Nutrition and health

Objectives:
The etiology of cancer type may vary significantly due to anatomy, embryology and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, however, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Therefore, this review article has been conducted.

Do potato intakes increase multiple cancer sites risk?

Study design:
This review article included 20 prospective cohort studies (with a total of 785,348 participants, of which 19,882 incident cases (persons with cancer)) and 36 case-control studies ( with a total of 21,822 cases (persons with cancer) and 66,502 controls (persons without cancer)).

Certainty of the evidence was low for total cancer, colorectal cancer, colon, rectal, renal, pancreatic, breast, prostate and lung cancer and very low for gastric and bladder cancer.

Results and conclusions:
The investigators found among cohort studies, no association between high versus low intake of total potato (white and yellow) consumption and overall cancers [RR = 1.04, 95% CI = 0.96 to 1.11, tau2 = 0.005, n = 18].

The investigators found no relation between total potato consumption (high compared with low intake) and risk of colorectal, pancreatic, colon, gastric, breast, prostate, kidney, lung or bladder cancer in cohort or case-control studies.

The investigators found no association between high versus low consumption of potato preparations (boiled/fried/mashed/roasted/baked) and risk of gastrointestinal-, sex-hormone-, or urinary-related cancers in cohort or case-control studies.

The investigators concluded that potato intakes or potato preparations are not associated with multiple cancer sites when comparing high and low intake categories. This finding is consistent with the findings from the 2018 meta-analysis regarding potato intake and risk of colorectal cancer.

Original title:
Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Mofrad MD, Mozaffari H, […], Azadbakht L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33861304/

Additional information of El Mondo:
Find more information/studies on potato consumption and cancer right here.

Objectives:
Does tart cherry (TC) supplementation improve recovery following strenuous exercise?

Study design:
This review article included 14 studies.

Results and conclusions:
The investigators found tart cherry supplementation had a small significant beneficial effect in reducing muscle soreness [effect size (ES) = -0.44, 95% CI = -0.87 to -0.02].

The investigators found a moderate significant beneficial effect was observed for recovery of muscular strength [ES = -0.78, 95% CI = -1.11 to -0.46] for tart cherry supplementation.

The investigators found a moderate significant effect was observed for muscular power [ES = -0.53, 95% CI = -0.77 to -0.29] for tart cherry supplementation.
A further subgroup analysis on this variable indicated a large significant effect of tart cherry supplementation on recovery of jump height [ES = -0.82, 95% CI = -1.18 to -0.45] and a small significant effect of tart cherry supplementation on sprint time [ES = -0.32, 95% CI = -0.60 to -0.04]. 

The investigators found a small significant effect was observed for both C-reactive protein [ES = -0.46, 95% CI = -0.93 to -0.00] and Interleukin-6 [ES = -0.35, 95% CI = -0.68 to -0.02] for tart cherry supplementation.

The investigators found no significant effects were observed for creatine kinase and tumor necrosis factor alpha (TNF-α) for tart cherry supplementation. 

The investigators concluded that tart cherry supplementation improves aspects of recovery from strenuous exercise.

Original title:
Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis by Hill JA, Keane KM, […], Howatson G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33440334/

Additional information of El Mondo:
Find here more information/studies on fruit and sport nutrition. 

Objectives:
Does garlic supplementation reduce adiponectin and leptin serum levels?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found that garlic supplementation did not significantly affect adiponectin [Hedges's = 0.20, 95% CI = -0.06 to 0.47, p = 0.12] and leptin [Hedges's = 0.08, 95% CI = -0.26 to 0.41, p = 0.65] concentrations in comparison with placebo.

The investigators found, however, in the subgroup analysis, significantly increased serum adiponectin level was seen following garlic supplementation in trials with a mean age of participants ˂30 years [Hedges's = 0.44, 95% CI = 0.01 to 0.87, p = 0.04], the doses ˂1.5 g/day [Hedges's = 0.38, 95% CI = 0.02 to 0.71, p = 0.04] and trials with duration ≥8 weeks [Hedges's = 0.48, 95% CI = 0.08 to 0.89, p = 0.02].

The investigators concluded that ˂1.5 g/day garlic supplementation during ≥8 weeks reduces adiponectin level among participants ˂30 years.

Original title:
Systematic review and meta-analysis of randomized, controlled trials on the effects of garlic supplementation on serum adiponectin and leptin levels by Shekarchizadeh-Esfahani P, Hassani B, […], Soraya N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33792129/

Additional information of El Mondo:
Find here more information/studies about review article/significant and garlic.

Adiponectin is a fat-derived hormone that appears to play a crucial role in protecting against insulin resistance/diabetes and atherosclerosis (atherosclerosis is the dominant cause of cardiovascular disease (CVD)). Decreased adiponectin levels are thought to play a central role in the development of obesity, cardiovascular disease and type 2 diabetes in humans.

Objectives:
Chemoprophylaxis with weekly doses of tafenoquine (200 mg/day for 3 days before departure [loading dose], 200 mg/week during travel and one-week post-travel [maintenance doses]) is effective in preventing malaria. Effectiveness of malaria chemoprophylaxis drugs in travellers is often compromised by poor compliance. Shorter schedules that can be completed before travel, allowing “drug-free holidays”, could increase compliance and thus reduce travel-related malaria. Therefore, this review article (meta-analysis) has been conducted.

Is a loading dose of tafenoquine alone effective in preventing malaria in short-term travellers?

Study design:
This review article included 9 RCTs with a total of 1,714 participants.

Results and conclusions:
The investigators found in long-term travellers, compared to mefloquine, tafenoquine with maintenance doses [OR = 1.05, 95% CI = 0.44 to 2.46] was equally effective in preventing malaria, while there was an increased risk of infection with the loading dose of tafenoquine alone [OR = 2.89, 95% CI = 0.78 to 10.68] and placebo [OR = 62.91, 95% CI = 8.53 to 463.88].

The investigators found in short-term travellers, loading dose of tafenoquine alone [OR = 0.98, 95% CI = 0.04 to 22.42] and tafenoquine with maintenance doses [OR = 1.00, 95% CI = 0.06 to 16.10] were as effective as mefloquine.

The investigators found the risk of adverse events (AEs) with tafenoquine with maintenance doses [OR = 1.03, 95% CI = 0.67 to 1.60] was similar to mefloquine, while loading dose of tafenoquine alone [OR = 0.58, 95% CI = 0.20 to 1.66] was associated with lower risk of AEs, although the difference was not statistically significant.

