International journal of clinical practice
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisEffects of dehydroepiandrosterone (DHEA) supplementation on cortisol, leptin, adiponectin, and liver enzyme levels: a systematic review and meta-analysis of randomized clinical trials.
Dehydroepiandrosterone (DHEA) supplementation has been investigated in patients with altered cortisol levels and is proposed to ameliorate the metabolic profile related to adipose tissue. However, further research is warranted and evidence is no compelling for liver safety. Hence, we aimed to meta-analyse the effects of DHEA supplementation on circulating levels of cortisol, liver enzymes, and adipokines. ⋯ DHEA supplementation decreased circulating cortisol but did not alter adiponectin, leptin, AST, and ALT levels. Hence, DHEA supplementation could be considered as an adjunct in the management of hypercortisolaemia and is safe for the liver.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisCoronary revascularization in patients with chronic kidney disease and end-stage renal disease: a meta-analysis.
To compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for revascularising coronary arteries in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). CKD is described as a continuous decrease in the glomerular filtration rate or abnormalities in kidney structure or function. ⋯ Patients with ESRD, but not CKD, who underwent CABG had significantly lower all-cause mortality and cardiac mortality. However, CABG was associated with an increased risk of early mortality in patients with CKD or ESRD. Adequately powered, contemporary, prospective RCTs are needed to define the optimal revascularisation strategy for patients with CKD and ESRD.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisEffectiveness of aromatherapy inhalation on anxiety and hemodynamic variables for patients with cardiovascular disease: a systematic review and meta-analysis.
Anxiety can negatively affect patients' prognosis in cardiovascular disease. Aromatherapy helps reduce anxiety level in chronic diseases. However, the effectiveness of aromatherapy on anxiety and haemodynamic variables remains uncertain. ⋯ It was found that aromatherapy reduced anxiety, systolic blood pressure, heart rate and breathing rate in patients with cardiovascular disease. This study provides information to researchers and health professionals about the effectiveness of aromatherapy on decreasing anxiety and haemodynamic variables in patients with cardiovascular disease. Also, the study can contribute to planning studies which are better designed, conducted and reported.
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Int. J. Clin. Pract. · Nov 2021
ReviewImmunonutrition hope? Oral nutritional supplement on cancer treatment.
To determine the efficacy and safety of antitumoral nutritional supplement (Oncoxin® ), and to describe its mechanism of action. ⋯ Current literature shows promising complementary effects of oral supplements to the standard treatment of cancer patients in diverse scenarios. It might help patients to deal with toxicities and adverse effects related to cancer treatment and improve their nutritional or clinical profiles.
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Int. J. Clin. Pract. · Nov 2021
Impact of pharmacist-led interventions on patient care in ambulatory care settings: A systematic review.
In an era of rapid evolution in healthcare delivery, major changes have occurred within the profession of pharmacist. Because the impact of pharmacist-led interventions in the hospital setting has been well-studied and showed mixed findings on drug-related readmissions, all-cause emergency department visits and mortality, this systematic review focused on services provided by pharmacists in the community or ambulatory care setting without being limited to a specific intervention or outcome. ⋯ Our results showed that CMR can play a major role in the management of drug-related problems and economic issues. AR can significantly improve patient compliance. Larger, standardised and rigorously designed intervention studies are needed to help decision-makers to select appropriate interventions leading to meaningful improvements in patient care.