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Herbal medicine for Sports
02 Aug 18

In this study, herbs for sport are discussed (1). Emergent evidence suggests that the health benefits from plants are attributed to their bioactive compounds such as Polyphenols, Terpenoids, and Alkaloids which have several physiological effects on the human body. At times, manufacturers launch numerous products with banned ingredient inside with inappropriate amounts or fake supplement inducing harmful side effect. Unfortunately up to date, there is no guarantee that herbal supplements are safe for anyone to use and it has not helped to clear the confusion surrounding the herbal use in sport field especially. Hence, the purpose of this review is to provide guidance on the efficacy and side effect of most used plants in sport. The authors have identified plants according to the following categories: Ginseng, alkaloids, and other purported herbal ergogenics such as Tribulus Terrestris, Cordyceps Sinensis. We found that most herbal supplement effects are likely due to activation of the central nervous system via stimulation of catecholamines. Ginseng was used as an endurance performance enhancer, while alkaloids supplementation resulted in improvements in sprint and cycling intense exercises. Despite it is prohibited, small amount of ephedrine was usually used in combination with caffeine to enhance muscle strength in trained individuals. Some other alkaloids such as green tea extracts have been used to improve body mass and composition in athletes. Other herbs (i.e. Rhodiola, Astragalus) help relieve muscle and joint pain, but results about their effects on exercise performance are missing.

References

(1) Sellami M, et al. Herbal medicine for sports: a review. J Int Soc Sports Nutr. 2018;15:14
Acupuncture for Dry Eye Syndrome
02 Aug 18

In a former meta-analysis review, acupuncture was considered a potentially effective treatment for dry eye syndrome (DES), but there were heterogeneities among the outcomes. In this study, the authros updated the meta-analysis and conducted subgroup analysis to reduce the heterogeneity and suggest the most effective acupuncture method based on clinical trials (1). The authors searched the appropriate databases. The results showed that nineteen studies with 1126 patients were included. For treatment duration, treatment longer than 1 month was more effective than shorter treatment. With regard to treatment frequency, treatment less than three times a week was more effective than more frequent treatment. In the acupoint analysis, acupuncture treatment including the BL2 and ST1 acupoints was less effective than treatment that did not include them. None of those factors reduced the heterogeneity. The authors conclude that acupuncture was more effective in treating DES but showed high heterogeneity.

References

(1) Kim BH, et al. Optimizing acupuncture treatment for dry eye syndrome: a systematic review. BMC Complement Altern Med. 2018; 18(1):145.
Vitamin D and Blood Sugar in Women with Osteoporosis
02 Aug 18

Postmenopausal osteoporosis (PMO) is associated with other comorbidities such as impaired glucose homeostasis and cardiovascular disease. Vitamin D insufficiency is highly prevalent and may be a common link between these disorders. In this study, the aim was to assess the relationship between circulating levels of Vitamin D (25(OH)D) and parameters of glucose homeostasis in a cohort of women with PMO to establish a serum concentration threshold of 25(OH)D for improved glycemic parameters (1). This cross-sectional study included 40 women with PMO. The results showed that circulating levels of 25(OH)D were related to glucose parameters in women with PMO, resulting in an indicator of insulin sensitivity independent of age, body mass index, percent body fat, and undercarboxylated osteocalcin. The authors conclude that this study supports the hypothesis that circulating 25(OH)D levels are related to improved glucose homeostasis in women with PMO. However, this relationship was apparent only in the presence of high circulating levels of 25(OH)D.

References

(1) Avila-Rubio V, et al. Higher Levels of Serum 25-Hydroxyvitamin D Are Related to Improved Glucose Homeostasis in Women with Postmenopausal Osteoporosis. J Womens Health (Larchmt). 2018.
DNA Methylation in ageing and cancer
19 Jun 18

In this article, the authors review information related to DNA methylation, and its association with cancer and ageing (1). The review outlines the key factors, including diet, which modulate DNA methylation. Ageing and diseases, including cancer, are often accompanied by aberrant DNA methylation, a key epigenetic process, which is crucial to the regulation of gene expression. Significantly, it has been observed that with age and certain disease states, DNA methylation status can become disrupted. For instance, a broad array of cancers are associated with promoter-specific hypermethylation and concomitant gene silencing. This review highlights that hypermethylation, and gene silencing, of the EN1 gene promoter, a crucial homeobox gene, has been detected in various forms of cancer. This has led to this region being proposed as a potential biomarker for diseases such as cancer. The authors conclude the review by describing a recently developed novel electrochemical method that can be used to quantify the level of methylation within the EN1 promoter and emphasise the growing trend in the use of electrochemical techniques for the detection of aberrant DNA methylation.

