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Nieuwe meta-analyses, RCTs en systematic reviews die wij dagelijks monitoren in PubMed. Onafhankelijk geïndexeerd, niet redactioneel bewerkt.
Nutrients · 2026
Iodine deficiency during pregnancy remains a leading cause of preventable neurodevelopmental impairment worldwide, yet quantitative characterization of the dose-response relationship between maternal iodine status and child neurodevelopment is lacking. A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted for prospective cohort studies published up to February 2026 reporting associations between maternal iodine status and child neurodevelopmental outcomes across at least three exposure categories. All continuous effect estimates were converted to standardized mean differences (Hedges' g) to permit pooling across heterogeneous assessment instruments, and meta-analyses were stratified by neurodevelopmental domain (cognitive, language, motor, behavior, academic). A two-stage dose-response meta-analysis was used to characterize non-linearity. Risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS). Ten prospective cohort publications corresponding to eight independent cohorts were included. After converting all continuous effect estimates to standardized mean differences (Hedges' g) and consolidating the three overlapping MoBa publications into a single cohort, the pooled analysis revealed a significant negative association between suboptimal maternal iodine status and child neurodevelopmental performance (Hedges' g = -0.13, 95% CI: -0.20 to -0.06, p < 0.001; I2 = 95.2%). Domain-stratified analysis identified cognitive outcomes as most consistently affected (g = -0.22, 95% CI: -0.30 to -0.14; I2 = 37.5%), followed by motor (g = -0.17; I2 = 0%) and language outcomes (g = -0.16; I2 = 92.5%), with between-domain heterogeneity explaining 38.6% of the total variance (p = 0.012). Binary outcome analysis confirmed increased odds of adverse neurodevelopmental outcomes (OR = 1.19, 95% CI: 1.03 to 1.39, p = 0.026). Subgroup analysis by iodine exposure indicator showed directionally consistent negative effects across dietary intake (g = -0.11), UIC (g = -0.11) and UI/Cr (g = -0.28), with no significant between-subgroup difference (p = 0.237). Exploratory dose-response modeling on the Hedges' g scale suggested that neurodevelopmental performance in the fitted curves approached its maximum within a mid-range of dietary iodine intake (approximately 150-300 µg/d); however, the quadratic non-linearity terms did not reach statistical significance after cohort consolidation (p = 0.612 for dietary intake; p = 0.436 for UI/Cr), and these findings should therefore be interpreted as exploratory. Suboptimal maternal iodine status during pregnancy was associated with modest decrements in child neurodevelopmental performance, with exploratory dose-response analyses suggesting that the fitted curves approached their maximum within a mid-range of dietary iodine intake. Although statistical evidence for quadratic non-linearity was attenuated after consolidating overlapping cohorts, the directional pattern across indicators remained consistent with an inverted U-shaped relationship, supporting maintenance of adequate but not excessive iodine nutrition during pregnancy.
Clinical oral investigations · 2026
This systematic review aims to assess the efficacy of chemical agents (CA) in subgingival irrigation as an adjunct to non-surgical periodontal treatment (NSPT) in the treatment of periodontitis. Search strategies were developed for MEDLINE via PubMed, Web of Science, and LILACS databases for publications up to March 2025. Risk of bias was assessed according to the RoB 2.0 tool. Random-effects meta-analyses were conducted for clinical attachment level (CAL), probing pocket depth (PPD), and bleeding on probing (BOP). From 1244 studies initially screened, 16 randomized clinical trials were included for qualitative and quantitative analyses. Studies assessed the effects of the following chemical agents: Povidone-iodine (PVP-I), Essential Oils (EOs); Chlorhexidine (CHX), Ozonated water (OW) and Boric Acid (BA). Overall, the meta-analysis showed that the adjunctive use of CA as subgingival irrigation did not provide additional benefit in PPD reduction, CAL gain, and BOP compared with controls (P > 0.05). Most studies raised some concerns with risk of bias, and 2 showed a high risk of bias. Adjunctive use of chemical agents in subgingival irrigation during NSPT for periodontitis patients does not appear to provide additional benefit over NSPT alone, although evidence levels are low to very low. CA are frequently used as adjuncts to NSPT, despite uncertainty regarding their real clinical contribution. The findings of this study help clinicians make more evidence-based decisions and avoid unnecessary use of adjunctive subgingival irrigation strategies during periodontal treatment.
