ABSTRACT
The novelty of the present study is studying the ability of aqueous Ziziphus spina-christi leaves' extract (ZSCE) to produce eco-friendly and cost-effective silver nanoparticles (Ag NPs) against Fusarium wilt disease. Phytochemical screening of ZSCE by HPLC showed that they contain important antimicrobial substances such as Rutin, Naringin, Myricetin, Quercetin, Kaempferol, Hesperidin, Syringeic, Eugenol, Pyrogallol, Gallic and Ferulic. Characterization methods reveal a stable Ag NPs with a crystalline structure, spherical in shape with average particle size about 11.25 nm. ZSCE and Ag NPs showed antifungal potential against F. oxysporum at different concentrations with MIC of Ag NPs as 0.125 mM. Ag NPs treatment was the most effective, as it gave the least disease severity (20.8%) and the highest protection rate (75%). The application of ZSCE or Ag NPs showed a clear recovery, and its effectiveness was not limited for improving growth and metabolic characteristics only, but also inducing substances responsible for defense against pathogens and activating plant immunity (such as increasing phenols and strong expression of peroxidase and polyphenol oxidase as well as isozymes). Owing to beneficial properties such as antifungal activity, and the eco-friendly approach of cost and safety, they can be applied in agricultural field as novel therapeutic nutrients.
Subject(s)
Fusarium , Metal Nanoparticles , Ziziphus , Metal Nanoparticles/chemistry , Antifungal Agents/pharmacology , Ziziphus/chemistry , Ziziphus/metabolism , Silver/chemistry , Plant Extracts/chemistryABSTRACT
The green synthesis of selenium nanoparticles (Se NPs) had been synthesized by pomegranate peel extract (PPE). The antimicrobial, antioxidant, and anticancer activities of the synthesized Se NPs, as well as their hemocompatibility, were investigated. Se NPs were characterized by UV-Vis., SEM, XRD, HR-TEM, DLS, EDX, FTIR, and mapping techniques. HR-TEM image represented the spheroidal forms with moderately monodispersed NPs with a mean diameter 14.5 nm. The SEM image of Se NPs, incorporated with PPE, exhibits uniform NP surfaces, and the appearance was clear. The antimicrobial results confirmed the potential of Se NPs to hinder the growth of some tested pathogenic microbes. Results revealed that Se NPs exhibited promising antibacterial activity against Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, and Streptococcus mutans where inhibition zones were 29, 16, 41, 22, and 54 mm, respectively. Likewise, it exhibited antifungal activity where the values of inhibition zones were 41, 40, 38, and 36 mm against Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, and A. niger, respectively. The antioxidant activities of Se NPs at concentrations 250-4000 µg/mL were greater than 90% in all cases. Se NP concentrations of 500 µg/mL or less are safe in usage according to hemocompatibility study. Se NPs had an IC50 of 113.73 µg/mL in a cytotoxicity experiment. Results revealed that Se NPs have promising anticancer activities against MCF7 and Mg63 cancerous cell line, where IC50 was 69.8 and 47.9 µg/mL, respectively. In conclusion, Se NPs were successfully biosynthesized using PPE for the first time; these Se NPs had promising antimicrobial, antioxidant, and anticancer activities.
