The effects of probiotics, prebiotics and synbiotics on the reduction of IBD complications, a periodic review during 2009–2020

Aims: To perform a systematic review on randomized controlled trials to examine the efficacy of probiotics, prebiotics and synbiotics in the treatment of IBD. Methods and Results: PubMed, Web of science, Scopus and Google Scholar were systematically searched from January 2009 to January 2020 using the following keywords: ‘Inflammatory Bowel Disease’, ‘Probiotics’ and ‘Clinical trial’. The statistical analysis was performed using SPSS software version 24.0. A total of 1832 articles were found during the initial search and 21 clinical trials were eligible. Studies comparing the effects of probiotics and placebo among patients with active ulcerative colitis (UC) showed a significant difference in clinical outcomes. Moreover, probiotics improved the overall induction of remission rates among patients with Crohn’s disease (CD). Probiotics significantly decreased the IL-1β, TNF-α and IL-8 levels. Also, the need for systemic steroids, hospitalization, surgery, as well as histological score and disease activity index significantly decreased in patients who used probiotic or pro-/synbiotics. Conclusions: The use of probiotics, as food supplements, can induce anti-inflammatory reactions, balance the intestinal homeostasis and induce remission in IBD. The efficacy of probiotics on remission induction is more reported in UC rather than CD. Larger well-designed clinical trials are needed to further determine whether probiotics are of clear benefits for remission in IBD. © 2020 The Society for Applied Microbiolog

Caring burden and quality of life of family caregivers in patients undergoing hemodialysis: A descriptive-analytic study

Background: Caring role, especially in chronic diseases, has a negative impact on the health of family caregivers and can affect their quality of life.Therefore, this study aimed to investigate the care burden and quality of life in family caregivers of hemodialysis patients and their relationship with some characteristics of caregivers and patients.Methods: This study was conducted as a descriptive-analytic study in Isfahan from January to February 2017.Sampling was done using census.The number of participants was 254.The data gathering tools consisted of a three-part questionnaire including demographic characteristics, the Zarit questionnaire for caring burden, and SF-36 quality of life questionnaire.Data were analyzed using descriptive statistics, Pearson correlation coefficient test, Spearman�s coefficient, ANOVA, and univariate general linear regression.A significant level of 5 was considered.Results: The mean scores of the quality of life and caring burden were 30.4±9.9 and 44.8±6.2, respectively in caregivers.The age of the patient under care (P<0.01), cost of medications (P=0.08), and hours of care in 24 hours (P<0.01) had a significant relationship with care givers� quality of life.Also, univariate general linear regression revealed that care burden had a significant relationship with the quality of life (P=0.03).Conclusion: Family caregivers who experienced more caring burden had a low quality of life.The researchers suggest that supportive and educational programs should be designed and implemented for this group of patients and their caregivers. © 2019, Shriaz University of Medical Sciences. All rights reserved

Nitazoxanide and doxycycline sensitivity among metronidazole resistant helicobacter pylori isolates from patients with gastritis

Background: Antibiotic therapy should be done based on resistance characteristics of Helicobacter pylori strains to commonly prescribed antibiotics in areas with higher resistance rates. Objectives: This study examined antibacterial activity of nitazoxanide and doxycycline against clinical H. pylori isolates showing different metronidazole resistance levels. Methods: A total of 122 patients, who underwent endoscopy were enrolled in this study from 3 hospitals of Tehran, during November 2014 to July 2015. Helicobacter pylori isolates were obtained from gastric biopsies of the patients after culture in specific culture medium and characterization by both biochemical and molecular methods. Antimicrobial susceptibility to metronidazole was detected using the agar dilution method and minimum inhibitory concentrations of nitazoxanide and doxycycline were determined for metronidazole resistant strains. Results: From a total of 122 gastric biopsy specimens, 55 H. pylori strains were recovered (45). Thirty-three of these strains (60.0) were resistance to metronidazole. MIC50 and MIC90 values for metronidazole were 32 and 64 µg/mL, respectively. MIC50 and MIC90 values for doxycycline and nitazoxanide were measured as 4 and �8 µg/mL, and 8 and �32 µg/mL, respectively. Conclusions: Dominance of high level metronidazole resistance H. pylori strains among the studied patients questioned its usefulness for first-line therapy in Iran. Nitazoxanide and doxycycline showed superior activity against H. pylori strains in comparison to metronidazole, which should be considered for alternative therapies. © 2018, Kowsar Medical Publishing Company. All rights reserved

