5 research outputs found
Could Cardiac Shockwave Therapy be the Breakthrough Solution for Refractory Angina? A Systematic Review and Meta-Analysis
No full textBackground: Refractory angina (RA) is a chronic condition unresponsive to standard treatments like PCI or CABG, leaving limited options for many patients. Cardiac shockwave therapy (CSWT) is a novel, noninvasive approach that enhances myocardial perfusion through microvascular regeneration. This systematic review and meta-analysis evaluate the effectiveness of CSWT in managing RA. Methods: A comprehensive literature search was conducted using electronic databases (Cochrane, PubMed, and ScienceDirect), including comparative studies with controls that evaluated CSWT in RA patients between 2010 and 2024. Studies not in English, with irrelevant outcomes, or lacking full-text access, were excluded. Data were extracted and analyzed using a random-effects model to address heterogeneity. Results: Seven studies, including 3 randomized controlled trials (RCTs) and 4 observational studies, with a total of 417 patients were analyzed. CSWT demonstrated significant improvements in multiple clinical outcomes. CSWT reduces angina severity in CSWT reduces angina severity in CCS grade (MD -0.76, 95% CI -0.97, -0.55, P < 0.00001) and in NYHA class (MD -0.62, 95% CI -0.95, -0.30, P = 0.0002), increased the 6- Minute Walk Test (6MWT) distance by 57.63 meters (MD 57.63, 95% CI 16.71, 98.54, P = 0.006), increased SAQ scores by 10.96 points (MD 10.96, 95% CI 1.66, 20.26, P = 0.02), improved LVEF by 4.43% (MD 4.43, 95% CI: 2.66 to 6.21, P< 0.01), and decreased nitroglycerin usage by 1.62 intake per week (MD -1.62, 95% CI -2.61, -0.62, P = 0.001). However, there was no significant difference in LVEDD between the two groups. Conclusion: CSWT appears to be a promising therapeutic option for patients with RA, demonstrating improvement in CCS angina class, NYHA class, 6-min walk test distances, SAQ score, LVEF, and reduces nitroglycerin usage.
Keyword: Cardiac Shockwave Therapy, Refractory Angina, Non-invasive Cardiac Therapy, Chronic Angina Treatment, Innovative Angina Therapies
 
Sub-acute polyethylene microplastic inhalation exposure induced pulmonary toxicity in wistar rats through inflammation and oxidative stress
No full textPlastic waste, particularly polyethylene (PE) plastic bags and bottles, poses a significant environmental problem and health risk when degraded into microplastics. Recent atmospheric microplastic pollution increases inhalation exposure, necessitating a study on toxicity in the lungs. However, the inhalation toxicology of PE microplastics is poorly understood. This study used Wistar rats that are divided into control and PE group. The PE groups were exposed to PE microplastic through inhalation for 28 days with the daily dose of 15 mg/m3. Inflammatory marker such as Inflammatory exudate, Alveolar thickening, and NF-κB were in PE group increased significantly compared to control group. the increment of MDA and decrement of SOD in PE group revealed the oxidative stress occurred. These results suggest that sub-acute PE microplastic inhalation may contribute to inflammation pathogenesis via the NF-κB pathway as a result of oxidative stress
Gut microbiota modulation using prebiotics, probiotics, and synbiotics for CD4+ T-cell recovery in HIV: A systematic review and meta-analysis
No full textIntroduction: Human immunodeficiency virus (HIV) compromises the immune system by targeting key regulatory lymphocytes essential for coordinating immune responses. It continues to pose a significant global health burden, with approximately 40 million cases recorded by the end of 2023. Currently, highly active antiretroviral therapy (HAART) is the key therapeutic strategy, but it has several limitations, prompting the importance of new therapeutic approaches. This paper evaluates the effectiveness of gut microbiota basesd immunomodulatory therapies, consisting of prebiotics, probiotics, and synbiotics in HIV treatment while considering clinical, socioeconomic, and therapeutic influencing factors. Methods: This study was conducted based on PRISMA guidelines using multiple databases. Studies were employed based on established inclusion parameters, focusing on the efficacy of gut microbiota interventions in CD4+ T-cell counts.Subgroup analyses were performed based on intervention type, dosage, duration, HAART status, and