Subject(s)
Anti-Infective Agents , Metal Nanoparticles , Pomegranate , Selenium , Antioxidants/pharmacology , Selenium/pharmacology , Anti-Infective Agents/pharmacology , Anti-Bacterial Agents/pharmacology , Plant Extracts/pharmacology , Microbial Sensitivity TestsABSTRACT
Coronavirus disease 2019 (COVID-19) has a wide-ranging spectrum of clinical symptoms, from asymptomatic/mild to severe. Recent research indicates that, among several factors, a low vitamin D level is a modifiable risk factor for COVID-19 patients. This study aims to evaluate the effect of vitamin D on hospital and laboratory outcomes of patients with COVID-19.Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) and clinicaltrials.gov were searched until July 2022, using relevant keywords/Mesh terms. Only randomized clinical trials (RCTs) that addressed the topic were included. The Cochrane tool was used to assess the studies' risk of bias, and the data were analyzed using the review manager (RevMan 5.4).We included nine RCTs with 1586 confirmed COVID-19 patients. Vitamin D group showed a significant reduction of intensive care unit (ICU) admission (risk ratio = 0.59, 95% confidence interval (CI) [0.41, 0.84], P = 0.003), and higher change in vitamin D level (standardized mean difference = 2.27, 95% CI [2.08, 2.47], P < 0.00001) compared to the control group. Other studied hospital and laboratory outcomes showed non-significant difference between vitamin D and the control group (P ≥ 0.05).In conclusion, vitamin D reduced the risk of ICU admission and showed superiority in changing vitamin D level compared to the control group. However, other outcomes showed no difference between the two groups. More RCTs are needed to confirm these results.
Subject(s)
COVID-19 , Humans , Randomized Controlled Trials as Topic , Vitamin D/therapeutic use , Vitamins , Dietary Supplements , HospitalsABSTRACT
BACKGROUND: Tongkat Ali (TA) or Eurycoma longifolia is a herbal medicine (HM) plant traditionally used to treat sexual dysfunction and enhance libido in men. Websites containing information about HM are abundant. However, studies have shown that in general the quality of websites containing information on HM is low. The present study aims to assess the quality and risks of websites containing information about TA supplements and to identify the health claims for TA. METHODOLOGY: A cross-sectional study to evaluate the quality and risks of websites discussing TA supplements was conducted. Online marketing websites, research articles, news articles, personal opinions, and those restricted by password were excluded. The quality and risks of websites were assessed using a modified DISCERN tool and a set of risk assessment criteria, respectively. The health claims for TA were identified and analyzed using content analysis. RESULTS: Overall, 321 websites met the inclusion criteria and were further evaluated. The overall rating of the quality of the websites was low, with a mean score ± standard deviation of 1.07 ± 0.51. Most websites lacked information that there may be more than one possible treatment choice and did not discuss areas of uncertainty. However, 67.9% (218/321) of the websites received a risk score of zero. A minority of websites (5/321, 1.6%) discouraged the use of conventional medicines. The most common health claims for TA included in the websites related to the enhancement of testosterone level (121/321, 37.7%), treatment of malaria (112/321, 34.9%), and improvement in libido (108/321, 33.6%). CONCLUSIONS: Websites containing information about TA supplements generally have a low-quality rating based on a modified DISCERN tool despite having a low-risk score. Government agencies and healthcare professionals (HCPs) must be more proactive in the critique and dissemination of information relating to HM, and in ensuring the safe use of HM among the public and patients.
Subject(s)
Eurycoma , Cross-Sectional Studies , Humans , Internet , Male , Plant Extracts/adverse effects , TestosteroneABSTRACT
Extracts of Ascophyllum nodosum are commonly used as commercial biostimulants in crop production. To further understand the seaweed extract-induced phenomena in plants, a transcriptomic study was conducted. RNA-seq differential gene expression analysis of tomato plants treated with a commercial A. nodosum extract formulation (Stimplex) revealed the up-regulation of 635 and down-regulation of 456 genes. Ontology enrichment analysis showed three gene categories were augmented, including biological processes, cellular components, and molecular functions. KEGG pathway analysis revealed that the extract had a strong influence on the expression of genes involved in carbon fixation, secondary metabolism, MAPK-signalling, plant hormone signal transduction, glutathione metabolism, phenylpropanoid and stilbenoid metabolism, and plant-pathogen interactions. qRT-PCR validation analysis using 15 genes established a strong correlation with the RNA sequencing results. The activities of defence enzymes were also significantly enhanced by seaweed extract treatment. Furthermore, AN-SWE treated tomato plants had significantly higher chlorophyll and growth hormone content and showed improved plant growth parameters and nutrient profiles than the control. It is postulated that seaweed extract-induced gene regulation was responsible for favourable plant responses that enabled better growth and tolerance to stress conditions. This study provides evidence at the transcriptomic level for the positive effects of foliar application of the Ascophyllum nodosum extract (Stimplex) observed in treated tomato plants.
