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Necrotizing enterocolitis ( NEC ) is one of the most serious gastrointestinal emergencies in very low birth weight ( VLBW ) preterm neonates , affecting 7 - 14 % of these neonates . Due to the seriousness of the disease , prevention of NEC is the most important goal . Current evidence from systematic review and meta- analysis revealed that probiotics are the most promising intervention in reduction of the incidence of NEC in VLBW neonates . As per the evidence , prebiotics modulate the composition of human intestine microflora to the benefit of the host by suppression of colonization of harmful microorganism and /or the stimulation of bifidobacterial growth , decreased stool viscosity , reduced gastrointestinal transit time , and better feed tolerance . Prebiotics may be potential alternatives or adjunctive therapies to probiotics , despite a lack of evidence supporting its clinical efficacy in prevention of NEC . In this article , we discuss evidence -based physiological effects of prebiotics and its therapeutic role in prevention of NEC | [
"ABSTRACT A healthy intestinal microbiota is considered to be important for priming of the infants ' mucosal and systemic immunity . Breast-fed infants typically have an intestinal microbiota dominated by different Bifidobacterium species . It has been described that allergic infants have different levels of sp... | 4115d8f6-06ff-11f0-808a-c43d1ab1c353 |
BACKGROUND Several clinical trials have investigated the impact of glucomannan on plasma lipids , body weight , fasting blood glucose ( FBG ) , and blood pressure ( BP ) , but have yielded conflicting results and had only modest sample sizes . OBJECTIVE The objective was to perform a meta- analysis of r and omized controlled trials of glucomannan to better characterize its impact on plasma lipids , FBG , body weight , and BP . DESIGN A systematic literature search of MEDLINE , EMBASE , CINAHL , Web of Science , the Cochrane Library , and the Natural Medicines Comprehensive Data base was conducted from the earliest possible date through November 2007 . A r and om-effects model was used to calculate the weighted mean difference ( WMD ) and 95 % CIs as the difference between the mean for the glucomannan and control groups . St and ard methods for assessing statistical heterogeneity and publication bias were used . RESULTS Fourteen studies ( n = 531 ) met the inclusion criteria . The use of glucomannan significantly lowered total cholesterol [ weighted mean difference ( WMD ) : -19.28 mg/dL ; 95 % CI : -24.30 , -14.26 ] , LDL cholesterol ( WMD : -15.99 mg/dL ; 95 % CI : -21.31 , -10.67 ) , triglycerides ( WMD : -11.08 mg/dL ; 95 % CI : -22.07 , -0.09 ) , body weight ( WMD : -0.79 kg ; 95 % CI : -1.53 , -0.05 ) , and FBG ( WMD : -7.44 mg/dL ; 95 % CI : -14.16 , -0.72 ) . The use of glucomannan did not appear to significantly alter any other study endpoints . Pediatric patients , patients receiving dietary modification , and patients with impaired glucose metabolism did not benefit from glucomannan to the same degree . CONCLUSIONS Glucomannan appears to beneficially affect total cholesterol , LDL cholesterol , triglycerides , body weight , and FBG , but not HDL cholesterol or BP | [
"The effects of the soluble fiber konjac glucomannan ( GM ) on serum cholesterol concentrations were investigated in 63 healthy men in a double-blind crossover , placebo-controlled study . After a 2-wk baseline period , the subjects were given 3.9 g GM or placebo daily for 4 wk . After a washout period of... | 4115dbee-06ff-11f0-808a-c43d1ab1c353 |
