Muth - Revision history

M.bennett at 07:39, 25 July 2019

2019-07-25T07:39:23Z

M.bennett at 07:31, 25 July 2019

2019-07-25T07:31:24Z

M.bennett: Created page with " '''Some evidence that an oral preparation of superox..."

2019-07-25T07:13:38Z

Created page with " '''Some evidence that an oral preparation of superox..."

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'''Some evidence that an oral preparation of superoxide dismutase can reduce DNA damage following a single hyperbaric oxygen exposure in volunteers'''

'''Clinical bottom line:'''

{| class="Table" style="width:432.35pt; border:solid windowtext 1.0pt" width="0"
|-
| style="width:429.35pt; border:solid windowtext 1.0pt" width="576" |
'''1. Some evidence that oral superoxide dismutase taken for two weeks prior to a single exposure to HBO can reduce DNA damage. Clinical significance unknown'''

|}

 

'''Citation/s:''' 1. Muth CM, Glenz Y, Klaus M, Radermacher P, Speit G, Leverve X. Influence of an orally effective SOD on hyperbaric oxygen-related cell damage. Free Radic Res. 2004 Sep;38(9):927-32. '''Lead author's name and fax: '''Clause Muth: claus-martin.muth@medizin.uni-ulm.de

'''Three-part Clinical Question:'''For patients having hyperbaric oxygen therapy, does the oral ingetion of superoxide dismutase, compared to no such ingestion, result in a measureable antioxidant protection? '''Search Terms:''' Antioxidant, superoxide dismutase, volunteers

'''The Study:''' Double-blinded concealed randomised controlled trial with intention-to-treat. '''The Study Patients:''' Healthy volunteer divers '''Control group''' (N = 10; 9 analysed): A single exposure to 100% oxygen breathing at at 2.5 ATA for 60 minutes and two placebo capsules each day (containing only the vehicle) for 14 days prior to HBO. '''Experimental group''' (N = 10; 8 analysed): As above, but the capsules contained a wheat gliadin to allow oral ingestion and 500 IU of superoxide dismutase each.

'''The Evidence:'''

{| class="Table" style="border-top:outset; border-left:outset; border-bottom:inset; border-right:inset; border-width:1.0pt; border:solid windowtext 1.0pt"
|-
| style="width:139.1pt; border:solid windowtext 1.0pt" width="188" | '''Non-Event Outcomes'''
| style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | '''Time to outcomes'''
| style="width:97.75pt; border:solid windowtext 1.0pt" width="132" | '''Placebo group'''
| style="width:90.65pt; border:solid windowtext 1.0pt" width="123" | '''SOD group'''
| style="width:58.8pt; border:solid windowtext 1.0pt" width="81" | '''P-value'''
|-
| style="width:139.1pt; border:solid windowtext 1.0pt" width="188" |
'''Tail moment on COMET assay. Median and IQR'''

| style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | After HBO
| style="width:97.75pt; border:solid windowtext 1.0pt" width="132" | 0.42 (0.33 to 0.53)
| style="width:90.65pt; border:solid windowtext 1.0pt" width="123" | 0.32 (0.26 to 0.34)
| style="width:58.8pt; border:solid windowtext 1.0pt" width="81" | 0.03
|-
| style="width:139.1pt; border:solid windowtext 1.0pt" width="188" |
'''Plasma isoprostane levels (pg/ml). Median and IQR'''

| style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | After HBO
| style="width:97.75pt; border:solid windowtext 1.0pt" width="132" | 22.3 (14.2 to 34.9)
| style="width:90.65pt; border:solid windowtext 1.0pt" width="123" | 14.0 (12.9 to 14.9)
| style="width:58.8pt; border:solid windowtext 1.0pt" width="81" | 0.05
|}

 

'''Comments:''' 1. Very small study - underpowered with no discussion of sample size calculation. 2. The groups began with non-significant baseline differences in a number of parameters including tail moment. 3. No evidence of any effect on the concentration of oxidised glutathione (a marker of lipid peroxidation); glutathione peroxidase or catalase activity. 4. Authors only measured outcomes after a single exposure - the relevance for a course of HBOT remains unclear. 5. Given the emerging understanding of the role of HBO in decreasing pathological chronic inflammatory changes, the wisdom of using antioxidants in this setting is not clear.