International orthopaedics · 2026
To compare platelet-rich plasma (PRP) with hyaluronic acid (HA), corticosteroid (CS), or saline placebo (NS) for symptomatic knee osteoarthritis (OA) and to assess whether total blood-draw volume, a proxy for platelet dose, is associated with treatment effect. Following PRISMA, randomized controlled trials comparing intra-articular PRP with HA, CS, or NS were identified. Random-effects meta-analyses estimated mean differences (MDs) in pain (VAS) and function (WOMAC) at six and twelve months. Risk of bias was assessed with RoB 2.0 and certainty of evidence with GRADE. Subgroup analyses stratified PRP vs HA trials by total blood draw volume (< 40 mL vs ≥ 40 mL). Sixty-two trials (n = 4,969) were included. PRP improved VAS and WOMAC versus HA, CS, and NS at six months and remained superior versus HA and CS at twelve months (insufficient studies for twelve-month PRP vs NS). In PRP vs HA trials, blood draw volume ≥ 40 mL was associated with larger improvements in six-month WOMAC (P = 0.004) and twelve-month VAS (P = 0.029). Heterogeneity was substantial (I2 > 90% for most analyses), and evidence certainty ranged from moderate to very low. PRP provides superior patient-reported pain and function outcomes compared with HA, CS, and NS through six months, with benefits maintained to twelve months versus HA and CS in longer-term trials. Blood-draw volume may be a useful alternate when platelet dose is unreported.
European journal of obstetrics, gynecology, and reproductive biology · 2026
To study the effect of intrauterine instillation of Hyaluronan enriched media on reproductive outcomes of intrauterine insemination treatment. 100 couples with unexplained infertility were approached and were randomly allocated to the intervention and control arm with 1:1 allocation over 2 years of duration. The study participants received controlled ovarian stimulation and intrauterine insemination. Additionally, the intervention group, received intrauterine administration of Hyaluronan enriched media. The intervention group and control group was compared for clinical pregnancy, live birth and miscarriages using the SPSS statistical package (version 23.0). The study observed a trend of improved cumulative biochemical pregnancy rates (33.3% Vs 15.5%, RR 2.14, 95% CI 0.96-4.75, p = 0.061) and clinical pregnancy rates (31.1% Vs 15.5%, RR 2.00, 95% CI 0.89-4.48, p = 0.093) in the intervention group, which however did not reach statistical significance. The cumulative live birth occurrence was statistically significantly better in the intervention arm (28.9% vs 11.1%). RR 2.60, 95% CI 1.01-6.89, p = 0.047) of the trial. Similar miscarriage rates were observed in both arms of the trial (4.4% Vs 4.4%, RR 1.0, 95% CI 0.15-6.79, p = 1.00). The intrauterine insemination instillation of hyaluronan enriched media was well tolerated by participants in the intervention arm. The study suggests a potential benefit of use of hyaluronan enriched media as a novel minimally invasive add-on intervention to facilitate the enhancement of success rates of IUI treatment.
International journal of pharmaceutics · 2026
Atherosclerosis (AS), a chronic inflammatory disease characterized by lipid deposition in the arterial wall, serves as the primary pathological basis for cardiovascular diseases that contribute significantly to global morbidity and mortality. Recent advances in nanotechnology have enabled the design of smart nanoparticles for theranostic applications in AS. In particular, stimuli-responsive nanoparticles that react to endogenous cues, such as reactive oxygen species, pH, lipid, and enzymes within the AS microenvironment, have demonstrated considerable promise for targeted diagnosis and therapy. Likewise, nanoparticles engineered to respond to external stimuli, including ultrasound, light, and temperature, offer additional avenues for precise AS theranostics. These intelligent nanoparticles allow for targeted accumulation and controlled drug release specifically at atherosclerotic sites, thereby enhancing drug-loading capacity and delivery precision while reducing off-target effects and systemic toxicity. This review systematically outlines the research progress made over the past decade in the development of stimuli-responsive nanoparticles for AS theranostics, with special emphasis on their stimulus-triggered disassembly and degradation mechanisms. Finally, we provide an overview of the challenges and opportunities of applying these smart stimuli-responsive nanoparticles.
Frontiers in medicine · 2026
Knee osteoarthritis is a leading cause of chronic pain, functional limitation, and disability worldwide, imposing a substantial socioeconomic burden. Despite advances in conservative management and intra-articular therapies, many patients experience limited or transient symptomatic relief, underscoring the need for biologically based interventions. Intra-articular adipose-derived cell therapies, including adipose-derived mesenchymal stem or stromal cells (ADSCs), stromal vascular fraction (SVF), and microfragmented adipose tissue (MFAT), have emerged as regenerative strategies aimed at modulating inflammation and joint homeostasis. This systematic review evaluated the efficacy, structural effects, and safety of intra-articular adipose-derived cell-based therapies for knee osteoarthritis in adults. Randomized controlled trials published between 2015 and 2025 were identified through systematic searches of PubMed, Embase, Scopus, and Web of Science. Eligible studies compared ADSCs, SVF, or MFAT with placebo, hyaluronic acid, platelet-rich plasma, corticosteroids, or conservative care, and reported outcomes on pain, function, imaging-based structural changes, and safety. Nineteen randomized controlled trials met inclusion criteria. Across studies, adipose-derived interventions, particularly ADSC-based therapies, produced clinically meaningful reductions in pain and improvements in functional outcomes assessed by WOMAC, KOOS, and visual analog scales. Several ADSC and SVF trials reported favorable magnetic resonance imaging findings, including improvements in cartilage quality, although consistent cartilage regeneration was not demonstrated. MFAT trials yielded heterogeneous results, often showing symptomatic benefits comparable to established injective therapies but limited structural effects. No serious treatment-related adverse events were reported. Intra-articular adipose-derived cell therapies are safe and provide meaningful pain relief and functional improvement in selected patients, with ADSCs showing the most consistent clinical signals. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251241498, Identifier: CRD420251241498.
