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International Journal of Spine Surgery Mar 2024Our objective is to describe a minimally invasive endoscopic surgical technique for performing lateral lumbar interbody fusion (LLIF). LLIF is a common approach to...
BACKGROUND
Our objective is to describe a minimally invasive endoscopic surgical technique for performing lateral lumbar interbody fusion (LLIF). LLIF is a common approach to lumbar fusion in cases of degenerative lumbar disease; however, complications associated with psoas and lumbar plexus injury sometimes arise. The endoscopic modification presented here diminishes the requirement for sustained muscle retraction, minimizing complication risk while allowing for adequate decompression in select cases.
METHODS
Endoscopic LLIF (ELLIF) was performed in 3 patients from 2019 to 2021. Surgeries were performed in the lateral position under general anesthesia with neurophysiological monitoring. Discectomy, endplate preparation, and harvesting of iliac crest bone were performed through a working channel endoscope. The introduction of an interbody cage (Joimax EndoLIF) was performed over a nitinol blunt-tip wire (Joimax). No expandable blade retractors were required.
RESULTS
At 2-year follow-up of these 3 patients, the mean visual analog scale (VAS) score for leg pain improved from 9.3 to 1.7, and the mean Oswestry Disability Index (ODI) score improved from 40 to 8.3. There were no complications, readmissions, or recurrence of symptoms during the 2-year follow-up period. Patients spent an average of 36 hours in the hospital postoperatively and returned to normal daily activities after an average of 48 days.
CONCLUSIONS
A minimally invasive modification to the LLIF procedure is presented that offers several potential advantages due to the application of endoscopic techniques: reduced muscle retraction, smaller incision, and the opportunity to perform both indirect decompression and endoscopically visualized discectomy in the same fusion procedure.
CLINICAL RELEVANCE
The proposed endoscopic lateral lumbar interbody fusion and decompression is a minimally invasive technique that may provide patients with minimal complications, quick recovery, and good functional recovery.
PubMed: 38320807
DOI: 10.14444/8572 -
Evidence-based Complementary and... 2023leaves are among the most common materials employed in manufacturing herbal medicinal products. Despite the phytochemical variation of cultivars, there are no...
INTRODUCTION
leaves are among the most common materials employed in manufacturing herbal medicinal products. Despite the phytochemical variation of cultivars, there are no monographs to guide the cultivation, processing, and authentication of the materials.
METHODS
This study characterized 15 Ugandan leaf varieties, with reference to extraction index (EI), total phenolic content (TPC), antioxidant activity (AOA), and mangiferin concentration (MC). In addition, HPLC fingerprints were established to evaluate the overall phytoequivalence of the materials. Then, using hierarchical clustering (HC) and principal component analysis (PCA), the materials were assigned quality grades.
RESULTS
The mean EI was 9.39 ± 1.64% and varied among the varieties (=0.001); the TPC varied significantly ( < 0.0001), from 183.29 ± 2.36 mg/g (Takataka) to 79.47 ± 0.58 mg/g (Apple mango). AOA ranged from 16.81 ± 2.85 g/mL (Doodo red) to 87.85 g/mL (Asante). MC varied significantly ( < 0.0001), from 105.75 ± 0.60 mg/g (Kate) to 39.53 ± 0.30 mg/g (Asante). HC gave four major grades: A to D (A, varieties with the highest TPC, MC, and AOA). These parameters reduced to below average from group B to group D. The chromatographic fingerprints were visually similar, but the number of peaks varied, from 19 (Kawanda green) to 29 (Kawanda wide), with 23.5 ± 2.9 average peaks. Whole fingerprints were less similar ( < 0.8) than common peak fingerprints ( > 0.9, < 0.001). PCA grouped the fingerprints into five clusters; loading plots for PC 1 and 2 revealed two important compounds, one at Rt = 15.828 minutes (mangiferin) and the other at 6.021 minutes. Using the standardized common fingerprints, unknown field samples clustered closely with Koona, Kate, and Kawanda green varieties.