Subject(s)
Ascophyllum , Solanum lycopersicum , Solanum lycopersicum/genetics , Plant Extracts/pharmacology , Plant Growth Regulators/pharmacology , TranscriptomeABSTRACT
Breast cancer is a major cause of death in women worldwide. In this study, 60 female rats were classified into 6 groups; negative control, α-aminophosphonates, arylidine derivatives of 3-acetyl-1-aminoquinolin-2(1H)-one, DMBA, DMBA & α-aminophosphonates, and DMBA & arylidine derivatives of 3-acetyl-1-aminoquinolin-2(1H)-one. New α-aminophosphonates and arylidine derivatives of 3-acetyl-1-aminoquinolin-2(1H)-one were synthesized and elucidated by different spectroscopic and elemental analysis. Histopathological examination showed marked proliferation of cancer cells in the DMBA group. Treatment with α-aminophosphonates mainly decreased tumor mass. Bcl2 expression increased in DMBA-administered rats and then declined in the treated groups, mostly with α-aminophosphonates. The level of CA15-3 markedly declined in DMBA groups treated with α-aminophosphonates and arylidine derivatives of 3-acetyl-1-aminoquinolin-2(1H)-one. Gene expression of GST-P, PCNA, PDK, and PIK3CA decreased in the DMBA group treated with α-aminophosphonates and arylidine derivatives of 3-acetyl-1-aminoquinolin-2(1H)-one, whereas PIK3R1 and BAX increased in the DMBA group treated with α-aminophosphonates and arylidine derivatives of 3-acetyl-1-aminoquinolin-2(1H)-one. The molecular docking postulated that the investigated compounds can inhibt the Thymidylate synthase TM due to high hydrophobicity charachter.
Subject(s)
Antineoplastic Agents/therapeutic use , Mammary Neoplasms, Experimental/drug therapy , Thymidylate Synthase/antagonists & inhibitors , 9,10-Dimethyl-1,2-benzanthracene , Animals , Antineoplastic Agents/pharmacology , Caco-2 Cells , Computer Simulation , Drug Evaluation, Preclinical , Female , Fishes , Humans , Mammary Neoplasms, Experimental/chemically induced , Mammary Neoplasms, Experimental/pathology , Models, Molecular , Molecular Docking Simulation , Molecular Targeted Therapy/methods , Organophosphonates/chemical synthesis , Organophosphonates/chemistry , Organophosphonates/pharmacology , Organophosphonates/therapeutic use , Plant Extracts , Quinolines/chemical synthesis , Quinolines/chemistry , Quinolines/pharmacology , Quinolines/therapeutic use , Rats , Thymidylate Synthase/chemistryABSTRACT
Fibromyalgia is a debilitating chronic condition which poses a therapeutic challenge to the clinician. With a large backlog in patient flow subsequent to the COVID-19 pandemic and rising numbers of patients with post-acute sequelae of COVID-19 (PASC) presenting with fibromyalgia-like clinical features, there is an increasingly pressing need to identify broad cost-effective interventions. Low levels of vitamin D have previously been reported in patients with fibromyalgia, though any causative link has been difficult to establish. A systematic literature review on the association between vitamin D deficiency and fibromyalgia was performed examining retrospective evidence both for and against an association between vitamin D deficiency (VDD) and fibromyalgia and evaluating the therapeutic benefit from supplementation. A group of six studies were selected based on relevance, use of controls, quality of research and citations. Four primary studies assessing the prevalence of VDD in fibromyalgia patients versus controls were evaluated with a total 3,496 subjects. Three included females only and one larger study assessed males. Two (n = 313) concluded the presence of a statistically significant association, and two (n = 161) found none. Two randomised controlled trials assessing the effect of vitamin D supplementation in a total of 80 subjects found conflicting results, with pain reduction in one and none in the other. It is likely there exists an association between VDD deficiency and fibromyalgia in a large subset of patients, although establishing primary causation is difficult. There is a need for larger randomised controlled trial designs with more effective comparison with healthy subjects and control for confounding factors. Given VDD is a major problem in the general population, we recommend supplementation be recommended by healthcare professionals to fibromyalgia patients for the purpose of maintaining bone health given their potentially increased susceptibility to developing deficiency and its sequelae.