Journal of cosmetic dermatology · 2026
The interdental papilla plays a vital role in dental and facial aesthetics, as the loss of papilla manifests as unesthetic "black triangles". In recent years, non-surgical approaches such as hyaluronic acid injections, autologous platelet concentrates, laser therapy, and microneedling with vitamin C have emerged as alternatives to technically demanding and unpredictable surgical reconstruction. To evaluate the effectiveness, patient satisfaction, and safety of cosmetic non-surgical treatment modalities for the correction of black triangles. A comprehensive literature search was conducted using the PubMed, Cochrane Library, Scopus, and Embase databases, from January 2013 to January 2024. All case series, cohort studies, and randomized controlled trials with relevant outcomes were included. The BestBETs methodology was used, and the risk of bias was assessed using the "Quality Assessment Tool for Quantitative Studies." A total of 19 human studies met the inclusion criteria. Of these, six studies were classified as level II evidence, while the remaining 13 were categorized as level III or level IV evidence. Based on level II evidence, hyaluronic acid injections were effective and safe for correcting the black triangles and improving the smile. Evidence on non-surgical modalities such as autologous platelet concentrates, photobiomodulation therapy, and microneedling with vitamin C remains limited. Based on level II to level IV evidence, these conservative treatments are recommended as clinically effective for filling black triangle spaces, demonstrating high patient satisfaction and minimal adverse events. Non-surgical cosmetic treatments offer a promising alternative for reconstructing interdental papilla deficiencies, with benefits including reduced complications and favorable aesthetic outcomes. However, the current evidence remains limited, and findings should be interpreted with caution. Further well-designed, standardized clinical trials are required to establish the effectiveness, long-term stability, and patient-centred outcomes of these interventions.
International ophthalmology · 2026
To assess efficacy of 0.1% sodium hyaluronate on femtosecond laser scanning during small incision lenticule extraction (SMILE). A prospective randomized clinical trial was conducted involving 100 patients (200 eyes) who were prepared to undergo binocular SMILE. The two eyes of each participant were randomly assigned to either the 0.1% sodium hyaluronate eye drop group (HA group) or the no 0.1% sodium hyaluronate eye drop group (NHA group). Prior to the laser scan of SMILE, the HA group received an application of 0.1% sodium hyaluronate to the eye immediately. The NHA group did not receive 0.1% sodium hyaluronate. The number of intraoperative cases of black area and opaque bubble layer (OBL) and the lenticule separation time were recorded. Then, the Strehl Ratio (SR) was used to evaluate postoperative optical quality. The incidence of OBL and black area in HA group and NHA group was no statistical significance. The lenticule separation time of the HA group was significantly shorter than that of the NHA group (Z =  - 5.940, P < 0.01). The SR values of the HA group and the NHA group were as following 0.3608 (0.2879, 0.4359) and 0.3079 (0.2537, 0.3820) one month after SMILE, with significant difference between the two groups (Z =  - 3.163, P < 0.01). No additional complications were reported in any of the patients. The immediate application of 0.1% sodium hyaluronate during femtosecond laser scanning in SMILE may contribute to more favorable conditions for femtosecond laser scanning, facilitate lenticule separation, and is associated with better postoperative optical quality, as indicated by higher SR values at one month.
