International journal of clinical practice
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Int. J. Clin. Pract. · Nov 2021
ReviewVitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors.
Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. ⋯ Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisThe effectiveness of self-management programmes for people with type 2 diabetes receiving insulin injection: A systematic review and meta-analysis.
People with type 2 diabetes (T2D) receiving insulin injection are reported to encounter challenges to achieve optimal glycaemic control. The evidence on effectiveness of self-management programmes for T2D people receiving insulin injection is far from conclusive. ⋯ Self-management programmes have the potential to improve glycaemic control, weight management, blood lipids, self-management behaviours, self-efficacy and diabetes-related distress of people with T2D receiving insulin injection. More rigorous experimental trials are warranted to examine the effectiveness of self-management programme and its maintenance.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisThe effects of Cynara scolymus L. supplementation on liver enzymes: A systematic review and meta-analysis.
A systematic review and meta-analysis was conducted to summarise studies conducted on the effects of artichoke supplementation on liver enzymes. ⋯ Artichoke supplementation elicited significant reductions in liver enzymes, especially among patients with non-alcoholic fatty liver disease.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisRegular arrangement of collecting venules (RAC) as an endoscopic marker for exclusion of Helicobacter pylori (H. pylori) infection: A systematic review and meta-analysis.
Helicobacter pylori (H. pylori) is the most common cause of gastric cancer. Growing evidence suggests that the regular arrangement of collecting venules (RAC) can be used as an endoscopic marker to diagnose H. pylori infection. However, data on the diagnostic accuracy of RAC for H. pylori infection are conflicting. We performed a systematic review and meta-analysis of relevant studies to determine the diagnostic accuracy and clinical utility of RAC for the diagnosis of H. pylori infection. ⋯ RAC can be used as an endoscopic marker for exclusion of H. pylori infection. However, it cannot be recommended as a single indicator for the confirmation of H. pylori infection. The conclusion of this study should be treated with caution because significant heterogeneity exists between the evaluated studies.
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Int. J. Clin. Pract. · Nov 2021
ReviewChallenging patient phenotypes in the management of anemia of chronic kidney disease.
Chronic kidney disease (CKD) is often complicated by anaemia, which is associated with disease progression and increased hospital visits, decreased quality of life, and increased mortality. ⋯ Several therapies provide promising opportunities to address gaps with a standard of care, including hypoxia-inducible factor prolyl hydroxylase inhibitors, which stimulate haematopoiesis through promoting modest increases in serum erythropoietin and improved iron homeostasis. The critical issues in the management of anaemia of CKD in these challenging phenotypes and the clinical utility of new therapeutic agents in development for the treatment of anaemia of CKD should be assessed and the information should be made available to healthcare providers.