Effect of Curcumin Plus Piperine on Redox Imbalance, Fecal Calprotectin and Cytokine Levels in Inflammatory Bowel Disease Patients: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

The development and course of inflammatory bowel disease (IBD) are significantly influenced by inflammation and oxidative stress. Antioxidant therapy is a promising therapeutic option to enhance the clinical results of these individuals in this particular scenario. The purpose of this study is to assess the impact of curcumin, with or without piperine, on cytokines, fecal calprotectin (CalF), and oxidative stress enzymatic and non-enzymatic indicators in patients with IBD. METHODS: Patients with Crohn's disease (CD) or ulcerative colitis (UC) who were at least 18 years old and had intact liver and kidney function participated in this randomized, double-blind trial (trial registration: ensaiosclinicos.gov.br as RBR-89q4ydz). For 12 weeks, participants were randomly assigned to one of three groups: placebo, curcumin (1000 mg/day), or curcumin plus piperine (1000 mg + 10 mg/day). In order to examine oxidative stress indicators, CalF, and pro-inflammatory cytokines, blood and fecal samples were obtained, both prior to and following the intervention time. RESULTS: After adjusting for age, sex, and type of IBD, the curcumin plus piperine group had substantially higher serum levels of superoxide dismutase (SOD) than the placebo group (4346.9 ± 879.0 vs. 3614.5 ± 731.5; p = 0.041). There were no discernible variations between the groups in CalF, inflammatory markers, or other indicators of oxidative stress. CONCLUSIONS: In patients with inflammatory bowel disease (IBD), our study indicates that a 12-week curcumin plus piperine treatment effectively increases enzymatic antioxidant defense, especially SOD. These results demonstrate the potential therapeutic benefits of managing redox imbalance in individuals with IBD.

Antioxidant Therapy in Inflammatory Bowel Disease: A Systematic Review and a Meta-Analysis of Randomized Clinical Trials.

The objective of this study is to assess the effectiveness of treatment for inflammatory bowel diseases in modulating oxidative stress biomarkers and cytokine levels. A systematic review of clinical trials was conducted, searching electronic databases including PubMed, Science Direct, and Scopus. After excluding articles that did not meet the inclusion criteria, 19 studies were included in the systematic review and 8 in the meta-analysis (6 for antioxidant capacity, 6 for superoxide dismutase (SOD), and 5 for lipid peroxidation analyzed through malondialdehyde (MDA) levels). SOD was significantly modulated (RR = 0.3764, 95% CI [0.0262 to 0.7267], p = 0.035) but not antioxidant capacity (RR = 0.3424, 95% CI [0.0334 to 0.7183], p = 0.0742) or MDA (RR = -0.8534, 95% CI [-1.9333 to 0.2265], p = 0.1214). Nonetheless, studies investigating oxidative stress biomarkers and cytokines in the context of alternative therapies for IBD treatment are still scarce. This review highlights the potential of antioxidant supplementation in IBD management and underscores the need for further investigations into its effects on oxidative stress biomarkers and cytokines to improve therapeutic approaches for IBD patients.

Systematic review on efficacy of preventive measures for surgical site infection by multiple-drug resistant gram-negative bacilli.

BACKGROUND: There are no specific recommendations for prevention of surgical site infection (SSI) caused by multidrug resistant Gram-negative bacilli (MDR-GNB). Our objective was to systematically review the literature evaluating the efficacy and safety of measures specifically designed to prevent MDR-GNB SSI. METHODS: We searched MEDLINE, EMBASE, CINAHL and LILACS databases up to February 18, 2020. Randomized trials and observational cohort studies evaluating the efficacy of preventive measures against MDR-GNB SSI in adult surgical patients were eligible. We evaluated methodological quality of studies and general quality of evidence using Newcastle-Ottawa scale, Cochrane ROBINS-I and GRADE method. Random-effects meta-analyses were performed using Review Manager V.5.3 software. RESULTS: A total of 10,663 titles by searching databases were identified. Two retrospective observational studies, comparing surgical antibiotic prophylaxis (SAP) with or without aminoglycoside in renal transplantation recipients, and one non-randomized prospective study, evaluating ertapenem vs. cephalosporin plus metronidazole for SAP in extended spectrum beta-lactamase producing Enterobacteriales carriers undergoing colon surgery, were included. Risk of bias was high in all studies. Meta-analysis was performed for the renal transplantation studies, with 854 patients included. Combined relative risk (RR) for MDR GNB SSI was 0.57 (95%CI: 0.25-1.34), favoring SAP with aminoglycoside (GRADE: moderate). CONCLUSIONS: There are no sufficient data supporting specific measures against MDR-GNB SSI. Prospective, randomized studies are necessary to assess the efficacy and safety of SAP with aminoglycoside for MDR-GNB SSI prevention among renal transplantation recipients and other populations. PROSPERO 2018 CRD42018100845.