Journal of rehabilitation medicine · 2026
To compare the efficacy and safety of ultrasound-guided intra-articular hyaluronic acid injection versus supervised rehabilitation in patients with frozen-phase adhesive capsulitis. Single-center, parallel-group, randomized controlled trial with 26-week follow-up. Forty-six adults aged 40-70 years with clinically and radiologically confirmed frozen-phase adhesive capsulitis. Participants were randomly assigned to receive either three weekly ultrasound-guided intra-articular hyaluronic acid injections or supervised physical therapy twice weekly for six weeks. Outcomes assessed at baseline and at weeks 4, 6, 8, and 26 included the Shoulder Pain and Disability Index (SPADI) and shoulder range of motion. Both groups achieved significant within-group improvements in SPADI and range of motion over 26 weeks (all p < 0.01 vs. baseline). No statistically significant between-group differences were observed in total SPADI or its pain and disability subscales at any follow-up time point (all p > 0.05). At week 26, the hyaluronic acid group's mean total SPADI decreased from 43.0 ± 17.7 to 16.1 ± 12.8 (p < 0.01), while the rehabilitation group improved from 52.0 ± 18.4 to 23.2 ± 21.8 (p < 0.01). Pain subscores were reduced by 64.3% (hyaluronic acid) and 56.1% (rehabilitation); function subscores decreased by 60.9% and 54.8%, respectively (all p < 0.01). Both groups showed significant gains in active and passive flexion, abduction, and external rotation, without significant between-group differences (all p > 0.05). No treatment-related adverse events were observed. Ultrasound-guided hyaluronic acid injection and supervised rehabilitation produced comparable and clinically meaningful improvements in pain, function, and shoulder mobility in frozen-phase adhesive capsulitis.
Oral and maxillofacial surgery · 2026
This study aimed to evaluate whether adjunctive low-level laser therapy (LLLT) provides additional clinical benefit over an optimized arthrocentesis protocol with hyaluronic acid in patients with ADDwoR. From December 2022 to December 2023, a single-blinded prospective randomized clinical trial was conducted at The British University in Egypt's Department of Oral and Maxillofacial Surgery. The study involved 40 female participants diagnosed with Anterior Disc Displacement without Reduction (ADDwoR). Following TMJ arthrocentesis, subjects were assigned to one of two parallel cohorts: Group A received ten subsequent sessions of low-level laser therapy (LLLT), while Group B served as the control, receiving arthrocentesis alone. Treatment efficacy was evaluated based on pain intensity measured via a Visual Analogue Scale (VAS) and maximum mouth opening (MMO). Clinical assessments were performed at 2-week intervals over a 12-week follow-up period. No significant age-related differences were detected when comparing the intervention group to the control group (p = 0.087). No significant intergroup differences were observed in maximum mouth opening (MMO) or pain scores (VAS) at any follow-up time point (p > 0.05). Over the 12-week period, both study arms demonstrated significant clinical enhancement in terms of MMO and pain intensity (p < 0.001). Improvements in MMO were large in both groups, with postoperative values significantly higher than preoperative measurements. Pain scores decreased markedly following treatment, with preoperative scores significantly higher than all postoperative values. Overall, both interventions resulted in significant functional improvement and pain reduction, with no added benefit of the intervention over the control. While both TMJ arthrocentesis alone and arthrocentesis supplemented with LLLT significantly improved maximum mouth opening and reduced pain, LLLT did not provide a significant incremental benefit over arthrocentesis with hyaluronic acid. These findings suggest that clinical improvements are primarily driven by the main intervention and may reflect a possible therapeutic ceiling effect, beyond which adjunctive LLLT does not confer measurable short-term benefit. Not applicable.
Journal of ethnopharmacology · 2026
Ginkgo biloba L., a 'living fossil' with an evolutionary history spanning over 200 million years, occupies a prominent place in traditional medicine systems. Historical records, including the Chinese pharmacopoeia Ben Cao Gang Mu, document its use for treating various ailments related to the respiratory, circulatory, and cognitive systems. Modern pharmacological research has validated these traditional applications, identifying Ginkgo biloba extract (GBE) as a valuable phytomedicine for neurodegenerative, cardiovascular, and metabolic diseases. This comprehensive review aims to synthesize recent advances in GBE research, with a primary focus on literature from the past three years in GBE research, critically evaluating four key areas: 1) innovations in green extraction and purification technologies; 2) novel organelle-level mechanisms of action; 3) the development and application of nano-delivery systems for targeted therapy; and 4) clinical evidence and toxicological studies supporting GBE's therapeutic use and safety profile. This holistic review was conducted through a systematic literature search (covering 2003.8.15-2026.2.22) in databases including PubMed, Web of Science, and Scopus, using keywords related to GBE's extraction technologies, nano-delivery systems, organelle-level mechanisms, and clinical applications. The retrieved literature was screened and critically evaluated to synthesize recent advances, with a focus on identifying emerging trends, convergent evidence, and knowledge gaps across the four key areas outlined in the review's aim. Significant improvements in the sustainability and efficiency of GBE extraction have been achieved through recent technological innovations. (Deep Eutectic Solvent) DESs have emerged as tunable platforms for the selective and efficient extraction of bioactive compounds, while physical field-assisted methods enhance yields. Mechanistic studies reveal that GBE orchestrates cellular homeostasis by synchronously modulating mitochondrial bioenergetics, endoplasmic reticulum stress, and autophagic-lysosomal activity. Nano-delivery systems, such as liposomal nanoparticles and chitosan-coated carriers, effectively enhance the bioavailability and targeting precision of GBE's bioactive components, including quercetin. Clinically, standardized formulations like Ginkgo Diterpene Lactone Meglumine Injection (GDLI) show promise in improving cognitive outcomes in ischemic stroke and Alzheimer's disease, and in managing cardiovascular diseases. However, potential toxic side effects, primarily from ginkgolic acids (GA) and 4'-O-methylpyridoxine (MPN), necessitate rigorous quality control, with advanced methods like enzymatic degradation being developed for detoxification. GBE represents a promising, multifaceted therapeutic agent that effectively bridges traditional medicine and modern scientific innovation. Its broad-spectrum efficacy stems from the synergistic interactions of its bioactive constituents and their system-level regulatory mechanisms. To fully harness GBE's potential as a precision therapeutic agent, future research should focus on a coordinated technological strategy: employing green extraction methods such as DES to ensure sustainable and efficient compound isolation; developing standardized nano-formulations to overcome key pharmacokinetic limitations like low bioavailability and poor targeting; and applying multi-omics approaches to elucidate its organelle-level mechanisms of action. Validating these integrated innovations in large-scale clinical trials will be essential. Ultimately, the convergence of green chemistry, nanomedicine, and systems biology is key to translating GBE's multifaceted bioactivity into targeted and reliable clinical therapies.