The investigators concluded for short-term travellers, loading dose of tafenoquine alone is equally effective, has possibly lower rate of adverse events (AEs) and likely better compliance than standard tafenoquine or mefloquine chemoprophylaxis schedules with maintenance doses. Studies are needed to confirm if short-term travellers remain free of infection after long-term follow-up.

Original title:
Efficacy of a 3-day pre-travel schedule of Tafenoquine for malaria chemoprophylaxis: A network meta-analysis by Islam N, Wright S, […], Furuya-Kanamori L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33834208/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, malaria and food fortification/malnutrition right here.

Objectives:
Do magnesium intakes reduce risk of all-cause, cancer and cardiovascular disease (CVD) mortality?

Study design:
This review article included 19 prospective cohort studies with a total of 1,168,756 participants (52,378 deaths from all causes (all-cause mortality), 23,478 from cardiovascular disease (CVD) and 11,408 from cancer).
The follow-up period was 3.5 to 32 years.

Results and conclusions:
The investigators found dietary magnesium intake was significantly associated with a lower risk of 13% for all-cause mortality [pooled effect size (ES) = 0.87, 95% CI = 0.79 to 0.97, p = 0.009, I2 = 70.7%, p 0.001].

The investigators found dietary magnesium intake was significantly associated with a lower risk of 20% for cancer mortality [pooled ES = 0.80, 95% CI = 0.67 to 0.97, p = 0.023, I2 = 55.7%, p = 0.027].

The investigators found for supplemental and total magnesium intakes, no significant associations with risks of all-cause, cardiovascular disease and cancer mortality.

The investigators found, however, linear dose-response meta-analysis indicated that each additional intake of 100 mg/d of dietary magnesium was significantly associated with a 6% and 5% reduced risk of all-cause and cancer mortality, respectively.

The investigators concluded that higher intake of dietary magnesium (at least 100 mg/d of dietary magnesium) is associated with a reduced risk of all-cause and cancer mortality, but not cardiovascular disease mortality. Supplemental and total magnesium intakes are not associated with the risk of all-cause, cardiovascular disease and cancer mortality. These findings indicate that consumption of magnesium from dietary sources may be beneficial in reducing all-cause and cancer mortality and thus have practical importance for public health.  

Original title:
Total, Dietary, and Supplemental Magnesium Intakes and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies by Bagheri A, Naghshi S, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33684200/

Additional information of El Mondo:
Find more information/studies on magnesium consumption, cardiovascular disease and cancer right here.

Objectives:
Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results. Therefore, this review article has been conducted.

Does nut consumption reduce risk of type 2 diabetes?

Study design:
This review article included 5 prospective cohort studies and 3 cross-sectional studies.
The certainty of the evidence using NutriGrade was very low for all the exposures.

Results and conclusions:
The investigators found meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and type 2 diabetes.
Nonsignificant means that there is no association with a 95% confidence.

The investigators found meta-analyses of prospective cohort studies showed that peanut butter consumption significantly reduced type 2 diabetes incidence with 13% [RR = 0.87, 95% CI = 0.77 to 0.98, I2 = 50.6%, p = 0.16], whereas no association was observed between peanuts or tree nuts and type 2 diabetes.

The investigators found there was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies.

The investigators concluded peanut butter consumption may reduce type 2 diabetes incidence. May reduce because the certainty of the evidence using NutriGrade was very low.

Original title:
Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies by Becerra-Tomás N, Paz-Graniel I, […], Salas-Salvadó J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33471083/

Additional information of El Mondo:
Find more information/studies on nut consumption and diabetes right here.
 

Objectives:
Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy. Therefore, this review article (meta-analysis) has been conducted.

The aim of this systematic review and meta-analysis was to assess the following:
(1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes and mortality outcomes.
(2) the effects of multiple-micronutrient supplementation in adolescents compared with the effects in adult women and
(3) the effect modification, if any, of multiple-micronutrient supplementation by baseline and geographic characteristics of adolescents.

Study design:
This review article included 13 randomized controlled trials (RCTs) conducted in Africa and Asia with a total of 15,283 adolescents and 44,499 adult women with singleton births.

Effect modification by baseline characteristics and geographic region was inconclusive.

Results and conclusions:
The investigators found in adolescents, multiple-micronutrient (MMN) supplementation significantly reduced low birth weight [1-stage OR = 0.87, 95% CI = 0.77 to 0.97 and 2-stage OR = 0.81, 95% CI = 0.74 to 0.88], preterm birth [1-stage OR = 0.88, 95% CI = 0.80 to 0.98 and 2-stage OR = 0.86, 95% CI = 0.79 to 0.95] and small-for-gestational-age births [1-stage OR = 0.90, 95% CI = 0.81 to 1.00 and 2-stage OR = 0.86, 95%CI = 0.79 to 0.95] when compared with iron and folic acid (IFA) supplementation.

The investigators found the effects of multiple-micronutrient supplementation did not differ between adolescents and older women, although a potentially greater reduction in small-for-gestational-age births was observed among adolescents.

The investigators concluded multiple-micronutrient (MMM) supplementation improves birth outcomes among pregnant adolescents in low- and middle-income countries. Policy related to antenatal care in these settings should prioritize multiple-micronutrient supplementation over the currently recommended iron and folic acid (IFA) supplementation for all pregnant women, especially adolescents.

Original title:
Multiple-micronutrient supplementation in pregnant adolescents in low- and middle-income countries: a systematic review and a meta-analysis of individual participant data by Keats EC, Akseer N, […], Bhutta ZA.

Link:
https://pubmed.ncbi.nlm.nih.gov/33846729/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, pregnancy, micronutrients and food fortification/malnutrition right here.

Objectives:
Migraine is a common disease worldwide and migraine prevention is primarily currently based on pharmaceuticals. The mechanism of vitamin B2 may positively contribute to migraine. Therefore, this review article has been conducted.

Does vitamin B2 supplementation decrease migraine?

Study design:
This review article included 8 randomized controlled trials and 1 controlled clinical trial with 673 subjects.

