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New meta-analyses, RCTs and systematic reviews that we monitor daily in PubMed. Independently indexed, not editorially curated.
PeerJ · 2026
Patients with pancreatic cancer frequently experience malnutrition that is often unresponsive to conventional nutritional interventions. To evaluate the impact of n-3 polyunsaturated fatty acids (PUFAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), supplementation on body weight (BW), lean body mass (LBM), body mass index (BMI), serum albumin (ALB), and serum prealbumin (PA) in this population. This systematic review was prospectively registered with PROSPERO (CRD42023402888). Reviewers searched PubMed, Embase, Cochrane Library, Web of Science, Scopus, and ProQuest from inception to 31 January 2026. Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB 1.0). Statistical analyses were performed using RevMan 5.4. Certainty of evidence was evaluated using GRADEpro GDT. Nine randomized controlled trials (RCTs) were included and analyzed. Risk of bias was low in two studies, unclear in six, and high in one. The meta-analysis indicated that n-3 PUFAs may produce modest weight gain (SMD 1.41, 95% CI [0.36-2.46]; P = 0.008; low certainty, I 2 = 94%), though clinical significance is uncertain. No statistically significant effects were observed on LBM (SMD 0.21, 95% CI [-0.38-0.81]; P = 0.48; moderate certainty), BMI (WMD 0.59, 95% CI [-0.42-1.60]; P = 0.25; moderate certainty), ALB (SMD -0.07, 95% CI [-0.81-0.66]; P = 0.84; low certainty), or PA (SMD 0.13, 95% CI [-0.18-0.43]; P = 0.42; moderate certainty). This meta-analysis suggests that n-3 PUFAs may produce modest weight gain, but evidence is insufficient to support meaningful improvement in overall nutritional status. Due to low certainty, substantial heterogeneity, and small sample sizes, recommendations remain individualized rather than routine. Well-designed, large-scale trials are needed to clarify which patients may benefit from this intervention.
European journal of nutrition · 2026
Research on supplementation during high-intensity functional training (HIFT) is limited. We examined the effects of a multi-ingredient supplement containing fish protein, vitamin D, and ω3 fatty acids, taken during HIFT, on physical performance in trained individuals. Twenty-five recreationally trained participants (14 females, 11 males) underwent 6 weeks of HIFT (3 times/week) while taking each of three supplements, separated by 2-week washout periods in a researcher-blinded, randomized, triple-crossover, and counterbalanced fashion. The supplements and daily doses were (a) 0.6 g fish protein/kg body mass, 21 μg vitamin D, and 1.8 g ω3 fatty acids [including 1.4 g eicosapentaenoic (EPA) and docosahexaenoic acid (DHA)], (b) 0.6 g/kg whey protein, and (c) 0.6 g/kg maltodextrin. Participants followed isoenergetic diets providing 1.0 g protein/kg body mass, 30 μg vitamin D, and 0.2 g EPA and DHA daily. Training variables were assessed during the 1st and 6th weeks of each intervention period. Endurance and strength variables were measured before and after each intervention period. Data were analyzed using 2-way repeated-measure ANOVA (supplement × training). HIFT augmented workout duration per training session (p = 0.007). One-repetition maximum and maximal force of shoulder press, as well as strength endurance of core muscles, increased by 3-6% with training (p < 0.001). Supplementation did not affect any of these adaptations. Six weeks of HIFT improved some training and performance variables in recreationally trained adults. However, increasing the intake of protein, vitamin D, and ω3 fatty acids did not influence the variables assessed. NCT05402527 (22/4/2022), clinicaltrials.gov.
