scholarly journals Vitamin D Food Fortification and Nutritional Status in Children: A Systematic Review of Randomized Controlled Trials

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2766 ◽  
Author(s):  
Paula Nascimento Brandão-Lima ◽  
Beatriz da Cruz Santos ◽  
Concepción Maria Aguilera ◽  
Analícia Rocha Santos Freire ◽  
Paulo Ricardo Saquete Martins-Filho ◽  
...  

Children are in the risk group for developing hypovitaminosis D. Several strategies are used to reduce this risk. Among these, fortification of foods with vitamin D (25(OH)D) has contributed to the achievement of nutritional needs. This systematic review aims to discuss food fortification as a strategy for maintenance or recovery of nutritional status related to vitamin D in children. The work was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International prospective register of systematic reviews (PROSPERO) database (CRD42018052974). Randomized clinical trials with children up to 11 years old, who were offered vitamin D-fortified foods, and who presented 25(OH)D concentrations were used as eligibility criteria. After the selection stages, five studies were included, totaling 792 children of both sexes and aged between two and 11 years. Interventions offered 300–880 IU of vitamin D per day, for a period of 1.6–9 months, using fortified dairy products. In four of the five studies, there was an increase in the serum concentrations of 25(OH)D with the consumption of these foods; additionally, most children reached or maintained sufficiency status. Moreover, the consumption of vitamin D-fortified foods proved to be safe, with no concentrations of 25(OH)D > 250 nmol/L. Based on the above, the fortification of foods with vitamin D can help maintain or recover the nutritional status of this vitamin in children aged 2–11 years. However, it is necessary to perform additional randomized clinical trials in order to establish optimal doses of fortification, according to the peculiarities of each region.

2021 ◽  
pp. 194338752110461
Author(s):  
Giovanni Cunha ◽  
Pedro Henrique de Azambuja Carvalho ◽  
Lílian Caldas Quirino ◽  
Luiz Henrique Soares Torres ◽  
Valfrido Antônio Pereira Filho ◽  
...  

Study Design: A systematic review according to PRISMA statement has been designed to answer the preliminary question: “ In titanium mesh exposures, is there a treatment alternative which leads to an increased graft maintenance?” and fill the PICO assessment out. Objective: To review studies published in the past 20 years (1999-2019) in which mesh exposure has occurred, detecting the suitable approaches to treat exposure allowing the graft maintenance. Methods: Initial search on PUBMED, SCOPUS, and COCHRANE databases resulted in 777 articles, and hand-searching identified 6 articles. After removing duplicates and unrelated articles, eligibility criteria were applied, and 31 studies were selected (randomized clinical trials, retrospective/prospective clinical trials, and case series). Results: A total of 677 surgical sites and 225 cases of mesh exposure were identified. Eleven treatments have been identified. Chlorhexidine was the primary approach in 46% of cases, followed by oral hygiene instructions and follow-up with 22.5% of occurrences. In 21% of clinical situations, titanium mesh removal was the treatment of choice, associated with other measures (i.e., antibiotic prescription). There seems to be a consensus in cases of infection. When this complication was associated with tissue dehiscence, the primary treatment was mesh removal. The same does not occur when the site needs to be cleaned for long-term periods. Conclusion: In 2 decades of use of titanium meshes, the available treatments do not seem to have evolved, and there is not enough data to establish a guideline.


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Atsushi Nakajima ◽  
Ayako Shoji ◽  
Kinya Kokubo ◽  
Ataru Igarashi

