Effect of tamoxifen on fibrosis, collagen content and transforming growth factor-ß1, -ß2 and -ß3 expression in common bile duct anastomosis of pigs.

End-to-end anastomosis in the treatment for bile duct injury during laparoscopic cholecystectomy has been associated with stricture formation. The aim of this study was to experimentally investigate the effect of oral tamoxifen (tmx) treatment on fibrosis, collagen content and transforming growth factor-ß1, -ß2 and -ß3 expression in common bile duct anastomosis of pigs. Twenty-six pigs were divided into three groups [sham (n = 8), control (n = 9) and tmx (n = 9)]. The common bile ducts were transected and anastomosed in the control and tmx groups. Tmx (40 mg/day) was administered orally to the tmx group, and the animals were euthanized after 60 days. Fibrosis was analysed by Masson's trichrome staining. Picrosirius red was used to quantify the total collagen content and collagen type I/III ratio. mRNA expression of transforming growth factor (TGF)-ß1, -ß2 and -ß3 was quantified using real-time polymerase chain reaction (qRT-PCR). The control and study groups exhibited higher fibrosis than the sham group, and the study group showed lower fibrosis than the control group (P = 0.011). The control and tmx groups had higher total collagen content than the sham group (P = 0.003). The collagen type I/III ratio was higher in the control group than in the sham and tmx groups (P = 0.015). There were no significant differences in the mRNA expression of TGF-ß1, -ß2 and -ß3 among the groups (P > 0.05). Tmx decreased fibrosis and prevented the change in collagen type I/III ratio caused by the procedure.

Effects of electroacupuncture on stress-related symptoms in medical students: a randomised placebo-controlled study.

OBJECTIVE: To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students. METHODS: Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6-8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory-Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire-abbreviated version (WHOQOL-bref). RESULTS: EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group. CONCLUSIONS: EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.

Effects of electroacupuncture on stress-related symptoms in medical students: a randomised controlled pilot study.

OBJECTIVE: To assess the effects of electroacupuncture on stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students, and provide data to inform a power analysis to determinate numbers for future trials. METHODS: Twenty-five students were randomly assigned to an electroacupuncture (n=12) group or control group (n=13) that did not receive treatment. Electroacupuncture was applied at a continuous frequency 2 Hz for 20 min once a week for 8 weeks at sites on the extremities, face, ear and scalp. The outcomes of the students treated with electroacupuncture were compared with those of the control group at the endpoint, controlling the influence of baseline scores. The instruments used were self-administered questionnaires that comprised the validated Portuguese version of the mini-sleep questionnaire (MSQ), the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Beck depression inventory (BDI), the Beck anxiety inventory, the Maslach burnout inventory-student survey (MBI-SS), and World Health Organization quality of life assessment - abbreviated version (WHOQOL-bref). RESULTS: The medical students treated with electroacupuncture showed a significant decrease compared with the control group for MSQ scores (p=0.04) and PSQI (p=0.006). After treatment, 75% students in the electroacupuncture group presented a good sleep quality, compared with 23.1% of the students in the control group. No significant difference on daytime sleepiness was shown by the ESS. The electroacupuncture group showed significant improvement on depressive symptoms (BDI), the emotional exhaustion and cynicism dimensions of burnout (MBI-SS) and physical health (WHOQOL-bref). CONCLUSIONS: Electroacupuncture was associated with a significant reduction of stress-related symptoms, but because of the study design the authors cannot say what proportion of the reduction was due to needle stimulation.

Effects of electroacupuncture on local anaesthesia for inguinal hernia repair: a randomised placebo-controlled trial.

OBJECTIVE: To assess the effect of electroacupuncture (EA), akin to percutaneous electroneurostimulation, on pain and biochemical measures during and after inguinal hernia repair. METHODS: Thirty-three patients were randomised to EA (n=16) or sham transcutaneous electrical nerve stimulation (TENS) control (n=17). EA was applied at different frequencies, through needles inserted around the incision, over selected peripheral nerve branches and in the ear, from 30 min before surgery until the end of surgery, when needles were removed. All patients also received routine sedation and local anaesthesia. RESULTS: There was no difference between the pain scores in the groups receiving EA and sham TENS in the immediate postoperative period, which may be owing to adequate levels of analgesia from conventional techniques. On the fourth and seventh postoperative days, less pain and lower consumption of analgesic drugs were reported in the treatment group. Seroma occurred more frequently in the control group, which also had higher glucose blood levels in the immediate postoperative surgery period. The single case of chronic postoperative pain occurred in the control group. CONCLUSIONS: The sample size was too small to draw any conclusions about the effect of EA on pain and other parameters following inguinal hernia surgery, but our observations suggest that future studies in this area are justified.

