scholarly journals Effect of Oral Nutritional Supplementation on Growth in Children with Undernutrition: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3036
Author(s):  
Zhiying Zhang ◽  
Fei Li ◽  
Bridget A. Hannon ◽  
Deborah S. Hustead ◽  
Marion M. Aw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Repeated Measures ◽  
Meta Analysis ◽  
Intervention Group ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Anthropometric Measures ◽  
Oral Nutritional Supplements ◽  
Z Scores ◽  
Usual Diet

Oral nutritional supplements (ONS) are used to promote catch-up growth in children with undernutrition. We conducted a systematic review and meta-analysis to summarize the evidence of ONS intervention effects on growth for 9-month- to 12-year-old children who were undernourished or at nutritional risk. Eleven randomized controlled trials met the inclusion criteria; trials compared changes in anthropometric measures in children using ONS or ONS + DC (dietary counselling) to measures for those following usual diet or placebo or DC alone. The RCTs included 2287 children without chronic diseases (mean age 5.87 years [SD, 1.35]; 56% boys). At follow-up time points up to 6 months, results showed that children in the ONS intervention group had greater gains in weight (0.423 kg, [95% confidence interval 0.234, 0.613], p < 0.001) and height (0.417 cm [0.059, 0.776], p = 0.022) versus control; greater gains in weight (0.089 kg [0.049, 0.130], p < 0.001) were evident as early as 7–10 days. Longitudinal analyses with repeated measures at 30, 60, and 90 days showed greater gains in weight parameters from 30 days onwards (p < 0.001), a trend towards greater height gains at 90 days (p = 0.056), and significantly greater gains in height-for-age percentiles and z-scores at 30 and 90 days, respectively (p < 0.05). Similar results were found in subgroup analyses of studies comparing ONS + DC to DC alone. For children with undernutrition, particularly those who were mildly and moderately undernourished, usage of ONS in a nutritional intervention resulted in significantly better growth outcomes when compared to control treatments (usual diet, placebo or DC alone).

The effect of walnut consumption on cardio-metabolic profiles of individuals with abnormal glucose homeostasis: a systematic review and meta-analysis of clinical trials

2021 ◽  
pp. 1-31
Author(s):  
Hanieh Malmir ◽  
Bagher Larijani ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Systematic Review ◽  
Glucose Homeostasis ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Control Group ◽  
Metabolic Profiles ◽  
Anthropometric Measures ◽  
Cholesterol Levels

Abstract Findings on the effect of walnut consumption on cardio metabolic profiles in individuals with abnormal glucose homeostasis are conflicting. We summarized earlier data in this regard. A systematic literature search of relevant reports published in Medline/PubMed, ISI web of Science, EMBASE, SCOPUS and Google Scholar up to October 2020 was conducted. Randomized trials that enrolled individuals with abnormal glucose homeostasis in which the main intervention was walnut consumption were included. Abnormal glucose homeostasis was defined as a spectrum of impaired glucose tolerance or pre-diabetic status that is associated with insulin resistance. Twelve studies were included in systematic review and eight in meta-analysis. No significant effect of walnut consumption on anthropometric measures, including weight [WMD: −0.13; 95% CI: −0.64, 0.39 kg], BMI [−0.08; −0.47, 0.32 kg/m2] and waist circumference [0.01; −0.50, 0.52 cm] was observed. Although walnut intake did not influence on lipid profiles (including triglyceride, total- and HDL-cholesterol levels), individuals in the intervention group tended to have lower levels of LDL-cholesterol than those in the control group [−0.10; −0.20, 0.01 mmol/L; P=0.06]. Other cardio-metabolic factors including markers of glycemic control [fasting blood glucose and hemoglobin A1C levels], blood pressure and stimulus-adjusted response measure (a parameter of endothelial function) were not significantly affected. However, walnut consumption resulted in a significant increase in flow-mediated dilation [0.93%;: 0.16, 1.71%]. Summarizing earlier evidence, we found that walnut consumption might influence FMD and LDL-cholesterol levels in individuals with abnormal glucose homeostasis. It did not affect other cardio-metabolic profiles in these individuals.

Effects of wearable technology on patients with diabetes: A systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Dongjun Wu ◽  
Nicholas Buys ◽  
Guandong Xu ◽  
Jing Sun
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Relapse Prevention ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Intervention Group ◽  
Wearable Technologies ◽  
Patients With Diabetes ◽  
Hba1c Levels

