Intradiscal steroid injection for the treatment of chronic non-specific low back pain in patients with Modic type 1 change.

OBJECTIVE: The aim of this study was to evaluate and aggregate the evidence from the published studies to determine the effectiveness of intradiscal steroid injection (ISI) in patients with symptomatic Modic type I change (MCI). MATERIALS AND METHODS: A systematic literature search was independently performed by two authors. The electronic database, including PubMed, Embase, the Cochrane Library, and Web of Science, were searched with the given search terms but without language restriction. The studies that met the inclusion criteria were included. The relevant data were extracted, and two authors independently assessed the quality of the included studies. We performed the present study using the STATA software package. RESULTS: The present work included seven studies with 434 patients with chronic low back pain (CLBP). The risk of bias in the included randomized controlled trials (RCTs) was rated from low to unclear, and all the included observational studies were rated as high quality. The result of the meta-analysis revealed that there were significant differences in pain intensity [standardized mean difference (SMD): 3.09, 95% confidence interval (CI): 1.60-4.58; p<0.01] and self-assessed improvement/satisfaction [odds ratio (OR): 11.41, 95% CI: 3.39-38.41; p=0.05] after ISI compared to before treatment. However, no significant differences in the proportion of patients with full or part-time employment (OR: 1.03, 95% CI: 0.55-1.91; p>0.05), receiving additional care for CLBP (OR: 0.78, 95% CI: 0.36-1.71; p>0.05), and serious adverse events (OR: 1.09, 95% CI: 0.58 to 2.05; p>0.05) were detected between the groups. CONCLUSIONS: Among CLBP patients with MCI, the use of ISI was significantly associated with a reduction in pain intensity in the short term.

L-malate reverses oxidative stress and antioxidative defenses in liver and heart of aged rats.

The intracellular levels of antioxidant and free radical scavenging enzymes are gradually altered during the aging process. An age-dependent increase of oxidative stress occurring throughout the lifetime is hypothesized to be the major cause of aging. The current study examined the effects of L-malate on oxidative stress and antioxidative defenses in the liver and heart of aged rats. Sprague-Dawley male rats were randomly divided into four groups, each group consisting of 6 animals. Group Ia and Group IIa were young and aged control rats. Group Ib and Group IIb were young and aged rats treated with L-malate (210 mg/kg body weight per day). L-malate was orally administrated via intragastric canula for 30 days, then the rats were sacrificed and the liver and heart were removed to determine the oxidant production, lipid peroxidation and antioxidative defenses of young and aged rats. Dietary L-malate reduced the accumulation of reactive oxygen species (ROS) and significantly decreased the level of lipid peroxidation in the liver and heart of the aged rats. Accordingly, L-malate was found to enhance the antioxidative defense system with an increased activity of antioxidant enzymes, such as superoxide dismutase (SOD) and glutathione peroxidase (GPx) and increased glutathione (GSH) levels in the liver of aged rats, a phenomenon not observed in the heart of aged rats. Our data indicate that oxidative stress was reversed and the antioxidative defense system was strengthened by dietary supplementation with L-malate.

Plasma membrane damage to Candida albicans caused by chlorine dioxide (ClO2).

AIM: To investigate the plasma membrane damage of chlorine dioxide (ClO(2)) to Candida albicans ATCC10231 at or below the minimal fungicidal concentration (MFC). METHODS AND RESULTS: ClO(2) at MFC or below was adopted to treat the cell suspensions of C. albicans ATCC10231. Using transmission electron microscopy, no visible physiological alteration of cell shape and plasma membrane occurred. Potassium (K(+)) leakages were significant; likewise, it showed time- and dose-dependent increases. However, adenosine triphosphate (ATP) leakages were very slight. Research shows that when 99% of the cells were inactivated, the leakage was measured at 0.04% of total ATP. Compared with the mortality-specific fluorescent dye of DiBAC(4)(3), majority of the inactivated cells were poorly stained by propidium iodide, another mortality-specific fluorescent dye which can be traced by flow cytometry. CONCLUSION: At or below MFC, ClO(2) damages the plasma membranes of C. albicans mainly by permeabilization, rather than by the disruption of their integrity. K(+) leakage and the concomitant depolarization of the cell membrane are some of the critical events. SIGNIFICANCE AND IMPACT OF THE STUDY: These insights into membrane damages are helpful in understanding the action mode of ClO(2).