Vitamin E for Alzheimer’s dementia and mild cognitive impairment (Review)

This is the final version of the article. Available from the publisher via the DOI in this record.Background Vitamin E occurs naturally in the diet. It has several biological activities, including functioning as an antioxidant to scavenge toxic free radicals. Evidence that free radicals may contribute to the pathological processes behind cognitive impairment has led to interest in the use of vitamin E supplements to treat mild cognitive impairment (MCI) and Alzheimer’s disease (AD). This is an update of a Cochrane Review first published in 2000, and previously updated in 2006 and 2012. Objectives To assess the efficacy of vitamin E in the treatment of MCI and dementia due to AD. Search methods We searched the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS), the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as many trials databases and grey literature sources on 22 April 2016 using the terms: “Vitamin E”, vitamin-E, alpha-tocopherol. Selection criteria We included all double-blind, randomised trials in which treatment with any dose of vitamin E was compared with placebo in people with AD or MCI. Data collection and analysis We used standard methodological procedures according to the Cochrane Handbook for Systematic Reviews of Interventions. We rated the quality of the evidence using the GRADE approach. Where appropriate we attempted to contact authors to obtain missing information. Main results Four trials met the inclusion criteria, but we could only extract outcome data in accordance with our protocol from two trials, one in an AD population (n = 304) and one in an MCI population (n = 516). Both trials had an overall low to unclear risk of bias. It was not possible to pool data across studies owing to a lack of comparable outcome measures. In people with AD, we found no evidence of any clinically important effect of vitamin E on cognition, measured with change from baseline in the Alzheimer’s Disease Assessment Scale - Cognitive subscale (ADAS-Cog) over six to 48 months (mean difference (MD) -1.81, 95% confidence interval (CI) -3.75 to 0.13, P = 0.07, 1 study, n = 272; moderate quality evidence). There was no evidence of a difference between vitamin E and placebo groups in the risk of experiencing at least one serious adverse event over six to 48months (risk ratio (RR) 0.86, 95% CI 0.71 to 1.05, P = 0.13, 1 study, n = 304; moderate quality evidence), or in the risk of death (RR 0.84, 95% CI 0.52 to 1.34, P = 0.46, 1 study, n = 304; moderate quality evidence). People with AD receiving vitamin E showed less functional decline on the Alzheimer’s Disease Cooperative Study/Activities of Daily Living Inventory than people receiving placebo at six to 48 months (mean difference (MD) 3.15, 95% CI 0.07 to 6.23, P = 0.04, 1 study, n = 280; moderate quality evidence). There was no evidence of any clinically important effect on neuropsychiatric symptoms measured with the Neuropsychiatric Inventory (MD -1.47, 95% CI -4.26 to 1.32, P = 0.30, 1 study, n = 280; moderate quality evidence). We found no evidence that vitamin E affected the probability of progression from MCI to probable dementia due to AD over 36 months (RR 1.03, 95% CI 0.79 to 1.35, P = 0.81, 1 study, n = 516; moderate quality evidence). Five deaths occurred in each of the vitamin E and placebo groups over the 36 months (RR 1.01, 95% CI 0.30 to 3.44, P = 0.99, 1 study, n = 516; moderate quality evidence). We were unable to extract data in accordance with the review protocol for other outcomes. However, the study authors found no evidence that vitamin E differed from placebo in its effect on cognitive function, global severity or activities of daily living. There was also no evidence of a difference between groups in the more commonly reported adverse events. Authors’ conclusions We found no evidence that the alpha-tocopherol form of vitamin E given to people with MCI prevents progression to dementia, or that it improves cognitive function in people with MCI or dementia due to AD. However, there is moderate quality evidence from a single study that it may slow functional decline in AD. Vitamin E was not associated with an increased risk of serious adverse events or mortality in the trials in this review. These conclusions have changed since the previous update, however they are still based on small numbers of trials and participants and further research is quite likely to affect the results.This update was supported by the National Institute for Health Research (NIHR), via Cochrane Infrastructure funding to the Cochrane Dementia and Cognitive Improvement group

Pooled Analysis of the Efficacy and Safety of Video Capsule Endoscopy in Patients with Implantable Cardiac Devices