ABSTRACT
INTRODUCTION: Plumbago indica L. is considered a valuable source in the Plumbaginaceae family for various types of active compound such as alkaloids, phenolics and saponins. To promote the usage of P. indica in the bionanotechnology field, zinc oxide nanoparticles (ZnONPs) were biosynthesized by using its alcoholic extract. The inhibitory effects of ZnONPs and the plant extract were also evaluated against HSV-1. METHODS: ZnONPs were described by the following techniques, UV-visible spectroscopy, Fourier transform infrared spectroscopy (FTIR), dynamic light scattering (DLS), zeta potential, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and x-ray diffraction (XRD). The phenolic and flavonoid contents of P. indica extract, which are accountable for bioreduction, formation and stabilization of the nanoparticles, were analyzed by HPLC technique. The antiviral assessment was implemented on both agents by using Vero cell lines. RESULTS: DLS revealed that the average size of ZnONPs was 32.58 ± 7.98 nm and the zeta potential was -20.8 mV. The observation of TEM analysis revealed that the particle size of ZnONPs varied from 2.56 to 8.83 nm. The XRD analysis verified the existence of pure crystals of hexagonal shapes of nanoparticles of ZnO with a main average size of 35.28 nm that is approximating to the values of particle size acquired by SEM analysis (19.64 and 23.21 nm). The HPLC analysis of P. indica ethanolic extract showed that gallic acid, chlorogenic acid and rutin were the major compounds, with concentrations equal to 8203.99, 2965.95 and 1144.99 µg/g, respectively. Regarding the antiviral assessment, the synthesized uncalcinated ZnONPs were found to exhibit a promising activity against HSV-1, with CC50 and IC50 values equal to 43.96 ± 1.39 and 23.17 ± 2.29 µg/mL, respectively. CONCLUSION: The green synthesized ZnONPs are considered promising adjuvants to enhance the efficacy of HSV-1 drugs.
Subject(s)
Antiviral Agents , Herpesvirus 1, Human , Metal Nanoparticles , Plumbaginaceae , Zinc Oxide , Antiviral Agents/pharmacology , Herpesvirus 1, Human/drug effects , Plant Extracts/pharmacology , Plumbaginaceae/chemistry , Zinc Oxide/pharmacologyABSTRACT
Rumex dentatus has been used traditionally for ailment of cardiovascular diseases. The aim of the present study was to assess cardiovascular effects in isolated perfused rabbit heart. Aqueous and n-butanolic fractions were assessed for their effect on perfusion pressure (PP), force of contraction (FC) and heart rate (HR) of rabbit heart using Langendorff's method. The possible mechanisms of action of extracts/fraction were assessed with and without application of different agonist/antagonist. Phytochemical, toxicity and anti-oxidant activities were also determined. Both extracts at 1mg/mL dose produced a highly significant decrease in FC and HR but PP remained unchanged. Moreover, aqueous fraction of Rumex dentatus at 0.001mg/mL dose produced a highly significant decrease in FC and HR but no significant change in PP was observed. Atropine 10-5 M did not inhibit the cardiac depressant response of both fractions. Furthermore, both fractions blocked the positive ionotropic and chronotropic effects of adrenaline and calcium chloride. Phytochemical studies have shown the presence of some phytochemicals. Acute and sub-chronic toxicity studies demonstrated that test extracts are safe and produced no significant changes in haematological and biochemical parameters. Crude extract showed significant antioxidant activity like ascorbic acid. This study revealed that this plant have good cardiac depressant effect.
