[Integrative medicine and geriatrics : towards a convergence?] / Médecine intégrative et gériatrie : vers une convergence ?

In recent years integrative medicine has been the subject of growing interest among the overall population as well as the medical and scientific community. According to the Swiss health survey, approximately 40 % of the Swiss population regularly use complementary therapies. The fields of application of integrative medicine in geriatrics seem large (pain, cognitive disorders, end-of-life support, anxiety, etc.). Although scientific evidence is progressing in this area, studies targeting the population > 65 years old are still limited. The aim of this article is to expose some examples of complementary medicine applications in in geriatric care and the potential for rapprochement between integrative medicine and geriatric.

La médecine intégrative fait l'objet d'un intérêt accru au sein de la population et de la communauté médicale et scientifique ces dernières années. Selon l'Enquête suisse sur la santé, environ 40 % de la population suisse a régulièrement recours à des thérapies complémentaires. Les domaines d'application des médecines intégratives dans les soins gériatriques semblent vastes (douleurs, troubles du sommeil, accompagnement de fin de vie, anxiété, etc.). Les études ciblant spécifiquement la population de 65 ans et plus dans ce domaine restent encore limitées à notre connaissance. Cet article a pour but de présenter quelques exemples d'applications de médecine complémentaire dans la prise en charge des syndromes gériatriques et sensibiliser au potentiel de rapprochement entre la médecine intégrative et la gériatrie.

Medicinal Plants, Phytochemicals and Regulation of the NLRP3 Inflammasome in Inflammatory Bowel Diseases: A Comprehensive Review.

Ongoing research explores the underlying causes of ulcerative colitis and Crohn's disease. Many experts suggest that dysbiosis in the gut microbiota and genetic, immunological, and environmental factors play significant roles. The term "microbiota" pertains to the collective community of microorganisms, including bacteria, viruses, and fungi, that reside within the gastrointestinal tract, with a particular emphasis on the colon. When there is an imbalance or disruption in the composition of the gut microbiota, it is referred to as dysbiosis. Dysbiosis can trigger inflammation in the intestinal cells and disrupt the innate immune system, leading to oxidative stress, redox signaling, electrophilic stress, and inflammation. The Nod-like Receptor (NLR) Family Pyrin Domain Containing 3 (NLRP3) inflammasome, a key regulator found in immunological and epithelial cells, is crucial in inducing inflammatory diseases, promoting immune responses to the gut microbiota, and regulating the integrity of the intestinal epithelium. Its downstream effectors include caspase-1 and interleukin (IL)-1ß. The present study investigated the therapeutic potential of 13 medicinal plants, such as Litsea cubeba, Artemisia anomala, Piper nigrum, Morus macroura, and Agrimonia pilosa, and 29 phytocompounds such as artemisitene, morroniside, protopine, ferulic acid, quercetin, picroside II, and hydroxytyrosol on in vitro and in vivo models of inflammatory bowel diseases (IBD), with a focus on their effects on the NLRP3 inflammasome. The observed effects of these treatments included reductions in IL-1ß, tumor necrosis factor-alpha, IL-6, interferon-gamma, and caspase levels, and increased expression of antioxidant enzymes, IL-4, and IL-10, as well as regulation of gut microbiota. These effects could potentially provide substantial advantages in treating IBD with few or no adverse effects as caused by synthetic anti-inflammatory and immunomodulated drugs. However, additional research is necessary to validate these findings clinically and to develop effective treatments that can benefit individuals who suffer from these diseases.

Curcumin-Based Nanomedicines in the Treatment of Inflammatory and Immunomodulated Diseases: An Evidence-Based Comprehensive Review.

Curcumin (CUR) is a polyphenol extracted from the rhizome of Curcuma longa that possesses potent anti-inflammatory and antioxidant potential. Despite CUR's numerous beneficial effects on human health, it has limitations, such as poor absorption. Nano-based drug delivery systems have recently been applied to improve CUR's solubility and bioavailability and potentialize its health effects. This review investigated the effects of different CUR-based nanomedicines on inflammatory and immunomodulated diseases. PUBMED, EMBASE, COCHRANE, and GOOGLE SCHOLAR databases were searched, and the Scale for Assessment of Narrative Review Articles (SANRA) was used for quality assessment and PRISMA guidelines. Overall, 66 studies were included comprising atherosclerosis, rheumatoid arthritis (RA), Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), Huntington's disease (HD), inflammatory bowel diseases (IBD), psoriasis, liver fibrosis, epilepsy, and COVID-19. The available scientific studies show that there are many known nanoformulations with curcumin. They can be found in nanosuspensions, nanoparticles, nanoemulsions, solid lipid particles, nanocapsules, nanospheres, and liposomes. These formulations can improve CUR bioavailability and can effectively be used as adjuvants in several inflammatory and immune-mediated diseases such as atheroma plaque formation, RA, dementia, AD, PD, MS, IBD, psoriasis, epilepsy, COVID-19, and can be used as potent anti-fibrotic adjuvants in fibrotic liver disease.

