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BMJ Case Reports Aug 2022A woman in her 30s presented to the emergency department with acute onset, progressively worsening left-sided abdominal pain after exercise. She was found to be...
A woman in her 30s presented to the emergency department with acute onset, progressively worsening left-sided abdominal pain after exercise. She was found to be hypotensive and diaphoretic, with free intraperitoneal fluid detected on bedside point-of-care ultrasound. Resuscitation was initiated, a presumptive diagnosis of ruptured ectopic pregnancy was made, and obstetrics and gynaecology were consulted. Point-of-care urine pregnancy testing, however, was negative, and subsequent CT angiography of the patient's abdomen revealed an angiomyolipoma (AML) with active haemorrhage. Ultimately, embolisation was performed in the interventional radiology suite, with improvement of patient haemodynamics. Ruptured AML is a rare, life-threatening condition that needs to be included in the differential diagnosis of haemorrhagic shock in female patients of reproductive age presenting to the emergency department.
Topics: Angiomyolipoma; Diagnosis, Differential; Female; Humans; Kidney Neoplasms; Leukemia, Myeloid, Acute; Physicians; Pregnancy; Shock, Hemorrhagic
PubMed: 35944938
DOI: 10.1136/bcr-2021-248626 -
Cureus Jun 2022Autoimmune polyendocrine syndrome type 2, also known as Schmidt's syndrome, is a rare autosomal dominant life-threatening syndrome. It is defined by the presence of...
Autoimmune polyendocrine syndrome type 2, also known as Schmidt's syndrome, is a rare autosomal dominant life-threatening syndrome. It is defined by the presence of Addison's disease in combination with at least one of the known autoimmune diseases: thyroid autoimmune disease, type 1 diabetes, and hypogonadism. It is more common in middle-aged females and is treatable if diagnosed early. However, in this case, we report Schmidt's syndrome in a young male without a family history. A 20-year-old male with a past medical history of hypothyroidism, adrenal insufficiency, and type 1 diabetes presented to the emergency department (ED) feeling lethargic, somnolent, and diaphoretic. Laboratory blood tests showed elevated thyroid-stimulating hormone, hyperkalemia of 6.4 mmol/L, and hyponatremia of 131 mmol/l indicating an Addisonian crisis. The patient had low blood glucose (at home: 60 mg/dL, and at ED: 85 mg/dL), hypotensive blood pressure of approximately 85/55 mmHg, and a peaked T-wave on EKG, which were consistent with the diagnosis of Schmidt's syndrome. Based on the laboratory findings and history, the patient was diagnosed with polyendocrine syndrome Type 2 (Schmidt's syndrome). The patient was treated for adrenal insufficiency first followed by thyroid insufficiency. Schmidt's syndrome is a rare disease and difficult to diagnose because the presentation depends on which gland is initially involved. A few cases have been reported in the literature of atypical presentations of Schmidt's syndrome. Therefore, this case report can contribute to the medical literature on Schmidt's syndrome, which can help in early diagnosis and improve patient outcomes.
PubMed: 35911265
DOI: 10.7759/cureus.26322 -
The American Journal of Case Reports Jul 2022BACKGROUND Acute aortic syndrome (AAS) is a spectrum of severe life-threatening disease processes that are often initially encountered in the emergency department (ED)...
BACKGROUND Acute aortic syndrome (AAS) is a spectrum of severe life-threatening disease processes that are often initially encountered in the emergency department (ED) setting and require prompt recognition and treatment to prevent significant complications, including death. We describe an atypical presentation of aortic intramural hematoma in a female patient during sexual intercourse, a situation not previously described in the literature. CASE REPORT The patient was a 45-year-old woman who presented to the ED with a chief concern of chest pain. Just prior to the onset of her symptoms, the patient was having sexual intercourse with her husband, and during her orgasm she felt a "pop" in her chest with radiation to her back. The patient was diaphoretic and hypertensive on arrival, with a blood pressure of 220/140 mmHg. Computed tomography angiography of the chest was performed and showed an intramural hematoma (or thrombosed dissection) of the distal aortic arch and descending thoracic aorta. In the ED, the patient was started on intravenous antihypertensives, which were eventually switched to oral agents. Cardio-thoracic surgery staff was consulted and recommended medical management. As oral doses were increased, the intravenous antihypertensives were weaned, and the patient was eventually discharged home with scheduled outpatient follow-up. CONCLUSIONS Intramural aortic hematoma is a form of AAS with independent pathogenesis but similar progression, complications, and treatment as aortic dissection and thus demands efficient diagnosis and treatment. A high degree of suspicion, even in atypical situations, is paramount, as efficient recognition and treatment can be lifesaving.