Pharmacology · 2026
Previous studies have explored the effect of Ginkgo biloba extract (Gbe) on hyperlipidemia; however, the results were inconclusive. We aimed to assess the efficacy and safety of Gbe on hyperlipidemia. Pubmed, Wanfang, China National Knowledge Infrastructure (CNKI) were searched until Dec 31, 2024. Mean difference was pooled using random-effects models. Ten randomised controlled trials were included in our study. Compared with proprietary Chinese medicine, the effect of Gbe on hyperlipidemia was not statistically significant, including total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL). Compared with western medicine, the effect of Gbe on HDL was statistically significant (MD = 0.14, 95% CI= 0.01, 0.28, I2 = 81.06%, P = 0.017), not on TC, TG and LDL. In the age-specific analysis, we found that the effect of Gbe on TC was statistically significant among 50-60 age group (MD = -0.43, 95% CI= -0.85, -0.01, I2 = 83.76%, P = 0.042). Notably, among participants aged ≤50 years, TG reduction is greater in the control group than in the Gbe group (MD = 0.12, 95% CI= 0.03, 0.21, I2 = 0.00%, P = 0.012). In the dose-specific analysis, the medium dose group of Gbe had a more significant reduction on TC and TG (TC: MD=-0.69, 95% CI=-1.02, -0.37, I2 = 51.3%, P < 0.001; TG: MD = -0.34, 95% CI = -0.53, -0.15, I2 = 0.00%, P = 0.001). Gbe demonstrates a greater therapeutic effect on HDL compared with Western medicine and shows non-inferiority to proprietary Chinese medicine in improving HDL levels. Gbe shows a significant therapeutic effect on TC levels among individuals aged 50-60 years and in the medium-dose group.
The American journal of clinical nutrition · 2026
Muscle disuse leads to muscle atrophy that has been attributed to declines in basal and postprandial muscle protein synthesis (MPS) rates. Leucine regulates MPS and may attenuate disuse-induced declines in MPS rates and muscle mass. The purpose of this study was to evaluate the capacity of leucine supplementation to attenuate disuse-induced declines in MPS rates and muscle mass in young and older adults. In a randomized, double-blind, parallel-group design, 24 young (23 ± 4 y) and 24 older (69 ± 4 y) recreationally active adults (equal sex distribution) underwent 3 d of unilateral knee immobilization (leg casting) and received a leucine [group of adult study participants who supplemented with 5 g of leucine 3 × daily with each main meal during 3 d of unilateral knee immobilization by means of a full leg cast (LEU)] or energy-matched carbohydrate [group of adult study participants who supplemented with 5 g of carbohydrate 3 × daily with each main meal during 3 d of unilateral knee immobilization by means of a full leg cast (PLA)] supplement. Preimmobilization and postimmobilization, quadriceps muscle cross-sectional area (CSA) was assessed in the immobilized (IM) and nonimmobilized (NO-IM) leg by computed tomography. MPS rates were assessed in both legs during immobilization via 2H2O coupled with saliva, blood, and muscle biopsy sampling. In young and older adults, MPS rates were ∼15% and ∼23% lower in the IM compared with NO-IM leg (1.28 ± 0.29 compared with 1.50 ± 0.26 and 1.10 ± 0.16 compared with 1.46 ± 0.28%/d, respectively; leg: both P < 0.001), with no differences between LEU compared with PLA treatments (treatment: P = 0.932 and P = 0.742, respectively). CSA decreased by ∼1.2% and ∼1.1% in the IM leg in young and older adults (from 7162 ± 1148 to 7076 ± 1129 mm2 and from 5813 ± 1092 to 5750 ± 1096 mm2, respectively; leg × time interaction: both P < 0.001), with no differences between LEU compared with PLA (treatment: P = 0.374 and P = 0.998). IM leg MPS rates were lower in older compared with young adults [difference: -0.18 (95% confidence interval: -0.31, -0.04) %/d; P = 0.013]. No differences were observed in the absolute (mm2) or relative (%) decline in CSA between young and older adults (both P > 0.05). Leucine supplementation does not attenuate the decline in daily MPS rates or muscle mass during short-term limb immobilization in young or older adults. Clinical Trial Register No. (Netherlands Trial Register): NL-OMON45771.
