Effectiveness of Passion Fruit Peel Flour (Passiflora edulis L.) versus Turmeric Flour (Curcuma longa L.) on Glycemic Control: Systematic Review and Meta-Analysis.

BACKGROUND: It is undeniable that diabetes may cause several health complications for the population. Many of these complications are associated with poor glycemic control. Due to this, strategies to handle this problem are of great clinical importance and may contribute to reducing the various complications from diabetes. OBJECTIVE: The aim of this study was to compare the effectiveness of the passion fruit peel flour versus turmeric flour on glycemic control. METHODS: This is a systematic review and meta-analysis following the PRISMA protocol. The following inclusion criteria were applied: (1) Case-control studies, cohort studies, and clinical trials, due to the improved statistical analysis and, in restrict cases, cross-sectional studies; (2) Articles published in any language. The databases used for the search were PubMed, Scopus, Web of Science, Cochrane, and LILACS. A bias analysis and a meta-analyses were undertaken using R Studio (version 3.3.1) using effect- size models. RESULTS: A total of 565 studies were identified from which 11 met the inclusion and exclusion criteria. Through isolated analysis, the effectiveness of turmeric flour on glycemic control was in the order of 0.73 CI (Confidence Interval) (from 0.68 to 0.79) and the effectiveness of passion fruit peel flour was 0.32 CI (0.23 to 0.45). The joint analysis resulted in 0.59 CI (0.52 to 0.68). The assessment of blood glucose was by glycated hemoglobin levels. All values were significant at a p < 0.05 level. CONCLUSION: Both interventions showed significant effects on glycemic control.

Long-Term Prognostic Value of Myocardial Fibrosis in Patients With Chagas Cardiomyopathy.

BACKGROUND: Myocardial fibrosis (MF) according to cardiac magnetic resonance (CMR) is a frequent finding in Chagas cardiomyopathy and has been associated with risk factors of poor outcome. OBJECTIVES: The goal of this study was to determine the prognostic value of MF in predicting combined hard events or all-cause mortality. METHODS: Patients with Chagas cardiomyopathy who had a previous CMR evaluation were included, and clinical follow-up was retrospectively obtained. The primary outcome was a combination of all-cause mortality, heart transplantation, antitachycardia pacing or appropriate shock from an implantable cardioverter-defibrillator, and aborted sudden cardiac death; the secondary outcome was all-cause mortality. RESULTS: A total of 130 patients were included; mean age was 53.6 ± 11.5 years, and 53.9% were female. The majority of patients reported no symptoms of heart failure or arrhythmia, but electrocardiographic and echocardiographic abnormalities were common. On CMR, left ventricular dilatation and dysfunction were frequent, and MF was found in 76.1%, with a mean mass of 15.2 ± 16.5 g. Over a median follow-up of 5.05 years, 58 (44.6%) patients reached the combined endpoint, and 45 (34.6%) patients died. MF was associated with the primary outcome as a continuous variable (adjusted hazard ratio: 1.031; 95% CI: 1.013 to 1.049; p = 0.001) and as a categorical variable (MF ≥12.3 g) (adjusted hazard ratio: 2.107; 95% CI: 1.111 to 3.994; p = 0.022), independently from the Rassi risk score. MF expressed as a continuous variable was also associated with all-cause mortality (adjusted hazard ratio: 1.028; 95% CI: 1.005 to 1.051; p = 0.017) independently from the Rassi risk score. CONCLUSIONS: MF is an independent predictor of adverse outcome in Chagas cardiomyopathy. Our data may support the use of CMR in better risk-stratifying this population and possibly guiding therapy.

Long-Term Prognostic Value of Myocardial Fibrosis in Patients With Chagas Cardiomyopathy

BACKGROUND; Myocardial fibrosis (MF) according to cardiac magnetic resonance (CMR) is a frequent finding in Chagas cardiomyopathy and has been associated with risk factors of poor outcome. OBJECTIVES The goal of this study was to determine the prognostic value of MF in predicting combined hard events orall-cause mortality. METHODS: Patients with Chagas cardiomyopathy who had a previous CMR evaluation were included, and clinical follow-up was retrospectively obtained. The primary outcome was a combination of all-cause mortality, heart transplantation, antitachycardia pacing or appropriate shock from an implantable cardioverter-defibrillator, and aborted sudden cardiac death; the secondary outcome was all-cause mortality. RESULTSA: total of 130 patients were included; mean age was 53.6 11.5 years, and 53.9% were female. The majority of patients reported no symptoms of heart failure or arrhythmia, but electrocardiographic and echocardiographic abnormalities were common. On CMR, left ventricular dilatation and dysfunction were frequent, and MF was found in76.1%, with a mean mass of 15.2 16.5 g. Over a median follow-up of 5.05 years, 58 (44.6%) patients reached the combined endpoint, and 45 (34.6%) patients died. MF was associated with the primary outcome as a continuous variable (adjusted hazard ratio: 1.031; 95% CI: 1.013 to 1.049; p»0.001) and as a categorical variable (MF$12.3 g) (adjusted hazard ratio: 2.107; 95% CI: 1.111 to 3.994; p»0.022), independently from the Rassi risk score. MF expressed as a continuous variable was also associated with all-cause mortality (adjusted hazard ratio: 1.028; 95% CI: 1.005 to 1.051; p»0.017) independently from the Rassi risk score. CONCLUSIONS: MF is an independent predictor of adverse outcome in Chagas cardiomyopathy. Our data may support the use of CMR in better risk-stratifying this population and possibly guiding therapy.