European journal of nutrition · 2026
Anti-inflammatory diets, such as the Mediterranean Diet (MedDiet) have shown positive effects on disease activity in Rheumatoid Arthritis (RA). The Dietary Inflammatory Index (DII) has been associated with RA risk. However, the effect of improving diet quality with a MedDiet and impact on the DII and patient-reported outcome measures (PROMs) has not been investigated. To assess the effects of a MedDiet and adherence to the Irish Healthy Eating Guidelines (HEG) on change in DII and to determine whether change in DII and energy-adjusted DII (e-DII) scores is associated with improvements in PROMs in adults with RA in Ireland. 40 Participants were randomised to a MedDiet (n = 20) or a HEG intervention (n = 20) for 12 weeks. DII was calculated based on food diaries collected. Between and within group data was analysed in SPSS. Baseline e-DII was 0.99 ± 2.37, 0.79 ± 2.60, 1.20 ± 2.16 for total cohort (n = 40), MedDiet, and HEG groups, respectively (p = 0.588). e-DII significantly improved for the cohort following the MedDiet (p = 0.022) and HEG (p = 0.004) groups. Differences in PROMs across tertiles of e-DII change were not statistically significant, irrespective of diet assignment. Participants in the most anti-inflammatory e-DII tertile group had significantly greater intakes of omega-3 fatty acids, dietary fibre, vitamin A, vitamin E, folic acid, and beta-carotene compared to those in the pro-inflammatory tertile group (p < 0.05). Improving dietary quality with either a MedDiet or the Irish HEG improved e-DII scores in a cohort of people living with RA, however, no statistically significant change in PROMs were observed.
Pediatric pulmonology · 2026
While caffeine therapy is well-established for managing apnea of prematurity (AOP), standardized protocols for its discontinuation are lacking. This study evaluated whether earlier cessation at 33 weeks postmenstrual age (PMA) is as safe as conventional discontinuation at 34 weeks. Preterm neonates (26-32 weeks of gestation) on caffeine for AOP, who were off respiratory support and apnea-free for 5 consecutive days by 33 weeks PMA, were randomized to early discontinuation (Group A) or conventional discontinuation at 34 weeks PMA (Group B). The primary outcome was recurrence of apnea (RAP) post-cessation. Apnea recurrence was similar between groups (13.7% vs. 10%; OR 1.44, p = 0.71). Caffeine duration was significantly shorter in Group A (21.5 vs. 28.5 days, p = 0.024). No significant differences were noted in secondary outcomes or neonatal morbidities. Early discontinuation of caffeine at 33 weeks PMA in stable preterm neonates appears safe and may reduce drug exposure without increasing apnea risk.
Frontiers in pharmacology · 2026
Characterized by a total or partial shortage of insulin, diabetes is a chronic metabolic condition. Its widespread occurrence and related complications present a significant global public health issue. Ganoderma lucidum (Curtis) P. Karst. 1881 (Polyporaceae), a valuable traditional Chinese medicine, contains polysaccharides as its primary active metabolites. Polysaccharides exhibit virous pharmacological properties including hypoglycemic, hypolipidemic, immunomodulatory, and anti-tumor effects. Although recent research has increasingly investigated the potential of G. lucidum polysaccharides (GLPs) to manage diabetes and its complications, a systematic integration of these findings is lacking. The review comprehensively summarizes relevant literature retrieved from databases including PubMed, Sci-Hub, Science Direct, Scopus, and Open Access Library. GLPs demonstrates defensive impacts against diabetes and its associated complications including nephropathy, hepatopathy, cardiomyopathy, refractory wound healing, neuropathy, retinopathy, and erectile dysfunction--through mechanisms involving oxidative stress modulation, glucolipid metabolism regulation, anti-apoptosis, islet cells repair, and the gut microbiota remodeling. Furthermore, drug combination strategies and novel formulation development represent promising directions for future applications This review provides a theoretical foundation for the advancement of effective and low toxicity natural therapies for diabetes based on GLPs.