clinical setting. Moreover, sensitivity analysis, meta-regression, and publication bias assessment were also performed to ensure findings robustness and explore source of heterogeneity. Results: A total of 21 studies were assessed in this meta-analysis. Risk of bias assessment indicated that most studies had a low risk of bias, though some concerns were noted. Prebiotics showed the greatest improvement by a mean difference (MD) of 52.15 cells/mm3 (95 % CI: −5.64 to 109.93), though not statistically significant (p = 0.08). Synbiotics showed a more consistent and statistically significant effect (MD = 39.48 cells/mm3; 95 % CI: 34.39 to 44.58; p < 0.00001). Notably, greatest immunological benefits were observed among HAART-naive individuals, with low-dose prebiotics (4–10 g/day), moderate intervention durations (4–6 months), and in low- and middle-income countries (LMICs). Sensitivity analysis using leave-one-out method confirmed findings robustness, while meta-regression identified key variables contributing to heterogeneity. Moreover, publication bias using Egger's and Begg's test was not evident in most outcomes, except for LMIC-based studies, which showed potential small-study effects. Conclusion: Gut microbiota based immunomodulators show promising potential in supporting immune function among people living with HIV. However, due to study variability, high heterogeneity and wide confidence intervals (CI) in some subgroups, these findings are hypothesis-generating. Further high-quality studies should focused in homogeneous populations to validate efficacy and guide clinical implementation
Determining the Risk of Type 2 Diabetes for rs1801133 Genotypes in Multiethnic Populations: A Global Meta-Epidemiological Study
No full textThe rs1801133 (C677T) polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene has been linked to type 2 diabetes (T2D) risk. This study aimed to assess the association between rs1801133 genotypes (CC, CT, TT) and T2D across multiethnic populations and to identify genotype- and region-specific risks. A global meta-epidemiological analysis was conducted using data from 19 studies comprising 6479 participants from Asia, Africa, Europe, and America. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses by region were also performed. The results of the CC vs. CT dominant genetic model were OR 95% CI = 0.63 (0.46–0.87); p = 0.005; the CC vs. TT genetic recessive model yielded OR 95% CI = 0.59 (0.38–0.91); p = 0.02; and the CT vs. TT codominance genetic model yielded OR 95% CI = 0.95 (0.65–1.37); p = 0.78. Based on the subgroup analysis, the CC genotype is predominantly associated with an increased risk of T2D in both Africa and Europe. From this study, the CC genotype was proven to be highly contributory to T2D risk compared to the CT and TT genotypes. These findings highlight the need for ethnicity-informed genetic screening and targeted prevention strategies in global diabetes management
The gut-skin axis in psoriasis: Evidence-based insights from a meta-analysis on probiotics-synbiotics-mediated microbiota interventions
No full textPsoriasis, a chronic immune-mediated skin condition, has been intricately linked to gut microbiota dysbiosis through the gut-skin axis. This meta-analysis synthesizes data from 15 randomized controlled trials encompassing 1,423 participants to evaluate the efficacy of gut microbiota interventions—probiotics and synbiotics—in psoriasis management. The findings reveal that probiotics significantly improved the Psoriasis Area and Severity Index (PASI) (Mean Difference [MD]: −4.05, 95 % CI: −6.73 to −1.38; p < 0.0001) and Dermatology Life Quality Index (DLQI) (MD: −5.74, 95 % CI: −11.45 to −0.03; p = 0.0001), outperforming synbiotics and systemic pharmacological therapies such as anti-TNF-α and anti-interleukin agents. Notably, probiotics demonstrated superior systemic anti-inflammatory (TNF-α and IL-17) and immunomodulatory responses, and enhanced gut barrier integrity. This study highlights probiotics as a promising adjunct or alternative therapy, paving the way for integrative treatment strategies that address psoriasis's multifaceted pathophysiology. Future research should focus on long-term efficacy and molecular mechanisms to optimize outcomes. These findings could redefine therapeutic paradigms, offering a cost-effective and accessible solution for millions of psoriasis patients worldwide