Effects of intradialytic inspiratory muscle training at different intensities on diaphragm thickness and functional capacity: clinical trial protocol in patients undergoing haemodialysis.

INTRODUCTION: Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) commonly present with a sedentary behaviour and reduced functional capacity, factors that can compromise their prognosis. Intradialytic inspiratory muscle training (IMT) can increase respiratory muscle strength and, consequently, improve functional capacity, besides being easy to apply, cheap and performed in a supervised setting. However, few studies show the effects of this type of training applied at different intensities in this population. This study aims to compare the effects of IMT at different intensities in adults with ESRD undergoing HD. METHODS AND ANALYSIS: A randomised, double-blind, sham-controlled trial will be conducted on 36 subjects randomly allocated into three groups: IMT at intensities of 30% or 50% of maximal inspiratory pressure (intervention groups), or 10% of maximal inspiratory pressure (sham-IMT). All the interventions will be supervised and performed three times per week, for 12 weeks, totalling 36 sessions. The primary outcomes are the 6-minute walk test, diaphragm thickness and the response of VO2peak post-intervention. Respiratory muscle strength, 24-hour ambulatory blood pressure measurement and the Kidney Disease Quality of Life 36-item short form survey will be evaluated as secondary outcomes. ETHICS AND DISSEMINATION: This study has been approved by the Research Ethics Committee of the Hospital de Clínicas de Porto Alegre (ID: 2020-0458). The results of this study will be disseminated by conference presentations and peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT04660383.

Selenium in sediment and food webs of the Tapajós River basin (Brazilian Amazon) and its relation to mercury.

BACKGROUND: We investigated Se levels along the Tapajós River basin - which is an important tributary of the Amazon River - and the possible antagonistic effect of Se in Hg availability. This is the first study to investigate Se transfer from abiotic to biotic compartments and along the food chain in aquatic ecosystems of the Amazon basin. METHODS: Se concentrations were measured in superficial sediment (n = 29), plankton (n = 28) and fishes (n = 121) along two stretches of the Tapajós River basin (Tapup/mi and Taplow), comprising approximately 500 km with different hydrological characteristics. RESULTS: Se concentrations in sediment were significantly higher in the Taplow (345-664 µg kg-1) than in the Tapup/mi (60-424 µg kg-1). The seasonal flooding of the Amazon River probably helps to carry selenium-rich sediment to the Tapajós mouth (Taplow stretch). We suggest that Se in sediment could decrease the bioavailability of Hg resulting in lower MeHg concentrations in fish, as observed in the Taplow (45-934 µg kg-1). Sediment and plankton were positively correlated in relation to their Se concentrations (r = 0.62; p = 0.001) suggesting that sediment can possibly be the main source of Se to plankton. Our data indicate Se uptake by primary consumers, as noted in phytoplankton levels. The decrease of Se concentrations along the food chain was also noteworthy. CONCLUSION: This work elucidates some aspects of Se biogeochemistry in the Amazon basin and shows its importance regarding Hg cycles in aquatic ecosystems.

Direct determination of the nutrient profile in plant materials by femtosecond laser-induced breakdown spectroscopy.