Background. In the 2010s, medications with new mechanisms were introduced in Japan for the treatment of chronic idiopathic constipation (CIC). A few systematic reviews have compared medications’ relative efficacy, but the reviews included studies on patients from various races, even though the mechanism of CIC is considered to differ between races. The aim of this study was to use a systematic review and network meta-analysis to compare the relative efficacy of these medications in Japanese patients. Methods. We conducted a meta-analysis and report it here according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified studies by searching MEDLINE (via the PubMed interface) and the Cochrane Library and ICHUSHI databases and included randomized clinical trials that compared medications for CIC with placebo in Japanese adults. Two reviewers independently screened and assessed articles, abstracted data, and assessed the risk of bias. We pooled data by random-effects meta-analyses and also performed a Bayesian network meta-analysis to indirectly compare data. Results. The present systematic review and meta-analyses included 1460 patients in 6 randomized clinical trials: 2 on linaclotide, 3 on elobixibat, 2 on lubiprostone, and 1 on lactulose. The results of direct comparisons showed that linaclotide, elobixibat, and lubiprostone were superior to placebo in the change of spontaneous bowel movements (SBMs) within 1 week: linaclotide, 1.95 (95% CI, 1.51-2.39); elobixibat, 5.69 (95% CI, 3.31-8.07); and lubiprostone, 2.41 (95% CI, 0.82-4.01). The Bayesian network meta-analysis showed consistent results. Elobixibat 10 mg was ranked first for the increase in SBMs and complete SBMs within 1 week and the time to first SBM. Lubiprostone 48 μg was ranked first for the proportion of patients with SBM within 24 hours. Conclusion. Our direct and indirect meta-analyses revealed that the new CIC medications available in Japan have equal efficacy but that elobixibat and lubiprostone are highly likely to be more efficacious.


2021 ◽  
Vol 10 (13) ◽  
pp. e147101321219
Author(s):  
Christine Men Martins ◽  
Milena Filippini Knecht ◽  
Larissa dos Santos de Moraes ◽  
Victor Eduardo de Souza Batista

This study comprehensively reviewed two different treatments for regenerative endodontic: platelet-rich plasma and induced blot clot, in regarding to periapical healing.  Two investigators performed a systematic review. MEDLINE/PubMed, Cochrane Library and Scopus supplied relevant data from studies published until December 2020 to answer the PICO question. Primary outcome was periapical healing. Eight randomized clinical trials fulfilled eligibility criteria. Primary outcome indicated that platelet-rich plasma results in similar or better periapical healing compared to blot clot group. The reported failures were related to blot clot group due to incomplete radiographic parameters, pain and reinfection; however, few cases of unsuccess were reported to platelet-rich plasma group. Only two studies observed better results to blot clot group in relation to increase of radiographic area and partial pulp canal obliteration. This review showed that procedures using platelet-rich plasma were successful in treating permanent teeth with root development.


Pain Medicine ◽  
2020 ◽  
Author(s):  
Javier Martinez-Calderon ◽  
Mar Flores-Cortes ◽  
Jose Miguel Morales-Asencio ◽  
Alejandro Luque-Suarez

Abstract Objective This systematic review aimed to evaluate the effectiveness of different interventions at reducing pain-related fear in people with fibromyalgia and to analyze whether the included trials reported their interventions in full detail. Design Systematic review. Setting No restrictions. Methods The Cochrane Library, CINAHL, EMBASE, PsycINFO, PubMed, and Scopus were searched from their inception to April 2020, along with manual searches and a gray literature search. Randomized clinical trials were included if they assessed pain-related fear constructs as the primary or secondary outcome in adults with fibromyalgia. Two reviewers independently performed the study selection, data extraction, risk-of-bias assessment, Template for Intervention Description and Replication (TIDieR) checklist assessment, and grading the quality of evidence. Results Twelve randomized clinical trials satisfied the eligibility criteria, including 11 cohorts with a total sample of 1,441 participants. Exercise, multicomponent, and psychological interventions were more effective than controls were in reducing kinesiophobia. However, there were no differences in decreasing kinesiophobia when self-management and electrotherapy were used. There were also no differences between groups with regard to the rest of the interventions and pain-related constructs (fear-avoidance beliefs, fear of pain, and pain-related anxiety). However, a serious risk of bias and a very serious risk of imprecision were detected across the included trials. This caused the overall certainty of the judged evidence to be low and very low. Additionally, the included trials reported insufficient details to allow the full replication of their interventions. Conclusions This systematic review shows that there are promising interventions, such as exercise, multicomponent, and psychological therapies, that may decrease one specific type of fear in people with fibromyalgia, i.e., kinesiophobia. However, because of the low–very low certainty of the evidence found, a call for action is needed to improve the quality of randomized clinical trials, which will lead to more definitive information about the clinical efficacy of interventions in this field.


PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69269 ◽  
Author(s):  
Francesca Sperati ◽  
Patrizia Vici ◽  
Marcello Maugeri-Saccà ◽  
Saverio Stranges ◽  
Nancy Santesso ◽  
...  

2021 ◽  
Author(s):  
Akram Hernández-Vásquez ◽  
Antonio Barrenechea-Pulache ◽  
Daniel Comandé ◽  
Diego Azañedo

ABSTRACTObjectiveTo conduct a living systematic review of the clinical evidence regarding the effect of different mouth-rinses on the viral load of SARS-CoV-2 in the saliva of infected patients. The viral load in aerosols, the duration of the reduction in viral load, viral clearance, SARS-CoV-2 cellular infectivity, and salivary cytokine profiles were also evaluated.Materials and methodsThis study was reported using the PRISMA guidelines. An electronic search was conducted in seven databases and in preprint repositories. We included human clinical trials that evaluated the effect of mouth-rinses with antiseptic substances on the viral load of SARS-CoV-2 in the saliva of children or adults that tested positive for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR). Risk of bias was assessed using the ROBINS-I tool. PROSPERO registration number CRD42021240561.ResultsFour studies matching eligibility criteria were selected for evaluation (n=32 participants). Study participants underwent oral rinses with hydrogen peroxide (H2O2) at 1 %, povidone–iodine (PI) at 0.5% or 1%, chlorhexidine gluconate (CHX) at 0.2% or 0.12% or cetylpyridinium chloride (CPC) at 0.075%. Only one study included a control group with sterile water. Three of the studies identified a significant reduction in viral load up to 3, 4, and 6 hours after the use of mouthwashes with PI, CHX, and CPC or PI vs. sterile water, respectively, while one study did not identify a significant reduction in viral load after the use of H2O2 rinses.ConclusionsAccording to the present systematic review, the effect of the use of mouth-rinses on SARS-CoV-2 viral load in the saliva of COVID-19 patients remains uncertain. This is mainly due to the limited number of patients included and a high risk of bias present in the studies analyzed. Evidence from well-designed randomized clinical trials is required for further and more objective evaluation of this effect.


2021 ◽  
Vol 19 (2) ◽  
pp. 83-90
Author(s):  
Ana C. Coelho-Oliveira ◽  
Bruno B. Monteiro-Oliveira ◽  
Rebeca B. M. Cavalcante ◽  
Daniel B. Santos ◽  
Anelise Sonza ◽  
...  

Objective: Consistent independent associations between lowserum 25-hydroxyvitamin D concentrations and susceptibilityto acute respiratory tract infections have suggested apossible involvement of vitamin D in reducing the risk ofrespiratory infections and proposing its replacement as apotential strategy for prevention or treatment in this context.However, the role of vitamin D supplementation in theinfection by the novel coronavirus named SARS-CoV-2 isstill under investigation and no clinical evidence has beenreported to date. Methods: Electronic searches in Pubmed,Embase and Scopus databases were conducted and threecohort studies that analyzed the effects of interaction ofvitamin D with COVID-19, published only in English, wereincluded. Two reviewers, which independently examinedtitles and abstracts, identified records through database searchand reference screening and irrelevant studies were excludedbased in eligibility criteria. Relevant full texts were analyzedfor eligibility, and all relevant studies were included in thesystematic review. Results: Three cohort studies were includedin this systematic review with a mean methodologicalquality low. Only one study demonstrated interaction of lowvitamin D concentration in patients with a positive diagnosisfor COVID-19. Randomized clinical trials and studies of goodmethodological quality are necessary to confirm the findingsof this systematic review. Conclusions: This systematic reviewhas not demonstrated consistent associations between lowlevels of vitamin D and susceptibility to COVID-19 infection.Further studies on vitamin D supplementation for the preventionof COVID-19 infection should be conducted..


2020 ◽  
Vol 39 (6) ◽  
pp. 1742-1752 ◽  
Author(s):  
Silvia Fogacci ◽  
Federica Fogacci ◽  
Maciej Banach ◽  
Erin D. Michos ◽  
Adrian V. Hernandez ◽  
...  

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