Enhanced bioactivity of Zanthoxylum schinifolium fermented extract: Anti-inflammatory, anti-bacterial, and anti-melanogenic activity.

Fermented extracts have evolved to be a potential alternative to synthetic chemicals, owing to their anti-inflammatory and anti-bacterial properties. This study intends to assess the potential of fermented Zanthoxylum schinifolium extract for use in biomedical applications. Probiotic bacteria, Lactobacillus rhamnosus A6-5, were deployed as a seed culture for fermentation. The fermented extract showed greater tyrosinase inhibitory activity and reduced melanin production (58.3%) compared with the raw extract. Cytotoxicity assay inferred that 500 µg/mL is the ideal non-toxic concentration with maximum cell viability. In addition, DAPI staining did not show any damage to the chromatin structure of the cells. The anti-aging property of the fermented extract was confirmed by a decrease in IL-6 content. The fermented extract showed lower MIC (40 mg/mL) and MBC (60 mg/mL), indicating greater anti-bacterial activity than the raw extract. The results confirmed that the fermented Z. schinifolium extract has high biomedical properties compared with the raw extract and can be used as an ideal skin whitening agent.

US Trends of Opioid-use Disorders and Associated Factors Among Hospitalized Patients With Spinal Conditions and Treatment From 2005 to 2014.

STUDY DESIGN: Serial cross-sectional study utilizing the National Inpatient Sample (NIS) 2005 to 2014. OBJECTIVE: The aim of this study was to examine the trends of opioid-use disorders among hospitalized patients with spinal conditions and treatment and to identify its contributing factors. SUMMARY OF BACKGROUND DATA: The opioid is widely used in chronic spinal conditions, and misuse of prescriptions is the main culprit of the opioid crisis. Cannabis, the most commonly utilized illicit drug, has recently been substituted for opioid despite increasing cannabis-use emergency room visits. There is limited information on opioid-use disorders, the association with cannabis, and other contributing factors. METHODS: We analyzed the 2005 to 2014 NIS data that identified opioid-use disorders among hospitalized patients with cervical and lumbar spinal conditions and treatment using the International Classification of Disease, Ninth Revision-Clinical Modification codes for opioid abuse, dependence, poisoning, and cervical and lumbar spinal diseases and procedures. The compound annual growth rate (CAGR) was used to quantify trends of opioid-use disorders among hospitalized patients. Multilevel and multivariable regression analyses were performed to determine their contributing factors. RESULTS: The number of hospitalizations with spinal conditions and treatment increased from 2005 to 2011, then decreased between 2011 and 2014 with an overall decrease in length of stay, resulting in the CAGR of -1.60% (P < .001). Almost 3% (2.93%, n = 557,423) of hospitalized patients with spinal conditions and treatment were diagnosed as opioid-use disorders and its CAGR was 6.47% (P < .0001). Opioid-use disorders were associated with cannabis-use disorders (odds ratio 1.714), substance use, mental health condition, younger age, white race, male sex, higher household income, and public insurance or uninsured. CONCLUSION: This study suggests that opioid-use disorders are increasing among hospitalized patients with spinal conditions and treatment and associated with several demographic, and socioeconomic factors, including cannabis-use disorders. LEVEL OF EVIDENCE: 3.

Dissociation between the growing opioid demands and drug policy directions among the U.S. older adults with degenerative joint diseases.

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others.As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation.A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45-64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital stays among 65 and older in the nation, Oregon and Washington states from 2008 through 2017. Orthopedic operations (knee arthroplasty, total or partial hip replacement, spinal fusion or laminectomy) and opioid-related hospital stays were measured. The compound annual growth rate (CAGR) was used to quantify temporal trends of orthopedic operations by age groups as well as opioid-related hospital stays and was tested by Rao-Scott correction of χ for categorical variables.The CAGR (4.06%) of orthopedic operations among age 65 and older increased (P < .001) unlike the unchanged rate among age 45 to 64. The CAGRs of opioid-related hospital stays among age 65 and older were upward trends among seniors in general (6.79%) and in Oregon (10.32%) and Washington (15.48%) in particular (all P < .001).Orthopedic operations and opioid-related hospital stays among seniors increased over time in the U.S. Marijuana legalization might have played a role of gateway drug to opioid among seniors.