Uncaria tomentosa in the treatment of the herpes labialis: randomized double-blind trial / Uncaria tomentosa no tratamento de herpes labial: estudo duplo-cego randomizado

Introduction: the lesions caused by herpes simplex are common and have symptoms affecting the quality of life of affected people. Objective: this study aims to assess the safety efficacy of cream with Uncaria tomentosa (cat?s claw), for topical treatment of the herpes labialis. Methods: a clinical investigation was undertaken by means of controlled, randomized, double-blinded protocol in humans. According to the regulatory procedures, 74 patients were selected based on inclusion/exclusion criteria previously submitted to the Local Ethical Committee (no 144/02) whenever herpes labialis lesion appeared. Following, those selected through medical evaluation received either the test (Uncaria) or the reference (Acyclovir) drug. Results: fifty-four episodes of herpes labialis lesions ecloded in 31 volunteers. After their clinical assessment, one showed 4 episodes, two had 3 episodes and six had 2 infections. Hence, 27 patients received the reference drug while 27 applied the Uncaria cream four times a day. Overall, there were not significant differences between either responses. Although, the Uncaria group showed lower scores on the first two days of treatment (p < 0,005; t = 0,028), on day 3, it was even to Acyclovir. Conclusion:the assessment of clinical efficacy of either treatment demonstrated that both drugs were safe as no adverse reactions were reported. Futher, there was no difference (p > 0,05) in the overall period infections as well as in the inflammatory process or crost formation. Regarding the severity of inflammatory reaction, the clinical efficacy of Uncaria tomentosa was significantly better than acyclovir. Rather than the being antiviral drug, the Uncaria tomentosa may act as an anti-inflammatory agent and this would possibly represent an advantage of not inducing viral resistance for long use.

Introdução: as lesões causadas por herpes simples são comuns e apresentam sintomatologia que altera a qualidade de vida das pessoas acometidas. Objetivo: este estudo visa avaliar a eficácia da segurança de creme com Uncaria tomentosa (unha-de-gato) para o tratamento tópico de herpes labial. Métodos: a pesquisa clínica foi realizada por meio de protocolo controlado, randomizado e duplo-cego. De acordo com os procedimentos de regulamentação, 74pacientes foram selecionados com base em critérios de inclusão e exclusão previamente submetidos à Comissão de Ética Local (no 144/02), sempre a lesão de herpes labial apareceu. Em seguida, os selecionados através de avaliação médica receberam o produto-teste (Uncaria) ou o de referência (aciclovir).Resultados: cinquenta e quatro episódios de lesões de herpes labial eclodiram em 31 voluntários. Após a avaliação clínica, um apresentou quatro episódios, dois tiveram três episódios e seis tinham duas infecções. Assim, 27 pacientes receberam a droga de referência, enquanto 27 aplicaram o creme Uncaria quatro vezes por dia. Em geral, não houve diferença significativa entre as respostas. Contudo, o grupo de Uncaria apresentou escores inferiores nos dois primeiros dias de tratamento (p < 0,005 t = 0,028), depois do dia 3, foi similar ao aciclovir. Conclusão: a avaliação da eficácia clínica dos tratamentosdemonstraram que ambas as drogas foram seguras, bem como não foram notificadas reações adversas. Além disso, não houve diferença significativa (p 0,05) no período total de infecções, bem como no processo inflamatório ou na formação de crosta. Quanto à gravidade da reação inflamatória, a eficácia clínica da Uncaria tomentosa foi significativamente melhor do que o aciclovir. Em vez de a droga ser antiviral, a Uncaria tomentosa pode atuar como um agente anti-inflamatório e isso, possivelmente, representa uma vantagem de não induzir resistência viral para uso por muito tempo.

