A Systematic Review and Meta-analysis of Clinical Studies on Ankylosing Spondylitis and Neutrophil to Lymphocyte Ratio.

BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a marker for many inflammatory diseases. Ankylosing spondylitis (AS) is among these inflammatory diseases, and many studies have compared the NLR ratio between patients with AS and healthy controls. AIM: This study aims to systematically review and analyze the available evidence about the significance of NLR values in AS. METHOD: Based on Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched Embase, Pubmed, ISI Web of Science, and Scopus databases from inception to August 2020 using ("Ankylosing spondyl* " OR "Bechterew Disease" OR "Rheumatoid Spondylitis") AND ((neutrophil* AND lymphocyte*) OR NLR) as key terms of the search strategy. Data selection and extraction were conducted separately by two authors. We appraised the included articles according to the Joanna Briggs checklist. Comprehensive Meta-analysis Version 2 was used for analysis and assessment of publication bias. I2 > 75% and p-value < 0.05 were considered significant. RESULT: In total, 182 studies resulted from a search in all databases. Duplicate removal, title, abstract, and full-text screening yielded 12 related studies, with 11 included in the meta-analysis. Quality assessment was satisfying in all studies. Pooled difference in NLR means value between patients and controls was 0.38 (95% CI: 0.24-0.52, p-value <0.0001). An I2 of 51% and a Cochran Q test p-value of <0.05 indicated moderate heterogeneity; thus, subgroup analysis had no indication. Publication bias was not significant (Funnel plot with an Egger's intercept of -0.07; p-value=0.95). CONCLUSION: Significant higher amounts of NLR may be strongly indicative of underlying inflammation in AS.

Gastrointestinal and hepatic abnormalities in patients with confirmed COVID-19: A systematic review and meta-analysis.

Although not common, gastrointestinal and liver symptoms have reportedly been the initial presentation of coronavirus disease-2019 (COVID-19) in a large group of patients. Therefore, knowing the frequency and characteristics of these manifestations of COVID-19 is important for both clinicians and health policy makers. A systematic review and meta-analysis of the available data on the gastrointestinal and liver manifestations of patients with COVID-19 was performed. PubMed and Scopus databases and Google Scholar search engine were searched for published and unpublished preprint articles up to 10 April 2020. Original studies providing information on clinical digestive symptoms or biomarkers of liver function in patients with polymerase chain reaction confirmed diagnosis of COVID-19 were included. After quality appraisal, data were extracted. Prevalence data from individual studies were pooled using a random-effects model. Overall, 67 studies were included in this systematic review and meta-analysis, comprising a pooled population of 13 251 patients with confirmed COVID-19. The most common gastrointestinal symptoms were anorexia (10.2%, 95% confidence interval [CI] = 6.2%-16.4%), diarrhea (8.4%, 95% CI = 6.2%-11.2%), and nausea (5.7%, 95% CI = 3.7%-8.6%), respectively. Decreased albumin levels (39.8%, 95% CI = 15.3%-70.8%), increased aspartate aminotransferase (22.8%, 95% CI = 18.1%-28.4%), and alanine aminotransferase (20.6%, 95% CI = 16.7%-25.1%) were common hepatic findings. After adjusting for preexisting gastrointestinal (5.9%) and liver diseases (4.2%), the most common gastrointestinal findings were diarrhea (8.7%, 95% CI = 5.4%-13.9%), anorexia (8.0%, 95% CI = 3.0%-19.8%), and nausea (5.1%, 95% CI = 2.2%-14.3%). Gastrointestinal and liver manifestations are not rare in patients with COVID-19, but their prevalence might be affected by preexisting diseases. Diarrhea and mild liver abnormalities seem to be relatively common in COVID-19, regardless of comorbidities.

Dietary antioxidants and fibre intake and depressive symptoms in Iranian adolescent girls.