References

(1) Morgan AE, et al. The role of DNA methylation in ageing and cancer. Proc Nutr Soc. 2018 Apr 30:1-11.
Topical ozone therapy for herpes zoster
19 Jun 18

In this article, the authors observed the clinical efficacy and safety of topical ozone therapy for patients with herpes zoster by reflectance confocal microscopy (RCM) (1).  A total of 60 patients with herpes zoster were divided into a control group and an ozone treatment group. In the control group, patients took oral valacyclovir tablets or granules (0.3 g per day, three times a day) and they were subjected to local weak laser irradiation treatment plus topical 2% mupirocin ointment twice a day. In the ozone group, the treatment is same as the control group except mupirocin ointment was replaced with topical ozone treatment (hydrotherapy every day plus ozonated oil twice a day). The clinical symptoms, discoid cell and adverse reactions were observed and taken records at day 0, 3, 7 and 14. Statistical analysis was performed to compare the clinical efficacy between the 2 groups. The results showed that on the seventh day of treatment, the discoid cells of the ozone group disappeared, and the difference between the control group and the ozone group was statistically significant. The difference of decreased percentage of pain scores at each time point between the 2 groups was statistically significant. The clinical efficacy was 100% in the ozone group and 86.7% in the control group, with significant difference between the 2 groups. The authors conclude that topical ozone therapy in patients with herpes zoster is helpful in relieving pain, shortening the course as well as improving the clinical efficacy without obvious adverse reactions.

References

(1) Huang J, et al. [Topical ozone therapy: An innovative solution to patients with herpes zoster]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018 Feb 28;43(2):168-172.
Acupuncture for Anxiety
19 Jun 18

Anxiety disorders are one of the most common mental health concerns with a major contribution to the global burden of disease. Pharmacology and psychotherapy stand for the conventional treatment for anxiety disorders but these present limited efficacy, especially in the case of chronic anxiety, with high relapse rates and often causing adverse side effects. Clinical research studies render acupuncture as a valid treatment therapy for anxiety disorders without significant adverse effects (1). This article reviewed the literature on the effectiveness of acupuncture and electroacupuncture for the treatment of patients with anxiety. The systematic review of the clinical research was focused on published clinical trials (controlled, randomized and non-randomized) regarding the treatment of anxiety with acupuncture. Only clinical trials where anxiety was treated as the therapeutic target, and not as a secondary measurement or being associated with other health condition or disease, were considered. After review, the results showed that 13 papers were identified to match exclusion and inclusion criteria and were selected for this analysis. Methodology, design, and quality of the research were highly variable and are discussed and compared. The authors conclude that overall, there is good scientific evidence encouraging acupuncture therapy to treat anxiety disorders as it yields effective outcomes, with fewer side effects than conventional treatment.

References

(1) Amorim D, et al. Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complement Ther Clin Pract. 2018 May;31:31-37
Vitamin D for Asthma
19 Jun 18

Asthma is a prolonged respiratory disease related with hyper-responsiveness and increased inflammation of airways; affects millions peoples worldwide. Vitamin D possess anti-inflammatory and immunomodulatory activities (1). Its deficiency (the level less than 20 ng/mL in the serum) is found to be related to occurrence of pulmonary diseases including bacterial and viral infections and asthma. Some studies indicate that low levels of vitamin D in the serum are related to reduced lung function and increased airway inflammation as well as overall poor results in asthmatic patients. Thus, it provides positive relation between vitamin D and asthma. This article discusses how the results of clinical trials are inconsistent and do not provide supportive information about positive role of vitamin D in asthma. The results of the authors showed that little or even no effect of supplementation of vitamin D in improvement of onset, symptoms or progression of asthma was found in comprehensive interventional studies in adults, children and pregnant woman, and that's what the authors conclude.