Results and conclusions:
The investigators found 400 mg/day vitamin B2 supplementation for 3 months significantly decreased migraine days [p = 0.005, I2 = 89%], duration [p = 0.003, I2 = 0], frequency [p = 0.001, I2 = 65%] and pain score [p = 0.015, I2 = 84%].

The investigators concluded that 400 mg/day vitamin B2 supplementation for 3 months has significant effect on days, duration, frequency and pain score of migraine attacks.

Original title:
Effect of Vitamin B2 supplementation on migraine prophylaxis: a systematic review and meta-analysis by Chen YS, Lee HF, […], Hu FW.

Link:
https://pubmed.ncbi.nlm.nih.gov/33779525/

Additional information of El Mondo:
Find here more information/studies about review article/significant and vitamin B2.

Objectives:
Previous population studies on the associations between dietary fatty acids (FAs), plasma FAs levels and the risk of age-related macular degeneration (AMD) have yielded inconclusive results. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary fatty acids (EPA and DHA) intakes or higher plasma fatty acids levels reduce risk of age-related macular degeneration?

Study design:
This review article included 11 prospective cohort studies with 167,581 participants. During the follow-up periods (ranging from 3 to 28 years), 6,318 cases of age-related macular degeneration were recorded.

Results and conclusions:
The investigators found that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) and eicosatetraenoic acid (EPA) combined significantly reduced risk of early age-related macular degeneration with 33% [RR = 0.67, 95% CI = 0.51 to 0.88].
Significantly means that there is an association with a 95% confidence.

The investigators found that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) significantly reduced risk of early age-related macular degeneration with 50% [RR = 0.50, 95% CI = 0.32 to 0.78].
Significantly means it can be said with a 95% confidence that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) really reduces risk of early age-related macular degeneration with 50%.

The investigators found that each 1 g/day increment of dietary intake of eicosatetraenoic acid (EPA) significantly reduced risk of early age-related macular degeneration with 60% [RR = 0.40, 95% CI = 0.18 to 0.87].
Significantly because RR of 1 was not found in the 95% CI of 0.18 to 0.87. RR of 1 means no risk/association.

The investigators found that higher plasma docosahexaenoic acid (DHA) levels significantly reduced risk of advanced age-related macular degeneration with 28% [RR = 0.72, 95% CI = 0.55 to 0.95].

The investigators found that higher plasma eicosatetraenoic acid (EPA) levels significantly reduced risk of advanced age-related macular degeneration with 43% [RR = 0.57, 95% CI = 0.40 to 0.81].

The investigators concluded that 1 g/day of dietary intake DHA and 1 g/day of dietary intake EPA and higher plasma DHA and EPA levels are associated with a reduced risk of age-related macular degeneration.

Original title:
Dietary fatty acid intake, plasma fatty acid levels, and the risk of age-related macular degeneration (AMD): a dose-response meta-analysis of prospective cohort studies by Zhong Y, Wang K, [...], Yao K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33469697/

Additional information of El Mondo:
Find more information/studies on EPA en DHA and elderly right here.

A high plasma EPA and DHA content can be obtained by eating a lot of oily fish and/or by taking EPA and DHA supplements (fish oil supplements).
Oily fish contains more EPA and DHA than non-oily fish.

Early age-related macular degeneration: most people do not experience adverse symptoms or vision loss in the early stage of age-related macular degeneration, but night vision problems are often reported. Though no pigmentary abnormalities are apparent upon examination, medium-sized drusen (>63 μm and ≤125 μm) are present.

Objectives:
Infections may play a role in the etiology of childhood cancer and immunizations may be protective because vaccinations stimulate the immune system. Observational studies reported inconsistent associations between vaccination and risk of childhood cancer. Therefore, this review article has been conducted.

Does vaccination reduce the risk of childhood leukemia?

Study design:
This review article included 35 studies for inclusion in 27 specific analyses on 11 different childhood cancer outcomes after exposure to 9 different types of vaccination.
The minority of the studies included in the meta-analysis were retrospective cohort or case cohort studies (31%), the majority were case-control studies (69%), of which 18 included population-based and 4 hospital-based controls.
Studies were published between 1968 and 2019 and covered a study period of 65 years (1943 to 2008).
The studies were conducted in Europe (57%), North America (26%), South America (8%), Australia or New Zealand (6%) and Asia (3%) with sample sizes ranging from 148 to 1,224,914 participants.
Most studies examined only children under 18 years of age.
Overall, the methodological quality assessments of the 35 studies included in the meta-analysis yielded an average score of 4.7 out of 9.0 for the NOS.

Results and conclusions:
The investigators found a significantly reduced risk of 51% for leukemia death [summary OR = 0.49, 95% CI = 0.32 to 0.74, I2 = 36%, n = 4, p value = 0.20] after bacillus Calmette-Guérin (BCG) vaccination, compared to children without this vaccination.

The investigators found a significantly reduced risk of 24% for acute lymphoblastic leukemia [summary OR = 0.76, 95% CI = 0.65 to 0.90, I2 = 20%, n = 5, p value = 0.29] after Haemophilus influenzae type b vaccination, compared to children without this vaccination.

The investigators found a significantly reduced risk of 43% for leukemia [summary OR = 0.57, 95% CI = 0.36 to 0.88, I2 = 74%, n = 4, p value = 0.01] after three or more vaccinations of any type, compared to children without these vaccinations.

The investigators found a significantly reduced risk of 38% for acute lymphoblastic leukemia [summary OR = 0.62, 95% CI = 0.46 to 0.85, I2 = 55%, n = 5, p value = 0.06] after three or more vaccinations of any type, compared to children without these vaccinations.

The investigators concluded these results are consistent with the hypothesis that vaccinations reduce the risk of childhood leukemia. However, the robustness and validity of these results is limited due to the small number, substantial heterogeneity and methodological limitations of available studies.

Original title:
Vaccination and the Risk of Childhood Cancer-A Systematic Review and Meta-Analysis by Marron M, Brackmann LK, […], Ahrens W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862764/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, vaccination and food fortification/malnutrition right here.

Acute lymphocytic leukemia (ALL) is also called acute lymphoblastic leukemia and is a type of cancer of the blood and bone marrow - the spongy tissue inside bones where blood cells are made.
 “Acute” means that the leukemia can progress quickly and if not treated, would probably be fatal within a few months.
"Lymphocytic" means it develops from early (immature) forms of lymphocytes, a type of white blood cell.
Acute lymphocytic leukemia is the most common type of cancer in children and treatments result in a good chance for a cure.

