38 research outputs found
Pycnogenol for the treatment of chronic disorders : a systematic review
Thesis (MNutr)-- Stellenbosch University, 2011.ENGLISH ABSTRACT: Background:
Oxidative stress has been implicated in the development of a number of conditions including
amongst others cancer, arthritic disorders and cardiovascular disease. Pycnogenol is a
herbal dietary supplement derived from French maritime pine bark extract. Pycnogenol is
standardised to contain 70 ± 5% procyanidin which is a powerful antioxidant. Pycnogenol is
marketed as a supplement for preventing or treating a wide range of chronic conditions.
Although several randomised controlled trials of Pycnogenol have been conducted to date,
this evidence has not yet been systematically reviewed.
Objectives: The aim was to carry out a systematic review in order to assess the efficacy and safety of
Pycnogenol for the treatment of chronic disorders.
Search methods
The electronic databases CENTRAL (until 18 September 2010), MEDLINE (until 18
September 2010) and EMBASE (until 13 October 2010) were searched, as well as three trial
registries. Furthermore the manufacturer of Pycnogenol was contacted and bibliographies of
included studies were hand-searched.
Selection criteria: Randomised controlled trials (RCTs) evaluating the effectiveness of Pycnogenol in adults or
children with any chronic disorder were included. The primary outcomes were any clinical
outcomes directly related to the disorder (stratified as participant- and investigator-reported)
as well as all-cause mortality. Adverse events and biomarkers of oxidative stress were also
assessed.
Data collection and analysis: Two authors independently assessed trial eligibility, extracted all data and judged
methodological quality. A third author additionally extracted information on outcomes and
results. With two exceptions, results for outcomes across studies could not be pooled mainly
due to poor quality reporting. Study authors were contacted for additional information.
Results: This review includes 15 RCTs with a total of 791 participants that have evaluated
Pycnogenol for the treatment of seven different chronic disorders. The disorders included
asthma (2 studies; N = 86), attention deficit hyperactivity disorder (1 study; N = 61), chronic
venous insufficiency (2 studies; N = 60), diabetes mellitus (4 studies; N = 201), erectile
dysfunction (1 study; N = 21), hypertension (2 studies; N = 69) and osteoarthritis of the knee
(3 studies; N = 293). Two of the studies were conducted exclusively in children; the others
involved adults. Due to small sample size, limited numbers of trials per condition, variation in
selected outcomes and outcomes measures and the risk of bias no definitive conclusions
regarding the efficacy or safety of Pycnogenol are possible.
Authors’ conclusions: Current evidence is insufficient to support Pycnogenol use for the treatment of any chronic
disorder. Well designed, adequately powered trials are recommended to establish the value
of this treatment.AFRIKAANSE OPSOMMING: Inleiding:
Oksidatiewe stres blyk ’n rol te speel in die ontwikkeling van ’n verskeidenheid siektes onder
andere kanker, artritis en kardiovaskulêre siektes. Pycnogenol, ‘n kruie-bevattende
dieetaanvulling wat uit Franse denneboombas vervaardig word, is gestandaardiseer om 70 ±
5% prosianidien – ’n kragtige anti-oksidant – te bevat. Die produk word bemark om ‘n wye
reeks chroniese siektes te voorkom of te behandel. Alhoewel daar tot op hede verskeie
kliniese proewe op Pycnogenol uitgevoer is, is die uitkomstes nog nie met behulp van ‘n
stelselmatiese oorsig geëvalueer nie.
Doelwitte: Die doel van hierdie studie was om met behulp van ‘n stelselmatiese oorsig die
doeltreffendheid en veiligheid van Pycnogenol ten opsigte van die behandeling van
chroniese siektes te evalueer.
Soektogstrategie: Die elektroniese databasisse CENTRAL (tot 18 September 2010), MEDLINE (tot 18
September 2010) en EMBASE (tot 13 Oktober 2010) is deursoek, asook drie registers met
kliniese proewe. Verder is die vervaardiger van Pycnogenol gekontak en is daar met die
hand deur bibliografieë van ingeslote studies gesif.
Keuringskriteria: Ewekansige gekontroleerde proewe (RCT’s) is ingesluit waarin die effektiwiteit van
Pycnogenol in volwassenes of kinders met enige chroniese siekte geëvalueer is. Enige
kliniese uitkomste wat direk aan die chroniese siekte verwant is (gesorteer as deelnemer- of
ondersoeker-gerapporteerde uitkomstes) asook mortaliteit (enige oorsake) is as die primêre
uitkomstes ondersoek.
