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BACKGROUND: Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory skin condition that presents with symptoms of intense pruritus, dryness, and erythema. Dissatisfaction with first-line therapies for AD, the desire to avoid steroids, and the extreme cost of effective biologics have created a demand for alternative treatment options such as oral vitamins and nutritional supplements. OBJECTIVE: The purpose of this review was to assess the effectiveness of oral nutritional supplements, pre- and probiotics, and vitamin deficiencies and supplements on AD symptomology and clinical course. METHODS: We searched Scopus, PubMed, and MEDLINE (Ovid interface) for English-language articles published between 1993 and 2023. The final search was conducted on June 22, 2023. The search terms comprised the following: "(Atopic Dermatitis or Atopic Eczema) AND (supplement OR vitamin OR mineral OR micronutrients OR Fish Oil OR Omega Fatty Acid OR Probiotics OR Prebiotics OR apple cider vinegar OR collagen OR herbal OR fiber)." RESULTS: A total of 18 studies-3 (17%) evaluating vitamins, 4 (22%) evaluating herbal medicine compounds, 2 (11%) evaluating single-ingredient nutritional supplements, and 9 (50%) evaluating pre- and probiotics-involving 881 patients were included in this review. CONCLUSIONS: Overall, there is weak evidence to support any one nutritional supplement intervention for the alleviation of AD symptoms. Multiple trials (4/18, 22%) showed promise for supplements such as Zemaphyte, kefir, and freeze-dried whey with Cuscuta campestris Yuncker extract. The most evidence was found on the effectiveness of probiotics on the clinical course of AD. Lactiplantibacillus plantarum, Ligilactobacillus salivarius, and Lactobacillus acidophilus specifically showed evidence of efficacy and safety across multiple studies (6/18, 33%). However, larger, more extensive randomized controlled trials are needed to determine the true effectiveness of these supplements on the broader population. TRIAL REGISTRATION: PROSPERO CRD42023470596; https://tinyurl.com/4a9477u7.
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Background/Aims: Argon plasma coagulation (APC) is an alternate ablative method to radiofrequency ablation for the treatment of Barrett's esophagus (BE), and it is preferred due to its lower cost and widespread availability. The present meta-analysis aimed to analyze the safety and efficacy of APC for the management of BE. Methods: A literature search from January 2000 to November 2022 was done for studies analyzing the outcome of APC in BE. The primary outcomes were clearance rate of intestinal metaplasia and adverse events (AE). Pooled event rates were expressed with summative statistics. Results: A total of 38 studies were included in the final analysis. The pooled event rate for clearance rate of intestinal metaplasia with APC in BE was 86.8% (95% confidence interval [CI], 83.5% to 90.2%), with high-power and hybrid APC having a higher rate compared to standard APC. The pooled incidence of AE with APC in BE was 22.5% (95% CI, 15.3% to 29.7%), without any significant difference between the subgroups, with self-limited chest pain being the commonest AE. The incidence of serious AE was only 0.4% (95% CI, 0.0% to 1.0%), while stricture development was seen only in 1.7% (95% CI, 0.9% to 2.6%) of cases. The pooled recurrence rate of BE was 16.1% (95% CI, 10.7% to 21.6%), with a significantly lower recurrence with high-power APC than standard APC. Conclusions: High-power and hybrid APC seem to have an advantage over standard APC in terms of clearance rate and recurrence rate. Further studies are required to compare the efficacy and safety of hybrid APC with standard APC and radiofrequency ablation.
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Introduction: Telemedicine is increasingly popular with the recent surge in use due to the COVID-19 pandemic. Despite youth status as "tech natives," limited data are available on their perspectives on telemedicine. Our study seeks to understand youth telemedicine knowledge, prior experiences, preferences for use, and the impact of COVID-19 on these perspectives. Methods: Participants in MyVoice, a national text message cohort of U.S. youth age 14-24, were sent five open-ended questions in October 2019 and October 2020. A codebook was iteratively developed by using inductive analysis. Responses were independently coded by two investigators, with discrepancies resolved by discussion or a third investigator. Results: Sixty-five percent (836/1,283) and 77% (887/1,129) of participants responded to at least 1 question in 2019 and 2020, respectively. Most youth reported awareness of telemedicine and although many have not used it, COVID-19 has increased use. Further, many are willing to try telemedicine services. Most youth noted a preference for video rather than phone visits, but they believe both to be less effective than in person. Youth also reported varied preferences on services best suited for telemedicine, with COVID-19 positively impacting their views. Discussion: Youth are aware of and willing to use telemedicine services, with many reporting use during the COVID-19 pandemic. Youth are willing to accept a wide variety of telemedicine services, though they still desire in-person options. Health systems and clinics should offer a wide range of services via telemedicine to fit the varying needs of youth both during and after the COVID-19 pandemic.
