Nevin Manimala

Eur Geriatr Med. 2023 Oct 23. doi: 10.1007/s41999-023-00877-9. Online ahead of print.

ABSTRACT

PURPOSE: Dementia and Alzheimer’s disease (AD) pose significant challenges to public health globally with no effective treatment strategies available. Therefore, the research focuses on developing effective prophylaxis to prevent the onset of these diseases. Recent studies have suggested that low-dose aspirin may help reduce the risk of dementia. Nonetheless, evidence regarding the correlation between aspirin consumption and the onset of dementia and AD is limited. This review aims to provide an up-to-date summary of the existing evidence and evaluate the association between aspirin and the onset of dementia and Alzheimer’s disease.

METHODS: A systematic search of PubMed, Embase, Web of Science, PsycINFO, and CINAHL databases was conducted to find eligible studies published until April 2023. A random-effects meta-analysis of the eligible studies was then performed to assess the link between aspirin use and the onset of dementia and Alzheimer’s disease. Additionally, we conducted subgroup analyses to evaluate the overall effect of low-dose (75-100 mg) aspirin consumption on the onset of dementia and AD.

RESULTS: A total of 875 studies were identified, with only 22 meeting the inclusion criteria. There was no statistically significant impact of aspirin consumption on the onset of dementia (HR 1.13, 11 studies) or Alzheimer’s disease (HR 0.91, 3 studies). Additionally, subgroup analysis showed that taking low doses of aspirin (75-100 mg) did not significantly affect the onset of either dementia (HR 0.96, 13 studies) or Alzheimer’s disease (HR 0.85, 2 studies).

CONCLUSIONS: Aspirin use does not decrease the risk of dementia or AD, even when taken in low doses. However, the quality of the studies analyzed was inadequate, with only three randomized controlled trials included in the review. Future high-quality studies are needed to assess the effect of aspirin consumption on these diseases. These findings may assist clinicians in selecting appropriate prophylactic strategies for patients at risk of developing dementia and AD.

PMID:37870707 | DOI:10.1007/s41999-023-00877-9

Biol Trace Elem Res. 2023 Oct 23. doi: 10.1007/s12011-023-03895-7. Online ahead of print.

ABSTRACT

Zinc supplementation has therapeutic effects on cardiovascular disease (CVD) risk factors, including dyslipidemia, hyperglycemia, and inflammation as the main contributors to CVD pathogenesis. Since CVD is a major cause of mortality among people with type 2 diabetes mellitus (T2DM), this study aimed to overview the potential effects of zinc supplementation on CVD risk factors in T2DM patients. To determine appropriate randomized clinical trials (RCTs) investigating the effects of zinc supplementation on CVD risk factors, electronic sources including PubMed, Web of Science, and Scopus were systematically searched until January 2023. The heterogeneity of trials was checked using the I² statistic. According to the heterogeneity tests, random-effects models were estimated, and pooled data were defined as the weighted mean difference (WMD) with a 95% confidence interval (CI). Of the 4004 initial records, 23 studies that met inclusion criteria were analyzed in this meta-analysis. The pooled findings indicated the significant lowering effects of zinc supplementation on triglycerides (TG), total cholesterol (TC), fasting blood glucose (FBG), hemoglobin A1C (HbA1C), and C-reactive protein (CRP), while high-density cholesterol (HDL) concentrations showed an elevation after zinc supplementation. In addition to statistical significance, the effect of zinc supplementation on most of the variables was clinically significant; however, the quality of evidence in the included studies is regarded as low or very low for most variables. Our study demonstrated that zinc supplementation has beneficial effects on glycemic control markers, lipid profile, and CRP levels as a classic marker of inflammation in T2DM. Due to the high degree of heterogeneity between studies and the low rate of quality in them, further well-designed studies are necessitated to strengthen our findings.

PMID:37870684 | DOI:10.1007/s12011-023-03895-7

Environ Sci Pollut Res Int. 2023 Oct 23. doi: 10.1007/s11356-023-30516-6. Online ahead of print.