Femtosecond laser-induced breakdown spectroscopy (fs-LIBS) has been used for the first time for quantitative determination of nutrients in plant materials from different crops. A highly heterogeneous population of 31 samples, previously analyzed by inductively coupled plasma optical emission spectroscopy, covering a wide range of matrices was interrogated. To tackle the analysis, laser-induced plasmas under argon atmosphere of pellets prepared from sieved cryogenically ground leaves were studied. Predictive functions based on univariate and multivariate modeling of optical emissions associated to macro- (Ca, Mg, and P) and micronutrients (Cu, Fe, Mn and Zn) were designed. Hierarchical cluster analysis was performed to select representative calibration (n(cal)=17) and validation (n(val)=14) datasets. The predictive performance of calibration functions over fs-LIBS data was compared with that attained on spectral information from nanosecond LIBS (ns-LIBS) operating at different wavelengths (1064 nm, 532 nm, and 266 nm). Findings established higher accuracy and less uncertainty on mass fractions quantification from fs-LIBS, whatever the modeling approach. Quality coefficients below 20% for the accuracy error on mass fractions' prediction in unknown samples, and residual predictive deviations in general above 5, were obtained. In contrast, only multivariate modeling satisfactorily handled the non-linear variations of emissions in ns-LIBS, leading to 2-fold decrease in the root mean square error of prediction (RMSEP) of Ca, Mg, P, Cu, Fe, Mn and Zn in comparison with the univariate approach. But still, an averaged quality coefficient about 35% and residual predictive deviations below 3 were found. Similar predictive capabilities were observed when changing the laser wavelength. Although predicted values by ns-LIBS multivariate modeling exhibit better agreement with reference mass fractions as compared to univariate functions, fs-LIBS conducts better quantification of nutrients in plant materials since it is less dependent on the chemical composition of the matrices.

Alelopatia de extratos de adubos verdes sobre a germinação e crescimento inicial de alface / Allelopathy of green manures extracts on germination and initial growth of the lettuce

Extratos aquosos obtidos de palhas de três gramíneas e três leguminosas nas concentrações de 2,5%, 5% e 10% foram preparados com o objetivo de determinar o potencial alelopático dessas espécies utilizadas como adubos verdes sobre alface (Lactuca sativa L.), e estimar a melhor concentração para uso desses extratos em bioensaios de laboratório. Para análise da germinação foram consideradas as variáveis porcentagem de germinação e índice de velocidade de germinação. Para análise do crescimento inicial consideraram-se as variáveis porcentagem de plantas normais, comprimento de raiz e parte aérea, massa fresca de raiz e parte aérea e massa seca de raiz e parte aérea. Os adubos verdes utilizados para preparação dos extratos foram as leguminosas crotalária (Crotalaria anagyroides H.B.K.), feijão-de-porco (Canavalia ensiformis (L.) DC) e guandu-anão Cajanus cajan (L). Millsp e as poaceas aveiapreta (Avena strigosa Schieb), sorgo (Sorghum bicolor (L.) Moench) e milheto (Pennisetum glaucum (L.) R. Brown), em cultivo exclusivo e consorciadas, perfazendo dezesseis tratamentos (crotalária, feijão-de-porco, guandu-anão, aveiapreta, sorgo, milheto, crotalária + aveia-preta, crotalária + sorgo, crotalária + milheto, feijão-de-porco + aveia-preta, feijão-de-porco + sorgo, feijão-de-porco + milheto, guandu-anão + aveia-preta, guandu-anão + sorgo, guandu-anão + milheto e testemunha). Adotou-se um arranjo fatorial 16 x 3 (quinze extratos de adubos verdes e testemunha x três concentrações), com três repetições. Os extratos que proporcionam maior efeito nas variáveis estudadas são os de feijão-de-porco e feijão-de-porco + aveia preta e a concentração que melhor estima o efeito dos extratos de adubo verdes é 5%.

Aqueous extracts obtained from three Poaceae species and three legume species straws at concentrations of 2,5%, 5% and 10% were prepared in order to determine the allelopathic potential of these species used as green manures on lettuce (Lactuca sativa L.), and to estimate these extracts optimal concentration for use in laboratory bioassays. For germination analysis, it was considered the variables percent germination and speed of germination index. For initial growth analysis, it was considered the variables percentage of normal plants, radicle and shoot lengths, and fresh and dry weight of the radicle and shoot. Green manures used for the preparation of extracts were the legume species sunn hemp(Crotalaria anagyroides H.B.K.), jack bean (Canavalia ensiformis (L.) DC) and pigeon pea (Cajanus cajan (L). Millsp and the Poaceae species black oat (Avena strigosa Schieb), shattercane (Sorghum bicolor (L.) Moench) and millet (Pennisetum glaucum (L.) R. Brown), with and without intercropping, completing a total of sixteen treatments (sun hemp, jack bean, pigeon pea, black oat, shattercane, millet, sun hemp + black oat, sun hemp + shattercane, sun hemp + millet, jack bean + black oat, jack bean + shattercane, jack bean + millet, pigeon pea + black oat, pigeon pea + shattercane, pigeon pea + millet and control). It was adopted a 16 x 3 factorial design (Fifteen green manures and the control X three concentrations) with three repetitions. The extracts that provide the greatest effect on the studied variables were from jack bean and jack bean + black oat and the concentration that best estimates the effect of green manures extracts of is 5%.