Dataversameling en -ontleding: Twee navorsers het onafhanklik van mekaar proewe gekeur, alle relevante data onttrek en
gehalte van die metodiek beoordeel. ‘n Derde navorser het die resultate van die uitkomstes
bykomend onttrek. Met twee uitsonderings, kon resultate van uitkomstes van die
verskillende ingeslote studies kon nie statisties saamgevoeg word nie, hoofsaaklik as gevolg
van swak rapportering. Skrywers van die ingeslote studies is in verband met die verlangde
inligting gekontak.
Resultate: Vyftien RCT’s met ‘n totaal van 791 deelnemers is ingesluit. In hierdie studies is Pycnogenol
vir die behandeling van sewe verskillende chroniese siektes geëvalueer: asma (2 studies; N
= 86), aandagafleibaarheid-hiperaktiwiteitsgebreksindroom (1 studie; N = 61), chroniese
veneuse ontoereikendheid (2 studies; N = 60), diabetes mellitus (4 studies; N = 201),
erektiele disfunksie (1 studie; N = 21), hipertensie (2 studies; N = 69) en osteo-artritis van
die knie (3 studies; N = 293). Twee van hierdie studies is uitsluitlik met kinders gedoen; die
res was volwassenes. As gevolg van klein steekproewe, ‘n beperkte aantal studies per
siekte, wisseling in uitkomstes en die risiko vir sydigheid kan geen definitiewe gevolgtrekking
oor die doeltreffendheid en veiligheid van Pycnogenol gemaak word nie.
Skrywers se gevolgtrekking: Tans is daar nie voldoende wetenskaplike bewyse om Pycnogenol-gebruik vir die
behandeling van enige chroniese siekte aan te beveel nie. Goed ontwerpte proewe met ‘n
voldoende aantal deelnemers word aanbeveel om die waarde van hierdie behandeling
onomwonde vas te stel
Mapping oral cancer research in South Africa
The aim of the present study was to review the scope of oral squamous cell carcinoma (OSCC) research in South Africa, including its epidemiology, diagnosis, associated risk factors and management. All publications relating to OSCC on the South African population were sought. A total of 72 studies were included and classified into seven categories; most studies were case reports or case series
Low carbohydrate versus balanced carbohydrate diets for reducing weight and cardiovascular risk
Key Concepts for making informed Choices
Teach people to think critically about claims and comparisons — they will make better decisions
Methods used and lessons learnt in conducting document reviews of medical and allied health curricula : a key step in curriculum evaluation
CITATION: Rohwer, A., Schoonees, A. & Young, T. 2014. Methods used and lessons learnt in conducting document reviews of medical and allied health curricula -
a key step in curriculum evaluation. BMC Medical Education, 14:236, doi:10.1186/1472-6920-14-236.The original publication is available at http://www.biomedcentral.com/1472-6920/14/236Publication of this article was funded by the Stellenbosch University Open Access Fund.Background: This paper describes the process, our experience and the lessons learnt in doing document reviews of health science curricula. Since we could not find relevant literature to guide us on how to approach these reviews, we feel that sharing our experience would benefit researchers embarking on similar projects.
Methods: We followed a rigorous, transparent, pre-specified approach that included the preparation of a protocol, a pre-piloted data extraction form and coding schedule. Data were extracted, analysed and synthesised. Quality checks were included at all stages of the process.
Results: The main lessons we learnt related to time and project management, continuous quality assurance, selecting the software that meets the needs of the project, involving experts as needed and disseminating the findings to relevant stakeholders.
Conclusion: A complete curriculum evaluation comprises, apart from a document review, interviews with students and lecturers to assess the learnt and taught curricula respectively. Rigorous methods must be used to ensure an objective assessment.Publishers' Versio
Antiviral efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV-infected children and adolescents : a systematic review protocol
Publication of this article was funded by the Stellenbosch University Open Access Fund.The original publication is available at http://www.systematicreviewsjournal.com/content/3/1/87Adetokunboh, O.O., Schoonees, A. & Wiysonge, C.S. 2014. Antiviral efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV-infected children and adolescents: a systematic review protocol. Systematic Reviews, 3(87), doi:10.1186/2046-4053-3-87.Abstract
Background:
Abacavir is one of the recommended nucleoside reverse transcriptase inhibitors (NRTIs) for the
treatment of HIV infections among children and adolescents. However, there are concerns that the antiviral efficacy
of abacavir might be low when compared to other NRTIs especially among children. There are also concerns that
abacavir use may lead to serious adverse events such as hypersensitivity reactions and has potential predisposition
to developing cardiovascular diseases.