Nutrients · 2026
Our objective was to evaluate the acute effect of L-leucine supplementation and high-intensity sprint exercise on appetite-controlling neuropeptides and their association with the subjective perception of appetite (SPA), satiety (SPS), food intake, and inflammatory response in overweight participants. In a double-masked, randomized, counterbalanced, and crossover design, 12 sedentary overweight adult men performed four experiments: (1) exercise and L-leucine (EX-Leu), (2) exercise and placebo (EX-PLA), (3) L-leucine without exercise (SED-Leu), and (4) placebo without exercise (SED-PLA). The supplementation consisted of three daily doses of 70 mg/kg body weight of L-leucine or placebo (on the day of exercise and one day after). During the experiments, we recorded the food intake, SPA, and SPS, and evaluated the neuropeptides (GLP-1, PYY, CCK, and ghrelin) and cytokines (IL1-beta, IL-6, IL-10, and TNF-α) in peripheral blood. The acute exercise trial consisted of four sets of 30 sec cycle ergometer sprint exercises. EX-Leu, EX-PLA, and SED-Leu decreased SPA, compared to SED-PLA; only EX-PLA improved SPS; EX-PLA and EX-Leu reduced food intake. GLP-1 decreased in the EX-PLA trial compared to SED-Leu. IL-6 and IL1-β levels increased in the EX-Leu trial compared to SED-PLA. An anti-inflammatory profile was identified in the EX-PLA trial compared to the other trials. Both neuropeptides (increased) and cytokines (a pro-inflammatory profile) were associated with changes in SPA, SPS, and food intake. The acute inflammatory balance induced by EX-Leu seems to improve appetite control. Sprint exercise had a consistent acute anorexic effect, while isolated L-leucine decreased SPA, but their impact on SPS and food intake is not clear (FAPESP grants: 2020/09936-2 and 2021/03601-1).
Journal of pineal research · 2026
Preterm birth is associated with increased oxidative stress and brain dysmaturation, contributing to adverse neurodevelopmental outcomes. Preterm infants are physiologically unable to produce melatonin during early postnatal life, potentially increasing their vulnerability to oxidative injury. We planned and conducted a prospective, multicentre, randomized, double-blind, placebo-controlled study to investigate whether 15 days of early oral melatonin (ME) supplementation after birth increases ME levels and reduces oxidative stress in preterm newborns at the end of administration period. The level of malondialdehyde (MDA), a lipid peroxidation product, was considered an early biological marker of the efficacy of ME treatment. The results of the first phase of the study are already available to view on Journal of Pineal Research. Here, we presented the results of the second phase of the trial, in which we investigated whether early oral ME supplementation supports clinical outcomes and brain maturation at term-equivalent age (TEA) in 54 infants with a gestational age of ≤ 29 weeks + 6 days, who received either oral ME or a placebo (PL) for 15 days after birth. No significant differences were observed between groups in the incidence of major neonatal comorbidities in particular patent ductus arteriosus (PDA), sepsis, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP). Cranial ultrasound findings and clinical assessments using General Movements (GMs), the Neonatal Neurobehavioral Scale (NNNS), and the NAVEG scale showed comparable results. On the other hand, magnetic resonance imaging (MRI) revealed a significantly higher total brain maturity score in ME-treated infants compared with the PL group (46 vs. 43; p = 0.011), with in particular more advanced white matter and subplate compartment maturation. Quantitative MRI analysis demonstrated significantly higher T1-weighted/T2-weighted signal ratio values in major white matter tracts, including the pyramidal tract, consistent with enhanced myelination. Additionally, we observed a positive trend in the association between reduced serum MDA levels-reflecting lower lipid peroxidation-at the end of ME administration and higher T1-weighted/T2-weighted ratio values in the pyramidal bundles in subjects at TEA. These findings suggest that early oral melatonin supplementation supports cerebral white matter maturation in preterm infants, potentially through antioxidant mechanisms. Melatonin may represent a promising adjunctive strategy to mitigate oxidative stress-related brain dysmaturation in this vulnerable population, warranting further investigation in larger trials. Trial Registration: ClinicalTrials.gov Registration Number: NCT04235673; Web link to study on registry: https://clinicaltrials.gov/study/NCT04235673.