Psychiatry research · 2026
Iron plays a central role in neurodevelopment and dopaminergic regulation, yet its relationship with schizophrenia remains conceptually unresolved. Research conducted across the life span, from prenatal exposure to postmortem brain tissue, has produced fragmented findings without an integrating physiological framework. We aimed to systematically synthesize this literature and reinterpret prior findings through core principles of iron regulation, with particular attention to the distinction between absolute iron depletion and inflammation-driven functional restriction. We conducted a PROSPERO-registered systematic review (CRD42022382842) following PRISMA guidelines and included 51 studies spanning genetic risk, gestational exposure, peripheral biomarkers, neuroimaging, and postmortem analyses. Genetic studies do not implicate core iron-regulatory pathways in inherited schizophrenia risk. Large population-based cohorts consistently associate maternal iron deficiency during pregnancy with increased schizophrenia risk in offspring. Sixteen studies assessed adult peripheral iron markers; most report lower serum iron, although heterogeneity remains substantial. Few investigations evaluated regulatory markers such as hepcidin, and only one examined the hepcidin-ferroportin pathway directly. Neuroimaging studies in early psychosis report reduced subcortical iron alongside increased dopaminergic activity, whereas postmortem investigations describe cortical iron-ferritin decoupling in chronic stages. Across levels of analysis, apparent inconsistencies converge when iron physiology is considered. Absolute iron depletion and inflammation-driven functional iron restriction represent biologically distinct states that share reduced circulating iron but arise from different mechanisms. Stratifying schizophrenia according to iron phenotype offers a coherent framework to reinterpret prior evidence and guide future mechanistic research.
Hemoglobin · 2026
Transfusion-dependent β-thalassemia (B-TM) is complicated by progressive iron overload, remaining a primary cause of organ toxicity and mortality despite chelation therapy advances. Accurate monitoring of hepatic and cardiac iron levels is crucial. Traditional methods, like serum ferritin and magnetic resonance imaging (MRI) T2* relaxometry, improved outcomes but suffer from biological variability, operator dependence, and reduced precision in severe iron overload. Artificial intelligence (AI), machine learning (ML), and deep learning (DL) show promise in overcoming these limitations by automating image analysis, enhancing measurement precision, and enabling earlier detection of organ damage. This systematic review examines current evidence on AI and DL applications for monitoring iron overload and organ toxicity in B-TM patients. A search of PubMed, Scopus, and Web of Science identified studies (2019-January 2026) using AI-based models to evaluate liver iron concentration, myocardial iron concentration, or iron-related complications. Eight studies met the inclusion criteria. Most focused on DL-driven analysis of MRI R2*/T2* data for hepatic and cardiac iron assessment. These demonstrated improved segmentation accuracy, decreased interobserver variability, and better performance in severe iron overload. Additionally, ML models utilizing clinical data effectively predicted skeletal issues. While reported performance metrics were generally positive, most studies were retrospective, single-center, and lacked external validation, resulting in a high risk of bias. AI and DL approaches hold significant potential to transform iron overload monitoring in β-thalassemia. However, prospective multicenter validation, standardized reporting, and explainable AI are strictly required before these technologies can be adopted for routine clinical use.
BMC oral health · 2026
To evaluate the role of matrix metalloproteinases (MMPs) and cathepsins in dentin erosion and assess the efficacy of synthetic and natural inhibitors in preventing collagen matrix degradation and preserving dentin integrity. A systematic literature search was conducted and updated in January 2025 across PubMed, Scopus, and Web of Science, targeting studies that investigated the role of matrix metalloproteinases (MMPs) and/or cysteine cathepsins in dentin erosion or erosion-abrasion models. In vitro, in situ, and in vivo experimental studies evaluating the effects of synthetic and natural protease inhibitors were included. Study selection, data extraction, and risk of bias assessment were performed following PRISMA 2020 guidelines. A total of 22 studies met the inclusion criteria, comprising predominantly in vitro designs, alongside in situ and combined experimental models. Across studies, MMP-2, MMP-8, and MMP-9, together with cathepsin K, were consistently identified as key enzymes involved in collagen degradation following acidic challenges. Erosive protocols varied in pH, exposure time, and cycling frequency, but uniformly promoted demineralization and enzymatic activation. Synthetic inhibitors (e.g., ferrous sulfate, stannous fluoride) and natural compounds (e.g., green tea catechins, theaflavins) demonstrated significant reductions in enzymatic activity and dentin loss. Importantly, studies assessing combined inhibition of MMPs and cathepsins reported the greatest protective effects, supporting a multimodal strategy to limit erosive dentin degradation. Acidic challenges promote the activation of matrix metalloproteinases and cysteine cathepsins, thereby accelerating dentin erosion through progressive collagen degradation. Both synthetic and natural inhibitors were shown to attenuate proteolytic activity and reduce dentin loss under experimental conditions. Notably, strategies targeting multiple enzymatic pathways consistently demonstrated greater protective effects than single-agent approaches. Nevertheless, the predominance of in vitro and in situ evidence highlights the need for well-designed clinical studies to confirm the long-term efficacy and translational relevance of these interventions. The incorporation of MMP and cathepsin inhibitors into preventive and therapeutic oral care strategies represents a promising adjunct for enhancing dentin resistance to erosive challenges. However, clinical implementation requires standardized experimental protocols, clearer dose-response characterization, and validation in long-term clinical settings. Advancing dual-targeted inhibitory approaches may contribute to more effective and durable dentin preservation in patients at risk of erosive tooth wear.