Objectives:
Previous studies on the association between alcohol intake and risk of fracture have reached conflicting findings. Therefore, this review article has been conducted.

Does alcohol consumption increase risk of fractures?

Study design:
This review article included 38 prospective cohort studies with a total sample size of 5,053,117 participants and 169,560 cases of fracture.

Results and conclusions:
The investigators found in a random-effects meta-analysis, that alcohol consumption significantly increased risk of total fractures with 35% [RR = 1.35, 95% CI = 1.01 to 1.81] and any fractures with 24% [RR= 1.24, 95% CI = 1.11 to 1.38].
Significant because RR of 1 was not found in the 95% CI of 1.01 to 1.81. RR of 1 means no risk/association.

The investigators found, however, no significant association between alcohol intake and risk of hip fractures [RR = 1.19, 95% CI = 0.96 to 1.48], osteoporotic fractures [RR = 2.01, 95% CI = 0.76 to 5.34], vertebral fractures [RR = 0.98, 95% CI = 0.68 to 1.40] and wrist fractures [RR = 0.99, 95% CI = 0.85 to 1.16].
No significant because RR of 1 was found in the 95% CI of 0.85 to 1.06. RR of 1 means no risk/association.

The investigators concluded that alcohol consumption is positively associated with risk of total fractures and any fractures.

Original title:
A systematic review and meta-analysis of prospective cohort studies on the association between alcohol intake and risk of fracture by Asoudeh F, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33596741/

Additional information of El Mondo:
Find more information/studies on alcohol and osteoporosis right here.
 

Objectives:
Soy has several beneficial effects on cardiovascular disease (CVD). However, results of clinical trial studies are equivocal. Therefore, this review article has been conducted.

Is there a causal relationship between soy consumption and improvements in blood pressure in adults?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found pooled effects from 17 studies revealed a significant improvement in systolic blood pressure (SBP) [MD = -1.64, 95% CI = -3.25 to -0.04 mmHg, I2 = 50.5%] following soy consumption, in comparison with controls (groups without soy consumption).

The investigators found pooled effects from 17 studies revealed a significant improvement in diastolic blood pressure (DBP) [MD = -1.21, 95% CI = -2.29 to -0.12 mmHg, I2 = 50.7%] following soy consumption, in comparison with controls (groups without soy consumption).

The investigators found subgroup analysis demonstrated a reduction in both systolic blood pressure and diastolic blood pressure in younger participants with lower baseline blood pressure and intervention durations of 16 weeks.

The investigators concluded there is a causal relationship between soy consumption and improvements in blood pressure in adults.

Original title:
Soy intake is associated with lowering blood pressure in adults: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials by Mosallanezhad Z, Ranjbar S, […], Jalali M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33636295/

Additional information of El Mondo:
Find more information/studies on soy consumption and lowering blood presurre right here.

Objectives:
The emergence of artemisinin resistance in Southeast Asia and Plasmodium falciparum kelch13 propeller gene mutations in sub-Saharan African pose the greatest threat to global efforts to control malaria. This is a critical concern in Uganda, where artemisinin-based combination therapy (ACT) is the first-line treatment for uncomplicated falciparum. Therefore, this review article has been conducted.

The objective of this review article is to compare the efficacy and safety of dihydroartemisinin-piperaquine (DHA-PQ) and artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria in Ugandan children?

Study design:
This review article included 11 RCTs with a total of 3,798 participants.

A target dose (range) of 4 (2-10) mg/kg bw per day dihydroartemisinin and 18 (16-27) mg/kg bw per day piperaquine given once a day for 3 days for adults and children weighing ≥ 25 kg. The target doses and ranges for children weighing  25 kg are 4 (2.5-10) mg/kg bw per day dihydroartemisinin and 24 (20-32) mg/kg bw per day piperaquine once a day for 3 days.

A total dose of 5-24 mg/kg bw of artemether and 29-144 mg/kg bw of lumefantrine. Artemether + lumefantrine is given twice a day for 3 days (total, six doses). The first two doses should, ideally, be given 8 h apart.

Results and conclusions:
The investigators found PCR unadjusted treatment failure was significantly lower with dihydroartemisinin-piperaquine at day 28 [RR = 0.30, 95% CI = 0.19 to 0.49, participants = 7,863, studies = 5, I2 = 93%, low quality evidence] and at day 42 [RR = 0.53, 95% CI = 0.38 to 0.76, participants = 1,618, studies = 4, I2 = 79%, moderate quality of evidence].

The investigators found PCR adjusted treatment failure at day 42 was significantly lower with dihydroartemisinin-piperaquine treatment group [RR = 0.45, 95% CI = 0.28 to 0.72, participants = 1,370, studies = 5, high quality of evidence] and it was below 5% in both arms at day 28 (moderate quality of evidence).

The investigators found artemether-lumefantrine showed a longer prophylactic effect on new infections which may last for up to 63 days [PCR-adjusted treatment failure: RR = 2.04, 95% CI = 1.13 to 3.70, participants = 1,311, studies = 2, moderate quality of evidence].

The investigators found compared to artemether-lumefantrine, dihydroartemisinin-piperaquine was associated with a slightly higher frequency of cough [RR = 1.07, 95% CI = 1.01 to 1.13, 2,575 participants, 6 studies, high quality of evidence].
In both treatment groups, the risk of recurrent parasitaemia due to possible recrudescence was less than 5% at day 28.

The investigators found the appearance of gametocyte between 29 and 42 days was also significantly lower in dihydroartemisinin-piperaquine than artemether-lumefantrine [RR = 0.26, 95% CI = 0.12 to 0.56, participants = 623, studies = 2, I2 = 0%].

The investigators concluded compared to artemether-lumefantrine, dihydroartemisinin-piperaquine appears to reduce treatment failure and gametocyte carriage in Ugandan children. This may trigger dihydroartemisinin-piperaquine to become the first-line treatment option of uncomplicated falciparum malaria in Ugandan children. Both treatments were safe and well-tolerated.

Original title:
Efficacy and safety of dihydroartemisinin-piperaquine versus artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Ugandan children: a systematic review and meta-analysis of randomized control trials by Assefa DG, Zeleke ED, [...], Manyazewal T.

