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Pycnogenol for the treatment of chronic disorders : a systematic reviewSchoonees, Anel 03 1900 (has links)
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.
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Fatores de risco aos sintomas de deglutição em idosos da comunidade = Risk factors to swallowing symptoms in community elderly / Risk factors to swallowing symptoms in community elderlyNeves, Danielle Akemi, 1981- 07 December 2012 (has links)
Orientador: Lucia Figueiredo Mourão / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T01:11:00Z (GMT). No. of bitstreams: 1
Neves_DanielleAkemi_M.pdf: 1334992 bytes, checksum: 72981897418a949b51026587b3c64471 (MD5)
Previous issue date: 2012 / Resumo: Introdução: O processo de envelhecimento ou senescência, tem como evento concomitante o risco aumentado para o aparecimento de doenças crônicas (DC); no entanto, poucos estudos analisam a influência das DC no envelhecimento natural do processo da deglutição. Objetivo: Descrever e investigar os fatores de risco sociodemográficos, doenças crônicas, sintomas depressivos, saúde bucal e fatores nutricionais sobre os sintomas de deglutição em idosos da comunidade. Método: Estudo transversal realizado a partir dos dados do Estudo sobre Fragilidade em Idosos Brasileiros. Dentre os 900 idosos recrutados (65 anos ou mais) sem alterações neurológicas limitantes, que integravam amostra representativa de Campinas, SP, foram excluídos os idosos com déficit cognitivo sugestivo de demência e os idosos que autorrelataram história de acidente vascular cerebral ou câncer. Foram levantadas as variáveis sobre gênero, idade, renda familiar e colhidos o autorrelato de doenças crônicas, saúde bucal e sintomas de deglutição. Foram feitas as medidas de peso e altura para cálculo do índice de massa corporal (IMC) e investigada a presença de sintomas depressivos através da Escala de Depressão Geriátrica. O tratamento estatístico consistiu em análises descritivas e de regressão logística multivariada. Resultados: A amostra constituiu de 507 idosos, sendo a maioria mulheres (69,2%), com média de idade de 71,9 anos. A prevalência dos sintomas em fase oral foi de 39,1% e em fase faríngea de 35,9%, sendo os mais referidos: dificuldade ou dor para mastigar e sensação de alimento parado. Número de doenças e grau de depressão apareceram como fatores de risco aos sintomas em fase oral tendo OR=1,33 (IC=1,15-1,55) e OR=2,13 (IC=1,44-3,15) respectivamente. Sensação de boca seca (OR=0,50; IC=0,34-0,74), número de doenças (OR=1,53;IC=1,30-1,81) e renda familiar (OR=0,71;IC=0,55-0,92) foram fatores de risco aos sintomas em fase faríngea. Idade foi fator de risco apenas para a ocorrência de pigarro tendo OR=1,05 (IC=1,00-1,11). Conclusão: As DC como doenças do coração, doença pulmonar, depressão e osteoporose, bem como o maior número de DC, a maior idade, a menor renda familiar, o menor IMC e a sensação de boca seca, são fatores de risco aos sintomas de deglutição em idosos da comunidade / Abstract: Introduction: Aging is a natural process which leads to changes in swallowing process, however there are few studies which analyze the interference of chronic diseases (CD) in the natural aging of swallowing process. Objective: Describing and Investigating the socio-demographic risk factors, chronic diseases, depressive symptoms, oral health and nutritional status on swallowing symptoms in elderly. Method: Cross-sectional study performed based on data from the Study of Brazilian Elderly Frailty. Among 900 elderly recruited (65 or older) with no limiting neurological dysfunctions who integrated representative samples from Campinas, SP, elderly who presented suggestive dementia cognitive deficit who self-reported stroke and cancer were excluded. Data on gender, age, family yields, CDs, oral health and swallowing symptoms were collected. Weight and height were measured to calculate body mass index, and the depresssive symptoms were investigated by using geriatric depression scale. The statistical analysis were based on the multivariate logistic regression analysis Results: Samples were built out of 507 elderly, and mostly formed from women (69.2%), whereas the mean age was 71.9 years. The swallowing oral phase symptoms prevalence was at 39.1% and pharynx phase was at 35.9%, difficulty in chewing and the feeling of food stuck in throat is mostly reported. The multivariate logistic regression analysis showed that the number of diseases (OR=1,33; IC=1,15-1,55) and depression (OR=2,13;IC=1,44-3,15) were risk factors to oral phase. Dry mouth self-report (OR=0,50; IC=0,34-0,74), number of diseases (OR=1,53;IC=1,30-1,81) and family yields (OR=0,71;IC=0,55-0,92) were risk factors to the gathered pharynx phase symptoms. The age (OR=1,05; IC=1,00-1,11) was a risk factor solely to throat clearing occurrence. Conclusion: Chronic diseases such as heart disease, pulmonary disease, depression and osteoporosis, as well as higher number of diseases, older age, shorter family yields, shorter body mass index and dry mouth self-report are risk factors to swallowing symptoms in community elderly / Mestrado / Gerontologia / Mestra em Gerontologia
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The potential relationships between hormone biomarkers and functional and health outcomes of ageingEendebak, Robert January 2017 (has links)
Although the female menopause has been extensively characterized as a well-defined symptomatic state of oestrogen deficiency, which responds relatively well to oestrogen replacement therapy, the symptomatic state of androgen deficiency in men is poorly defined and uncertainty exists whether it responds to testosterone replacement. It has been proposed that hypothalamic-pituitary-testicular (HPT)-axis function (responsible for the production of androgens) and regulation could be viewed as a âbarometerâ of health status in older men and that potential alterations in HPT-axis function and regulation reflect subclinical and clinical deficits in function and health, which may result in an aged phenotype of human health and disease in older men. The HPT-axis constitutes a well-defined, tractable, clinically-relevant, biological system, which may permit insight into the mechanisms underlying the expression of ageing-related phenotypes of human health and disease. By using a different lens â such as the genetic background; the compensatory responses within the HPT-axis; the syndromes of androgen deficiency; the ethnic background of an individual or the life course trajectory of function and health from conception into older age â to magnify potential dysregulation in the HPT-axis will it be possible to visualize and understand the phenotypic expression of human male ageing as a gradient of functional and health outcomes. This will allow for a better understanding of the physiological mechanics underlying symptomatic expression of dysregulation in the HPT-axis.
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