ABSTRACT
Although the anticancer role of curcumin has been extensively addressed in preclinical research, only a few studies were carried out in humans, with conflicting results. The aim of this systematic review is to collate together the results of the therapeutic effect of curcumin in cancer patients. A literature search was carried out in Pubmed, Scopus, and the Cochrane Central Register of Controlled Trials up to 29 January 2023. Only randomized controlled trials (RCTs) designed to evaluate the effects of curcumin on cancer progression, patient survival, or surgical/histological response were included. Seven out of 114 articles, published between 2016 and 2022, were analyzed. They evaluated patients with locally advanced and/or metastatic prostate, colorectal, and breast cancers, as well as multiple myeloma and oral leucoplakia. Curcumin was given as an add-on therapy in five studies. Cancer response was the most investigated primary endpoint and curcumin issued some positive results. On the contrary, curcumin was ineffective in improving overall or progression-free survival. The curcumin safety profile was favorable. In conclusion, available clinical evidence is not strong enough to support the therapeutic use of curcumin in cancer. New RCTs exploring the effects of different curcumin formulations in early-stage cancers would be welcome.
ABSTRACT
BACKGROUND AND AIM: Respiratory failure in SARS-CoV-2 patients is characterized by the presence of hypoxemia and hypocapnia without relevant dyspnea. To date, the use of respiratory parameters other than PaO2/FiO2 ratio to stratify the risk of worsening of these patients has not been sufficiently studied. Aim of this work was to evaluate whether the ratio between partial pressure levels of carbon dioxide (PaCO2) and the fraction of inspired oxygen (FiO2) measured at emergency department (ED) admission is predictive of the clinical course of patients suffering from SARS-CoV-2 pneumonia. METHODS: We retrospectively studied 236 patients with SARS-CoV-2 pneumonia evaluated at the ED of the Perugia Hospital. The end-points were: in-hospital mortality, need for invasive mechanical ventilation (IMV) and length of in-hospital stay (LOS). Clinical, blood gas and laboratory data were collected at ED admission. RESULTS: Of the 236 patients 157 were male, the mean age was 64 ± 16. Thirtythree patients (14%) needed IMV, 49 died (21%). In the univariate analysis, the PaCO2/FiO2 ratio was inversely associated with the need for IMV (p <0.001), mortality (p <0.001) and LOS (p = 0.005). At the multivariate analysis the PaCO2/FiO2 ratio was found to be predictive of the need for IMV, independently from age, gender, number of comorbidities, neutrophils, lymphocytes, glomerular filtrate, d-dimer, LDH and CRP. CONCLUSIONS: the PaCO2/FiO2 ratio is predictive of the risk of respiratory failure worsening in patients with SARS-CoV-2 pneumonia, independently from other several confounding factors.