Topics: Aortic Dissection; Antihypertensive Agents; Aortic Diseases; Coitus; Female; Hematoma; Humans; Middle Aged
PubMed: 35898118
DOI: 10.12659/AJCR.936167 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Jul 2022The Chinese medicinal herb Mahuang is herbaceous stem of Ephedra sinica, E. intermedia, or E. equisetina(Family, Ephedraceae). In China, Mahuang has been used, all the... (Review)
Review
The Chinese medicinal herb Mahuang is herbaceous stem of Ephedra sinica, E. intermedia, or E. equisetina(Family, Ephedraceae). In China, Mahuang has been used, all the way over a millennium, as a key component herb of many herbal medicines for management of epidemics of acute respiratory illness and is also used in officially recommended herbal medicines for COVID-19. Mahuang is the first-line medicinal herb for cold and wheezing and also an effective diuretic herb for edema. However, Mahuang can also exert significant adverse effects. The key to safety and effectiveness is rational and precise use of the herb. In this review article, we comprehensively summarize chemical composition of Mahuang and associated differences in pharmacognosy, pharmacodynamics and pharmacokinetics of Mahuang compounds, along with the adverse effects of Mahuang compounds and products. Based on full understanding of how Mahuang is used in Chinese traditional medicine, systematic research on Mahuang in line with contemporary standards of pharmaceutical sciences will facilitate promoting Chinese herbal medicines to become more efficient in management of epidemic illnesses, such as COVID-19. To this end, we recommend research on Mahuang of two aspects, i.e., pharmacological investigation for its multicompound-involved therapeutic effects and toxicological investigation for clinical manifestation of the adverse effects, chemicals responsible for the adverse effects, and conditions for safe use of the herb and the herb-containing medicines.
Topics: Drugs, Chinese Herbal; Ephedra; Ephedra sinica; Ephedrine; Humans; Plants; COVID-19 Drug Treatment
PubMed: 35850791
DOI: 10.19540/j.cnki.cjcmm.20220425.601 -
Journal of Ethnopharmacology Oct 2022Inflammation is the body's normal protective response to injury and is stimulated by pathogens, toxic compounds, damaged cells or radiation, promoting healing and...
ETHNOPHARMACOLOGICAL RELEVANCE
Inflammation is the body's normal protective response to injury and is stimulated by pathogens, toxic compounds, damaged cells or radiation, promoting healing and restoring homeostasis to the injured tissue. Leaves of Piper gaudichaudianum Kunth, known as "pariparoba" are widely used in folk medicine for the relief of toothache, while the fresh roots are used as anti-inflammatory and to treat liver disorders. For P. mikanianum (Kunth) Steud is known as "aguaxima", is widely used in the treatment of inflammation, rheumatism and ulcer, with its roots being used for stomach disorders and as a diaphoretic in intermittent fevers.
AIM OF THE STUDY
Therefore, this work aims to chemically characterize the essential oil of Piper gaudichaudianum and Piper mikanianum, as well as the evaluation of neutrophil antichemotactic activity of both essential oils in order to complement the information of its traditional use, taking the leaves as plant material and, with that, corroborating its use in folk medicine for the treatment of inflammatory diseases.
MATERIALS AND METHODS
The essential oil from leaves of both Piper species were obtained from crushed fresh samples, by hydrodistillation using a Clevenger type-apparatus for 4 h. The yield determination was performed as vol/wt (v/w) and in triplicate. The amount of essential oil obtained was quantified in mL. The identification and quantification of the compounds was performed using gas chromatography-mass spectrometry (GC-MS) and gas chromatography-flame ionization detection (GC-FID). The in vitro anti-inflammatory activity was evaluated using the model of modified Boyden chamber. In this test the essential oils were tested for their ability to inhibit leukocyte chemotaxis stimulated by Escherichia coli lipopolysaccharide.
