An evidence-based systematic review of vanadium by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
An evidence-based systematic review of goji (Lycium spp.) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
Although the cardiotoxic effects of cocaine are universally recognized, the association between cocaine and cardiomyopathy and/or heart failure is poorly understood. To conduct a comprehensive review and meta-analysis on the association between cocaine, heart failure, and cardiomyopathy, we first conducted a broad-term search in PubMed, Embase, Web of Science, and Scopus for human studies containing primary data on the relationship between cocaine and heart failure or cardiomyopathy. We were interested in studies with data beyond acute coronary syndromes. Retrieved studies were grouped into different categories based on possible hypotheses to test by meta-analysis. A second search with specific terms was then conducted. For grouped studies with sufficient clinical and methodological homogeneity, effect sizes were calculated and combined for meta-analysis by the Random Effects model. There is in general a need for more primary data studies that investigate heart failure and/or cardiomyopathy in cocaine users for mechanisms independent of ischemia. There were, however, enough studies to combine by meta-analyses that showed that chronic cocaine use is associated with anatomical and functional changes more consistent with diastolic heart failure instead of the commonly taught dilated cardiomyopathy pathway. In patients without a history of ACS, chronic cocaine use was not associated with significantly reduced EF. The few studies on acute cocaine had conflicting results on whether single-dose intravascular cocaine results in acute heart failure. Studies identified that included beta-blockade therapy in cocaine users with cardiac disease suggest that beta-blockers are not unsafe and that may be effective in the treatment of cocaine-associated heart failure. Chronic cocaine use is associated with anatomical and physiological changes of the heart muscle that are potentially reversible with beta-blockade therapy.
Introduction: Social determinants of health, such as food security, are an important target for health providers, particularly in the care of patients from underserved populations, including the uninsured and socially marginalized. Preliminary research has shown that food insecurity status (FIS) is associated with negative health outcomes.Objective: We aim to present a concise, yet comprehensive resource that lists the health outcomes associated with FIS. This guide is meant to provide innovative health providers with the tools needed to justify the importance of using FIS screening and treatment as a preventive medicine intervention.Methods: We conducted a systematic review of peer-reviewed manuscripts that studied FIS in the United States of America (USA) and at least one health outcome. We searched PubMed, Embase, Web of Science, and Scopus and had multiple reviewers examine each abstract and manuscript. We only retained peer-reviewed studies that contained USA data, directly measured FIS, and directly compared FIS to a health outcome.Results: The initial search yielded 1,817 manuscripts. After screening abstracts for duplicates and inclusion criteria, a total of 117 manuscripts were retained and fully examined. Several manuscripts showed significant association between FIS and neurologic, cardiac, endocrine, and pulmonary health outcomes. Studies in the USA population show robust associations between FIS and poor mental health (including depression, anxiety, sleep disorders, impaired cognitive functioning, and epilepsy), metabolic syndrome, hyperlipidemia, greater risk for bone fracture in children, higher risk of end-stage renal disease in patients with chronic kidney disease, self-reported poor health, and higher mortality in patients with the human immunodeficiency virus. Though other literature reviews show positive associations between FIS and health outcomes such as diabetes, body mass index, and hypertension, our systematic review showed mixed results.Conclusions: FIS leaves underserved populations at risk for negative health outcomes. More research should be done to examine the effects of FIS alleviation as a preventative medicine intervention.
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