Subject(s)
Antioxidants/pharmacology , Cardiovascular Agents/pharmacology , Heart/drug effects , Isolated Heart Preparation , Plant Extracts/pharmacology , Rumex/chemistry , Animals , Atropine/pharmacology , Calcium Chloride/pharmacology , Cardiovascular Agents/adverse effects , Epinephrine/pharmacology , Female , Heart Rate/drug effects , Isolated Heart Preparation/methods , Male , Mice , Myocardial Contraction/drug effects , Plant Extracts/adverse effects , Rabbits , Rats , Rats, Sprague-Dawley , Rumex/adverse effectsABSTRACT
Antihypertensive studies on aqueous-methanolic extract prepared from seeds of Cydonia oblonga M. were carried out. The test extract in 200, 400 and 600 mg/kg doses was investigated in normotensive, high cholesterol and glucose fed hypertensive rats through non-invasive blood pressure measuring technique. Acute and sub-chronic toxicity studies were conducted in mice and rats, respectively. The test extract significantly decreased dose dependently the systolic, diastolic and mean arterial pressures. The test extract in 600mg/kg dose produced maximum effect and prevented rise in blood pressure of high cholesterol diet and glucose fed rats as compare to control in 21 days studies. The extract was found safe up to 4g/kg dose in mice. In sub-chronic toxicity study, no significant alteration in blood chemistry of extract treated rats was observed except reduction in the low density cholesterol levels. It is concluded that Cydonia oblonga seeds extract possess antihypertensive effect which supports its use in folklore.
Subject(s)
Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Plant Extracts/therapeutic use , Rosaceae/chemistry , Animals , Antihypertensive Agents/adverse effects , Blood Pressure/drug effects , Disease Models, Animal , Dose-Response Relationship, Drug , Female , Male , Mice , Plant Extracts/adverse effects , Rats , Rats, Sprague-Dawley , Rosaceae/adverse effects , Seeds/adverse effects , Seeds/chemistryABSTRACT
The modern trend of research is highly focused on finding new bioactive molecules from medicinal plants. As a functional bicyclic monoterpene, Bornyl acetate (BA) has displayed antioxidant and anti-inflammatory properties in different types of cells and tissues. The purpose of this research was to evaluate the probable hypotensive effect of BA, an underlying mechanism(s) backboned by in-silico studies. Mean arterial pressure and heart rate were recorded via invasive blood pressure measuring technique in normotensive Sprague-Dawley rats following the administration of BA (1-80mg/kg). Docking studies were carried out with various targets involved in the pathophysiology of hypertension.RO5 and ADMET properties were also evaluated. In the current study dose-dependent reduction in systolic, diastolic and mean arterial pressure was observed. Pretreatment with atropine and captopril significantly (p<0.001) reduced the hypotensive effect produced by BA. On the other hand docking studies showed pronounced interactions with M2 mAch receptor in an agonistic way and ACE protein in an antagonistic way. BA justified all cut-off limits of RO5 and had an acceptable predicted computational toxicity profile. Results postulate that dose-dependent hypotensive effect of BA is mediated through the muscarinic pathway and ACE inhibitory activity corresponding well with findings of in-silico studies.
Subject(s)
Antihypertensive Agents/pharmacology , Camphanes/pharmacology , Monoterpenes/pharmacology , Animals , Antihypertensive Agents/chemistry , Blood Pressure/drug effects , Camphanes/chemistry , Computer Simulation , Heart Rate/drug effects , Molecular Docking Simulation , Molecular Structure , Monoterpenes/chemistry , Rats , Rats, Sprague-DawleyABSTRACT
Present study was conducted to validate the folkloric claims of morus nigra l. (moraceae) using invasive blood pressure measuring and ex vivo vasorelaxant experimental techniques. Intravenous administration of mn. Aq in 0.01-30 mg/kg doses caused significant decrease in mean arterial pressure and heart rate in fructose-induced hypertensive rats. It also showed relaxation in high k+ [80 mm] and pe (1µm) mediated aortic contraction with ec50 1.25 and 3.72mg/ml values, respectively. Vaso-relaxant effect of mn.aq was partially blocked in presence of l-name with ec50, 5.32mg/ml value, but showed concentration dependent significant inhibition of ligand gated and voltage gated ca+2 channels and intracellular ca+2 release, similar to verapamil. Findings of current study designate that aqueous fraction of m. Nigra possesses antihypertensive activity with concentration-dependent vaso-relaxant effect predominantly mediated through endothelial-independent calcium channel blocking pathways accompanied by partial involvement of endothelium-dependent nos mediated relaxation.