OBJECTIVE: To investigate the cross-sectional association between dietary intakes of antioxidants and fibre and depressive symptoms among Iranian adolescent girls. DESIGN: A cross-sectional population-based study. SETTING: Primary schools in two different cities located in northeastern Iran (Mashhad and Sabzevar). PARTICIPANTS: A total of 988 adolescent girls aged 12-18 years were included in the study. RESULTS: Subjects with no or minimal depression symptoms had significantly higher dietary intakes of α-carotene (P = 0·01), ß-carotene (P = 0·006), lutein (P = 0·03) and vitamin C (P = 0·04) when compared with subjects with mild-to-severe depression symptoms. Soluble dietary fibre and insoluble dietary fibre intakes were also significantly higher in healthy adolescents compared with those with depression symptoms (P < 0·001). In multivariate-adjusted model 2, the OR (95 % CI) of depressive symptoms were 0·61 (95 % CI 0·37, 1·01), 0·42 (95 % CI 0·26, 0·69), 0·50 (95 % CI 0·31, 0·79), 0·71 (95 % CI 0·44, 1·15), 0·51 (95 % CI 0·32, 0·82) and 0·42 (95 % CI 0·25, 0·68) for the highest v. lowest quartile of vitamin C, ß-carotene, α-carotene, lutein, soluble dietary fibre and insoluble dietary fibre cereal intakes, respectively. CONCLUSIONS: Dietary intake of some antioxidants and dietary fibre intake was inversely associated with depression symptoms among Iranian adolescent girls.

Prevalence of combined and noncombined dyslipidemia in an Iranian population.

BACKGROUND: Combination of dyslipidemic phenotypes, including elevated plasma levels of low-density lipoprotein cholesterol (LDL-C), elevated plasma triglycerides (TG), and decreased low-density lipoprotein cholesterol (HDL-C) concentrations, is important because of the association of individual phenotypes with increased risk of cardiovascular disease (CVD). We investigated the prevalence of combined dyslipidemias and their effects on CVD risk in an Iranian large population. METHOD: A total of 9847 individuals were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Anthropometric parameters and biochemical indices were measured in all of the subjects. Different types of combined dyslipidemias including high TG + low HDL-C, high TG + low HDL-C + high LDL-C, low HDL-C + high LDL-C, high TG + high LDL-C, and finally high TG + high LDL-C + low HDL-C were considered. Ten-year CVD risk was calculated using the QRISK2 risk algorithm and adjustments were made as suggested by the Joint British Societies' (JBS2). Logistic regression analyses were performed to determine the association between different combined dyslipidemias and categorical QRISK. RESULTS: A total of 3952 males and 5895 females were included in this current study. Among the included subjects, 83.4% had one form of dyslipidemia, and 16.6% subjects were not dyslipidemic. The mean age was 48.88 ± 7.9 and 47.02 ± 8.54 years for dyslipidemic and nondyslipidemic groups, respectively. The results showed that the frequency of dyslipidemia was 98%, 87.1%, and 90% in subjects with metabolic syndrome, CVD, and diabetes, respectively. Our results suggested that around 15.7% of study population were at 10 years CVD risk (high ≥20) and it was higher in men than women (P < .001). Moreover, risk of CVD was higher in TG↑ & HDL↓ & LDL↑ group than other groups. CONCLUSION: Prevalence of dyslipidemia was 83.4% among Iranian adults. The results showed that individuals with increased plasma TG and LDL-C, and low HDL-C levels had the highest 10 years CVD risk compared to other combined dyslipidemic phenotypes.

Depression and anxiety symptoms are associated with prooxidant-antioxidant balance: A population-based study.