Methods:
We plan to do a systematic review to evaluate the antiviral efficacy and safety of abacavir-containing
combination antiretroviral therapy as first-line treatment of HIV-infected children aged between 3 months and 18 years,
compared with other NRTIs. We will search Scopus, Cochrane Central Register of Controlled Trials, MEDLINE, and Web
of Science databases for eligible studies regardless of language or publication status. We will check the reference lists
of included studies, search relevant conference proceedings, email the authors of included studies and also look for
unpublished and ongoing trials in prospective clinical trial registries. Two authors will independently screen search
outputs, select studies, extract data and assess the risk of bias in included studies. All disagreements will be resolved by
discussion and consensus. Where data allow, we will conduct meta-analysis for similar types of participants, study
designs, interventions, and outcome measures. If the results are statistically homogeneous, we will use the fixed-effect
model; otherwise, we will use the random-effects model and explore the reasons for heterogeneity using subgroup
analyses. Heterogeneity will be assessed with the Chi-squared test and quantified with the I-squared statistic.
Discussion:
The findings will be useful to policy makers and programme managers to inform treatment and
management of HIV in children and adolescents and to point out research gaps for future research.
Trial registration:
This review is registered with PROSPERO, registration number CRD42014009157.Stellenbosch UniversityPublishers' Versio
Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk: A Systematic Review and Meta-Analysis
Background
Some popular weight loss diets restricting carbohydrates (CHO) claim to be more effective, and have additional health benefits in preventing cardiovascular disease compared to balanced weight loss diets.
Methods and Findings
We compared the effects of low CHO and isoenergetic balanced weight loss diets in overweight and obese adults assessed in randomised controlled trials (minimum follow-up of 12 weeks), and summarised the effects on weight, as well as cardiovascular and diabetes risk. Dietary criteria were derived from existing macronutrient recommendations. We searched Medline, EMBASE and CENTRAL (19 March 2014). Analysis was stratified by outcomes at 3–6 months and 1–2 years, and participants with diabetes were analysed separately. We evaluated dietary adherence and used GRADE to assess the quality of evidence. We calculated mean differences (MD) and performed random-effects meta-analysis. Nineteen trials were included (n = 3209); 3 had adequate allocation concealment. In non-diabetic participants, our analysis showed little or no difference in mean weight loss in the two groups at 3–6 months (MD 0.74 kg, 95%CI −1.49 to 0.01 kg; I2 = 53%; n = 1745, 14 trials; moderate quality evidence) and 1–2 years (MD 0.48 kg, 95%CI −1.44 kg to 0.49 kg; I2 = 12%; n = 1025; 7 trials, moderate quality evidence). Furthermore, little or no difference was detected at 3–6 months and 1–2 years for blood pressure, LDL, HDL and total cholesterol, triglycerides and fasting blood glucose (>914 participants). In diabetic participants, findings showed a similar pattern.
Conclusions
Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets
Evaluating evidence-based health care teaching and learning in the undergraduate human nutrition; occupational therapy; physiotherapy; and speech, language and hearing therapy programs at a sub-Saharan African academic institution
<div><p>Background</p><p>It is important that all undergraduate healthcare students are equipped with evidence-based health care (EBHC) knowledge and skills to encourage evidence-informed decision-making after graduation. We assessed EBHC teaching and learning in undergraduate human nutrition (HN); occupational therapy (OT); physiotherapy (PT); and speech, language and hearing therapy (SPLH) programs at a sub-Saharan African university.</p><p>Methods</p><p>We used methodological triangulation to obtain a comprehensive understanding of EBHC teaching and learning: (1) through a document review of module guides, we identified learning outcomes related to pre-specified EBHC competencies; we conducted (2) focus group discussions and interviews of lecturers to obtain their perspectives on EBHC and on EBHC teaching and learning; and we (3) invited final year students (2013) and 2012 graduates to complete an online survey on EBHC attitudes, self-perceived EBHC competence, and their experience of EBHC teaching and learning.</p><p>Results</p><p>We reviewed all module outlines (n = 89) from HN, PT and SLHT. The OT curriculum was being revised at that time and could not be included. Six lecturers each from HN and OT, and five lecturers each from PT and SLHT participated in the focus groups. Thirty percent (53/176) of invited students responded to the survey. EBHC competencies were addressed to varying degrees in the four programs, although EBHC teaching and learning mostly occurred implicitly. Learning outcomes referring to EBHC focused on enabling competencies (e.g., critical thinking, biostatistics, epidemiology) and were concentrated in theoretical modules. Key competencies (e.g., asking questions, searching databases, critical appraisal) were rarely addressed explicitly. Students felt that EBHC learning should be integrated throughout the four year study period to allow for repetition, consolidation and application of knowledge and skills. Lecturers highlighted several challenges to teaching and practising EBHC, including lack of evidence relevant to the African context and lack of time within curricula.</p></div
Survey results of students on coverage of evidence-based health care competencies within allied health curricula.
<p>Survey results of students on coverage of evidence-based health care competencies within allied health curricula.</p