European journal of pediatrics · 2026
Iron deficiency anemia (IDA) remains a public health problem in children. Conventional iron therapy is effective but often causes gastrointestinal adverse effects that reduce adherence. Liposomal iron has been developed to enhance absorption and improve tolerability. This systematic review and meta-analysis evaluated the efficacy and safety of liposomal iron compared with conventional iron formulations in pediatric patients with IDA. We searched PubMed, Scopus, Web of Science, and the Cochrane Library up to February 21, 2026 for randomized controlled trials (RCTs) comparing liposomal iron with conventional oral iron in children with IDA. Analyses were performed using R software with the meta package. Continuous outcomes were pooled as mean differences (MDs) and dichotomous outcomes as risk ratios (RRs) with 95% confidence intervals (CIs) using a random-effects model. Subgroup analyses according to follow-up duration. Four RCTs involving 454 children were included. At 6 months, liposomal iron produced a significantly greater increase in hemoglobin compared with conventional iron (MD 0.96 g/dL, 95% CI 0.09-1.82; P = 0.03), although heterogeneity was substantial (I2 = 92.9%). No significant differences were observed at earlier time points. Liposomal iron significantly reduced total iron-binding capacity (MD - 35.52 μg/dL; P < 0.0001) and increased mean corpuscular hemoglobin (MD 1.83 pg; P < 0.0001). Liposomal iron was associated with fewer adverse events (RR 0.29; P = 0.02) and lower risk of constipation (RR 0.56; P = 0.02).Conclusion: Liposomal iron offered better tolerability and was non-inferior to conventional iron for most hematologic outcomes. Evidence remains preliminary and larger RCTs are needed to confirm its efficacy in pediatric IDA.
Frontiers in nutrition · 2026
The ergogenic effects of caffeine in team sports, particularly basketball, have been widely investigated. This systematic review and meta-analysis evaluated the effects of caffeine intake on basketball-specific skills and general physical and game-related performance outcomes. Eighteen studies employing a blinded, crossover design were included. Random-effects meta-analyses examined the effects of caffeine intake on isolated skills (e.g., free-throw and three-point shooting accuracy, dribbling speed), general physical performance (e.g., sprint speed, jump height, and agility), and game-related actions during real or simulated matches (e.g., assists, total points scored, and performance index rating). Low to moderate doses of caffeine intake improved general physical performance, including linear sprint speed (SMD: -0.27; 95% CI: -0.42- -0.13; p < 0.01), repeated-sprint speed (SMD: -0.45; 95% CI: -0.78 -0.13; p < 0.01), single-jump height (SMD: 0.15; 95% CI: 0.01-0.29; p = 0.04), and agility, reflected by shorter test completion times (SMD: -0.25; 95% CI: -0.51-0.00; p = 0.05). Low caffeine doses (2.3-3 mg/kg) did not significantly improve basketball-specific skills (i.e., shooting accuracy and dribbling speed), but were associated with enhanced overall performance during real or simulated competition (SMD: 0.25; 95% CI: 0.10-0.40; p < 0.01), alongside increased perceived muscle endurance (SMD: 0.53; 95% CI: 0.12-0.95; p = 0.01) and power (SMD: 1.01; 95% CI: 0.63-1.39; p < 0.01). In basketball, low-dose caffeine primarily enhances general physical rather than isolated technical skills. These findings highlight the importance of dose selection, suggesting that moderate caffeine dosage (>3 mg/kg) may be required to meaningfully influence performance in match-like basketball settings. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251060676, Identifier: CRD420251060676.