PURPOSE The goal of this meta- analysis was to determine the clinical utility of acute mountain sickness ( AMS ) history to predict future incidents of AMS . METHOD 17 studies ( n=7921 participants ) were included following a systematic review of the literature . A bivariate r and om-effects model was used to calculate the summary sensitivity and specificity of the diagnostic test , and moderator variables were tested to explain the heterogeneity across studies . The Quality Assessment of Diagnostic Accuracy Studies ( QUADAS-2 ) method was used to assess concerns for bias and applicability for the included studies . RESULTS The history of AMS had a low diagnostic accuracy for the prediction of future AMS incidents : the summary sensitivity was 0.50 ( 95 % CI ( 0.40 to 0.59 ) ) and the summary specificity was 0.72 ( 95 % CI ( 0.66 to 0.78 ) ) . There was significant heterogeneity in the sensitivity and specificity across studies , which we modelled using moderator analysis . Studies that restricted the use of acetazolamide and dexamethasone had not only a higher sensitivity ( 0.66 ) relative to those that did not ( 0.44 ; p=0.03 ) but also an increased false-positive rate ( 0.39 vs 0.23 , p=0.03 ) . The QUADAS-2 analysis showed that AMS histories were insufficiently detailed , and few studies controlled for prophylactic medication use or recent altitude exposure , leading to high risks of bias and concerns for applicability . CONCLUSIONS The use of AMS history to guide prophylactic strategies for high-altitude ascent is not supported by the literature ; however , the low sensitivity and specificity of this diagnostic test could reflect the quality of the available studies . Ensuring that the characteristics of the history and future ascents are similar may improve the clinical utility of AMS history | [
"The aims of this study were 1 ) to evaluate whether subjects suffering from acute mountain sickness ( AMS ) during exposure to high altitude have signs of autonomic dysfunction and 2 ) to verify whether autonomic variables at low altitude may identify subjects who are prone to develop AMS . Forty-one mountainee... | 4115dc8e-06ff-11f0-808a-c43d1ab1c353 |
The purpose of the current study was to clarify the role of the quadriceps tendon ( QT ) autograft for primary ACL reconstruction . Thus , a Bayesian network meta- analysis comparing patients undergoing a primary ACL reconstruction with QT versus patellar tendon ( PT ) and hamstring tendon ( HT ) autografts was conducted . This Bayesian network meta- analysis was conducted according to the PRISMA extension statement for reporting systematic review s incorporating network meta-analyses of health care interventions . In January 2020 , the main data bases were accessed . Articles comparing the outcomes of the QT autograft versus HT autograft and /or PT autograft for primary ACL reconstruction were included in the present study . The statistical analysis was performed with STATA Software/MP , through a Bayesian hierarchical r and om-effect model analysis . Data from a total of 2603 knees were analysed . The overall mean follow-up was 35.0 months . Among the different grafts were evidence d comparable values of IKDC , Tegner and Lysholm score . The QT autograft detected comparable rate of Lachman test > 3 mm , Pivot shift test > 3 m and instrumental laxity > 3 mm . The QT autograft showed a lower rate of autograft failure above all . The QT autograft detected the reduced rate of AKP than the PT . Quadriceps tendon autograft may represent a feasible option for primary ACL reconstruction . These results must be interpret within the limitations of the present network meta-anlaysis | [
"Abstract . This study documented postoperative morbidity during the first 4 months following anterior cruciate ligament ( ACL ) reconstruction using either patellar tendon or hamstring tendon autograft . Sixty-five patients undergoing primary arthroscopically assisted single-incision ACL reconstruction w... | 4115dcde-06ff-11f0-808a-c43d1ab1c353 |
OBJECTIVES to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes . DESIGN electronic published and unpublished literature /trial registries were systematic ally review ed . Studies evaluating medications with anti-cholinergic activity on cognitive function , delirium , physical function or mortality were eligible . RESULTS forty-six studies including 60,944 participants were included . Seventy-seven percent of included studies evaluating cognitive function ( n = 33 ) reported a significant decline in cognitive ability with increasing anti-cholinergic load ( P delirium and increasing anti-cholinergic drug load ( P > 0.05 ) . Five of the eight included studies reported a decline in physical function in users of anti-cholinergics ( P mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality , but this was not statistically significant . The method ological quality of the evidence -base ranged from poor to very good . CONCLUSION medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function , but limited evidence exists for delirium or mortality outcomes | [