References

(1) Szymczak I, Pawliczak R. Can vitamin D help in achieving asthma control? Vitamin D "revisited'': an updated insight. Adv Respir Med. 2018;86(2):103-109.
Soy isoflavones and xenobiotic metabolism
19 Jun 18

Soy isoflavones, such as genistein and daidzein, are bioflavonoids found in soy products that are able to interact with various hormones such as estrogen. In this article, a systematic review of published studies was carried out to investigate the characterization of isoflavones and their metabolites, sample pretreatment and quantitative analysis of isoflavones, and the influence of soy isoflavones on drug and xenobiotic metabolism. The results showed that aglycones with weak estrogen-like activities are the biologically active forms of the soy isoflavones in mammals. The most recent advances including extraction, purification and detection of isoflavones in soybean and soy products are discussed. The effects of soy isoflavones on drug and xenobiotic metabolism involve in regulation of phase I cytochrome P450 (CYPs) enzyme and phase I detoxifying enzymes expression and activity. At the molecular level, soy isoflavones have proved capable of estrogenic/antiestrogenic with tissue-selective, anti-cancer, anti-obesity, anti-oxidation, and tyrosine kinase inhibition activities. The authors conclude that soy isoflavones can decrease the incidence of many diseases and benefit for human health.

References

(1) Zhou T, et al. Soy isoflavones and their effects on xenobiotic metabolism. Curr Drug Metab. 2018 Apr 27.
Water exercise for coronary artery disease patients
03 May 18
It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD) (1). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. This study aimed to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients. Twenty-six male subjects with CAD were randomly divided into a training group, submitted to the WAET, and a control group. The WAET consisted of 3 weekly sessions on alternate days, totalling 48 sessions. The results showed that only the training group participants had improvement in the HR variability indices; patterns without variation decreased and an increase of patterns of two different variations , Shannon entropy, and normalized conditional entropy, whereas the control group had an increase of 0V (p = .04) and a decrease of normalized conditional entropy. All body composition variables remained unchanged.
References (1) Fiogbe E, et al. Water exercise in coronary artery disease patients, effects on heart rate variability, and body composition: A randomized controlled trial. Physiother Res Int. 2018; doi: 10.1002/pri.1713.
Restless leg syndrome and non-pharmacological treatment: a systematic review
03 May 18
Restless legs syndrome (RLS) is a sensorimotor disorder characterised by an uncomfortable urge to move the legs. This article attempted to synthesise results of non-pharmacological/non-surgical treatment compared to no-treatment controls or alternative treatment for RLS on any relevant outcome (1). The search yielded 442 articles. Eleven trials met inclusion criteria. Repetitive transcranial magnetic stimulation, exercise, compression devices, counterstrain manipulation, infrared therapy, and standard acupuncture were significantly more effective for RLS severity than control conditions. Vibration pads, cryotherapy, and transcranial direct current stimulation were ineffective in reducing RLS severity. Vibration pads, cryotherapy, yoga, compression devices, and acupuncture significantly improved some sleep-related outcomes. The authors conclude that repetitive transcranial magnetic stimulation, exercise, compression devices, counterstrain manipulation, infrared therapy, and standard acupuncture may reduce restless leg syndrome severity. Vibration pads, cryotherapy, yoga, compression devices, and acupuncture may improve some sleep-related outcomes in restless leg syndrome. References (1) Harrison EG, et al. Non-pharmacological interventions for restless legs syndrome: a systematic review of randomised controlled trials. Disabil Rehabil. 2018; doi: 10.1080/09638288.2018.1453875.
Menstrual disorders and PMS in teenagers and Vitamin D
03 May 18
There have been several studies evaluating the association between vitamin and mineral status and menstrual disturbance (1). In this study, the authors aimed to assess the relationship between the menstrual bleeding pattern and premenstrual syndrome (PMS) symptoms with serum 25-hydroxyvitamin D, and calcium levels in adolescent girls. There was no significant association between the symptoms of PMS, as assessed by the questionnaire and serum vitamin D status, or serum calcium concentrations, apart from the irritability. There appears to be an association between serum calcium, menstrual blood loss and irritability in adolescent girls. The authors conclude that the level of calcium was associated with the level of menstrual blood loss and irritability. However, no significant association was observed between the menstrual bleeding pattern or the PMS symptoms with a vitamin D status. References (1) Bahrami A, et al. J Obstet Gynaecol. 2018; doi: 10.1080/01443615.2018.1434764.
Nutrients for first-episode psychosis
03 May 18
This article aimed to review all studies examining efficacy, tolerability and the biological mechanisms of action, of nutrient supplementation in first episode psychosis (FEP) (1). A systematic review was conducted. The results included 11 studies. . Six studies examined omega-3 fatty acids, with inconsistent effects on psychiatric symptoms. However, mechanistic studies found significant improvements in hippocampal neuronal health and brain glutathione. Antioxidants "n-acetyl cysteine" and vitamin C also improved oxidative status in FEP, which was associated with reduced psychiatric symptoms. No benefits were found for vitamin E . Finally, one study trialling the amino acid taurine, showed significant improvements in positive symptoms and psychosociall functioning. The authors conclude that there is preliminary evidence that taurine improves outcomes in FEP, whereas effects of omega-3 and antioxidant vitamins/amino-acids are inconsistent; perhaps mainly benefitting patients with high levels of oxidative stress. References (1) Firth J, et al. Adjunctive nutrients in first-episode psychosis: A systematic review of efficacy, tolerability and neurobiological mechanisms. Early Interv Psychiatry. 2018, doi: 10.1111/eip.12544.
Vitamin D effects on athletic performance
03 May 18
This article discusses Vitamin D and its effects on athletic performance (1). Vitamin D is important for calcium homeostasis and bone metabolism. It also has important direct effects on skeletal muscle. Unlike authentic vitamins, which cannot be synthesized in the body, vitamin D is produced in the skin using sunlight. Through its nuclear receptor located throughout the body, including skeletal muscle, vitamin D initiates genomic and nongenomic pathways regulating multiple actions, including muscle cell proliferation and growth. In some studies, vitamin D supplementation has been shown to increase muscle strength, particularly in people who are vitamin D deficient. Higher serum levels of vitamin D are associated with reduced injury rates and improved sports performance. In a subset of the population, vitamin D appears to play a role in muscle strength, injury prevention, and sports performance.