ABSTRACT

The surge in fossil fuel consumption, culminating in global warming and climate change, compels nations to implement protective measures. Consequently, the concepts of “sustainable growth” and the “green economy” have gained prominence in response to heightened environmental consciousness. In light of these imperatives, nations have embarked on the formulation of sustainable and environmentally conscious policies, with the dual objective of safeguarding the environment and fostering economic growth. These factors have collectively contributed to the growing significance of energy policies within European nations, spurring a burgeoning momentum in research areas pertaining to energy efficiency and energy productivity. While extant literature has demonstrated the positive environmental impact of energy productivity, there exists a paucity of research pertaining to its economic implications. Energy productivity, defined as achieving equivalent or greater output with reduced energy consumption, bears the potential to influence economic output, thereby exerting cascading effects on various facets of the economy, including growth and exports. The principal aim of this study is to highlight that the augmentation of energy productivity can yield not only environmental advantages but also economic benefits. To achieve this objective, we conduct econometric analyses on panel data spanning the years 2000 to 2020 across the 27 member states of the European Union. Specifically, we explore the effects of energy productivity on diverse economic parameters, encompassing economic growth, high technology exports, medium and high technology exports, total exports, and trade volume. Employing the Driscoll-Kraay standard errors estimator, our findings evince that energy productivity exerts statistically significant and positive influences on economic growth, medium and high technology exports, total exports, and trade volume.

PMID:37870672 | DOI:10.1007/s11356-023-30516-6

Eur J Pediatr. 2023 Oct 23. doi: 10.1007/s00431-023-05275-8. Online ahead of print.

ABSTRACT

The optimal duration of antibiotic treatment for the most common bacterial meningitis etiologies in the pediatric population, namely Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, is not well-established in the literature. Therefore, we aimed to perform an updated meta-analysis comparing shorter versus longer antibiotic treatment in children with meningitis. PubMed, EMBASE, and Cochrane databases were searched for randomized controlled trials (RCTs) that compared shorter (up to 7 days) versus longer (10 days or double the days of the equivalent short course) duration of antibiotic treatment in children with meningitis and reported the outcomes of treatment failure, death, neurologic sequelae, non-neurologic complications, hearing impairment, nosocomial infection, and relapse. Heterogeneity was examined with I² statistics. RevMan 5.4.1 was used for statistical analysis and RoB-2 (Cochrane) for risk of bias assessment. Of 684 search results, 6 RCTs were included, with a cohort of 1333 children ages 3 weeks to 15.5 years, of whom 49.51% underwent a short antibiotic course. All RCTs included monotherapy with ceftriaxone, except one, which added vancomycin as well. No differences were found comparing the short and long duration of therapy concerning treatment failure, relapse, mortality, and neurologic complications at discharge and at follow-up. Conclusion: Because no statistically significant differences were found between groups for the analyzed outcomes, the results of this meta-analysis support shorter therapy. However, generalizing these results to complicated meningitis and infections caused by other pathogens should be made with caution. (PROSPERO identifier: CRD42022369843). What is Known: • Current recommendations on the duration of antibiotic therapy for bacterial meningitis are mostly based on clinical practice. • Defining an optimal duration of antibiotic therapy is essential for antimicrobial stewardship achievement, improving patient outcomes, and minimizing adverse effects. What is New: • There are no differences between shorter versus longer antibiotic treatment duration in regard to treatment failure, relapse, mortality, neurologic complications, and hearing impairment at discharge and at follow-up.

PMID:37870611 | DOI:10.1007/s00431-023-05275-8

Intensive Care Med. 2023 Oct 23. doi: 10.1007/s00134-023-07215-4. Online ahead of print.

ABSTRACT

PURPOSE: Intensive care unit (ICU) hospitalization is challenging for the family members of the patients. Most family members report some level of anxiety and depression, sometimes even resulting in post-traumatic stress disorder (PTSD). An association has been reported between lack of information and PTSD. This study had three aims: to quantify the psychological burden of family members of critically ill patients, to explore whether a website with specific information could reduce PTSD symptoms, and to ascertain whether a website with information about intensive care would be used.

METHOD: A multicenter double-blind, randomized, placebo-controlled trial was carried out in Austria and Switzerland.

RESULTS: In total, 89 members of families of critically ill patients (mean age 47.3 ± 12.9 years, female n = 59, 66.3%) were included in the study. 46 relatives were allocated to the intervention website and 43 to the control website. Baseline Impact of Event Scale (IES) score was 27.5 ± 12.7. Overall, 50% showed clinically relevant PTSD symptoms at baseline. Mean IES score for the primary endpoint (~ 30 days after inclusion, T1) was 24 ± 15.8 (intervention 23.9 ± 17.9 vs. control 24.1 ± 13.5, p = 0.892). Hospital Anxiety and Depression Scale (HADS – Deutsch (D)) score at T1 was 12.2 ± 6.1 (min. 3, max. 31) and did not differ between groups. Use of the website differed between the groups (intervention min. 1, max. 14 vs. min. 1, max. 3; total 1386 “clicks” on the website, intervention 1021 vs. control 365). Recruitment was prematurely stopped in February 2020 due to coronavirus disease 2019 (COVID-19).

