Phytotherapy for male luts: What happens then? 10-year research.

INTRODUCTION AND OBJECTIVES: Our objective is to assess the long-term results of phytotherapy, focusing on the interval between phytotherapy and pharmacological treatment and the predisposing risk factors to such switch on a 10-year follow-up. MATERIAL AND METHODS: The data of patients taking phytotherapy for mild to moderate male lower urinary tract symptoms (LUTS) from January to December 2010 were retrospectively reviewed from a prospectively maintained database. Patients were followed for 10 years through medical visits and telephone consultations. RESULTS: 102 patients underwent at least one cycle of phytotherapy for LUTS. Twenty (19.6%) patients resolved their symptoms after one phytotherapy cycle and stopped any treatment, 27 (26.4%) continued phytotherapy, and 52 (51%) switched to alpha-blockers and/or 5a-reductase inhibitors after a median interval of 24 months. The reasons for treatment switch were symptoms (n = 45) or clinical progression (increased residual volume n = 15; urinary retention, n = 5). Patients switching to synthetic drugs had median higher age (60 vs 49), prostate volume (40 vs 26 cc), prostate specific antigen (PSA) (1.9 vs 0.9 ng/ml), residual volume (40 vs 0 cc), and a lower maximum flow rate (Qmax) (12 vs 15 ml/s) at presentation. CONCLUSIONS: 46% patients with mild to moderate LUTS undergoing phytotherapy will be either free of treatment or still on phytotherapy at 10 years from disease presentation. Older patients with larger prostates, increased residual volume and PSA, should be informed regarding their higher risk of symptomatic or clinical progression: the risk of a treatment switch to alpha-blockers or 5a-reductase inhibitors becomes an actual fact after an average span of 2 years.

Higher plasma vitamin D is associated with reduced risk of Clostridium difficile infection in patients with inflammatory bowel diseases.

BACKGROUND: Patients with inflammatory bowel diseases (IBD) have an increased risk of clostridium difficile infection (CDI). Cathelicidins are anti-microbial peptides that attenuate colitis and inhibit the effect of clostridial toxins. Plasma calcifediol [25(OH)D] stimulates production of cathelicidins. AIM: To examine the association between plasma 25(OH)D and CDI in patients with IBD. METHODS: From a multi-institutional IBD cohort, we identified patients with at least one measured plasma 25(OH)D. Our primary outcome was development of CDI. Multivariate logistic regression models adjusting for potential confounders were used to identify independent effect of plasma 25(OH)D on risk of CDI. RESULTS: We studied 3188 IBD patients of whom 35 patients developed CDI. Patients with CDI-IBD were older and had greater co-morbidity. The mean plasma 25(OH)D level was significantly lower in patients who developed CDI (20.4 ng/mL) compared to non-CDI-IBD patients (27.1 ng/mL) (P = 0.002). On multivariate analysis, each 1 ng/mL increase in plasma 25(OH)D was associated with a 4% reduction in risk of CDI (OR 0.96, 95% CI 0.93-0.99, P = 0.046). Compared to individuals with vitamin D >20 ng/mL, patients with levels <20 ng/mL were more likely to develop CDI (OR 2.27, 95% CI 1.16-4.44). The mean plasma 25(OH)D in patients with CDI who subsequently died was significantly lower (12.8 ± 8.1 ng/mL) compared to those who were alive at the end of follow-up (24.3 ± 13.2 ng/mL) (P = 0.01). CONCLUSIONS: Higher plasma calcifediol [25(OH)D] is associated with reduced risk of C. difficile infection in patients with IBD. Further studies of therapeutic supplementation of vitamin D in patients with inflammatory bowel disease and C. difficile infection may be warranted.

Structural components of the nuclear body in nuclei of Allium cepa cells.

Nuclear bodies have long been noted in interphase nuclei of plant cells, but their structural component, origin and function are still unclear by now. The present work showed in onion cells the nuclear bodies appeared as a spherical structure about 0.3 to 0.8 microm in diameter. They possibly were formed in nucleolus and subsequently released, and entered into nucleoplasm. Observation through cytochemical staining method at the ultrastructural level confirmed that nuclear bodies consisted of ribonucleoproteins (RNPs) and silver-stainable proteins. Immunocytochemical results revealed that nuclear bodies contained no DNA and ribosomal gene transcription factor (UBF). Based on these data, we suggested that nuclear bodies are not related to the ribosome or other gene transcription activities, instead they may act as subnuclear structures for RNPs transport from nucleolus to cytoplasm, and may also be involved in splicing of pre-mRNAs.

[The effects of nitrendipine on the quality of life in the elderly patients with isolated systolic hypertension (ISH)].

By case-control study, we investigated the effects of nitrendipine on the quality of life in 100 patients who were participating in Chinese Trial of randomized double-blind systolic hypertension in the elderly. The results showed that the patients group had lower scores of quality of life than the matched normotensives (P < 0.05-P < 0.01). After 40-week treatment period, the active treatment group (45 patients) had satisfied blood-pressure control and improved physical symptoms. As compared with the active group, however, the control group (42 patients) scored significantly higher on physical symptoms (P < 0.05-P < 0.01), fewer on memory, vatality, vision, well-being and social activity (P < 0.05-P < 0.01). Our findings show that nitrendipine had some positive effects on the quality of life in the elderly patients with isolated systolic hypertension (ISH) and these can be meaningfully assessed with available psychosocial measures.

Acupuncture and emotion: the influence of acupuncture anesthesia on the sensory and emotional components of pain.

Objective indices (heart rate, perspiration quantity, finger plethysmograph curves, and facial expression) and subjective indices (sensory and emotional subject reports) were recorded for 25 young Chinese adults (16 men, 9 women) during and after the simultaneous application of a strong pain stimulus and either foot classical (alloneural points Tsusanli and Yanglingchuan) or hand classical (alloneural points Hegu and Neiguan) acupuncture. Both forms of acupuncture were equally effective, showing that stimulation of the same nerve is not essential for pain relief. Acupuncture assuaged the emotional, but not the sensory, response to the painful stimulation.

Psychological aspects of components of pain.

The present study investigated the inhibitory effects of acupuncture on the separate sensory and emotional components of pain and their relation to each other. Electro-acupuncture as practiced in China was applied to the same nerve used for initiating pain, and the responses of 9 adult volunteers (5 males, 4 females) were assessed. The results indicate that (a) pain involves at least two related but different components (the sensory component and the emotional component) and (b) electro-acupuncture has a stronger inhibitory effect on the emotional component of pain. The findings provide a new outlook for the improvement of the clinical effects of acupuncture and for further study of the pain mechanism.