References

1) Abrams GD, et al. Effects of Vitamin D on Skeletal Muscle and Athletic Performance. J Am Acad Orthop Surg. 2018. doi: 10.5435/JAAOS-D-16-00464.
Use of Complementary Health for acute complaints in the emergency department
20 Apr 18
This study aimed to determine the prevalence of complementary health approaches (CHAs) specifically for acute complaints in patients assessed in a pediatric emergency department (ED) and factors associated with use (1). A cross-sectional survey was offered to patients between the age of 28 days and 18 years assessed at a tertiary pediatric ED. The results showed that of 475 potential participants, 412 (86.7%) participated, of which 369 (89.5%) completed the survey. Overall, 28.7% reported using any CHA for their child to treat the presenting complaint in the prior 72 hours to the ED visit. Gastrointestinal complaints had the highest use of CHA (46.3% of presentations endorsed use). The most common complementary health products used were vitamins and minerals; the most common complementary health practice used was massage. The authors conclude clinicians should consider the use and safety of CHA when evaluating children presenting to the ED with acute conditions.

References

(1) Kalaichandran A, et al. Use of Complementary Health Approaches for Acute Complaints Presenting to the Emergency Department. Pediatr Emerg Care. 2018;doi: 10.1097/PEC.0000000000001424.
Reversal agents in the era of non-vitamin K oral anticoagulants
16 Apr 18
The purpose of this review is to outline the currently developed non-vitamin K oral anticoagulant (NOAC) molecular antagonists, their potential clinical roles and future directions (1). The incidence and prevalence of atrial fibrillation (AF) is expected to more than double between 2010 and 2030. Accordingly, the use of NOAC agents for thromboembolic stroke prevention is anticipated to increase. The development of effective and safe antidotes is needed to address the unmet need for rapid anticoagulation reversal. The immediate role for these novel antidotes is for reversal of NOAC activity in life threatening bleeding and urgent surgical intervention. In addition, reversal agents may play an important role in simplifying bridging protocols in the peri-procedural period for catheter ablation of AF and elective surgery. Currently, novel reversal agents are either decoy drug receptors or small molecule non-specific anticoagulant activity inhibitors. The authors discuss how these agents are at various stages of FDA investigation and approval, with emerging prospective data for safety and efficacy.

References

(1) Abed HS, et al. Reversal Agents in the Era of NOACs. J Atr Fibrillation. 2017;10(4):1634.