CONCLUSION: Family members of critically ill patients often have significant PTSD symptoms and online information on critical illness did not result in reduced PTSD symptoms.

PMID:37870597 | DOI:10.1007/s00134-023-07215-4

J Surg Oncol. 2023 Oct 23. doi: 10.1002/jso.27491. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Patients undergoing breast reconstruction following mastectomy are often admitted overnight. In 2020, our institution implemented a protocol change to discharge clinically stable patients immediately. In this study, we examine the safety of same-day discharge following mastectomy and reconstruction.

METHODS: Our retrospective study included female adults undergoing mastectomy and immediate alloplastic reconstruction from August 2019 to January 2020, before implementation of the same-day discharge protocol, and from March 2020 to September 2021, after the protocol implementation. Independent t-test and chi-square analysis was conducted to examine statistical differences.

RESULTS: Two hundred and eighty-five patients were included. Forty-two patients underwent reconstruction before the protocol change (Group 1) and 243 patients underwent reconstruction after the protocol change (Group 2). Group 2 had a greater percentage of prepectoral implant placement. There was no difference in demographics, complications, readmission, or reoperation. Within Group 2, 157 patients were discharged the same day (Group 2a) and 88 patients required overnight admission (Group 2b). Group 2b had higher body mass index, higher percentage of bilateral mastectomy, and larger mastectomy weights. Despite no differences in complications, Group 2b exhibited higher rates of requiring intravenous antibiotics and reoperation.

CONCLUSIONS: Patients may be safely discharged the same day following mastectomy and alloplastic reconstruction without an increase in complications.

PMID:37869984 | DOI:10.1002/jso.27491

Br J Nutr. 2023 Oct 23:1-38. doi: 10.1017/S0007114523002362. Online ahead of print.

ABSTRACT

Postmenopausal osteoporosis is a major concern for women worldwide, due to increased risk of fractures and diminished bone quality. Recent research on gut microbiota have suggested that probiotics can combat various diseases, including postmenopausal bone loss. Although several pre-clinical studies have explored the potential of probiotics in improving postmenopausal bone loss, the results have been inconsistent, and the mechanism of action remains unclear.To address this, a meta-analysis was conducted to determine the effect of probiotics on animal models of postmenopausal osteoporosis. The bone parameters studied were Bone Mineral Density (BMD), Bone Volume Fractions (BV/TV), and hallmarks of bone formation and resorption.Pooled analysis showed that probiotic treatment significantly improves BMD and BV/TV of the ovariectomised animals. Probiotics, while not statistically significant, exhibited a tendency toward enhancing bone formation and reducing bone resorption. Next, we compared the effects of Lactobacillus sp. and Bifidobacterium sp. on osteoporotic bone. Both probiotics improved BMD and BV/TV compared to control, but Lactobacillus sp. had a larger effect size. In conclusion, our findings suggest that probiotics have the potential to improve bone health and prevent postmenopausal osteoporosis. However, further studies are required to investigate the effect of probiotics on postmenopausal bone health in humans.

PMID:37869975 | DOI:10.1017/S0007114523002362

Anthropol Anz. 2023 Oct 18. doi: 10.1127/anthranz/2023/1737. Online ahead of print.

ABSTRACT

Diagnosis of specific infectious diseases in the skeleton is often difficult and relies on expert opinion. Statistics is not often used as a tool to assist in such diagnoses, and therefore this study aimed at employing data mining and machine learning in the form of decision tree analysis to aid in recognizing tuberculosis (TB) in skeletal remains and find patterns of skeletal involvement. The sample included 387 modern South African individuals (n = 207 individuals known to have died of TB and n = 180 as a control group) which were scored for the presence or absence of 21 skeletal lesions documented to be associated with TB. A pruned decision tree classification analysis was done to detect significant patterns and associations between variables which produced a model with a moderate classification rate based on four of the variables. As expected, vertebral changes were selected first, followed by rib, acetabular and lastly cranial changes. As a proof of concept, it was shown that machine learning was able to identify patterns of changes in TB skeletons versus a control group. However, further investigation into the use of machine learning in assessing skeletal changes associated with specific diseases is needed.