"OBJECTIVES To investigate the effects of darifenacin controlled-release ( CR ) and oxybutynin extended-release ( ER ) on cognitive function ( particularly memory ) in older subjects . METHODS Healthy subjects ( n=150 ) > /=60 years were r and omised to darifenacin , oxybutynin ER or placebo in a multic... | 4115dd2e-06ff-11f0-808a-c43d1ab1c353 |
BACKGROUND Observational and some experimental data suggest that low intake of vitamin K may be associated with an increased risk of fracture . OBJECTIVE To assess whether oral vitamin K ( phytonadione and menaquinone ) supplementation can reduce bone loss and prevent fractures . DATA SOURCES The search included the following electronic data bases : MEDLINE ( 1966 to June 2005 ) , EMBASE ( 1980 to June 2005 ) , the Cochrane Library ( issue 2 , 2005 ) , the ISI Web of Science ( 1945 to June 2005 ) , the National Research Register ( inception to the present ) , Current Controlled Trials , and the Medical Research Council Research Register . STUDY SELECTION R and omized controlled trials that gave adult participants oral phytonadione and menaquinone supplements for longer than 6 months were included in this review . DATA EXTRACTION Four authors extracted data on changes in bone density and type of fracture . All articles were double screened and double data extracted . DATA SYNTHESIS Thirteen trials were identified with data on bone loss , and 7 reported fracture data . All studies but 1 showed an advantage of phytonadione and menaquinone in reducing bone loss . All 7 trials that reported fracture effects were Japanese and used menaquinone . Pooling the 7 trials with fracture data in a meta- analysis , we found an odds ratio ( OR ) favoring menaquinone of 0.40 ( 95 % confidence interval [ CI ] , 0.25 - 0.65 ) for vertebral fractures , an OR of 0.23 ( 95 % CI , 0.12 - 0.47 ) for hip fractures , and an OR of 0.19 ( 95 % CI , 0.11 - 0.35 ) for all nonvertebral fractures . CONCLUSIONS This systematic review suggests that supplementation with phytonadione and menaquinone-4 reduces bone loss . In the case of the latter , there is a strong effect on incident fractures among Japanese patients | [
"We have recently demonstrated that glucocorticoid ( GC ) suppresses bone formation and enhances bone resorption , with result ant bone loss . This altered bone turnover is not due to the action of parathyroid hormone ( PTH ) , but appears to be related to the suppression of osteoprotegerin ( OPG ) . As vitamin ... | 4115dd74-06ff-11f0-808a-c43d1ab1c353 |
"A systematic review of r and omised controlled trials was undertaken to evaluate the effectivenes(...TRUNCATED) | ["To compare the use of r and omized controls ( RCTs ) and historical controls ( HCTs ) for cl(...TRUNCATED) | 4115ddb0-06ff-11f0-808a-c43d1ab1c353 |
"Maternal obesity is associated with increased risk of pregnancy complications such as gestationa(...TRUNCATED) | ["IMPORTANCE Short-term studies show that bariatric surgery causes remission of diabetes . The l(...TRUNCATED) | 4115ddec-06ff-11f0-808a-c43d1ab1c353 |
"Background . A number of studies have computed the minimally important difference ( MID ) for hea(...TRUNCATED) | ["BACKGROUND There is some evidence that quality of life ( QOL ) in patients with chronic obstruc(...TRUNCATED) | 4115de32-06ff-11f0-808a-c43d1ab1c353 |
"Many aspects of long-term pharmacological treatments for anxiety disorders ( AnxDs ) are stil(...TRUNCATED) | ["Abstract This long-term extension of an 8-week r and omized , naturalistic study in patients with(...TRUNCATED) | 4115de6e-06ff-11f0-808a-c43d1ab1c353 |
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