Link:
https://pubmed.ncbi.nlm.nih.gov/33794897/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, malaria and food fortification/malnutrition right here.

Objectives:
What are the blood concentrations of zinc, iron, manganese, magnesium, selenium and copper of patients with multiple sclerosis (MS)?

Study design:
This review article included 32 studies with 1,567 MS patients and 1,328 controls (people without MS).

Results and conclusions:
The investigators found pooled results using random-effects model indicated that the levels of zinc [WMD = -7.83 mcg/dL, 95% CI = -12.78 to -2.87, z = 3.09, p = 0.002] and iron [WMD = -13.66 mcg/dL, 95% CI = -23.13 to -4.19, z = 2.83, p = 0.005] were significantly lower in MS patients than in controls.

The investigators found, however, the levels of manganese [WMD = 0.03 mcg/dL, 95% CI = 0.01 to 0.04, z = 2.89, p = 0.004] were significantly higher in MS patients.

The investigators found no significant differences in the levels of magnesium, selenium and copper between both groups.

The investigators concluded that the circulating levels of zinc and iron are significantly lower in MS patients and that manganese level is significantly higher than those in the control group (people without MS).

Original title:
Blood Trace Element Status in Multiple Sclerosis: a Systematic Review and Meta-analysis by Nirooei E, Kashani SMA, […], Akbari H.

Link:
https://pubmed.ncbi.nlm.nih.gov/33611740/

Additional information of El Mondo:
Find here more information/studies about review article/significant, zinc, iron and manganese.

Objectives:
Peripheral neuropathy (PN) is common in patients with diseases that are in turn associated with deficiency of the B-vitamins, and vitamin treatment has shown mixed results. Therefore, this review article has been conducted.

Does a low vitamin B level increase the risk of peripheral neuropathy?

Study design:
This review article included 46 observational studies and 7 interventional studies.

Results and conclusions:
The investigators found the presence of peripheral neuropathy was significantly associated with lowered B12 levels [1.51, 95% CI = 1.23 to 1.84, n = 34, I2 = 43.3%, p = 0.003].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated methylmalonic acid levels [2.53, 95% CI = 1.39 to 4.60, n = 9, I2 = 63.8%, p = 0.005].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated homocysteine levels [3.48, 95% CI = 2.01 to 6.04, n = 15, I2 = 70.6%, p 0.001].

The investigators found treatment with vitamin B1 was associated with a significant improvement in symptoms of peripheral neuropathy [5.34, 95% CI = 1.87 to 15.19, n = 3, I2 = 64.6%, p = 0.059].

The investigators found B12 treatment (vs. the comparators) showed a non-significant association with symptom improvement [1.36, 95% CI = 0.66 to 2.79, n = 4, I2 = 28.9%].

The investigators found analysis of 7 trials combined showed a non-significant higher odds ratio for improvement under treatment with the B-vitamins [2.58, 95% CI = 0.98 to 6.79, I2 = 80.0%, p 0.001].

The investigators concluded peripheral neuropathy is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine levels. Well-designed studies, especially in non-diabetes peripheral neuropathy, are needed.

Original title:
Association between neuropathy and B-vitamins: A systematic review and meta-analysis by Stein J, Geisel J and Obeid R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33619867/

Additional information of El Mondo:
Find here more information/studies about review article/significant, vitamin B1 y B12 and chronic diseases.

Peripheral neuropathy refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased.

Increased methylmalonic acid levels are a sensitive indicator of mild vitamin B12 deficiency.
 

Objectives:
Although prior studies showed a correlation between environmental manganese (Mn) exposure and neurodevelopmental disorders in children, the results have been inconclusive. Therefore, this review article has been conducted.

Is a higher manganese exposure adversely associated with childhood neurodevelopment?

Study design:
This review article included 55 studies with 13,388 subjects.
The associations between manganese in biomarkers and neurodevelopmental outcomes were investigated in 15 cohort studies and 37 cross-sectional studies.
The neurological outcomes were assessed more frequently among children between 6 and 18 years of age than children under 6 years old.
A large percentage (44/55) of included studies was of high quality.

Results and conclusions:
The investigators found evidence from cohort studies showed that higher manganese exposure had a negative effect on neurodevelopment, mostly influencing cognitive and motor skills in children under 6 years of age, as indicated by various metrics.

The investigators found results from cross-sectional studies revealed that elevated manganese (Mn) in hair (H-Mn) and drinking water (W-Mn), but not blood (B-Mn) or teeth (T-Mn), were associated with poorer cognitive and behavioral performance in children aged 6-18 years old.
Of these cross-sectional studies, most papers reported that the mean of H-Mn was more than 0.55 μg/g.

The investigators found that a 10-fold increase in hair manganese was associated with a decrease of 2.51 points [95% CI = -4.58 to -0.45) in Full Scale IQ, while B-Mn and W-Mn generated no such significant effects.

The investigators found the pooled correlation analysis revealed that H-Mn showed a more consistent correlation with W-Mn than B-Mn.

The investigators found results regarding sex differences of manganese associations were inconsistent, although the preliminary meta-analysis found that higher W-Mn was associated with better Performance IQ only in boys, at a relatively low water manganese concentrations (most below 50 μg/L).

The investigators concluded higher manganese exposure is negatively associated with childhood neurodevelopment, especially cognitive and motor skills for children under 6 years old and cognitive and behavioural performance for children aged 6-18 years old.
In the older group (6-18 years old), hair is the most reliable indicator of manganese exposure. However, evidence demonstrated sex difference upon manganese exposure while a clear pattern is not elucidated. Population based biomonitoring studies with standard cleaning methodologies of hair are warranted in order to set reference ranges of manganese in hair at different ages. Large prospective cohort studies are certainly warranted in order to support these results and identify the underlying biological mechanisms.

Original title:
Biomarkers of environmental manganese exposure and associations with childhood neurodevelopment: a systematic review and meta-analysis by Liu W, Xin Y, […], Wang F.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531154/

Additional information of El Mondo:
Find more information/studies on manganese and food fortification/malnutrition right here.

Objectives:
Resistant starch type 2 (RS2) has been documented to regulate gut microbiota and to improve the clinical outcomes of several diseases. However, whether RS2 may benefit patients with end-stage renal disease under maintenance hemodialysis (MHD) remains unknown. Therefore, this review article has been conducted.