Subject(s)
Antihypertensive Agents/pharmacology , Calcium Channels/drug effects , Endothelium, Vascular/drug effects , Hypertension/drug therapy , Morus/chemistry , Plant Extracts/pharmacology , Administration, Intravenous , Animals , Blood Pressure/drug effects , Disease Models, Animal , Fruit/chemistry , Heart Rate/drug effects , Male , RatsABSTRACT
It is well established that antibiotic treatment selects for resistance, but the dynamics of this process during infections are poorly understood. Here we map the responses of Pseudomonas aeruginosa to treatment in high definition during a lung infection of a single ICU patient. Host immunity and antibiotic therapy with meropenem suppressed P. aeruginosa, but a second wave of infection emerged due to the growth of oprD and wbpM meropenem resistant mutants that evolved in situ. Selection then led to a loss of resistance by decreasing the prevalence of low fitness oprD mutants, increasing the frequency of high fitness mutants lacking the MexAB-OprM efflux pump, and decreasing the copy number of a multidrug resistance plasmid. Ultimately, host immunity suppressed wbpM mutants with high meropenem resistance and fitness. Our study highlights how natural selection and host immunity interact to drive both the rapid rise, and fall, of resistance during infection.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Resistance, Multiple, Bacterial/genetics , Meropenem/therapeutic use , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/drug effects , Selection, Genetic/genetics , Bacterial Outer Membrane Proteins/genetics , Bacterial Proteins/genetics , Humans , Hydro-Lyases/genetics , Membrane Transport Proteins/genetics , Microbial Sensitivity Tests , Middle Aged , Plasmids/genetics , Porins/genetics , Pseudomonas Infections/pathology , Pseudomonas aeruginosa/genetics , Pseudomonas aeruginosa/immunology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/microbiology , Sequence Analysis, DNA , Shock, Hemorrhagic/microbiologyABSTRACT
BACKGROUND Urinary tract candida infection can be due either to hematogenous dissemination of the organism or a retrograde infection. In debilitated or immunosuppressed septic patients, who have upper urinary tract obstruction with renal filling defect, fungal infection should be considered. We report on a patient with sepsis and renal fungal ball who was treated with percutaneous nephrostomy and intravenous antifungal agent, but the patient did not respond so instillation of fluconazole through nephrostomy was given. CASE REPORT A 60-year-old male patient with a known case of diabetes mellitus with refractory urine retention underwent transurethral resection of the prostate. Postoperatively, the patient developed recurrent high-grade fever with left loin pain, and elevated septic parameters; urine and blood culture were positive for Candida albicans. Computed tomography urography showed left hydronephrosis with filling defect in the left renal pelvis with suspected renal fungal ball. Left percutaneous nephrostomy was performed and intravenous fluconazole started but the fever did not subside, therefore, the treatment was changed to anidulafungin. The patient improved but urine from both the bladder and the nephrostomy remained positive for candida. Instillation of fluconazole at 300 mg in 500 mL normal saline was applied through the nephrostomy tube over 12 hours at 40 mL/hour for 7 days. CONCLUSIONS Renal fungal ball is rare but can be serious, especially in immunocompromised patients. Management options for renal fungal ball include intravenous antifungal agents and percutaneous nephrostomy with antifungal instillation of antifungal agents. The objective of this case report was to document treatment success with the use of fluconazole instillation through a nephrostomy tube.