RESULTS
The chemical composition of the essential oils revealed the identification of 26 constituents for P. gaudichaudianum being the sesquiterpenes β-selinene (14.0%) and viridiflorene (10.5%) the main compounds, followed by caryophyllene oxide (9.3%) and (E)-nerolidol (9.0%). For P. mikanianum essential oil, β-myrcene (17.2%) and bicyclogermacrene (26.3%) were the major components in the monoterpenes and sesquiterpene fractions, respectively. The essential oils were also tested for their ability to inhibit neutrophil chemotaxis in vitro when stimulated by Escherichia coli lipopolysaccharide. Both essential oils showed antichemotactic effect with reduction in migration of 0-72.2% for P. gaudichaudianum and 8.6-100% for P. mikanianum to same concentrations, suggesting a response to acute inflammatory processes.
CONCLUSIONS
Since up to date there is no report of this biological activities by this mechanism (antichemotactic assay) for essential oils this species. These results showed that the essential oils of P. gaudichaudianum and P. mikanianum have a great capacity to inhibit neutrophil chemotaxis in an inflammatory process, in a dose-dependent way, suggesting anti-inflammatory potential, by preventing its accumulation at the injury site with the possibility of tissue damage. Findings of these studies support the traditional use of these species in the treatment of inflammatory processes.
Topics: Anti-Inflammatory Agents; Escherichia coli; Gas Chromatography-Mass Spectrometry; Inflammation; Lipopolysaccharides; Oils, Volatile; Piper; Plant Leaves; Plant Oils
PubMed: 35840057
DOI: 10.1016/j.jep.2022.115533 -
Journal of Wound Care Jul 2022The present study aims to create -loaded nanofibre-based wound dressing materials to enhance the wound healing process. is an annual herb native to the Mediterranean...
OBJECTIVE
The present study aims to create -loaded nanofibre-based wound dressing materials to enhance the wound healing process. is an annual herb native to the Mediterranean region. It is antipyretic, antifungal, antioedema, antidiabetic, anti-inflammatory (wound, oral and pharyngeal mucosa), antispasmodic, treats chronic ocular surface diseases, acts as a stimulant and a diaphoretic. It is also used in the prevention of acute dermatitis, and in the treatment of gastrointestinal ulcers, wounds and burns.
METHOD
Electrospinning is an effective method for creating nano- and microfibres for biomedical applications. (CA) of various concentrations 5%, 10% and 15%)-loaded polyvinyl alcohol (PVA)/sodium alginate (SAlg) nanofibre mats were successfully produced via blend electrospinning. Nanofibre mats were evaluated using: scanning electron microscopy (SEM); Fourier transform infrared spectroscopy (FTIR) analysis; gel content; water vapour transmission rate (WVTR); swelling ratio; in vitro drug release studies; viability evaluation (cell culture and MTT assay); and an in vivo study using male Wistar rats. Rats were divided into three groups (n=3). In each group, rats were inflicted with five full-thickness wounds on the back and were treated with sterile gauze (control), PVA/SAlg nanofibre dressing (CA-free control), PVA/SAlg/CA5%, PVA/SAlg/CA10%, and PVA/SAlg/CA15% nanofibre dressing.
RESULTS
Results showed that the obtained fibres were smooth with no surface aggregates, indicating complete incorporation of . The release of from loaded PVA/SAlg fibre mats in the first four hours was burst released and then was constant. PVA/SAlg and PVA/SAlg/CA nanofibres were not toxic to L929 mouse fibroblasts and supported cell attachment and proliferation. The results of the in vivo study showed that the PVA/SAlg/CA10% nanofibre dressing had a higher full-thickness wound healing closure rate compared with the control group on days seven, 14 and 21 after treatment.
CONCLUSION
The results of this evaluation showed that PVA/SAlg/CA nanofibrous mats could be a candidate as an effective wound dressing; however, the percentage of CA in this compound needs further investigation.