Gabapentin for the hemodynamic response to intubation: systematic review and meta-analysis

Purpose Endotracheal intubation is the gold standard for securing the airway before surgery. Nevertheless, this procedure can produce an activation of the sympathetic nervous system and result in a hemodynamic response which, in high-risk patients, may lead to cardiovascular instability and myocardial ischemia. The aim of this review was to evaluate whether gabapentin can attenuate this response and whether such an attenuation could translate into reduced myocardial ischemia and mortality. Source We searched MEDLINE®, EMBASE™, CINAHL, AMED, and unpublished clinical trial databases for randomized-controlled trials that compared gabapentin with control, fentanyl, clonidine, or beta blockers for attenuating the hemodynamic response to intubation. Primary outcomes were mortality, myocardial infarction, and myocardial ischemia. Secondary outcomes were hemodynamic changes following intubation. Principal findings We included 29 randomized trials with only two studies at low risk of bias. No data were provided for the primary outcomes and no studies included high-risk patients. The use of gabapentin resulted in attenuation in the rise in mean arterial blood pressure [mean difference (MD), −12 mmHg; 95% confidence interval (CI), −17 to −8] and heart rate (MD, −8 beats·min−1; 95% CI, −11 to −5) one minute after intubation. Gabapentin also reduced the risk of hypertension or tachycardia requiring treatment (risk ratio, 0.15; 95% CI, 0.05 to 0.48). Data were limited on adverse hemodynamic events such as bradycardia and hypotension. Conclusion It remains unknown whether gabapentin improves clinically relevant outcomes such as death and myocardial infarction since studies failed to report on these. Nevertheless, gabapentin attenuated increases in heart rate and blood pressure following intubation when compared with the control group. Even so, the studies included in this review were at potential risk of bias. Moreover, they did not include high-risk patients or report adverse hemodynamic outcomes. Future studies are required to address these limitations

Bovine Leukemia virus (BLV) and risk of breast cancer: A systematic review and meta-analysis of case-control studies

Background: Breast cancer is reported as one of the most common cancers among females worldwide. Infectious agents especially viruses have been considered as role players in the development of breast cancer. Although some investigations suggest an association between bovine leukemia virus (BLV) and breast cancer, the involvement of this virus as a risk factor remains controversial. The present study aimed to find out any possible association between BLV and breast cancer through conducting a systematic review and meta-analysis. Methods: Systematic literature search was performed by finding related case-control articles from the PubMed, Google Scholar, Web of Science, Scopus, and EMBASE databases. The heterogeneity and the multivariable-adjusted OR and corresponding 95 CI were applied by meta-analysis and forest plot across studies. All statistical analyses were performed using Stata 14.1. Result: Based on a comprehensive literature search, 9 case-control studies were included for meta-analysis. The combination of all included studies showed that BLV infection is associated with an increased risk of breast cancer summary OR (95% CI) 2.57 (1.45, 4.56). Conclusion: This is the first meta-analysis to analyze a potential association between BLV infection and the risk of breast cancer. Control of the infection in cattle herds and screening of the milk and dairy products may help to reduce the transmission of the virus to humans. © 2020 The Author(s)

Nitazoxanide and doxycycline sensitivity among metronidazole resistant helicobacter pylori isolates from patients with gastritis

Background: Antibiotic therapy should be done based on resistance characteristics of Helicobacter pylori strains to commonly prescribed antibiotics in areas with higher resistance rates. Objectives: This study examined antibacterial activity of nitazoxanide and doxycycline against clinical H. pylori isolates showing different metronidazole resistance levels. Methods: A total of 122 patients, who underwent endoscopy were enrolled in this study from 3 hospitals of Tehran, during November 2014 to July 2015. Helicobacter pylori isolates were obtained from gastric biopsies of the patients after culture in specific culture medium and characterization by both biochemical and molecular methods. Antimicrobial susceptibility to metronidazole was detected using the agar dilution method and minimum inhibitory concentrations of nitazoxanide and doxycycline were determined for metronidazole resistant strains. Results: From a total of 122 gastric biopsy specimens, 55 H. pylori strains were recovered (45). Thirty-three of these strains (60.0) were resistance to metronidazole. MIC50 and MIC90 values for metronidazole were 32 and 64 µg/mL, respectively. MIC50 and MIC90 values for doxycycline and nitazoxanide were measured as 4 and �8 µg/mL, and 8 and �32 µg/mL, respectively. Conclusions: Dominance of high level metronidazole resistance H. pylori strains among the studied patients questioned its usefulness for first-line therapy in Iran. Nitazoxanide and doxycycline showed superior activity against H. pylori strains in comparison to metronidazole, which should be considered for alternative therapies. © 2018, Kowsar Medical Publishing Company. All rights reserved