PMID:37869964 | DOI:10.1127/anthranz/2023/1737

Eur Rev Med Pharmacol Sci. 2023 Oct;27(5 Suppl):130-134. doi: 10.26355/eurrev_202310_34081.

ABSTRACT

OBJECTIVE: It has been hypothesized that hyaluronidase may allow fluid to enter and exit the basal area of the flap more readily and thus allow waste metabolites from the distal portion of the flap to drain towards areas where the blood supply may be healthier. We aimed to test this hypothesis by seeing whether hyaluronidase enhances the survival of a flap created in an animal model.

MATERIALS AND METHODS: The experiment utilized 14 male Wistar rats to test the effect of administering hyaluronidase on flap survival. The study utilized the same “flap survival method” technique reported in numerous previous studies.

RESULTS: The area of necrosis in the animals of the intervention group was lower than in the control animals, and this result reached statistical significance.

CONCLUSIONS: Hyaluronidase may preserve tissue flap vitality, starting at the bottom end of the dosage range. Future research should establish the minimal concentration needed to obtain benefits. The optimal mode of administration, whether by injection or topical application, is also a topic for future studies.

PMID:37869958 | DOI:10.26355/eurrev_202310_34081

Eur Rev Med Pharmacol Sci. 2023 Oct;27(5 Suppl):121-129. doi: 10.26355/eurrev_202310_34080.

ABSTRACT

OBJECTIVE: Cancer-preventative medicines like curcumin, resveratrol, and nonsteroidal anti-inflammatory medications all have their effects modulated by ceramide. According to research, these medications raise ceramide levels in cancer cells, leading to programmed cell death. Recently, cancer research has been involved in sphingolipid metabolism. The critical molecule here is ceramide. We aimed to investigate if the inhibition of ceramidases induces death in the human renal cell carcinoma cell line.

MATERIALS AND METHODS: Human kidney carcinoma A-498 (ATCC® HTB-44™) cells were used as test cells. Ceranib-2, fetal bovine serum (FBS), penicillin/streptomycin, dimethyl sulfoxide, 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl-2H-tetrazolium bromide and Dulbecco’s Modified Eagle Medium High Glucose, caspase 3/7, annexin-V, Bcl-2 activation dual detection, and MitoPotential kits were used. 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl-2H-tetrazolium bromide (MTT) colorimetric assay, annexin-V analysis, caspase 3/7 analysis, Bcl-2 activation analysis, and measurement of mitochondrial membrane potential were performed.

RESULTS: MTT colorimetric assay results for 24 hours indicated that the viability of human renal cell carcinoma cells decreased compared to the control group with an increase in the applied concentration of the ceramidase inhibitor-ceranib-2. The growth inhibition by ceranib-2 for 24 hours did not decrease the viability under 50%; thus, it could not be possible to calculate the IC50 value for the short-term application of ceranib-2 for 24 hours to A-498 cells. A statistically significant decrease in cell viability was recorded at doses of 100, 50, 25, and 12.2 µM of ceranib-2, and no significant decrease was detected at the lower doses of ceranib-2. The highest inhibition caused by ceranib-2 on human renal cell carcinoma cells A-498 was detected at an application time of 72 hours. This inhibition was statistically significant for all applied doses of ceranib-2 on A-498 cells compared to untreated cells. Annexin-V technique that detects the translocation of phosphatidylserine to the outer membrane of apoptotic cells indicated that after the application of ceranib-2, apoptosis was triggered on A-498 cells with a total apoptotic profile of 12.12% compared to the untreated cells that were used as controls. Compared to untreated A-498 cells, a rise in percentage to 16.25% of cells with activated caspases 3/7 was recorded after applying IC50 concentration of ceranib-2 on A-498 cells for 48 hours.

CONCLUSIONS: The results of our study indicated that the application of ceramidase inhibitor, ceranib-2 on human renal cell carcinoma A-498 cells cause cytotoxicity, antiproliferative, growth inhibitory, and apoptotic efficacies in a dose and time-dependent manner probably via inhibiting the acid ceramidases that hydrolyze ceramides that induce cell death. For further conclusions, more mechanical, pharmacokinetic, and pharmaceutic, as well as in vitro and in vivo anti-cancer activity investigations are required.

PMID:37869957 | DOI:10.26355/eurrev_202310_34080