Topics: Alginates; Animals; Bandages; Calendula; Male; Mice; Nanofibers; Plant Extracts; Polyvinyl Alcohol; Rats; Rats, Wistar
PubMed: 35797256
DOI: 10.12968/jowc.2022.31.7.598 -
Frontiers in Plant Science 2022() Jepson is a medicinal plant that is frequently used by the Chumash Indians in southern California as a diaphoretic, calmative, diuretic, or antimicrobial agent....
() Jepson is a medicinal plant that is frequently used by the Chumash Indians in southern California as a diaphoretic, calmative, diuretic, or antimicrobial agent. Abietane-type diterpenoids (ATDs) and phenolic acids (PAs) are the main bioactive ingredients in . However, few studies have looked into the biosynthesis of ATDs and PAs in . In this study, using metabolic profiling focused on the ATDs and PAs in the roots and leaves of , we found a distinctive metabolic feature with all-around accumulation of ATDs, but absence of salvianolic acid B. To identify the candidate genes involved in these biosynthesis pathways, full-length transcriptome was performed by PacBio single-molecule real-time (SMRT) sequencing. A total of 50 and 40 unigenes were predicted to be involved in ATDs and PAs biosynthesis, respectively. Further transcriptional profile using Illumina HiSeq sequencing showed that the transcriptional variations of these pathways were consistent with the accumulation patterns of corresponding metabolites. A plant kingdom-wide phylogenetic analysis of cytochromes (CYPs) identified two CYP76AK and two CYP76AH subfamily genes that might contribute for the specific ATDs biosynthesis in . We also noticed that the clade VII laccase gene family was significantly expanded in compared with that of , indicating their involvements in the formation of salvianolic acid B. In conclusion, our results will enable the further understanding of ATDs and PAs biosynthesis in and genus.
PubMed: 35755672
DOI: 10.3389/fpls.2022.919025 -
Computational and Mathematical Methods... 2022The data mining analysis of the medication rule and the curative effect of traditional Chinese medicine in treating allergic rhinitis in children was performed by using...
The data mining analysis of the medication rule and the curative effect of traditional Chinese medicine in treating allergic rhinitis in children was performed by using the association rule Apriori algorithm. The model of interest degree was introduced to improve the Apriori algorithm, and the performance difference of the algorithm before and after improvement was analyzed. Traditional Chinese medicine prescriptions for the treatment of allergic rhinitis in children were selected from the dictionary of Chinese medicine formulations. The frequency, frequent itemsets, and the improved Apriori algorithm of each prescription were analyzed comprehensively. The results showed that both the execution time of the improved Apriori algorithm and the number of mining association rules were signally lower. 102 Chinese herbal compounds were selected, in which the occurrence frequency of Flos magnoliae was the highest (67 times, 5.33%). The occurrence frequency of diaphoretic drugs was the highest (412 times, 32.78%) in drug types. The occurrence frequency of Yu Ping Feng powder was the highest (21 times, 20.59%) in the Chinese herbal compound. After the association rule analysis of the improved Apriori algorithm, Perilla frutescens, Saposhnikovia divaricata, ginseng, Notopterygium root, and Astragalus propinquus Schischkin were often mixed with liquorice, and Flos magnoliae were usually mixed with Fructus xanthii and black plum. Compared with the conditions before treatment, the sign scores of children with allergic rhinitis were remarkably decreased after treatment with traditional Chinese medicine compounds ( < 0.05). The mining performance of the Apriori algorithm was improved by introducing an interest-based model. The treatment of traditional Chinese medicine on allergic rhinitis in children was combined with children's physiological and pathological characteristics of children, which used mild medicines.
Topics: Algorithms; Child; Data Mining; Drugs, Chinese Herbal; Humans; Medicine, Chinese Traditional; Rhinitis, Allergic
PubMed: 35693255
DOI: 10.1155/2022/7007370 -
Journal of Ethnopharmacology Jul 2022Zataria multiflora Boiss. (Z. multiflora) is a valuable medicinal plant that has been used in Iranian traditional and folk medicine as an antiseptic, carminative,... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect of two-month treatment with Zataria multiflora on inflammatory cytokines, pulmonary function testes and respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD).