BACKGROUND: Depression and anxiety are significantly associated with systemic inflammation. Moreover, oxidative stress resulting from a disturbance in the prooxidant-antioxidant balance is linked to inflammation-related conditions. Therefore, depression/anxiety symptoms may also be associated with oxidative stress. OBJECTIVE: To examine the association between depression/anxiety symptoms and serum prooxidant-antioxidant balance (PAB) in adults who participated in a large population-based, cross-sectional study. METHODS: Serum PAB values were measured in 7516 participants (62% females and 38% males) aged 35-65 years, enrolled in a population-based cohort study. beck depression and anxiety inventories were used to evaluate symptoms of depression and anxiety. Multinomial logistic regression was used to examine the effect of confounders on the status of serum PAB change. RESULTS: Among men, serum PAB values were increased incrementally from 1.55 ±â€¯0.47 to 1.59 ±â€¯0.47, 1.69 ±â€¯0.38, and 1.68 ±â€¯0.38 in the no or minimal, mild, moderate and severe depression groups, respectively (Ptrend < 0.001). Serum PAB values also increased significantly across these four corresponding groups among women [1.70 ±â€¯0.45, 1.73 ±â€¯0.44, 1.75 ±â€¯0.44, and 1.76 ±â€¯0.40, (Ptrend = 0.005)]. About anxiety, serum PAB values increased significantly across the four groups in men (Ptrend = 0.02) but not in women (Ptrend = 0.2). The adjusted odds ratios for serum PAB values among men with severe depression and anxiety symptoms were 1.75 and 1.27, respectively. Moreover, the adjusted odds ratios for serum PAB values among women with severe depression and anxiety symptoms were 1.40 and 1.17, respectively. CONCLUSION: Symptoms of depression and anxiety appear to be associated with higher degrees of oxidative stress, expressed by higher serum PAB values.

High Dose Vitamin D Supplementation Is Associated With a Reduction in Depression Score Among Adolescent Girls: A Nine-Week Follow-Up Study.

Although vitamin D deficiency is known to be a risk factor for some psychological disorders, there have been few studies on the effects of vitamin D supplementation on their symptoms. Depression and aggression are common mental disorders and are associated with disability and disease burden. We aimed to evaluate the effectiveness of high-dose vitamin D supplementation on depression and aggression scores in adolescent girls. Nine hundred forty adolescent girls received vitamin D3 at a dose of 50,000 IU/week for 9 weeks. Anthropometric parameters and blood pressure were measured using standard protocols at the baseline and at the end of the study. Depression score was evaluated using the Beck Depression Inventory-II and aggression was evaluated using the Buss-Perry Aggression Questionnaire at baseline and at the end of the study. Comparison among the four categories of depression score (normal, mild, moderate, and severe) revealed no significant differences in demographic and anthropometric parameters at baseline. After 9 weeks of vitamin D supplementation, there was a significant reduction on mild, moderate, and severe depression score. However, vitamin D supplementation had no significant effect on aggression score. Our results suggest that supplementation with vitamin D may improve depressive symptoms among adolescent girls, as assessed by questionnaire, but not aggression score. Formal, larger, randomized controlled studies are required to confirm this effect on cases with different degrees of depression.

Saffron in the treatment of depression, anxiety and other mental disorders: Current evidence and potential mechanisms of action.

BACKGROUND: Depression and anxiety are two common mental health problems with high economic and social costs. Currently, a number of treatments are available for patients with depression and anxiety disorders such as psychotherapy, electroconvulsive therapy and antidepressant drugs. Due to safety concerns, adverse effects, limited efficacy and low tolerability associated with many antidepressant and anti-anxiety medications, identification of novel agents with less toxicity and more favorable outcome is warranted. METHODS: The current article provides a non-systematic review of the available in vitro, in vivo and clinical evidence on the efficacy, safety and mechanisms of action of saffron and its active ingredients in the treatment of anxiety, depression and other mental disorders. RESULTS: Several interesting data have been reported about the antidepressant and anti-anxiety properties of saffron, the dried stigmas of Crocus sativus L., in several preclinical and clinical studies. In particular, a number of clinical trials demonstrated that saffron and its active constituents possess antidepressant properties similar to those of current antidepressant medications such as fluoxetine, imipramine and citalopram, but with fewer reported side effects. CONCLUSION: Saffron may exert antidepressant effects and represents an efficacious and safe treatment.