Subject(s)
Antifungal Agents/administration & dosage , Candidiasis/drug therapy , Diabetes Complications/complications , Fluconazole/administration & dosage , Kidney Diseases/drug therapy , Nephrostomy, Percutaneous , Administration, Topical , Candida albicans/isolation & purification , Candidiasis/complications , Diabetes Complications/immunology , Humans , Immunocompromised Host , Infusions, Intravenous , Kidney Diseases/complications , Male , Middle Aged , Prostatic Diseases/complications , Prostatic Diseases/surgery , Sepsis/complications , Transurethral Resection of Prostate , Urinary Retention/etiology , Urinary Retention/surgeryABSTRACT
Pruritus is associated with various skin diseases, dry skin, and with it an impaired skin barrier function. The study objective was to investigate short-term and long-term effects of two emollients on symptoms and skin barrier functions in xerotic eczema. Randomized, double-blind, study enrolling females/males, with bilateral itching. Two emollients, containing lactic acid and refined almond oil with/without polidocanol were administered on left versus right body sides. Itching severity, skin moisture, lipid content, and pH were assessed on Day 1, within 30-120 min after first administration, and on Days 7 and 14, and compared with baseline assessments. Severity of itching decreased 30 min after first administration of both emollients compared with baseline (p < .0001) and reached a maximum reduction of 63% (p < .0001) and 69% (p < .0001) on Day 14. Skin moisture and lipid content increased after first application, and further ameliorated within 14 days of treatment (p < .0001). Both emollients were tolerated well, and only a few adverse events were reported. This study confirmed the clinical efficacy of the two study emollients to substantially reduce itching already after first administration, and restore skin barrier integrity and thus should be considered as therapeutic approach for xerotic eczema.
Subject(s)
Eczema/drug therapy , Emollients/administration & dosage , Lactic Acid/administration & dosage , Plant Oils/administration & dosage , Pruritus/drug therapy , Skin/drug effects , Administration, Cutaneous , Adolescent , Adult , Aged , Double-Blind Method , Drug Administration Schedule , Eczema/diagnosis , Eczema/physiopathology , Emollients/adverse effects , Female , Humans , Lactic Acid/adverse effects , Male , Middle Aged , Plant Oils/adverse effects , Polidocanol/administration & dosage , Pruritus/diagnosis , Pruritus/physiopathology , Skin/innervation , Skin/pathology , Switzerland , Time Factors , Treatment Outcome , Young AdultABSTRACT
Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current understanding of the diagnosis, and to present the treatment options for this condition. Electronic databases were searched from 1966 to October 2017, including PubMed (MEDLINE) and Embase. We combined "delayed ejaculation," "retarded ejaculation," "inhibited ejaculation," or "anejaculation" as Medical Subject Headings (MeSH) terms or keywords with "epidemiology," "etiology," "pathophysiology," "clinical assessment," "diagnosis," or "treatment." Relevant sexual medicine textbooks were searched as well. The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. An approved form of drug therapy does not exist. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.
ABSTRACT
PURPOSE OF REVIEW: Patients suffering from end-stage renal disease and undergoing dialysis demonstrate extremely elevated cardiovascular morbidity and mortality rates. Though the prevalence of traditional risk factors is very high, the extent and severity of cardiovascular complications seem disproportionate to the underlying risk profile. RECENT FINDINGS: A growing body of evidence indicates that abnormalities of calcium and phosphorus metabolism may play an important role in the morbidity and mortality of end-stage renal disease patients. Calcification of several cardiovascular structures, a likely complication of hyperphosphatemia and excessive calcium load, is both highly prevalent and extensive in end-stage renal disease patients and carries a negative prognostic weight. The extent of calcification can be accurately quantified with noninvasive radiological techniques such as electron beam tomography. Utilizing electron beam tomography in patients undergoing dialysis it has been possible to demonstrate the rapid progression of cardiovascular calcification and to gauge the effect of treatment provided to slow such process. SUMMARY: The presence of deleterious cardiovascular calcification in end-stage renal disease can be diagnosed accurately and noninvasively with electron beam tomography. This technology also allows precise assessment of the effect of medical treatment for hyperphosphatemia on calcification of cardiovascular structures.