© 2019 Rabih Tabet et al. Background. To date, video capsule endoscopy (VCE) is still contraindicated by the FDA and the main manufacturers of Cardiac Implantable Electronic Devices (CIED) in patients with CIED, given a theoretical electromagnetic interference and possible device malfunction. Objectives. The objective of this study was to assess the safety profile and efficacy of VCE in patients with implantable cardiac devices through analyzing the risk of mutual interference. Methods. A systematic review of PubMed, Web of Science, and Embase databases was conducted. Peer-reviewed original articles, published in the English language and containing capsule endoscopy AND pacemaker , defibrillator OR left ventricular assist device as keywords, were selected. Studies performed in vitro, isolated case reports, and abstracts/posters were excluded. Results. A total of 735 VCE procedures were performed in patients with cardiac devices in various clinical settings. Cardiac events were not seen in any case. Interference on capsule images transmission was noted in 5 cases (left ventricular assist device (LVAD)) where few images were lost when the capsule was closest to the device. Finally, interference between capsule and telemetry leads was noted in 6 cases (4 Permanent Pacemakers (PPM), 2 Implantable Cardioverter-Defibrillator (ICD)) leading to image artifacts. Discussion. Adverse cardiac events were not seen in any study. Loss of images occurred when the VCE was in proximity to the device (only with LVAD) or after telemetry leads installation without affecting the completion rate and diagnostic yield of VCE. Conclusion. VCE is safe and remains efficient in patients with cardiac devices. If cardiac monitoring is required, wired systems are preferable

Outcome of Depression and Anxiety After War: A Prospective Epidemiologic Study of Children and Adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106884/1/jts21895.pd

Vitamin and mineral supplementation for prevention of dementia or delaying cognitive decline in people with mild cognitive impairment

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of vitamin and mineral supplementation for prevention of dementia or delaying cognitive decline in people with mild cognitive impairment

Theoretical and experimental study of tropylium formation from substituted benzylpyridinium species

Fragmentation pathways of unsubstituted and substituted benzylpyridinium compounds were investigated using mass-analysed kinetic energy (MIKE) technique in combination with high level of quantum chemical calculations in the gas phase. Fast atom bombardment (FAB) source was used for ionisation of the studied compounds. The formation of both benzylium and tropylium species were investigated. Hybrid Hartree-Fock/Density Functional Theory calculations have been performed to assess the geometries and the energies of the transition states and intermediates. For each cases, different reaction pathways were investigated, and particularly in the case of the formation of tropylium species, the formation of the seven-membered ring before or after the loss of pyridine were studied. The effect of para-methyl and para-methoxy substituents on the activation energy of the rearrangement process to form thermodynamically stable tropylium compounds has been studied. Theoretical calculations showed competition between direct bond cleavage and rearrangement reactions to form benzylium and tropylium compounds, respectively. Experimental results also suggested that the rearrangement process takes place to yield stable tropylium under “soft ionisation techniques”, such as FAB

X-ray absorption near edge structure investigation of vanadium-doped ZnO thin films

Abstract X-ray absorption near edge structure spectroscopy has been used to investigate the electronic and atomic structure of vanadium-doped ZnO thin films obtained by reactive plasma. The results show no sign of metallic clustering of Vatoms, +4 oxidation state of V, 4-fold coordination of Zn in the films, and a secondary phase (possibly VO2) formation at 15% V doping. O K edge spectra show V 3d–O 2p and Zn 4d–O 2p hybridization, and suggest that V4+ acts as electron donor that fills the σ* band. © 2006 Elsevier B.V. All rights reserved. Keywords: ZnO; XANES; Vanadium doping; Thin films; DC-sputterin

X-ray absorption near edge structure investigation of vanadium-doped ZnO thin films

Abstract X-ray absorption near edge structure spectroscopy has been used to investigate the electronic and atomic structure of vanadium-doped ZnO thin films obtained by reactive plasma. The results show no sign of metallic clustering of Vatoms, +4 oxidation state of V, 4-fold coordination of Zn in the films, and a secondary phase (possibly VO2) formation at 15% V doping. O K edge spectra show V 3d–O 2p and Zn 4d–O 2p hybridization, and suggest that V4+ acts as electron donor that fills the σ* band. © 2006 Elsevier B.V. All rights reserved. Keywords: ZnO; XANES; Vanadium doping; Thin films; DC-sputterin

Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in late life

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of vitamin and mineral supplementation on cognitive function in cognitively healthy people in late life