UNSTRUCTURED Aims: This systematic review and meta-analysis aimed to evaluate the effects of wearable technologies on HbA1c, blood pressure, body mass index (BMI), and fastening blood glucose (FBG) in patients with diabetes. Methods: We searched PubMed, Scopus, Embase, the Cochrane database, and the Chinese CNKI database from last 15 years until August 2021. The quality of the 16 included studies was assessed using the PEDro scale, and random effect models were used to estimate outcomes, with I2 used for heterogeneity testing. Results: A significant reduction in HbA1c (-0.475% [95% CI -0.692 to -0.257, P<0.001]) was found following telemonitoring. However, the results of the meta-analysis did not show significant changes in blood pressure, BMI, and glucose, in the intervention group (P>0.05), although the effect size for systolic blood pressure (0.389) and diastolic blood pressure may indicate a significant effect. Subgroup analysis revealed statistically significant effects of wearable technologies on HbA1c when supported by dietetic interventions (P<0.001), medication monitoring (P<0.001), and relapse prevention (P<0.001). Online messages and telephone interventions significantly affected HbA1c levels (P<0.001). Trials with additional online face-to-face interventions showed greater reductions in HbA1c levels. Remote interventions including dietetic advice (P<0.001), medication (P<0.001), and relapse prevention (P<0.001) during telemonitoring showed a significant effect on HbA1c, particularly in patients attending ten or more intervention sessions (P<0.001). Conclusion: Wearable technologies can improve diabetes management by simplifying self-monitoring, allowing patients to upload their live measurement results frequently and thereby improving the quality of telemedicine. Wearable technologies also facilitate remote medication management, dietetic interventions, and relapse prevention.

scholarly journals Sofosbuvir with daclatasvir and the outcomes of patients with COVID-19: a systematic review and meta-analysis with GRADE assessment

2021 ◽  
pp. postgradmedj-2021-140287
Author(s):  
Ahmad Fariz Malvi Zamzam Zein ◽  
Catur Setiya Sulistiyana ◽  
Wilson Matthew Raffaello ◽  
Arief Wibowo ◽  
Raymond Pranata
Keyword(s):  
Systematic Review ◽  
Absolute Risk ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Intervention Group ◽  
Control Group ◽  
Reduce Mortality Rate ◽  
Icu Admission ◽  
Clinical Recovery

PurposeThis systematic review and meta-analysis aimed to evaluate the effect of sofosbuvir/daclatasvir (SOF/DCV) on mortality, the need for intensive care unit (ICU) admission or invasive mechanical ventilation (IMV) and clinical recovery in patients with COVID-19.MethodsWe performed a systematic literature search through the PubMed, Scopus and Embase from the inception of databases until 6 April 2021. The intervention group was SOF/DCV, and the control group was standard of care. The primary outcome was mortality, defined as clinically validated death. The secondary outcomes were (1) the need for ICU admission or IMV and (2) clinical recovery. The pooled effect estimates were reported as risk ratios (RRs).ResultsThere were four studies with a total of 231 patients in this meta-analysis. Three studies were randomised controlled trial, and one study was non-randomised. SOF/DCV was associated with lower mortality (RR: 0.31 (0.12, 0.78); p=0.013; I2: 0%) and reduced need for ICU admission or IMV (RR: 0.35 (0.18, 0.69); p=0.002; I2: 0%). Clinical recovery was achieved more frequently in the SOF/DCV (RR: 1.20 (1.04, 1.37); p=0.011; I2: 21.1%). There was a moderate certainty of evidence for mortality and need for ICU/IMV outcome, and a low certainty of evidence for clinical recovery. The absolute risk reductions were 140 fewer per 1000 for mortality and 186 fewer per 1000 for the need for ICU/IMV. The increase in clinical recovery was 146 more per 1000.ConclusionSOF/DCV may reduce mortality rate and need for ICU/IMV in patients with COVID-19 while increasing the chance for clinical recovery.Protocol registrationPROSPERO: CRD42021247510.

scholarly journals Effectiveness of Oral Nutritional Supplements on Older People with Anorexia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 835
Author(s):  
Mengqi Li ◽  
Si Zhao ◽  
Shuang Wu ◽  
Xiufen Yang ◽  
Hui Feng
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Older People ◽  
Energy Intake ◽  
Meta Analysis ◽  
Nutritional Supplements ◽  
The Elderly ◽  
Randomized Controlled ◽  
Oral Nutritional Supplements ◽  
Positive Effect

Background: Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. Aims: The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). Methods: By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian–Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). Results: 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74–87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. Conclusions: The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.

scholarly journals Safety and efficacy of routine diagnostic test reduction interventions in patients admitted to the intensive care unit: A systematic review and meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 23-34
Author(s):  
Katherine P Hooper ◽  
Matthew H Anstey ◽  
Edward Litton
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Diagnostic Testing ◽  
Intervention Group ◽  
Cochrane Central Register ◽  
Safety And Efficacy ◽  
Significant Difference

Reducing unnecessary routine diagnostic testing has been identified as a strategy to curb wasteful healthcare. However, the safety and efficacy of targeted diagnostic testing strategies are uncertain. The aim of this study was to systematically review interventions designed to reduce pathology and chest radiograph testing in patients admitted to the intensive care unit (ICU). A predetermined protocol and search strategy included OVID MEDLINE, OVID EMBASE and the Cochrane Central Register of Controlled Trials from inception until 20 November 2019. Eligible publications included interventional studies of patients admitted to an ICU. There were no language restrictions. The primary outcomes were in-hospital mortality and test reduction. Key secondary outcomes included ICU mortality, length of stay, costs and adverse events. This systematic review analysed 26 studies (with more than 44,00 patients) reporting an intervention to reduce one or more diagnostic tests. No studies were at low risk of bias. In-hospital mortality, reported in seven studies, was not significantly different in the post-implementation group (829 of 9815 patients, 8.4%) compared with the pre-intervention group (1007 of 9848 patients, 10.2%), (relative risk 0.89, 95% confidence intervals 0.79 to 1.01, P = 0.06, I2 39%). Of the 18 studies reporting a difference in testing rates, all reported a decrease associated with targeted testing (range 6%–72%), with 14 (82%) studies reporting >20% reduction in one or more tests. Studies of ICU targeted test interventions are generally of low quality. The majority report substantial decreases in testing without evidence of a significant difference in hospital mortality.