Aging clinical and experimental research · 2026
Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease associated with major health complications, including cardiovascular risk. To evaluate the effects of resistance training (RT) combined with protein or carbohydrate supplementation on muscle strength, hypertrophy, and glycemic and lipid profiles in older adults with T2DM. A triple-blind randomized clinical trial was conducted with 60 men with T2DM, allocated into three groups: Protein Group (20 g whey protein), Maltodextrin Group (20 g maltodextrin), and Control Group (colored water). All participants completed a 12-week RT program performed twice weekly. Each session included six exercises, with three sets of 8-12 repetitions, guided by subjective perception of effort. Muscle strength progression was monitored through training loads. Glycemic response, HOMA-IR, and lipid profile were analyzed, while muscle thickness of the biceps brachii and vastus lateralis was measured using ultrasound. The Protein Group showed a significant reduction in HOMA-IR (p = 0.03), indicating improved insulin resistance. Lipid profile variables showed no significant changes across groups. Most exercises demonstrated significant load progression, except rowing and standing curls. Muscle thickness did not show significant differences in either muscle evaluated. RT improved muscle strength regardless of supplementation type but did not produce significant hypertrophy. Protein supplementation significantly reduced HOMA-IR, indicating early improvements in insulin sensitivity, whereas carbohydrate supplementation showed no metabolic effect. Lipid profile parameters remained unchanged, and no significant changes were observed in HbA1c or fasting glycemia.
Nutrition research reviews · 2026
Neuromuscular disorders (NMDs) are a heterogeneous group of conditions characterised by progressive muscle weakness, motor impairment, and risk of malnutrition, affecting the quality of life (QoL) of patients. While pharmacological treatments are essential for the management of symptoms, the role of diet, nutrition, and other lifestyle factors remains underexplored. This narrative systematic review, performed on PubMed, Web of Science, and Scopus following PRISMA guidelines, aimed to investigate the relationship between lifestyle, the progression of NMDs, and the QoL. A total of 30 studies (n = 5055 patients) met inclusion criteria. According to our search strategy, the most representative lifestyle factors were diet (70%), physical activity (53.3%), and emotional perception and care (36.7%); seven papers (23.3%) evaluated three or more lifestyle aspects. Overall, both quantitative and qualitative deficiencies emerged: calories, proteins, lipids, and fibres, as well as vitamin C, vitamin E, zinc, selenium, and calcium, were lower than recommended. A reduced consumption of fruits, vegetables, legumes, nuts, and seeds, replaced by ultra-processed foods, was detected. Diets optimised for calorie and nutrients intake, rich in anti-inflammatory foods, have shown benefits both in mitigating oxidative stress and muscle degeneration. Regarding other aspects of lifestyle, although physical activity was associated with improved motor performance and QoL, adherence was low, particularly among females. Negative emotional status emerged as a critical factor influencing patients’ overall well-being. Even in the most complex neuromuscular disease settings, addressing nutrition and dietary habits, in the context of lifestyle, could support patients and their families throughout the disease course and improve their QoL.
Asian Pacific journal of cancer prevention : APJCP · 2026
To evaluate the efficacy of vitamin B12 (cyanocobalamin) in preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients with gynecological cancer who are receiving neurotoxic chemotherapy. This randomized, double-blind, placebo-controlled study enrolled gynecological cancer patients undergoing chemotherapy at Rajavithi Hospital between January and September 2021. Patients were assigned in a 1:1 ratio to receive either vitamin B12 (500 micrograms) or a placebo, administered as two oral tablets twice daily from the start of chemotherapy until four weeks after completing six cycles. Primary endpoints included the incidence of CIPN, measured by the Patient Neurotoxicity Questionnaire (PNQ) score, and quality of life, assessed by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) at four time points: (i) before the first chemotherapy cycle, (ii) before the third cycle, (iii) before the sixth cycle, and (iv) four weeks after completion. Safety was evaluated by monitoring vitamin B12-related adverse events. Forty patients were randomized into either the vitamin B12 group (n = 20) or the placebo group (n = 20). Chemotherapy regimens included taxane-based combinations with either carboplatin (87.5%) or cisplatin (12.5%). The incidence of CIPN (PNQ score ≥ 4) was significantly lower in the vitamin B12 group than in the placebo group (5% vs. 20%, p = 0.008; OR 0.21, 95% CI: 0.07-0.66). No significant differences in FACT/GOG-Ntx scores or adverse effects were observed (p > 0.05). This study highlights the significant effect of vitamin B12 in reducing the incidence of CIPN among gynecological cancer patients undergoing neurotoxic chemotherapy, with a favorable safety profile. Therefore, vitamin B12 may be recommended as a preventive measure for CIPN in this context.