CONCLUSIONS
The EI, TPC, MC, and AOA values can be utilized to monitor consistency in the quality of materials and the production process. The grades generated can be used to select materials for cultivation and manufacturing. Where minimum concentrations are set, materials of different concentrations are used to dilute or concentrate each other. The HPLC fingerprints can be utilized to authenticate the materials. More samples from different agroecological regions of the country should be tested to cater to climatic variations in order to develop GMP-compliant botanical identification methods.
PubMed: 37576452
DOI: 10.1155/2023/7245876 -
International Journal of Environmental... Aug 2023The use of herbal medicines is increasing worldwide. While the safety profile of many herbal medicines is promising, the data in the literature show important...
The use of herbal medicines is increasing worldwide. While the safety profile of many herbal medicines is promising, the data in the literature show important interactions with conventional drugs that can expose individual patients to high risk. The aim of this study was to investigate the experience of the use of herbal medicines and preparations and the risks of interactions between herbal and conventional medicines among Latvian citizens. Data were collected between 2019 and 2021 using a structured questionnaire designed for pharmacy customers in Latvia. Electronic databases such as Drugs.com, Medscape, and European Union herbal monographs were reviewed for the risk of drug interactions and potential side effects when herbal medicines were involved. The survey included 504 respondents. Of all the participants, 77.8% used herbal preparations. Most of the participants interviewed used herbal remedies based on the recommendation of the pharmacist or their own initiative. A total of 38.3% found the use of herbal remedies safe and harmless, while 57.3% of respondents regarded the combination of herbal and regular drugs as unsafe. The identified herbal medicines implicated in the potential risk of serious interactions were grapefruit, St. John's wort, and valerian. As the risks of herb-drug interactions were identified among the respondents, in the future, both pharmacy customers and healthcare specialists should pay more attention to possible herb-drug interactions of over-the-counter and prescription medications.
Topics: Humans; Latvia; Plants, Medicinal; Phytotherapy; Prescriptions; Prescription Drugs
PubMed: 37623137
DOI: 10.3390/ijerph20166551 -
PhytoKeys 2024The first ever liverwort and hornwort checklist is provided for the Maluku Islands (Moluccas/Spice Islands) of Indonesia. We report 355 accepted and 16 doubtful species...
The first ever liverwort and hornwort checklist is provided for the Maluku Islands (Moluccas/Spice Islands) of Indonesia. We report 355 accepted and 16 doubtful species and reject 22 species previously reported for Maluku Islands. The list is based on the specimens housed in the Herbarium Bogoriense (BO) and reports from over 500 literature references, including monographs, regional studies, and molecular investigations. The Maluku Islands are part of the Wallacea Biodiversity Hotspot with many unique species found only in Wallacea. Publications focusing on liverworts and hornworts of Maluku Islands are few and scattered. Considering regionally widespread species that have been recorded elsewhere, we predict that further fieldwork exploring the diversity of habitats coupled with collections unveiled from regional herbaria, a number of new records remain to be reported.
PubMed: 38545400
DOI: 10.3897/phytokeys.239.116679 -
EJNMMI Radiopharmacy and Chemistry Apr 2024Steps have been taken by pharmaceutical companies to obtain marketing authorisation of PSMA ligands in the European Union. Since December 2022, Locametz® (PSMA-11,...
BACKGROUND
Steps have been taken by pharmaceutical companies to obtain marketing authorisation of PSMA ligands in the European Union. Since December 2022, Locametz® (PSMA-11, gozetotide) is licensed as kit for manual radiolabelling with gallium-68 and commercially available since mid-2023. The Summary of Product Characteristic (SmPC) describes manual radiolabelling with a maximum activity after radiolabelling of 1369 MBq. We aimed for radiolabelling with a higher activity to increase production efficiency, and thus, automated radiolabelling is strongly preferred over manual radiolabelling to reduce radiation exposure to personnel. The aim of this study was to develop and validate a method for automated radiolabelling of the Locametz® kit using ~ 2000 MBq of gallium-68 eluate for radiolabelling.
RESULTS
Automated radiolabelling of [Ga]Ga-PSMA-11 using the Locametz® kit provided a product which complies to the Ph. Eur., had a shelf-life of 6 h at room temperature, and theoretically reduced radiation exposure 5.7 times. Radiolabelling with one and two generator(s) resulted in a radiochemical yield of 91-102% and 96-101% after preparation, respectively. The radiochemical purity ranged from 98.0 to 99.6% for radiolabelling with one generator and ranged from 98.4 to 99.3% for radiolabelling with two generators with similar stability. The activity of the final product was much higher when using two generators, 1961-2035 MBq compared to 740-1260 MBq, which leads to ~ 1.5 times more patient syringes available per preparation.