Ultrastructural analysis of kidney, liver and duodenum isolated from treated rats with Ginkgo Biloba extract and effects of this medicinal plant on the biodistribution of the padiopharmaceutical sodium pertechnetate

Ginkgo biloba extract (EGb) has been used to treat memory and concentration deficits, acts as platelet activatingfactor antagonism and prevents against damages caused by free radicals. EGb is a standardized extract that contains 24% flavonoids and 6% terpenoids. The aim of this work was to evaluate the possible influence of an EGb on the ultrastructure of some organs isolated from rats and on the biodistribution of sodium pertechnetate (99mTcO4Na). The animals were treated with EGb and after six days, received 99mTcO4Na. The organs were isolated and fixed for ultrastructural analysis. The results showed that EGb has modified the ultrastructure of kidney, liver and duodenum and altered the biodistribution of 99mTcO4Na (P<0.05). It is speculated that the substances present in the EGb could act directly or generate metabolites capable to promote changes on the biodistribution of 99mTcO4Na and on the morphology of organs at ultrastructural level.

O extrato de Ginkgo Biloba extract (EGb) tem sido usado para tratar dificuldades de concentração,memória, age como antagonista do fator de ativação de plaquetas e previne contra danos causados por radicais livres. EGb é um extrato padronizado com 24% de flavonóides e 6% de lactonas terpênicas. O objetivo deste estudo foi avaliar o efeito de um EGb na ultraestrutura de alguns órgãos isolados de ratos e na biodistribuição do radiofármaco pertecnetato de sódio (99mTcO4Na). Os animais foram tratados com EGb e após 6 dias receberam 99mTcO4Na. Os órgãos foram isolados e a radioatividadedeterminada. Os tecidos foram fixados para microscopia eletrônica. Os resultados mostraram que EGb alterou a ultraestrutura do rim, figado e duodeno e modificou a biodistribuição do99mTcO4Na. Sugerimos que substâncias presentes no EGb poderiam agir diretamente ou gerar metabólitos capazes de promover alterações nabiodistribuição e na morfologia de órgãos em nível ultraestrutural.

The ingestion of a Nectandra membranacea extract changes the bioavailability of technetium-99m radiobiocomplex in rat organs.

The radiobiocomplexes labeled with technetium-99m (Tc-99m) have been widely used in nuclear medicine in single photon emission computed tomography and in basic research. The aim of this study was to assess the influence of a Nectandra membranacea extract on the bioavailability of the sodium pertechnetate (Na(99m)TcO(4)) radiobiocomplex in rat organs. The animals were treated with a N. membranacea extract (30 mg/ ml), for 6 days. Na(99m)TcO(4) was injected, the organs were isolated and weighed, and the radioactivity was determined in each organ (%ATI/organ). The %ATI/organ was divided by the mass of each organ to calculate the %ATI/g. A significant increase of the %ATI/organ of Na(99m)TcO(4) was observed in muscle and thyroid as well as in the %ATI/g in the heart, kidney and thyroid. These findings could result from the interaction between components of the plant extract and the radiobiocomplex which may influence the uptake Na(99m)TcO(4) in rat organs. Therefore, precaution is suggested in the interpretation of nuclear medicine results in patients using this herb.

The ingestión of a Nectandra membran cea extract changes the bioavailability of technetium-99m radiobiocomplex in rat organs

The radiobiocomplexes labeled with technetium-99m (Tc-99m) have been widely used in nuclear medicine in single photon emission computed tomography and in basic research. The aim of this study was to assess the influence of a Nectandra membran cea extract on the bioavailability of the sodium pertechnetate (Na99mTc0(4)) radiobiocomplex in rat organs. The animals were treated with a N. membran cea extract (30 mg/ ml), for 6 days. Na99mTc0(4) was injected, the organs were isolated and weighed, and the radioactivity was determined in each organ ( percentATI/organ). The percentATI/organ was divided by the mass of each organ to calculate the percentATI/g. A significant increase of the percentATI/organ of Na99mTc0(4) was observed in muscle and thyroid as well as in the percentATI/g in the heart, kidney and thyroid. These findings could result from the interaction between components of the plant extract and the radiobiocomplex which may influence the uptake Na99mTc0(4) in rat organs. Therefore, precaution is suggested in the interpretation of nuclear medicine results in patients using this herb.