Systematic review on efficacy of preventive measures for surgical site infection by multiple-drug resistant gram-negative bacilli

ABSTRACT Background: There are no specific recommendations for prevention of surgical site infection (SSI) caused by multidrug resistant Gram-negative bacilli (MDR-GNB). Our objective was to systematically review the literature evaluating the efficacy and safety of measures specifically designed to prevent MDR-GNB SSI. Methods: We searched MEDLINE, EMBASE, CINAHL and LILACS databases up to February 18, 2020. Randomized trials and observational cohort studies evaluating the efficacy of preventive measures against MDR-GNB SSI in adult surgical patients were eligible. We evaluated methodological quality of studies and general quality of evidence using Newcastle-Ottawa scale, Cochrane ROBINS-I and GRADE method. Random-effects meta-analyses were performed using Review Manager V.5.3 software. Results: A total of 10,663 titles by searching databases were identified. Two retrospective observational studies, comparing surgical antibiotic prophylaxis (SAP) with or without aminoglycoside in renal transplantation recipients, and one non-randomized prospective study, evaluating ertapenem vs. cephalosporin plus metronidazole for SAP in extended spectrum beta-lactamase producing Enterobacteriales carriers undergoing colon surgery, were included. Risk of bias was high in all studies. Meta-analysis was performed for the renal transplantation studies, with 854 patients included. Combined relative risk (RR) for MDR GNB SSI was 0.57 (95%CI: 0.25-1.34), favoring SAP with aminoglycoside (GRADE: moderate). Conclusions: There are no sufficient data supporting specific measures against MDR-GNB SSI. Prospective, randomized studies are necessary to assess the efficacy and safety of SAP with aminoglycoside for MDR-GNB SSI prevention among renal transplantation recipients and other populations. PROSPERO 2018 CRD42018100845.

Influence of sodium intake and sociodemographic, lifestyle and anthropometric variables on blood cholesterol of hypertensive women

The restriction of sodium intake, one of the pillars of antihypertensive treatment, has been associated with the increase in cholesterol levels. Given this, we hypothesize that a sodium intake restriction may increase cholesterol levels in hypertensive women. The present study aimed to evaluate the influence of sodium intake, sociodemo-graphic, lifestyle and anthropometric variables on the blood cholesterol levels of hypertensive women. This was a cross-sectional study with hypertensive and nondiabetic women aged 20 to 59 years, recruited from the primary healthcare units of Maceio, Alagoas, in the Brazilian Northeast. Sodium intake was estimated by the 24-hour urinary excretion of sodium; and blood cholesterol was estimated by capillary blood. Age (years), education level (<4 or ≥4 years), race (white or nonwhite), smoking and alcohol consumption were evaluated. The weight, height and waist circumference were measured and body mass index, conicity index and waist-to-height ratio were quantified. The percentage of body fat was measured using a tetrapolar bioelectrical impedance device. The relationship between blood cholesterol and other variables was assessed by multiple regression analysis. A significance level of 5% was used in the final model. This study included 165 hypertensive women. In linear regression, blood cholesterol was directly proportional to age (p<0.001), education level (p=0.01) and race (p=0.04). These variables, as well as sodium intake (p = 0.07) and conicity index (p = 0.12), were included in the multiple regression analysis. Sodium intake (p=0.03) and age (p=0.001) were related, in an inverse and a direct way, respectively, to the blood choles-terol in the hypertensive women studied. (AU)

ção da ingestão de sódio, um dos pilares do tratamento anti-hipertensivo, tem sido associada ao aumen-to dos níveis de colesterol. Diante disso, levantou-se a hipótese de que a ingestão de sódio influencia os níveis de colesterol de mulheres hipertensas, independentemente de outros fatores associados. Trata-se de um estudo transversal realizado com mulheres hipertensas e não diabéticas, na faixa etária entre 20 e 59 anos, recrutadas em unidades básicas de saúde de Maceió, Alagoas, situada no Nordeste do Brasil. A ingestão de sódio foi estimada pela excreção urinária de sódio de 24 horas; e o colesterol sérico foi mensurado por coleta de sangue capilar. Foram ava-liados idade (anos), escolaridade (<4 ou ≥4 anos), raça (branca ou não branca), tabagismo e consumo de álcool. O peso, a estatura e a circunferência da cintura foram aferidos e o índice de massa corporal, índice de conicidade e razão cintura/estatura foram calculados. A porcentagem de gordura corporal foi medida usando um dispositivo de impedância bioelétrica tetrapolar. A relação entre o colesterol sérico e as outras variáveis em estudo foi avalia-da por meio de análise de regressão múltipla, adotando-se um nível de significância de 5% no modelo final. Este estudo incluiu 165 mulheres hipertensas. Na análise de regressão linear, o colesterol sérico foi relacionado à idade (p<0,001), escolaridade (p=0,01) e raça (p=0,04). Essas variáveis, assim como o consumo de sódio (p=0,07) e o índice de conicidade (p=0,12), foram incluídas na análise de regressão múltipla. As variáveis que permaneceram no modelo final foram ingestão de sódio (p=0,03) e idade (p=0,001). A ingestão de sódio e a idade foram as variáveis que influenciaram o colesterol sérico de mulheres hipertensas. (AU)