Ophthalmology. Glaucoma · 2026
The Nicotinamide and Pyruvate in Open-Angle Glaucoma Trial aims to establish whether nicotinamide and pyruvate dietary supplementation provides neuroprotection in eyes with treated open-angle glaucoma (OAG). A prospective, two-site, 21-month, placebo-controlled, double-masked, phase III randomized clinical trial. Open-angle glaucoma patients recruited at Columbia University Irving Medical Center and Stanford University between March 1, 2023, and August 30, 2025. Study participants were randomized in a 1:1 ratio to either active product (3 g/day of nicotinamide and 1 g/day of calcium pyruvate) or placebo. Standard-of-care intraocular pressure-lowering treatment is continued throughout the study and can be modified at the discretion of the treating physician. The primary outcome measure is a composite of functional change based on automated perimetry of the central 10° of the visual field and/or structural change based on spectral-domain OCT. Periodic blood collection allows for evaluation of intervention-related metabolomics, transcriptomics, and proteomics, and measurement of serum levels of nicotinamide and pyruvate. Secondary outcomes include the evaluation of the tolerability and safety of nicotinamide and pyruvate in OAG and the identification of factors that predispose to greater responsiveness to metabolic neuroprotective therapies in OAG. An intention-to-treat analysis will be performed at the conclusion of the trial. This novel trial design may deliver valuable data on the neuroprotective potential of nicotinamide and pyruvate supplementation in glaucoma and improve our understanding of optimal study design for longitudinal randomized clinical trials focused on glaucoma neuroprotection. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
Muscle Stem Cells (MuSCs) drive muscle regeneration and slow pathological progression of muscle diseases. In preclinical models, nicotinamide (NAM) and pyridoxine (PN) synergistically increased MuSC proliferation and differentiation, and accelerated muscle regeneration. Herein we tested if NAM/PN could enhance MuSC activity and muscle regeneration in a randomized, placebo-controlled clinical trial. Men aged 18-49 years were supplemented daily with 714 mg NAM and 19 mg PN, or placebo, for 9 days following one session of damaging unilateral eccentric muscle contractions. The primary endpoint was MuSC activity via immunohistofluorescence on biopsy sections from the vastus lateralis muscle. Histological markers of muscle regeneration constituted secondary outcomes, and muscle damage was validated with clinical markers. 39 out of 43 enrolled participants completed the study. Supplementation of NAM/PN was well tolerated and increased blood concentrations of NAM and PN vitamers. 8 days after the contraction protocol, the number of Pax7, MyoD, and myogenin positive cells per damaged fiber was significantly higher in NAM/PN vs placebo groups (+29%-67%). NAM/PN also increased the proportion of regenerating fibers (+37%). Daily oral NAM/PN supplementation after high intensity muscle contractions enhances MuSC activity and accelerates muscle regeneration and repair, providing new opportunities for therapeutic applications in muscle recovery and muscle wasting disorders.