Do patients with end-stage renal disease under maintenance hemodialysis benefit from resistant starch type 2 supplementation?

Study design:
This review article included 5 RCTs with 179 patients under maintenance hemodialysis.

Resistant starch type 2 was used for 4 weeks to 2 months.

Results and conclusions:
The investigators found a significant decrease of blood urea nitrogen [WMD = -6.91, 95% CI = -11.87 to -1.95, I2 = 0%, p = 0.006], serum creatinine [WMD = -1.11, 95% CI = -2.18 to -0.05, I2 = 44%, p = 0.04] and interleukin (IL)-6 in blood [SMD = -1.08, 95% CI = -1.64 to -0.53, I2 = 35%, p = 0.0001] was revealed in the resistant starch type 2 group.

The investigators found analyses of blood levels of uric acid, p-cresyl sulfate, indoxyl sulfate, high sensitive C-reaction protein, albumin and phosphorus yielded no significant difference.

The investigators concluded that resistant starch type 2 improves the residual renal function of patients under maintenance hemodialysis and mitigate a proinflammatory response. Nevertheless, results should be cautiously interpreted, because of the limited sample size and different treatment dosages. Large and pragmatic multicenter trials are thus necessary to corroborate the beneficial effects of resistant starch type 2 supplementation on end-stage renal disease.

Original title:
Benefits of resistant starch type 2 for patients with end-stage renal disease under maintenance hemodialysis: a systematic review and meta-analysis by Jia L, Dong X, […], Zhang HL.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797550/

Additional information of El Mondo:
Find here more information/studies about review article/significant and renal disease.

Resistant starch (RS) is starch, including its degradation products, that escapes from digestion in the small intestine of healthy individuals, but rather turned into short-chain fatty acids (such as acetate, butyrate and propionate) by intestinal bacteria in the colon (large intestine). Short chain fatty acids can be absorbed into the body from the colon or stay put and be used by colonic bacteria for energy.

Different types of resistant starch are RS1, RS2 and RS3. 

Resistant starch is present in whole grains, fruits, vegetables and beans/legumes.

Resistant starch type 2 (resistant granules) is intrinsically resistant to digestion and contains high amounts of amylose. Resistant starch type 2 is found in fruits, potatoes, hi-maize RS products, corn and some legumes.

The more “raw” or “uncooked” a food is, the more resistant starch it tends to have, since heat results in gelatinization of starch - making it more accessible to digestion. Type 3 starch is the exception to this rule.

All starches are composed of 2 types of polysaccharides: amylose and amylopectin.

Amylopectin is highly branched, leaving more surface area available for digestion in the small intestine. Amylopectin is broken down quickly, which means it produces a larger rise in blood sugar (glucose) and subsequently, a large rise in insulin.

Amylose is a straight chain, which limits the amount of surface area exposed for digestion. Amylose predominates in resistant starch. Foods high in amylose are digested more slowly. They’re less likely to spike blood glucose or insulin.

Since resistant starch is incompletely digested, we only extract about 2 calories of energy per gram (versus about 4 calories per gram from other starches).
 

Objectives:
As the rise in prevalence of allergic diseases worldwide corresponds in time with increasing infant vaccination, it has been hypothesized that childhood vaccination may increase the risk of allergic disease. Therefore, this review article has been conducted.

Does childhood vaccination increase risk of allergic disease?

Study design:
This review article included 35 publications based on cohort studies and 7 publications based on randomized controlled trials (RCTs).

Results and conclusions:
The investigators found from 2 studies, early vaccination with BCG vaccine was associated with a 17%-reduced risk of eczema [RR = 0.83, 95% CI = 0.73 to 0.93, I2 = 0%] but not food allergy or asthma.

The investigators found no association between pertussis vaccine and any allergic outcome based on a single RCT.

The investigators found in cohort studies that childhood measles vaccination was associated with a reduced risk of 35% for eczema [RR = 0.65, 95% CI= 0.47 to 0.90, I2 = 0.0%], 22% for asthma [RR = 0.78, 95% CI = 0.62 to 0.98, I2 = 93.9%] and, with a similar, statistically non-significant reduction in sensitisation [RR = 0.78, 95% CI = 0.61 to 1.01, I2 = 19.4%].

The investigators concluded there is no evidence that childhood vaccination with commonly administered vaccines is associated with increased risk of later allergic disease. However, pooled analysis of both RCTs and cohort studies show that vaccination with BCG and measles vaccines are associated with a reduced risk of eczema.

Original title:
Childhood Vaccination and Allergy: A Systematic Review and Meta-analyses by Navaratna S, Estcourt MJ, […], Lodge CJ.

Link:
https://pubmed.ncbi.nlm.nih.gov/33569761/

Additional information of El Mondo:
Find more information/studies on vaccination and food fortification/malnutrition right here.

The BCG (Bacillus Calmette-Guérin) vaccination is used against tuberculosis.
Pertussis vaccine is a vaccine that protects against whooping cough (pertussis).

Objectives:
Visceral adipose tissue (VAT) are deleterious fat deposits in the human body and can be effectively reduced by exercise intervention. Despite well-established exercise prescriptions are available, the effective dosage of exercise for reducing VAT requires verification. Therefore, this review article has been conducted.

What is the most effective exercise dosage (modality, intensity, duration and amount) for decreasing visceral adipose tissue (VAT)?

Study design:
This review article included 32 RCTs with a total of 1,900 participants.

Results and conclusions:
The investigators found that 30-60 min of high-intensity interval training, 3 times per week for 12 to 16 weeks [SMD = -0.39, 95% CI = -0.60 to -0.18] and 30-60 min of aerobic exercise of at least moderate intensity, 3 times per week for 12 to 16 weeks [SMD = -0.26, 95% CI = -0.38 to -0.13] were beneficial for reducing visceral adipose tissue.

The investigators found, by contrast, resistance exercise, aerobic exercise combined with resistance exercise and sprint interval training had no significant effects on reducing visceral adipose tissue.

The investigators found no difference in visceral adipose tissue reduction was observed between exercising more or less than 150 minutes per week.

The investigators found meta-regression revealed that the effect of visceral adipose tissue reduction was not significantly influenced by an increase in the duration of or amount of exercise in an exercise program.

The investigators concluded that 30-60 min of high-intensity interval training, 3 times per week for 12 to 16 weeks and 30-60 min of aerobic exercise of at least moderate intensity, 3 times per week for 12 to 16 weeks causally reduce visceral adipose tissue.