ETHNOPHARMACOLOGICAL RELEVANCE
Zataria multiflora Boiss. (Z. multiflora) is a valuable medicinal plant that has been used in Iranian traditional and folk medicine as an antiseptic, carminative, diaphoretic, diuretic, anti-spasmodic and analgesic herbal medicine. This plant has been also used to relieve cough in common cold and respiratory tract disorders. The previous studies reported the pharmacological effects of Z. multiflora such as anti-inflammatory and anti-oxidant properties in respiratory disorders in animal models and clinical studies.
AIM OF THE STUDY
The effects of Z. multiflora extract on inflammatory cytokines, pulmonary function tests (PFT), and respiratory symptoms in chronic obstructive pulmonary diseases (COPD) patients were investigated.
MATERIALS AND METHODS
COPD patients (41 cases) were divided to three groups including placebo group (P) and groups received 3 and 6 mg/kg/day Z. multiflora extract (Z3 and Z6) for two months. Inflammatory cytokines, PFT values, and respiratory symptoms were assessed before treatment (stage 0), one (stage I) and two (stage II) months after treatment.
RESULTS
Serum levels of TNF-α and IL-8 were significantly decreased after two months treatment compared to baseline values in Z3 and Z6 groups. The PFT values including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly increased during two months treatment with Z3 and Z6. The peak expiratory flow (PEF) was also significantly increased after one-month treatment with Z6. The respiratory symptoms including cough, chest tightness, modified medical research council (mMRC) dyspnea scale were significantly improved after one and two treatments with both doses of Z. multiflora compared to baseline values.
CONCLUSION
The results suggest the potential therapeutic effect of Z. multiflora in COPD patients through reduction of inflammatory cytokines, increasing PFT values and improvement of respiratory symptoms.
Topics: Animals; Cough; Cytokines; Forced Expiratory Volume; Humans; Iran; Lamiaceae; Male; Plant Extracts; Pulmonary Disease, Chronic Obstructive; Testis
PubMed: 35398241
DOI: 10.1016/j.jep.2022.115265 -
Critical Reviews in Food Science and... 2023Elderberry (.) has been used in traditional medicine and as a supplement in many beverages and meals. Elderberry is a good source of bioactive flavonoids like quercetin,... (Review)
Review
BACKGROUND
Elderberry (.) has been used in traditional medicine and as a supplement in many beverages and meals. Elderberry is a good source of bioactive flavonoids like quercetin, kaempferol, and rutin, as well as other phenolic compounds. Extraction techniques significantly influence the efficiency of extraction of bioactive compounds. Green chemistry elements such as safety, environmental friendliness, run-down or at least minimal contaminants, efficiency, and economic criteria should all be addressed by an effective bioactive extraction process. Furthermore, micro/nanoencapsulation technologies are particularly effective for increasing bioavailability and bioactive component stability.
SCOPE AND APPROACH
This review article comprehensively describes new developments in elderberry extraction and encapsulation. Elderberry is largely employed in the food and pharmaceutical industries due to its health-promoting and sensory characteristics. Elderberry has traditionally been used as a diaphoretic, antipyretic, diuretic, antidepressant, and antitumor agent in folk medicine.
KEY FINDINGS AND CONCLUSIONS
Conventional extraction methods (e.g. maceration and Soxhelt extraction) as well as advanced green techniques (e.g. supercritical fluids, pulsed electric field, emulsion liquid extraction, microwave, and ultrasonic extraction) have been used to extract bioactives from elderberry. Over the other protective measures, encapsulation techniques are particularly recommended to protect the bioactive components found in elderberry. Microencapsulation (spray drying, freeze drying, extrusion, emulsion systems) and nanoencapsulation (nanoemulsions, solid lipid nanoparticles and nanodispersions, nanohydrogels, electrospinning, nano spray drying) approaches for elderberry bioactives have been examined in this regard.
Topics: Sambucus; Emulsions; Fruit; Flavonoids; Phenols; Plant Extracts
PubMed: 35021911
DOI: 10.1080/10408398.2022.2026290