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We outline the indications and contraindications of carotid endarterectomy (CEA) and appraise four key areas still debated to this day; shunting versus non-shunting, patch angioplasty (PA) versus primary closure (PC) and local anaesthesia (LA) versus general anaesthesia (GA). Importantly, we compare CEA with Best Medical Therapy (BMT), which is an area that is still largely debated, principally because many of the studies conducted to date do not reflect the era of modern BMT practices, and these outcomes are eagerly awaited. Literature searches were conducted using Pubmed with the keywords 'carotid', and 'endarterectomy', which provided a wide variety of journals and articles. We further stratified our data by using only randomised control trials (RCTs), meta-analyses, and systematic reviews, and then excluded studies with asymptomatic disease, diabetes, and plaque-imaging studies, including studies that did not fit our four desired topics for discussion. For each of the different domain's, results demonstrated similar peri-operative outcomes when comparing shunting vs. non-shunting and modality of anaesthesia and therefore practice still remains dependent on operator experience and preference. Patch-angioplasty reduces the risk of subsequent stroke, transient ischaemic attack (TIA), and re-stenosis compared to PC. In carotid stenosis >50% BMT offers limited benefits without accompanying surgical intervention and BMT alone tends to be advantageous primarily for patients with <50% carotid stenosis. Where CEA is appraised in terms of superiority of the procedural components; the literature does not support wildly contrasting outcomes to change majority practice. However, the area of considerable interest is superiority of BMT to surgical intervention in terms of both carotid artery stenting (CAS) and CEA and more studies need to be conducted in this area. [ABSTRACT FROM AUTHOR]

Background. Dyslipidemia is a major public health challenge worldwide, and chia seed, a nutrient‐dense functional food, could be beneficial in metabolic disorders. This systematic review and meta‐analysis were conducted to assess how chia seed intake affects lipid profiles. Methods. A comprehensive literature search was conducted on electronic databases including PubMed, Scopus, Web of Science, Cochrane, and Google Scholar up to January 2024. All randomized controlled trials (RCTs) addressing the effect of chia seed on triglyceride (TG), total cholesterol (TC), high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL) were included. Data were analyzed using a random‐effects model and reported as weighted mean differences (WMD) with 95% confidence intervals (CI). Subgroup and sensitivity analyses were also performed. The quality of studies was evaluated using the Cochrane risk of bias tool. Results. A total of seven RCTs involving 304 participants were included in the meta‐analysis. The results showed that chia consumption had no considerable effect on TG (WMD: −18.73 mg/dl; 95% CI: −55.46 to 18.00; p = 0.31), TC (WMD: −7.49 mg/dl; 95% CI: −15.60 to 0.63; p = 0.07), HDL (WMD: −2.85 mg/dl; 95% CI: −6.74 to 1.05; p = 0.15), and LDL (WMD: −8.09 mg/dl; 95% CI: −18.17 to 1.99; p = 0.11). However, subgroup analyses indicated that chia could decrease TC in patients with obesity and type 2 diabetes mellitus (T2DM) and LDL in patients with obesity. Conclusion. Chia consumption had no effect on lipid profiles including triglyceride, total cholesterol, LDL, and HDL. Nevertheless, patients with obesity and T2DM might benefit from its supplementation. [ABSTRACT FROM AUTHOR]

Growing evidence has suggested that the consumption of probiotics can decrease depressive symptoms. However, even the results of meta-analyses are conflicting. In this regard, we performed an umbrella meta-analysis and proposed the decisive impacts of probiotics on depressive symptoms. The following international databases were searched up to July 2021: PubMed/Medline, Web of Science, Scopus, EMBASE, and Google Scholar. Meta-analyses investigating the impact of supplementation of probiotics on depression symptoms in adults were included. According to the studies, random-effects model was used to perform the analysis. Subgroup analysis was performed by dosage of probiotics, duration of supplementation and total sample size. Publication bias was assessed using Egger's, Begg's and visual inspection of funnel plot. Ten meta-analyses (n = 8886 participants) were included in study. The pooled data indicated that probiotic supplementation significantly reduced depression symptoms (ES= −1.41; 95% CI: −2.53, −0.30, p = 0.016; I2 = 99.4, p = <0.001). Subgroup analysis of studies with intervention duration >8 weeks and dosage >10 × 109 CFU demonstrated a more robust effect of probiotics on decreasing depression symptoms. There was also significant between-study heterogeneity in which dosage was identified as source of it. The results of present umbrella meta-analysis suggest administration of probiotics for relieving depression symptoms for >8 weeks with dosage of >10 × 109 CFU. Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2051164 [ABSTRACT FROM AUTHOR]

Background: The results of published metaanalyses investigating the relationship between artificial sweeteners and the risk of cancer were conflicting. Our objective was to conduct an umbrella review encompassing systematic reviews and meta-analyses of observational studies to provide an ultimate insight on the subject. Methods: We conducted a comprehensive search on PubMed, Scopus, and Web of Science databases, covering the period up to July 2023. The summary effect sizes and their corresponding 95% confidence intervals were recalculated for the outcome using randomeffects model. Subgroup and sensitivity analyses were performed. Results: Overall, seven meta-analyses comprising from twenty-three datasets, were included. The findings of our study indicated that there is no significant association between the consumption of artificial sweeteners and risk of developing cancer (RR: 0.99; 95%CI: 0.95,1.04; p=0.45). Conclusion: In summary, the results presented in this comprehensive meta-analysis suggest that regular consumption of artificial sweeteners does not increase the risk of cancer development in general population. [ABSTRACT FROM AUTHOR]