Appraised by: Michael Bennett Prince of Wales Hospital; Thursday, 25 July 2019 Email: m.bennett@unsw.edu.au '''Kill or Update By:''' July 2024

← Older revision		Revision as of 07:39, 25 July 2019
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	<span style="font-family:">Appraised by: Michael Bennett Prince of Wales Hospital; Thursday, 25 July 2019<br/> Email: m.bennett@unsw.edu.au<br/> '''Kill or Update By:''' July 2024</span>		<span style="font-family:">Appraised by: Michael Bennett Prince of Wales Hospital; Thursday, 25 July 2019<br/> Email: m.bennett@unsw.edu.au<br/> '''Kill or Update By:''' July 2024</span>
−	<p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif\|center\|sumhorsa.gif]]</p>	+	<p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif\|center\|sumhorsa.gif]]</p> <p style="text-align: center;"> </p> <p style="text-align: center;"><span style="font-size:x-large;">[[Miscellaneous\|BACK]]</span></p>

@@ Line 1: / Line 1: @@
-'''<span style="font-size:16.0pt"><span style="line-height:107%"><span style="font-family:" times="" new="" roman",serif"="">Some evidence that an oral preparation of superoxide dismutase can reduce DNA damage following a single hyperbaric oxygen exposure in volunteers</span></span></span>'''
+'''<span style="font-size:16.0pt"><span style="line-height:107%"><span style="font-family:">Some evidence that an oral preparation of superoxide dismutase can reduce DNA damage following a single hyperbaric oxygen exposure in volunteers</span></span></span>'''
-'''<span style="font-family:" times="" new="" roman",serif"="">Clinical bottom line:</span>'''
+'''<span style="font-family:">Clinical bottom line:</span>'''
-{| class="Table" style="width:432.35pt; border:solid windowtext 1.0pt" width="0"
+{| class="Table" style="width: 819px; border: 1pt solid windowtext;" width="0"
 |-
-| style="width:429.35pt; border:solid windowtext 1.0pt" width="576" |
+| style="width: 808px; border: 1pt solid windowtext;" width="576" |
-'''<span style="font-family:" times="" new="" roman",serif"="">1. Some evidence that oral superoxide dismutase taken for two weeks prior to a single exposure to HBO can reduce DNA damage. Clinical significance unknown</span>'''
+'''<span style="font-family:">1. Some evidence that oral superoxide dismutase taken for two weeks prior to a single exposure to HBO can reduce DNA damage. Clinical significance unknown.</span>'''
 |}
@@ Line 13: / Line 13: @@
 &nbsp;
-'''<span style="font-family:" times="" new="" roman",serif"="">Citation/s:</span>'''<br/> <span style="font-family:" times="" new="" roman",serif"="">1. Muth CM, Glenz Y, Klaus M, Radermacher P, Speit G, Leverve X. Influence of an orally effective SOD on hyperbaric oxygen-related cell damage. Free Radic Res. 2004 Sep;38(9):927-32.<br/> '''Lead author's name and fax: '''Clause Muth: claus-martin.muth@medizin.uni-ulm.de</span>
+'''<span style="font-family:">Citation/s:</span>'''<br/> <span style="font-family:">1. Muth CM, Glenz Y, Klaus M, Radermacher P, Speit G, Leverve X. Influence of an orally effective SOD on hyperbaric oxygen-related cell damage. Free Radic Res. 2004 Sep;38(9):927-32.<br/> '''Lead author's name and fax: '''Clause Muth: claus-martin.muth@medizin.uni-ulm.de</span>
-'''<span style="font-family:" times="" new="" roman",serif"="">Three-part Clinical Question:</span>'''<span style="font-family:" times="" new="" roman",serif"="">For patients having hyperbaric oxygen therapy, does the oral ingetion of superoxide dismutase, compared to no such ingestion, result in a measureable antioxidant protection?<br/> '''Search Terms:''' Antioxidant, superoxide dismutase, volunteers</span>
+'''<span style="font-family:">Three-part Clinical Question:</span>'''<span style="font-family:">For patients having hyperbaric oxygen therapy, does the oral ingetion of superoxide dismutase, compared to no such ingestion, result in a measureable antioxidant protection?<br/> '''Search Terms:''' Antioxidant, superoxide dismutase, volunteers</span>