European thyroid journal · 2026
Radioactive iodine therapy (RIT) is commonly used as an adjuvant treatment for differentiated thyroid cancer (DTC). While its efficacy is well established, this therapy can cause radiation-induced damage to the salivary and lacrimal glands due to their ability to concentrate iodine. These adverse effects may lead to xerostomia, sialadenitis, or xerophthalmia. The aim of this review and meta-analysis was to estimate the prevalence and characteristics of salivary and lacrimal dysfunctions in patients treated with RIT for DTC. Following PRISMA guidelines, a systematic search was conducted in PubMed and Scopus databases to identify studies published between 2000 and 2024. Meta-analyses of prevalence and odds ratios were carried out using random-effects models to estimate the pooled prevalence of events and the influence of administered activity. Thirty-eight studies were included in the review, of which sixteen were retained for the meta-analyses. The pooled prevalence of xerostomia decreased from 60% (95% CI: 0.28-0.85) at <2 months to 17% (95% CI: 0.10-0.28) at more than 1 year post-RIT. A significant association was observed between high levels - with study-specific thresholds - of administered I131 activity and the occurrence of xerostomia. Sialadenitis and lacrimal dysfunctions were also frequently reported. Despite heterogeneity in protocols and assessment tools, most studies highlighted a frequently persistent impairment in many patients. This systematic review and meta-analysis highlighted the frequency and persistence of salivary and lacrimal dysfunctions following RIT.
Medicine · 2026
To prospectively evaluate the effects of rectal cleansing using a povidone-iodine (PI) and PI enhanced rectal enema on procedure-related infectious complications in patients undergoing transrectal prostate biopsy. Between September 2023 and March 2024, patients scheduled for their first transrectal ultrasound-guided prostate biopsy due to elevated prostate-specific antigen levels, suspicious multiparametric prostate magnetic resonance imaging findings, or abnormal digital rectal examination were prospectively randomized into 2 groups (n = 60 each). All patients received standard prophylactic measures, including antibiotic prophylaxis starting 1 day prior to the procedure and rectal mucosal cleansing with PI immediately before biopsy. Both groups additionally underwent rectal enema administration. In the intervention group, a PI enhanced rectal enema was administered by adding PI to the sodium phosphate enema solution, whereas the control group received a sodium phosphate enema alone. Post-procedural complications, including hematuria, hematospermia, rectal bleeding, fever, acute urinary retention, hospitalization, sepsis, and urine and blood culture results, were recorded and compared using chi-square tests. In total of 120 patients were enrolled. The mean age in both groups was 66.6 years (± 7.20). Hospitalization due to febrile urinary tract infection occurred in 6 patients (10%) in the control group versus 2 patients (3.3%) in the study group. Positive urine cultures were found in 6 patients (10%) in the control group, while no positive cultures were detected in the study group, a statistically significant difference (P = .046). No significant differences were observed between the groups in terms of hematuria, hematospermia, rectal bleeding or acute urinary retention. Rectal cleansing with a PI and PI enhanced rectal enema prior to transrectal prostate biopsy significantly reduced the rate of positive urine cultures. Although the reductions in febrile urinary tract infections and sepsis-related hospitalizations were not statistically significant, the overall trend suggests a potential benefit. Given that infectious complications are the most common adverse events associated with transrectal biopsy, this simple and low-cost intervention may improve patient safety.
Scientific reports · 2026
Thalidomide has shown promise as an adjunct therapy for β-thalassaemia, yet its effectiveness and safety are uncertain. This systematic review and meta-analysis evaluate the efficacy and safety of thalidomide in β-thalassaemia; in both transfusion-dependent and non-transfusion-dependent patients. Scopus, PubMed and Cochrane databases were searched for studies assessing the efficacy and safety of thalidomide in β-thalassaemia. Primary outcomes included transfusion response and haemoglobin increases whereas adverse events and effects on serum ferritin and spleen size were secondary outcomes. Study quality, risk of bias and heterogeneity were assessed using standardized tools. Nineteen studies comprising 1731 patients met the eligibility criteria. Thalidomide halved the transfusion requirements in 76% patients with transfusion-dependent β-thalassaemia (response rate of 0.76 [95%CI: 0.67-0.83]) and achieved transfusion independence in 55% (good response rate of 0.55 [95%CI: 0.47-0.63]). In non-transfusion-dependent β-thalassaemia, > 1 g/dl and > 2 g/dL rise in haemoglobin were seen among 91% (response rate- 0.91 [95%CI: 0.81-0.96]) and 76% (good response rate- 0.76 [95%CI: 0.63-0.85]) of patients, respectively. The most frequent adverse effects were constipation (15% [95% CI: 13.7-17.2]) and somnolence (15% [95%CI: 13.6-17.1%]). Thalidomide appears to be effective and tolerable in β-thalassaemia. It reduced the transfusion requirement in transfusion-dependent β-thalassaemia patients and increased the haemoglobin levels in non-transfusion-dependent β-thalassaemia patients.Systematic review registration: CRD42024627095.