Revista da Associacao Medica Brasileira (1992) · 2026
The aim of this study was to determine the effects of transdermal melatonin patches on sleep quality in patients undergoing urological surgery. This study is a randomized controlled trial. Fifty-seven patients hospitalized in the urology department of a university hospital in Istanbul were included. Patients were randomly assigned to two groups (melatonin and control). Patients in the melatonin group received transdermal melatonin containing 7 mg of melatonin at 11:00 PM in a quiet, darkened room the night before surgery. According to the results of this study, Richards-Campbell Sleep Scale sleep-quality scores increased significantly in the melatonin group (p<0.001). The control group showed lower sleep-quality scores. In addition, a statistically significant decrease was observed between the visual analog scale well-being scores before and after the application in the melatonin group (p<0.001). In this study, our results showed that melatonin patches improved sleep quality and psychological well-being in patients undergoing urological surgery.
Frontiers in medicine · 2026
In recent years, the application of dietary supplements in the treatment of ulcerative colitis (UC) has attracted more and more scholars' attention, and a number of studies have shown that dietary supplements have a non-negligible role in improving the clinical symptoms and quality of life of UC patients. This article aims to compare the efficacy and safety of dietary supplement therapy of UC through a comprehensive network meta-analysis method. A comprehensive literature search was conducted in multiple databases, including PubMed, the Cochrane Library, Embase, and Web of science, from their inception up to 30 October 2025. Network and routine meta-analyses using the mvmeta package in Stata 16.0 and Stata 12.0 software, and literature quality and risk of bias assessed using RevMan 5.3 software. A total of 24 randomized controlled trials were conducted with 1,491 participants and 14 dietary supplements. The results showed that probiotics [MD = -1.64, 95% CI (-2.91 to -0.38)] and selenium [MD = -2.43, 95% CI (-4.85 to -0.01)] had significant advantages compared with conventional medical treatment or placebo in reducing clinical activity index. Flaxseed extract [MD = -1.53, 95% CI (-2.82 to -0.24)] and vitamin A [MD = -1.93, 95% CI (-3.82 to -0.04)] had a clear advantage over conventional medical treatment or placebo in reducing the Mayo score; at the same time, in terms of IBDQ, probiotics [MD = 7.78, 95% CI (1.39 to 14.17)], flaxseed extract [MD = 8.58, 95% CI (2.31 to 14.85)], resveratrol [MD = 9.18, 95% CI (2.45 to 15.91)], curcumin [MD = 25.80, 95% CI (2.00 to 49.60)], butyrate [MD = 20.50, 95% CI (9.80, 31.20)] with higher scores compared to conventional drugs or placebo, indicating an improved quality of life for patients; synbiotics [MD = -0.69, 95% CI (-1.16 to -0.23)], flaxseed extract [MD = -0.8, 95% CI (-1.16 to -0.44)], and Achillea wilhelmsii [MD = -2.95, 95% CI (-3.52 to -2.38)] all showed significant advantages compared with conventional medical therapy or placebo for reducing C-reactive protein levels. Various dietary supplements have shown differentiated efficacy in adjuvant UC therapy. Probiotics and selenium are effective in improving clinical symptoms; flaxseed extract showed consistent benefits in improving Mayo score, IBDQ score, and reducing CRP, ESR, and FCAL, and had a wide range of application prospects. Butyrate and curcumin have significant effects in improving quality of life; synbiotics and Achillea wilhelmsii have outstanding advantages in reducing CRP. Due to the limitations of the number and quality of included studies, the above conclusions still need to be validated by more high-quality, large-sample RCTs.
Molecules (Basel, Switzerland) · 2026
Hydrophobic bioactive compounds, such as curcuminoids, β-carotene and long-chain lipids, as well as amphiphilic structural lipids (milk fat globule membrane (MFGM)-associated phospholipids), often exhibit low bioaccessibility due to poor aqueous solubility and/or susceptibility to degradation, which limits their effective use in functional foods. Buttermilk, a dairy byproduct enriched with proteins, lipids and MFGM components, provides a structurally complex, amphiphilic matrix that can enhance micellar solubilization, protect hydrophobic and amphiphilic compounds during digestion and thereby modulate their potential bioavailability. This systematic review and meta-analysis, conducted and reported in accordance with the PRISMA 2020 guidelines, synthesizes quantitative data from in vitro gastrointestinal digestion studies to evaluate the impact of buttermilk and related matrices (e.g., buttermilk yogurt, ultrafiltered buttermilk, and composite nanosystems) on the bioaccessibility of hydrophobic compounds and MFGM phospholipids compared with aqueous or non-buttermilk controls. We identified a limited but growing body of in vitro evidence indicating that buttermilk-based matrices generally increase the intestinal bioaccessibility of curcuminoids, β-carotene, omega-3 fatty acids, vitamin and MFGM phospholipids relative to non-buttermilk systems, with particularly pronounced effects in structured emulsions, yogurts, ultrafiltered buttermilk and MFGM-enriched nanosystems. Rather than a single effect size, the data point to a compound- and matrix-dependent spectrum of improvements, influenced by both the chemical nature of the bioactive and the supramolecular organization of the dairy matrix. Mechanistically, the available findings support a plausible hypothesis that buttermilk enhances bioaccessibility via MFGM-mediated micellar solubilization, interfacial protection against pH- and enzyme-driven degradation and favorable lipid partitioning, although these pathways remain to be confirmed in dedicated mechanistic and in vivo studies. Methodological heterogeneity and the exclusive reliance on in vitro models are important limitations, but overall, the synthesis supports buttermilk and MFGM-rich ingredients as sustainable, food-grade carriers for lipophilic nutraceuticals and highlights the importance of dairy matrix structure in the design of functional delivery systems.