-'''<span style="font-family:" times="" new="" roman",serif"="">The Study:</span>'''<br/> <span style="font-family:" times="" new="" roman",serif"="">Double-blinded concealed randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Healthy volunteer divers<br/> '''Control group''' (N = 10; 9 analysed): A single exposure to 100% oxygen breathing at at 2.5 ATA for 60 minutes and two placebo capsules each day (containing only the vehicle) for 14 days prior to HBO.<br/> '''Experimental group''' (N = 10; 8 analysed): As above, but the capsules contained a wheat gliadin to allow oral ingestion and 500 IU of superoxide dismutase each.</span>
+'''<span style="font-family:">The Study:</span>'''<br/> <span style="font-family:">Double-blinded concealed randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Healthy volunteer divers<br/> '''Control group''' (N = 10; 9 analysed): A single exposure to 100% oxygen breathing at at 2.5 ATA for 60 minutes and two placebo capsules each day (containing only the vehicle) for 14 days prior to HBO.<br/> '''Experimental group''' (N = 10; 8 analysed): As above, but the capsules contained a wheat gliadin to allow oral ingestion and 500 IU of superoxide dismutase each.</span>
-'''<span style="font-family:" times="" new="" roman",serif"="">The Evidence:</span>'''
+'''<span style="font-family:">The Evidence:</span>'''
-{| class="Table" style="border-top:outset; border-left:outset; border-bottom:inset; border-right:inset; border-width:1.0pt; border:solid windowtext 1.0pt"
+{| class="Table" style="border: 1pt solid windowtext; width: 754px;"
 |-
-| style="width:139.1pt; border:solid windowtext 1.0pt" width="188" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:" times="" new="" roman",serif"="">Non-Event Outcomes</span>'''</p>
+| style="width:139.1pt; border:solid windowtext 1.0pt" width="188" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:">Non-Event Outcomes</span>'''</p>
-| style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:" times="" new="" roman",serif"="">Time to outcomes</span>'''</p>
+| style="width: 154px; border: 1pt solid windowtext;" width="76" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:">Time to outcomes</span>'''</p>
-| style="width:97.75pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:" times="" new="" roman",serif"="">Placebo group</span>'''</p>
+| style="width: 148px; border: 1pt solid windowtext;" width="132" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:">Placebo group</span>'''</p>
-| style="width:90.65pt; border:solid windowtext 1.0pt" width="123" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:" times="" new="" roman",serif"="">SOD group</span>'''</p>
+| style="width: 113px; border: 1pt solid windowtext;" width="123" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:">SOD group</span>'''</p>
-| style="width:58.8pt; border:solid windowtext 1.0pt" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:" times="" new="" roman",serif"="">P-value</span>'''</p>
+| style="width: 114px; border: 1pt solid windowtext;" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="font-family:">P-value</span>'''</p>
 |-
 | style="width:139.1pt; border:solid windowtext 1.0pt" width="188" |
-'''<span style="font-family:" times="" new="" roman",serif"="">Tail moment on COMET assay. Median and IQR</span>'''
+'''<span style="font-family:">Tail moment on COMET assay. Median and IQR</span>'''
-| style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">After HBO</span></p>
+| style="width: 154px; border: 1pt solid windowtext;" width="76" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">After HBO</span></p>
-| style="width:97.75pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">0.42 (0.33 to 0.53)</span></p>
+| style="width: 148px; border: 1pt solid windowtext;" width="132" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">0.42 (0.33 to 0.53)</span></p>