Frontiers in nutrition · 2026
This systematic review, conducted under the COST Action CA20218 "Promoting Innovation of fermented foods" (PIMENTO), aimed to evaluate whether sourdough- and regular-bread fermentation improve iron bioavailability, absorption, and status in humans. Screening of PubMed, Scopus, and Cochrane Library (January 1970-December 2024) identified 8 human intervention studies, in healthy or iron-deficient participants, that met inclusion criteria. EFSA's scientific guidance for health claim applications, which integrates product characteristics and mechanisms of action to the human studies, was followed, and the extracted data were narratively presented. Results were inconclusive as acute postprandial studies increased non-haem iron bioavailability (especially in low-phytate breads); for example, low-phytate white bread produced a greater 2 h increase in serum iron than high-phytate wholemeal bread (59 vs. 30 μg Fe/100 mL), while exogenous phytase increased iron absorption by 50% for ferrous sulfate and 61% for iron bis-glycine chelate. However, long-term trials did not improve, and in one case even decreased, ferritin and total body iron; specifically, in the low-phytate sourdough rye bread group, ferritin declined from 32 ± 7 to 27 ± 6 μg/L and total body iron from 6.9 ± 1.4 to 5.4 ± 1.1 mg/kg over 12 weeks. On the other hand, phytate reduction combined with iron fortification showed positive effects on haemoglobin or prevented iron depletion; in anaemic children, fermented amaranth bread increased haemoglobin [adjusted β = 8.9 g/L (95% CI: 3.5-14.3)] and reduced anaemia prevalence (32% vs. 56%) compared to control bread. Despite convincing mechanistic evidence that the sourdough-fermentation process in bread fabrication improves iron bioavailability, through reduction of phytate, no human studies address this research question with the appropriate control and study quality. osf.io/gzt8m.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
No specific therapy is approved for human T-cell lymphotropic virus type 1 (HTLV-1) infection. We tested the effect of dolutegravir (DTG) on clinical outcomes and on HTLV-1 proviral load (PVL) in adults with HTLV-1 infection. We conducted an open-label, randomized controlled phase 2 trial in Salvador, Brazil. Symptomatic adults with HTLV-1 infection were randomized 1:1 to DTG 50 mg once daily or vitamin C (VTC) 500 mg once daily for 48 weeks. We evaluated changes in gait performance (timed 10-meter walk test [T10MWT]). Key secondary endpoints included change in PVL and prespecified neurofunctional and urinary outcomes. Primary analyses emphasized intragroup and between-group comparisons; exploratory per-protocol analyses were performed for neurofunctional measures. Asymptomatic participants were included for PVL and immunological evaluations. Eighty-three participants (53 symptomatic) were randomized (DTG, n = 43; VTC, n = 40). At week 48, there was no between-group difference in T10MWT. However, DTG use significantly reduced PVL over 48 weeks compared with VTC (P < .001). Exploratory per-protocol analyses found significant improvements associated with DTG use in lower limb spasticity (P < .001), sensory function (light touch, P = .035; pinprick, P = .001), and median nocturia frequency (P = .012). Network analysis of cytokine expression showed a change in the DTG group from baseline to week 48, with loss of negative correlations and a more balanced pattern. DTG was well tolerated, with no unexpected safety signals. In this pilot randomized trial, DTG use was associated with significantly reduced PVL and improvement in neurofunctional and immunological characteristics of participants in exploratory analyses. These findings provide evidence supporting the use of integrase inhibitors for HTLV-1 infection. Clinical Trials Registration. Brazilian Clinical Trial Register (ReBEC), code RBR-5x7ccxp.