CONCLUSION
Automated radiolabelling of [Ga]Ga-PSMA-11 using the Locametz® kit with higher gallium-68 activity than specified in the SmPC results in a product that is in compliance with the Ph. Eur. monograph and has a shelf-life of 6 h at room temperature. Radiolabelling with two generators proved possible and resulted in a product with similar quality but with much higher efficiency.
PubMed: 38632189
DOI: 10.1186/s41181-024-00260-4 -
Journal of Ethnopharmacology Jan 2024The Westhoff collection of Chinese materia medica (c. 1870) at the Utrecht University Museum in Utrecht, the Netherlands, contains an original, handwritten catalogue,...
ETHNOPHARMACOLOGICAL RELEVANCE
The Westhoff collection of Chinese materia medica (c. 1870) at the Utrecht University Museum in Utrecht, the Netherlands, contains an original, handwritten catalogue, which was putatively ascribed to a Chinese medicine practitioner. It provides a detailed record of the Chinese names, plant parts, preparations, and applications of the specimens contained in glass bottles, which probably reflects the physician's personal interpretation of Chinese medicine in Indonesia at the end of the 19th century. Such individual catalogues can reveal historical changes and regional variations in the use of traditional Chinese medicine, which can lead to a better understanding of the history and development of this field.
AIM OF THE STUDY
We addressed the following questions: 1) What are the contents of the Westhoff catalogue? 2) What medicinal preparations and applications were recorded in the catalogue, and which ones are dominant? 3) How similar is the use of Chinese materia medica in Westhoff catalogue compared to the modern Chinese Pharmacopeia? 4) What other specific information is contained in the Westhoff catalogue?
MATERIALS AND METHODS
The catalogue had been digitized previously, and all handwritten Dutch text has been transcribed and translated into English. The information for each entry was summarized and analyzed, the medicinal applications were compared to modern Chinese pharmacopeia or other monographs on Chinese materia medica.
RESULTS
The catalogue contains 436 entries, for which 395 corresponding specimens still exist in the Westhoff collection of Chinese materia medica. Each entry contains a serial number, a Chinese name, a phonetic Dutch transcription of the Chinese name, a description of the plant, animal, or mineral origin of the medicinal product, the preparation method, and the medical indication for which it should be used. The dominant preparation method is decoction (79% of the entries). The most frequently mentioned applications are fever, skin diseases, strengthening and wounds. Around 80% of the medicinal applications in the catalogue were also listed for the same CMM in modern monographs. The catalogue also sheds light on typical characteristics of popular medicine, their geographic origin, and social aspects of traditional Chinese medicine in Indonesia around 1870.
CONCLUSIONS
The Westhoff catalogue is a valuable record of Chinese materia medica and its practice in a specific time and space. It reflects an individual physician's interpretation of Chinese medicine, shows the difficulties in the interpretation of cultural-bound health issues between the Dutch and the Chinese, and provides evidence that traditional Chinese medicine spread not only in East Asia but also to the distant Western world.
Topics: Animals; Materia Medica; Medicine, Chinese Traditional; Indonesia; Netherlands; Asia, Eastern; Drugs, Chinese Herbal; China
PubMed: 37531803
DOI: 10.1016/j.jep.2023.116987 -
Biodiversity Data Journal 2024Insects represent one of the most diverse groups in the organism world with extremely rich species and morphological diversity, playing important roles in natural and...
BACKGROUND
Insects represent one of the most diverse groups in the organism world with extremely rich species and morphological diversity, playing important roles in natural and city ecosystems. Regional compilation of insect species lists helps to clarify the richness of insect species in a region, enhances our understanding the structure and function of a local ecosystem and promotes the protection and development of insect resources. Moreover, it also serves as a valuable reference for cities with small area, large population and high urbanisation like Macao. Macao (Macau) Special Administrative Region (SAR) is situated at the Pearl River Delta on the southeast coast of mainland China. With urban development accelerating at great rate in a quite restricted area, Macao still has rich fauna, within which the insect diversity is surprisingly high.