Green tea and green tea extract in oncological treatment: A systematic review

2021 ◽  
pp. 1-13
Author(s):  
Fanny Wiese ◽  
Sabine Kutschan ◽  
Jennifer Doerfler ◽  
Viktoria Mathies ◽  
Jens Buentzel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Green Tea ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Specific Antigen ◽  
Intervention Group ◽  
Epigallocatechin Gallate ◽  
Oncological Treatment ◽  
Complementary Method ◽  
Tea Extract

Abstract. Purpose: Teas are an essential part of traditional phytotherapy. The aim of this systematic review is to assess the clinical evidence using green tea catechins in cancer care. Methods: A systematic search was conducted searching five electronic databases concerning the effectiveness and risks of epigallocatechin gallate (EGCG) on cancer patients. Results: Seven studies with 371 patients were included. Patients were mainly suffering from breast and prostate cancer. Dosing ranged from 28 mg to 1600 mg EGCG, intervention time from 7 days to 6 months with different applications (topical 2 studies; oral 5 studies). The studies showed heterogeneous methodological quality and results leading not to conduct a meta-analysis. There was a small decrease in prostate-specific-antigen levels in one study (N=60; T0:(mean±SD) 9.6±5.2 ng/ml, T1: 8.4±4.3 ng/ml vs. T0: 9.9±8.5 ng/ml, T1: 10.0±9.0 ng/ml; p=0.04), whereas in a second study only a trend was seen. Topical green tea was as effective as metronidazole powder in reducing the odor of fungating malignant wounds (1 study; N=30) with a consequent increase in quality of life (QoL) (p<0.001), improvement of appetite (p<0.001), malodorous control (p<0.001), social activities (p<0.001). Radiotherapy-induced diarrhea was lower in the green tea intervention group compared to placebo (1 study; N=42; week 4+5: without diarrhea p=0.002). Conclusions: The studies suggest that EGCG is as effective as a local antibiotic in malodorous control and improvement of QoL of fungating malignant wounds. Green tea could be a possible complementary method for treating acute radiation-induced diarrhea. Due to limitations, further studies with higher methodological quality and larger sample sizes are needed.

scholarly journals Late childhood and adolescence growth sensitivity to political transition: the case of South African Cape coloured schoolchildren during and post-apartheid

2012 ◽  
Vol 75 (1) ◽  
pp. 19-31 ◽  
Author(s):  
Madelief G.B.C. Bertens ◽  
Stanley Ulijaszek ◽  
Sławomir Kozieł ◽  
Maciej Henneberg
Keyword(s):  
South African ◽  
Repeated Measures ◽  
Childhood And Adolescence ◽  
Low Ses ◽  
Anthropometric Measures ◽  
Significant Interaction Effect ◽  
Nelson Mandela ◽  
Z Scores ◽  
The Impact ◽  
Measurement Period

Abstract South Africa underwent major social and economic change between 1987 and 1995. The release of Nelson Mandela in February 1990 proclaimed an end to the political system of apartheid, and the first freely elected non-White government in 1994 instigated social and economic reforms aimed at alleviating the consequences of apartheid. This paper aims to examine the impact of these socio-economic and political changes on height, weight and body mass index (BMI) in childhood and late adolescence. An analysis was carried out of longitudinal data of 258 urban and rural South African Cape Coloured schoolchildren (6-18 years old) across the transitional periods from apartheid between 1987 and 1990, to this transition between 1991 and 1993, and finally to post-apartheid between 1994 and 1995. The anthropometric measures were standardized into age independent Z-scores. Analyses of variance with repeated measures were conducted to examine the growth in height, weight and BMI across these periods. The results show a significant main effect of measurement periods on height, weight and BMI Z-scores. Across time, the subjects increased in overall size, height, weight and BMI. For all the anthropometric measures there was a significant interaction effect between measurement period and sex, but none between measurement period and SES. The average increase in height, weight and BMI across time differed significantly for girls and boys, the average z-scores being greater in girls than in boys. For boys, there was little difference in height, weight and BMI Z-scores according to SES, and little increase across periods. Girls were generally taller, heavier with greater BMI than boys, and their scores increased across the time periods. High SES girls were taller, heavier and had higher BMI than low SES girls. Across the measurement periods, BMI and weight somewhat converged between the high and low SES girls. In the discussion these differences reflecting social sex distinctions are addressed.

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