Original title:
Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials by Chang YH, Yang HY and Shun SC.

Link:
https://pubmed.ncbi.nlm.nih.gov/33558643/

Additional information of El Mondo:
Find here more information/studies about fat and sport nutrition. 

A causal relationship can be found in RCTs.

High intensity interval trainings are:
-using a stationary bike, pedal as hard and fast as possible for 30 seconds.
-after jogging to warm up, sprint as fast as you can for 15 seconds.
-perform squat jumps as quickly as possible for 30 to 90 seconds.

Objectives:
Does vitamin A supplementation reduce risk of bronchopulmonary dysplasia (BPD) in premature infants?

Study design:
This review article included 9 RCTs with 709 infants received vitamin A treatment (intervention group) and 700 infants did not receive vitamin A treatment (control group).
The dose of vitamin A regimens varied from 1500 to 10,000 IU (450 to 3,003 micrograms) and the treatment durations generally lasted for 4 weeks.

The funnel plots for all synthesized outcomes remained symmetrical, indicating that there was no significant publication bias.

Results and conclusions:
The investigators found when compared to the control group, vitamin A supplementation significantly reduced the incidence of bronchopulmonary dysplasia in premature infants with 33% [OR  =  0.67, 95% CI = 0.52 to 0.88].
The sensitivity analyses were performed by excluding single RCT one by one. The results of sensitivity analysis of all outcomes had indicated no substantial result changes among the overall estimates.

The investigators concluded that vitamin A supplementation is beneficial to reduce bronchopulmonary dysplasia in premature infants.  

Original title:
Vitamin A supplementation prevents the bronchopulmonary dysplasia in premature infants: A systematic review and meta-analysis by Ding Y, Chen Z and Lu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837939/

Additional information of El Mondo:
Find more information/studies on vitamin A and pregnancy right here.

Bronchopulmonary dysplasia is a form of chronic lung disease that develops in preterm neonates treated with oxygen and positive-pressure ventilation.
 

Objectives:
Recent evidence suggests that diet can modify the risk of future cognitive impairment and dementia. A biologically plausible rationale and initial clinical data indicate that the antioxidant activities of dietary carotenoids may assist the preservation of cognitive function. Therefore, this review article has been conducted.

Does carotenoid supplementation improve cognitive performance among healthy adults?

Study design:
This review article included 9 RCTs, involving 2,228 subjects in the treated group (group with carotenoid supplementation) and 2,174 subjects in control group (group without carotenoid supplementation).
The age of all participants varied from 45 to 78 years.
The majority of clinical trials assessed the effect of xanthophylls such as lutein, zeaxanthin, and astaxanthin, whereas only 1 study determined the effects of β-carotene.
The duration of carotenoid supplementation ranged from 2 weeks to 12 months.
The dosage of carotenoids administered in the studies ranged from 0.5 mg/d to 50 mg/d.
There was no evidence of publication bias.

Results and conclusions:
The investigators found results of the pooled meta-analysis showed a significant effect of carotenoid intervention on cognitive outcomes [Hedge's g = 0.14, 95% CI = 0.08 to 0.20, p 0.0001, I2 = 0.00%].
The sensitivity analysis did not change the overall findings obtained from the primary analysis.

The investigators concluded that these results highlight the potential role of carotenoids (0.5 mg/d to 50 mg/d) in the protection of mental functions even in subjects (healthy participants aged 45-78 years) without cognitive impairment. This is particularly important because the population is aging and preservation of cognitive function is crucial for individual autonomy and quality of life, even in non-demented subjects. Further well-powered and long-term trials are required to determine treatment duration, type of carotenoid and optimal dosage.

Original title:
Carotenoids and Cognitive Outcomes: A Meta-Analysis of Randomized Intervention Trials by Davinelli S, Ali S, […], Corbi G.

Link:
https://www.mdpi.com/2076-3921/10/2/223/htm

Additional information of El Mondo:
Find more information/studies on carotenoids and dementia right here.
 

Objectives:
The occurrence of fetal and neonatal disorders in pregnant women with Zika virus infection in the literature is not consistent. Therefore, this review article has been conducted.

What is the prevalence rate of disorders in fetuses/neonates of pregnant women with confirmed or probable Zika virus infection?

Study design:
This review article included 21 cohort studies with a total of 35,568 pregnant women.

Results and conclusions:
The investigators found the meta-analysis showed that central nervous system abnormalities had the highest prevalence ratio of 0.06 [95% CI = 0.03 to 0.09].

The investigators found the meta-analysis showed that intracranial calcifications had a prevalence ratio of 0.01 [95% CI = 0.01 to 0.02] and ventriculomegaly 0.01 [95% CI = 0.01 to 0.02].

The investigators found the meta-analysis showed that the prevalence ratio of microcephaly was 0.03 [95% CI = 0.02 to 0.05], fetal loss (miscarriage and stillbirth) was 0.04 [95% CI = 0.02 to 0.06], small for gestational age was 0.04 [95% CI = 0.00 to 0.09], low birth weight was 0.05 [95% CI = 0.03 to 0.08] and prematurity was 0.07 [95% CI = 0.04 to 0.10].

The investigators found the meta-analysis showed that the positivity in RT-PCR for ZIKV performed in neonates born to infected mothers during pregnancy was 0.25 [95% CI = 0.06 to 0.44].

The investigators found the meta-analysis of meta-analysis for microcephaly with the prevalence ratios from other two previously systematic reviews was 0.03 [95% CI = 0.00 to 0.25].

The investigators concluded that the disorders in foetuses and neonates of pregnant women with probable or confirmed Zika virus infection are microcephaly, CNS congenital abnormalities, intracranial calcifications, ventriculomegaly, fetal loss, small for gestational age, low birth weight and prematurity. The continuous knowledge of this magnitude is essential for the implementation development of health initiatives and programs, in addition to promoting disease prevention, especially in the development of a vaccine for Zika virus.

Original title:
Fetal, neonatal, and infant outcomes associated with maternal Zika virus infection during pregnancy: A systematic review and meta-analysis by Martins MM. Alves da Cunha AJL, […], de Andrade Medronho R.

Link:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246643

Additional information of El Mondo:
Find more information/studies on pregnancy and food fortification/malnutrition right here.