NEW INFORMATION
In this study, we systematically sorted out major references items of manuals or handbooks, monographs, articles, dissertations, official websites and other publicly available information sources about the insects recorded in Macao and, thus, generated a checklist of 15 orders, 166 families, 868 genera, 1,339 species and 118 subspecies. During this process, the preliminarily summarised list was re-examined to eliminate synonyms and invalid species, based on many more extensive literature reviews. Besides, spelling errors of scientific names, authors and years were corrected. Meanwhile, the catalogue revealed a different composition pattern of species diversity between orders from those of the world and China. Even based on the most conservative estimates, the number of insect species in Macao should not be lower than 3,340 species, which hints at the necessity of deeper investigations with adequate collecting in the future to achieve more comprehensive recognition and understanding of Macao's insect biodiversity.
PubMed: 38617834
DOI: 10.3897/BDJ.12.e118110 -
Scientific Reports Jan 2024We aimed to summarize the cancer risk among patients with indication of group I pharmaceuticals as stated in monographs presented by the International Agency for... (Meta-Analysis)
Meta-Analysis
We aimed to summarize the cancer risk among patients with indication of group I pharmaceuticals as stated in monographs presented by the International Agency for Research on Cancer working groups. Following the PRISMA guidelines, a comprehensive literature search was conducted using the PubMed database. Pharmaceuticals with few studies on cancer risk were identified in systematic reviews; those with two or more studies were subjected to meta-analysis. For the meta-analysis, a random-effects model was used to calculate the summary relative risks (SRRs) and 95% confidence intervals (95% CIs). Heterogeneity across studies was presented using the Higgins I square value from Cochran's Q test. Among the 12 group I pharmaceuticals selected, three involved a single study [etoposide, thiotepa, and mustargen + oncovin + procarbazine + prednisone (MOPP)], seven had two or more studies [busulfan, cyclosporine, azathioprine, cyclophosphamide, methoxsalen + ultraviolet (UV) radiation therapy, melphalan, and chlorambucil], and two did not have any studies [etoposide + bleomycin + cisplatin and treosulfan]. Cyclosporine and azathioprine reported increased skin cancer risk (SRR = 1.32, 95% CI 1.07-1.62; SRR = 1.56, 95% CI 1.25-1.93) compared to non-use. Cyclophosphamide increased bladder and hematologic cancer risk (SRR = 2.87, 95% CI 1.32-6.23; SRR = 2.43, 95% CI 1.65-3.58). Busulfan increased hematologic cancer risk (SRR = 6.71, 95% CI 2.49-18.08); melphalan was associated with hematologic cancer (SRR = 4.43, 95% CI 1.30-15.15). In the systematic review, methoxsalen + UV and MOPP were associated with an increased risk of skin and lung cancer, respectively. Our results can enhance persistent surveillance of group I pharmaceutical use, establish novel clinical strategies for patients with indications, and provide evidence for re-categorizing current group I pharmaceuticals into other groups.