Neuroscience and biobehavioral reviews · 2026
Posttraumatic stress disorder (PTSD) is a severe mental health condition that can arise following exposure to a traumatic event. The identification of biomarkers using imaging techniques, such as positron emission tomography (PET) scans, offers an alternative to increasingly complex diagnostic approaches. This systematic review aims to assess and summarise the evidence for molecular biomarkers in PTSD. Studies published before June 2025 that examined brain changes using PET imaging in adult PTSD patients, were identified from three electronic databases. Inclusion criteria included original human studies, a PTSD diagnosis, and inclusion of healthy controls (not exposed to trauma) and/or trauma-exposed controls who did not develop PTSD. Studies with incomplete reporting, non-English publications, and those lacking control groups were excluded. The risk of bias was assessed using the Newcastle-Ottawa Scale. After screening the 1102 retrieved articles, 20 met the inclusion criteria. These involved 483 patients and 522 controls, including 426 healthy controls and 96 trauma-exposed controls. PTSD was associated with increased glucose metabolism in the amygdala and dorsal anterior cingulate cortex, alongside hypometabolism of the hippocampus and precuneus. Alterations in neurotransmitter systems, stress and inflammation systems, as well as elevated amyloid-beta accumulation, were also observed in PTSD. This review highlights converging neurobiological alterations in PTSD, including changes in metabolism, neurotransmission, and inflammation. These alterations predominantly involve large-scale brain networks such as the salience network, default mode network, and frontoparietal network, reflecting disruptions in emotion regulation, self-referential processing, and executive control. PET imaging shows promise for improving diagnosis, monitoring treatment response, and informing personalised interventions.
Frontiers in endocrinology · 2026
Endocrine-disrupting chemicals (EDCs) are well known for their ability to interfere with endocrine function; however, growing evidence indicates that they can also cause profound neurotoxic effects. These substances can affect both the central and peripheral nervous systems of aquatic organisms, including fish, and can disrupt neurobehavioral development, posing a potential threat to aquatic species. In this systematic review, we examine the neurotoxic effects of EDCs on zebrafish (Danio rerio), a widely utilized model organism for investigating vertebrate nervous system development. A comprehensive bibliographic search was conducted in PubMed using the terms "developmental neurotoxicity" and "fish," which yielded 603 articles. The search was refined by incorporating the terms "endocrine disruptors" and "zebrafish," resulting in 15 relevant studies. Of these, three were excluded-two due to irrelevance to the topic and one for being a review on strobilurin, a fungicide. The remaining 12 studies provided insights into the neurotoxic effects of 14 chemicals, including 6-OH-BDE-47 (2,2´,4,4´-tetrabromodiphenyl ether), atrazine, BDE-209, bisphenol (BPA), bisphenol S (BPS), Cd, estrone, OBS, Pb, tributyltin (TBT), tris(2-chloroethyl) phosphate (TCEP), tris(1,3-dichloro-2-propyl) phosphate (TDCPP), Thifluzamide (THM), and Ti. These compounds, encompassing biocides, heavy metals, hormones, brominated compounds, plastic components, and flame retardants, were identified as potential EDCs that disrupt nervous system development and behavior in zebrafish during embryonic, larval, and adult stages. Studies have also investigated co-exposure effects of binary mixtures like BDE-209 with Pb, BPA with Ti, and TBT with Cd. We identified significant neurodevelopmental endpoints, including alterations in thyroid/sex steroid hormone levels; neurotransmitter contents, including dopamine, serotonin, and GABA; AChE activity; locomotor behavior; and expression of sensitive genes and proteins. Notably, these neurotoxic effects were shown to have intergenerational/transgenerational/epigenetic consequences. Overall, this review provides comprehensive evidence of the neurotoxic potential of EDCs on zebrafish, emphasizing their relevance to vertebrate neurodevelopment and the potential implications for human health.