CNS congenital anomalies are birth defects of the physical structure of the brain or spinal cord that develop in utero or when a foetus is developing during pregnancy.

Ventriculomegaly is a condition in which the ventricles appear larger than normal on a prenatal ultrasound. The ventricles of the brain are a communicating network of cavities filled with cerebrospinal fluid (CSF) and located within the brain parenchyma.

Microcephaly is a condition where a baby's head is much smaller than expected.

Intracranial calcifications refer to calcifications (small deposits of calcium) within the brain parenchyma or vasculature.

Objectives:
Recent systematic reviews and meta-analyses of randomized, double-blind, placebo-controlled trials (double-blind, placebo-controlled RCTs) have reported controversial findings regarding the associations between calcium supplements on the risk of cardiovascular disease (CVD). Therefore, this review article has been conducted.

Do calcium supplements increase risk of cardiovascular disease (CVD)?

Study design:
This review article included 13 RCTs with 28,935 participants in an intervention group (group with calcium supplements) and 14,243 in a control group (group without calcium supplements).

The mean age of the study participants was 66.3 years (range: 35 to 97 years) and 92.8% of those were women.
Publication bias was not observed.

Results and conclusions:
The investigators found calcium supplements significantly increased the risk of cardiovascular disease with 15% in healthy postmenopausal women [RR = 1.15, 95% CI = 1.06 to 1.25, I2 = 0.0%, n = 14].

The investigators found calcium supplements significantly increased the risk of coronary heart disease with 16% in healthy postmenopausal women [RR = 1.16, 95% CI = 1.05 to 1.28, I2 = 0.0%, n = 9].

The investigators found in the subgroup meta-analysis, dietary calcium intake of 700-1000 mg per day or supplementary calcium intake of 1000 mg per day significantly increased the risk of cardiovascular disease and coronary heart disease.

The investigators concluded that the use of calcium supplements (1000 mg per day) is significantly associated with the increased risk of cardiovascular disease and coronary heart disease by 15%, specifically in postmenopausal women. These findings should be explicitly confirmed by conducting further RCTs with cardiovascular disease outcome measures as well as the incidence of osteoporosis or fractures as the primary endpoints.

Original title:
Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials by Myung SK, Kim HB, […], Oh SW.

Link:
https://pubmed.ncbi.nlm.nih.gov/33530332/

Additional information of El Mondo:
Find more information/studies on calcium consumption, elderly and cardiovascular diseases right here.

Objectives:
N-acetylcysteine (NAC) is an antioxidant that can regenerate glutathione and is primarily used for acetaminophen overdose. NAC has been tested and used for preventing iatrogenic acute kidney injury or slowing the progression of chronic kidney disease, with mixed results. Therefore, this review article has been conducted.

Has NAC administration a positive effect on the serum creatinine level and the serum cystatin C level?

Study design:
This review article included 6 studies (4 studies were before/after single-arm prospective trials and 2 were parallel randomized controlled trials, comparing NAC against placebo) with a total of 199 participants.

Overall, these studies are small, with a median sample size of 30 (range: 10-60).
The proportion of men ranged from 48% to 83%.
The mean patient age ranged from 33 to 71 years.
The follow-up periods were mostly short.
There was no evidence of publication bias both by visual examination or the Egger test for the analysis of NAC and cystatin C.

Results and conclusions:
The investigators found there was a small but significant decrease in serum creatinine after n-acetylcysteine (NAC) administration overall [WMD = -2.80 μmol/L, 95% CI = -5.6 to 0.0, p = 0.05].

This was greater with non-Jaffe methods [WMD = -3.24 μmol/L, 95% CI = -6.29 to -0.28, p = 0.04] than Jaffe [WMD = -0.51 μmol/L, 95% CI = -7.56 to 6.53, p = 0.89] and in particular with intravenous [WMD = -31.10 μmol/L, 95% CI = -58.37 to -3.83, p = 0.03] compared with oral NAC [WMD = -2.5 μmol/L, 95% CI = -5.32 to 0.32, p = 0.08].

The investigators found there was no change in cystatin C after n-acetylcysteine (NAC) administration [WMD = -0.84 μmol/L, 95% CI = -3.14 to 1.47, p = 0.48, I2 = 0%, p = 0.99].

The investigators concluded there is a small but significant decrease in serum creatinine with n-acetylcysteine (NAC) administration but not in cystatin C. This effect seems to be higher when creatinine is measured with the enzymatic assay (non-Jaffe method) and with intravenous n-acetylcysteine administration.

Original title:
A Systematic Review of the Effect of N-Acetylcysteine on Serum Creatinine and Cystatin C Measurements by Huang JW, Lahey B, […], Hiremath S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879108/

Additional information of El Mondo:
Find here more information/studies about review article/significant, n-acetylcysteine and kidney diseases.

The Jaffe and enzymatic methods (non-Jaffe methods) are the 2 most common methods for measuring serum creatinine. The Jaffe method is less expensive than the enzymatic method but is also more susceptible to interferences.

Intravenous therapy (abbreviated as IV therapy) is a medical technique that delivers fluids, medications and nutrition directly into a person's vein.
 

Objectives:
Does citrus dietary intake reduce the risk of lung cancer?

Study design:
This review article included 21 observational studies.

Results and conclusions:
The investigators found pooled analyses showed that those with the highest citrus fruit dietary intake compared to the lowest intake had a 9% reduction in lung cancer risk [OR = 0.91, 95% CI = 0.84 to 0.98].

The investigators found a nonlinear association between citrus dietary intake and lung cancer risk in the dose-response analysis [p = 0.0054] and that the risk reached the minimum [OR = 0.91] around 60 g/d.
However, no obvious dose-response association was observed with intakes above 80 g/d.

The investigators concluded that citrus fruit dietary intake is negatively associated with the risk of lung cancer. Besides, there is a nonlinear dose-response relationship between citrus fruit dietary intake and lung cancer risk within a certain range (60-80g per day).

Original title:
Citrus fruit intake and lung cancer risk: A meta-analysis of observational studies by Wang J, Gao J, [...], Qian BY.

Link:
https://pubmed.ncbi.nlm.nih.gov/33529754/

Additional information of El Mondo:
Find more information/studies on fruit consumption and cancer right here.

Citrus fruits include oranges, lemons, limes and grapefruits.