Topics: Humans; Etoposide; Methoxsalen; Azathioprine; Melphalan; Busulfan; Neoplasms; Hematologic Neoplasms; Cyclophosphamide; Cyclosporins; Pharmaceutical Preparations
PubMed: 38172159
DOI: 10.1038/s41598-023-50602-6 -
Scientific Reports Apr 2024Chronic obstructive pulmonary disease (COPD) has a high prevalence and a major impact on health-related quality of life (HRQL). COPD exacerbations are an important cause... (Observational Study)
Observational Study
Chronic obstructive pulmonary disease (COPD) has a high prevalence and a major impact on health-related quality of life (HRQL). COPD exacerbations are an important cause of morbidity and mortality, affecting cardiovascular risk, and are associated with poorer health status. The aim of this study was to assess the association between cardiovascular risk (CVR) and HRQL, according to exacerbator or non-exacerbator phenotype. We undertook a cross-sectional, observational, descriptive study of 107 patients with COPD. Patients with two or more moderate exacerbations or one severe exacerbation in the previous year were considered as exacerbators. The CVR was calculated with the Framingham scale and SCORE (Systematic Coronary Risk Evaluation) and the HRQL was assessed with the generic questionnaire Short Form-36 Health Survey (SF-36), the St George Respiratory Questionnaire (SGRQ) and the COPD Assessment Test (CAT). Statistical analysis was done with SPSS version 26.0 for Windows. The SF-36 and the SGRQ showed lower values for the exacerbator phenotype, indicating a poorer quality of life. The CAT questionnaire showed values above 10 for the exacerbator phenotype, and lower values in the non-exacerbator group. After categorizing the sample according to their median age (65 years), we found a greater deterioration in HRQL in patients under 65 years of age according to the SF-36, the SGRQ and the CAT. We also detected differences in HRQL between non-exacerbator patients with a high CVR according to the Framingham (≥ 20%) and SCORE (≥ 5%) scales compared to those without this risk. A tendency towards worse HRQL was observed in non-exacerbator patients with a high CVR, which was statistically significant for the SGRQ impact domain on the SCORE scale. The CAT also showed a worse quality of life in non-exacerbator patients with a high CVR, which was significant in the Framingham model (Framingham high risk 8.41 vs non-high risk 6.05, p < 0.01). These differences were not observed in exacerbator patients. Our findings confirm that a high CVR influences HRQL in patients with COPD, especially in non-exacerbator patients with a high CVR, measured according to the SGRQ and the CAT.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Quality of Life; Male; Female; Aged; Middle Aged; Phenotype; Cross-Sectional Studies; Cardiovascular Diseases; Surveys and Questionnaires; Heart Disease Risk Factors; Risk Factors
PubMed: 38678074
DOI: 10.1038/s41598-024-60406-x -
Turkish Journal of Pharmaceutical... Jan 2024Post-marketing/surveillance studies show that most of the many vegetable oils that are sold with health-promoting claims or statements with high nutritional values and...
OBJECTIVES
Post-marketing/surveillance studies show that most of the many vegetable oils that are sold with health-promoting claims or statements with high nutritional values and are beneficial against diseases are off-limits of related monographs/criteria. Defining the oil with a fast, cheap, and efficient analytical method is needed to express fatty acids in any herbal product to authenticate, trace, specify, and classify the content.The majority of the after marketing/surveillance studies shows that most of the many vegetable oils that are sold with health-promoting claims or statements with high nutritional values and are beneficial against diseases are off-limits of related monographs/criteria. Defining the oil with fast, cheap and efficient analytical method to express fatty acids in any herbal product, to authenticate, trace, specify and classify the content is needed.
MATERIALS AND METHODS
Here, we define a new simple tool with a headspace single drop microextraction (HS-SDME) method coupled with a gas chromatography-flame ionization detector (GC-FID) for the analysis of common fatty acids (FAs) in oils. Linolenic acid, γ-linolenic acid, and linoleic acid in olive oil, thyme oil, and fish oil were determined. Derivatization was performed with 0.2 mL of 2 mol/L KOH in methanol to transfer the FAs of oils into their methyl esters (FAMEs). Then, FAMEs were extracted using a head space single drop, which is 2.0 μL of sodium dodecyl sulfate:1-butanol (1:3, ) mixture.
RESULTS
The most suitable extraction condition was that 360 μL of the FAMEs, 2.0 mL vial, 0.07 g NaCl as a salting-out effect, 45 °C extraction temperature, and 35 min extraction time. The precision of the method was below 12%, with accuracy validated by the GC-FID reference method.The most suitable extraction condition was that 360 μL of the fatty acid methyl esters (FAMEs), 2.0 mL vial, 0.07 g NaCl as a salting-out effect, 45 °C extraction temperature, and 35 min extraction time. The precision of the method was below 12% with an accuracy validated by the GC-FID reference method.
CONCLUSION
The HS-SDME can be used effectively for extracting FAs from oils for improved analysis of other FAs. The method is of direct importance and relevance for the herbal, pharmaceutical, and cosmetics industries.The HS-SDME can be used for effectively for extracting fatty acids from oils for improved analysis of other fatty acids while the method is direct importance and relevance for herbal, pharmaceutical, cosmetics industry.
PubMed: 38257845
DOI: 10.4274/tjps.galenos.2023.63494