The effects of probiotics, prebiotics and synbiotics on the reduction of IBD complications, a periodic review during 2009�2020

Aims: To perform a systematic review on randomized controlled trials to examine the efficacy of probiotics, prebiotics and synbiotics in the treatment of IBD. Methods and Results: PubMed, Web of science, Scopus and Google Scholar were systematically searched from January 2009 to January 2020 using the following keywords: �Inflammatory Bowel Disease�, �Probiotics� and �Clinical trial�. The statistical analysis was performed using SPSS software version 24.0. A total of 1832 articles were found during the initial search and 21 clinical trials were eligible. Studies comparing the effects of probiotics and placebo among patients with active ulcerative colitis (UC) showed a significant difference in clinical outcomes. Moreover, probiotics improved the overall induction of remission rates among patients with Crohn�s disease (CD). Probiotics significantly decreased the IL-1β, TNF-α and IL-8 levels. Also, the need for systemic steroids, hospitalization, surgery, as well as histological score and disease activity index significantly decreased in patients who used probiotic or pro-/synbiotics. Conclusions: The use of probiotics, as food supplements, can induce anti-inflammatory reactions, balance the intestinal homeostasis and induce remission in IBD. The efficacy of probiotics on remission induction is more reported in UC rather than CD. Larger well-designed clinical trials are needed to further determine whether probiotics are of clear benefits for remission in IBD. © 2020 The Society for Applied Microbiolog

Comparison of confirmed COVID-19 with SARS and MERS cases - Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta-analysis

Introduction: Within this large-scale study, we compared clinical symptoms, laboratory findings, radiographic signs, and outcomes of COVID-19, SARS, and MERS to find unique features. Method: We searched all relevant literature published up to February 28, 2020. Depending on the heterogeneity test, we used either random or fixed-effect models to analyze the appropriateness of the pooled results. Study has been registered in the PROSPERO database (ID 176106). Result: Overall 114 articles included in this study; 52 251 COVID-19 confirmed patients (20 studies), 10 037 SARS (51 studies), and 8139 MERS patients (43 studies) were included. The most common symptom was fever; COVID-19 (85.6, P <.001), SARS (96, P <.001), and MERS (74, P <.001), respectively. Analysis showed that 84 of Covid-19 patients, 86 of SARS patients, and 74.7 of MERS patients had an abnormal chest X-ray. The mortality rate in COVID-19 (5.6, P <.001) was lower than SARS (13, P <.001) and MERS (35, P <.001) between all confirmed patients. Conclusions: At the time of submission, the mortality rate in COVID-19 confirmed cases is lower than in SARS- and MERS-infected patients. Clinical outcomes and findings would be biased by reporting only confirmed cases, and this should be considered when interpreting the data. © 2020 John Wiley & Sons, Lt

Spatio-temporal atlas of bone mineral density ageing

Osteoporosis is an age-associated bone disease characterised by low bone mass. An improved understanding of the underlying mechanism for age-related bone loss could lead to enhanced preventive and therapeutic strategies for osteoporosis. In this work, we propose a fully automatic pipeline for developing a spatio-temporal atlas of ageing bone. Bone maps are collected using a dual-energy X-ray absorptiometry (DXA) scanner. Each scan is then warped into a reference template to eliminate morphological variation and establish a correspondence between pixel coordinates. Pixel-wise bone density evolution with ageing was modelled using smooth quantile curves. To construct the atlas, we amalgamated a cohort of 1714 Caucasian women (20–87 years) from five different centres in North Western Europe. As a systematic difference exists between different DXA manufacturers, we propose a novel calibration technique to homogenise bone density measurements across the centres. This technique utilises an alternating minimisation technique to map the observed bone density measurements into a latent standardised space. To the best of our knowledge, this is the first spatio-temporal atlas of ageing bone