoids (isotretinoin, tazarotene and adapalene) and fluorouracil were the two most effective topical treatments. Oral retinoids were the most effective oral therapy and were prescribed in the cases of generalized Darier disease. For localized and resistant skin lesions, physical therapies including surgical excision, dermabrasion and CO2 laser ablation were the first line choices. Limitations of this article include the inability to verify the accuracy of the published data, the relatively small sample size, the absence of randomized controlled clinical trials and possible unidentified confounding factors in various studies. In every therapeutic approach to Darier disease, consideration of patient comorbidities, disease distribution, severity and treatment accessibility is essential. Large and randomized clinical trials are necessary for the comparison of the efficacy and the safety of all the treatments of Darier disease and settling a consensus for management.

scholarly journals Management of male breast cancer

2011 ◽  
pp. 44-52
Author(s):  
Nikolay V. Dimitro v ◽  
Sunil Nagpal ◽  
Shalini Chitneni
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Male Breast Cancer ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Female Breast Cancer ◽  
Male Breast ◽  
Treatment Modalities ◽  
Lack Of Information ◽  
Low Incidence

The management of male breast cancer is still under discussion due to lack of information from prospective, randomized clinical trials and low incidence of this disease. Current management is based largely on extrapolation from data related to treatment of female breast cancer. Over the last two decades, several review articles have discussed mainly retrospective and anecdotal data related to hormonal and chemotherapy treatment modalities. In this review, we present the most recent information and future considerations related to the management of male breast cancer. In addition to the conventional treatment options we will discuss the possible role of targeted therapy. Establishing a national or global registry for male breast cancer will provide more precise information about the natural history of the disease and will facilitate the design and execution of prospective, randomized multicenter clinical trials.

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