Evaluation of quality of life and static balance in postmenopausal osteoporosis women after Tai Chi Chuan practice: an observational randomized case control study.

Post-menopausal osteoporosis women are at increased risk for skeletal fractures with higher mortality and lower quality of life. Some studies have reported fall risk reduction in the elderly after Tai chi practice. Tai chi is a weight bearing mind-body exercise that has been reported to positively influence bone mineral density and improve postural control in different pathologies. The aim of this observational randomized case control study is to evaluate the effect of Tai chi on balance and quality of life in postmenopausal women with osteoporosis. A total of 98 postmenopausal osteoporosis women, aged 70.6±8.2 years (mean and standard deviation), (mean T-score of the hip and spine were-2.9± 0.92 and -2.8±1.08), have been recruited in outpatients University Physical Medicine and Rehabilitation Hospital between June 2016 and September 2018. They have been randomized to a Tai group (56 patients, mean age 71.61±7.97 years) practiced 6-month Tai chi program, two times week, plus standard care or to a Control Group (42 patients, mean age 69.71±8.61 years) practiced usual care. Patients with oncological, neurological, cognitive, vestibular and visual diseases were excluded. Patients were evaluated at baseline (T0), prior Tai chi and after 6 month (T1) with 36-Item Short Form Health Survey (SF-36), and a stabilometric-standardized exam performed for the evaluation, respectively, of the quality of life and the static balance. The groups were homogenous at baseline. T1 evaluation showed better results in Tai chi group, in SF36 Physical functioning (p level: 0.021), Physical health pain (p level: 0.020), Physical composite score (p level: 0.003) scores, compared with control group. There were not significant differences between groups in stabilometric analysis. Tai chi group showed significant better stabilometric values at T1 compared with T0 in mean anterior-posterior (p level: 0.001) and medio-lateral (p level: 0.019) velocity, in perimeter (p level 0.001) , and in the area of the ellipse ( p level 0.006) in a within group analysis. Tai chi seemed to be effective in improving physical aspects of quality of life, in postmenopausal women with osteoporosis. Standing balance seems to increase after 6 months Tai chi program, in post-menopausal also if results were not significant. Further studies will be useful to measure effects of a Tai chi longer practice, as literature suggests, and a possible reduction of falling risk and fractures.

Melatonin reduces the need for sedation in ICU patients: a randomized controlled trial.

BACKGROUND: Critically ill patients suffer from physiological sleep deprivation and have reduced blood melatonin levels. This study was designed to determine whether nocturnal melatonin supplementation would reduce the need for sedation in patients with critical illness. METHODS: A single-center, double-blind randomized placebo-controlled trial was carried out from July 2007 to December 2009, in a mixed medical-surgical Intensive Care Unit of a University hospital, without any form of external funding. Of 1158 patients admitted to ICU and treated with conscious enteral sedation, 82 critically-ill with mechanical ventilation >48 hours and Simplified Acute Physiology Score II>32 points were randomized 1:1 to receive, at eight p.m. and midnight, melatonin (3+3mg) or placebo, from the third ICU day until ICU discharge. Primary outcome was total amount of enteral hydroxyzine administered. RESULTS: Melatonin treated patients received lower amount of enteral hydroxyzine. Other neurological indicators (amount of some neuroactive drugs, pain, agitation, anxiety, sleep observed by nurses, need for restraints, need for extra sedation, nurse evaluation of sedation adequacy) seemed improved, with reduced cost for neuroactive drugs. Post-traumatic stress disorder prevalence did not differ between groups, nor did ICU or hospital mortality. Study limitations include the differences between groups before intervention, the small sample size, and the single-center observation. CONCLUSION: Long-term enteral melatonin supplementation may result in a decreased need for sedation, with improved neurological indicators and cost reduction. Further multicenter evaluations are required to confirm these results with different sedation protocols.

Cytotoxic and antioxidant properties of selected Scutellaria species from the Western Ghats of Peninsular India.

CONTEXT: Scutellaria (Lamiaceae), commonly known as 'Skullcaps', has been extensively used in Traditional Chinese Medicine (TCM). Recently, much emphasis has been given to this genus due to the rich source of bioflavonoids that contribute to its biological properties. Therefore, different species of Scutellaria are being explored worldwide. OBJECTIVES: Cytotoxic, antioxidant, and phytochemical properties of Scutellaria colebrookiana Benth and S. violacea (Heyne ex Benth) Don collected (October 2009-February 2010) from Western Ghats of India have been analysed. MATERIALS AND METHODS: In vitro cytotoxicity and free radical scavenging effects of root extracts in various solvents were analysed. Spectrophotometric and HPLC methods were performed for phytochemical analysis. RESULTS: Chloroform extract exhibited significant cytotoxicity in Dalton's Lymphoma Ascites (DLA) and Ehrlich Ascites Carcinoma (EAC) cells with IC(50) values 150 and 140 µg/mL for S. colebrookiana and 250 and 280 µg/mL for S. violacea, respectively. Moreover, the extract was effective in scavenging free radicals and inhibiting membrane peroxidation in vitro with IC(50) values 158.3 and 167.5 (superoxide), 17.5 and 28.0 (hydroxyl), 76.25 and 69.75 (DPPH), 24.5 and 28.0 (ABTS), 69.75 and 64.6 (lipid peroxidation), 41 and 31.5 µg/mL (erythrocyte hemolysis), respectively. Antioxidant effect observed with acetone extract was also comparable to that of chloroform extract. Phytochemical screening revealed the presence of baicalein. DISCUSSION AND CONCLUSION: Scutellaria species of Western Ghats showed cytotoxic and antioxidant potential and the presence of baicalein. This suggests that S. colebrookiana and S. violacea could be used as alternative sources for baicalein in view of the reported scarcity of S. baicalensis.