Nutrition
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Reports on the association between coffee or tea consumption and subarachnoid hemorrhage (SAH) risk are inconsistent. The aim of this study was to determine if an association exists between consumption of coffee or tea and the risk for SAH. ⋯ Our meta-analysis of current evidence does not support an association between the consumption of coffee or tea and SAH risk. Further studies with prospective designs that control for important confounders and provide sufficient data for dose-response analysis are warranted.
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Randomized Controlled Trial
Efficacy of perioperative immunonutrition in esophageal cancer patients undergoing esophagectomy.
Malnutrition is common in patients with esophageal cancer, resulting in increased postoperative complications and mortality. Although preoperative immunonutrition can significantly reduce the incidence of postoperative infectious complications, its effect in patietns with esophageal cancer undergoing esophagectomy remains unclear. The aim of this study was to investigate the effects of perioperative immunonutritional support on the postoperative course and long-term survival of this group of patients. ⋯ Perioperative immunonutrition may improve early postoperative nutritional status and reduce postoperative infectious complications in patients with esophageal cancer undergoing esophagectomy.
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Epicardial adipose tissue is a particular visceral fat depot with unique anatomic, biomolecular, and genetic features. Epicardial fat displays both physiological and pathological properties. Epicardial fat expresses genes and secretes cytokines actively involved in the thermogenesis and regulation of lipid and glucose metabolism of the adjacent myocardium. ⋯ Epicardial fat is a measurable and modifiable risk factor that can serve as a novel and additional tool for cardiovascular risk stratification. Pharmacologically targeting epicardial fat with drugs such as glucagon peptide-like 1 analogs or sodium glucose transport 2 inhibitors reduces the epicardial fat burden and induces beneficial cardiometabolic effects. Assessment and manipulation of epicardial fat transcriptome might open new avenues in the prevention of cardiometabolic diseases.
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Review Meta Analysis
Effect of alpha-lipoic acid supplementation on lipid profile: A systematic review and meta-analysis of controlled clinical trials.
Several studies have shown the effect of alpha-lipoic acid (ALA) on lipid profile. However, findings remain controversial. This systematic review and meta-analysis was conducted to systematically summarize the available clinical trials that examined the effects ALA supplementation on the lipid profile of adults. ⋯ Significant changes were not observed in serum high-density lipoprotein (WMD, -0.092 mg/dL; 95% CI, -3.014 to 2.831; P = 0.025). Supplementation dosage and body mass index were potential sources of heterogeneity, in which those with body mass index >30 kg/m2 who received >600 mg/d ALA showed better improvements in lipid profile. Our findings showed that supplementation with ALA significantly decreased the serum concentrations of TG, total cholesterol, and low-density lipoprotein but did not affect serum levels of high-density lipoprotein in adults.
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Review Meta Analysis
Current evidence on ω-3 fatty acids in enteral nutrition in the critically ill: A systematic review and meta-analysis.
Fish oil exerts anti-inflammatory and immunomodulatory properties that may be beneficial for critically ill patients, thus multiple randomized controlled trials and meta-analyses have been performed. However, controversy remains as to whether fish oil-enriched enteral nutrition can improve clinical outcomes in adult critically ill patients in intensive care units (ICUs). The aim of this study was to provide an up-to-date systematic review and meta-analysis of all randomized controlled trials of fish oil-containing enteral nutrition addressing relevant clinical outcomes in critically ill patients. ⋯ Enteral fish oil supplementation cannot be recommended for critically ill patients, as strong scientific evidence for improved clinical benefits was not found. There is a signal of mortality benefit in patients with acute respiratory distress syndrome; however, results are based on low-quality studies. Further research should focus on the relation between the individual critically ill patients' immune response, the administration of fish oil, and clinical outcomes.