-| style="width:90.65pt; border:solid windowtext 1.0pt" width="123" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">0.32 (0.26 to 0.34)</span></p>
+| style="width: 113px; border: 1pt solid windowtext;" width="123" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">0.32 (0.26 to 0.34)</span></p>
-| style="width:58.8pt; border:solid windowtext 1.0pt" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">0.03</span></p>
+| style="width: 114px; border: 1pt solid windowtext;" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">0.03</span></p>
 |-
 | style="width:139.1pt; border:solid windowtext 1.0pt" width="188" |
-'''<span style="font-family:" times="" new="" roman",serif"="">Plasma isoprostane levels (pg/ml). Median and IQR</span>'''
+'''<span style="font-family:">Plasma isoprostane levels (pg/ml). Median and IQR</span>'''
-| style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">After HBO</span></p>
+| style="width: 154px; border: 1pt solid windowtext;" width="76" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">After HBO</span></p>
-| style="width:97.75pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">22.3 (14.2 to 34.9)</span></p>
+| style="width: 148px; border: 1pt solid windowtext;" width="132" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">22.3 (14.2 to 34.9)</span></p>
-| style="width:90.65pt; border:solid windowtext 1.0pt" width="123" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">14.0 (12.9 to 14.9)</span></p>
+| style="width: 113px; border: 1pt solid windowtext;" width="123" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">14.0 (12.9 to 14.9)</span></p>
-| style="width:58.8pt; border:solid windowtext 1.0pt" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:" times="" new="" roman",serif"="">0.05</span></p>
+| style="width: 114px; border: 1pt solid windowtext;" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="font-family:">0.05</span></p>
 |}
 &nbsp;
-'''<span style="font-family:" times="" new="" roman",serif"="">Comments:</span>'''<br/> <span style="font-family:" times="" new="" roman",serif"="">1. Very small study - underpowered with no discussion of sample size calculation.<br/> 2. The groups began with non-significant baseline differences in a number of parameters including tail moment.<br/> 3. No evidence of any effect on the concentration of oxidised glutathione (a marker of lipid peroxidation); glutathione peroxidase or catalase activity.<br/> 4. Authors only measured outcomes after a single exposure - the relevance for a course of HBOT remains unclear.<br/> 5. Given the emerging understanding of the role of HBO in decreasing pathological chronic inflammatory changes, the wisdom of using antioxidants in this setting is not clear.</span>
+'''<span style="font-family:">Comments:</span>'''<br/> <span style="font-family:">1. Very small study - underpowered with no discussion of sample size calculation.<br/> 2. The groups began with non-significant baseline differences in a number of parameters including tail moment.<br/> 3. No evidence of any effect on the concentration of oxidised glutathione (a marker of lipid peroxidation); glutathione peroxidase or catalase activity.<br/> 4. Authors only measured outcomes after a single exposure - the relevance for a course of HBOT remains unclear.<br/> 5. Given the emerging understanding of the role of HBO in decreasing pathological chronic inflammatory changes, the wisdom of using antioxidants in this setting is not clear.</span>
-<span style="font-family:" times="" new="" roman",serif"="">Appraised by: Michael Bennett Prince of Wales Hospital; Thursday, 25 July 2019<br/> Email: m.bennett@unsw.edu.au<br/> '''Kill or Update By:''' July 2024</span>
+<span style="font-family:">Appraised by: Michael Bennett Prince of Wales Hospital; Thursday, 25 July 2019<br/> Email: m.bennett@unsw.edu.au<br/> '''Kill or Update By:''' July 2024</span>