Electroacupuncture treatment of benign prostatic hyperplasia: A case report

Benign prostatic hyperplasia (BPH) is characterized by symptoms such as frequent urination and difficulty in urination. Currently, treatment is mainly carried out using medications and surgery, but all of these methods can lead to certain adverse effects. In this case, a ninety-year-old male elderly patient came to our acupuncture clinic for treatment of urinary tract occlusion due to BPH. According to the patient's condition, we adopted the eletroacupuncture treatment protocol of Prof. Zhanglian Wang, a famous experienced Chinese medicine doctor. After six weeks of acupuncture treatment, the patient's urinary status improved significantly. This case suggests that acupuncture may be an effective complementary alternative therapy for BPH.     

儿童泌尿系感染定位诊断指标研究

小儿上尿路感染发病年龄小,多伴有发热症状,膀胱刺激征不明显,早期不易识别,且容易反复发作,严重者可并发急性肾损伤及肾瘢痕形成,目前儿童泌尿系感染的定位诊断指标包含血CRP、PCT;尿NAG、NGAL、β2-mG;影像学检查包括99mTc-DMSA、肾脏增强CT、肾脏DWI。其中,尿NGAL对定位诊断具有较高的敏感度及特异度;肾DWI检查应用前景广阔,但金标准仍为99mTc-DMSA,本文就上述定位诊断指标进行综述。     

The use of acupuncture for managing gynaecologic conditions: An overview of systematic reviews

Acupuncture is increasingly popular for the treatment of many medical complaints, including gynaecologic conditions. The aim of this study was to summarise the evidence from systematic reviews (SRs) and meta-analyses assessing the efficacy of acupuncture in treating common gynaecologic conditions. Six electronic databases, including two major English-language databases (PubMed and the Cochrane Library) and four Korean databases, were systematically searched for SRs and meta-analyses concerned with acupuncture and common gynaecologic diseases. The following English search terms were used: (gynaecologic disease in MeSH terms) AND (acupuncture or acup*) AND (systematic review OR meta-analysis). In addition, three Korean traditional medicine journals (The Journal of the Korean Acupuncture and Moxibustion Society, The Journal of Korean Oriental Medicine and The Journal of Oriental Obstetrics and Gynaecology) were searched. The quality of the included studies was assessed using the Overview Quality Assessment Questionnaire. Of the 55 potentially relevant studies that were found, 16 SRs were included in this report. These reviews evaluated the efficacy of acupuncture for treating the side effects of breast cancer chemotherapy, menstrual disturbances, menopausal symptoms, female infertility, uterine fibroids and polycystic ovary syndrome. Acupuncture was clearly beneficial in the management of chemotherapy-induced nausea and vomiting. In addition, current evidence suggests that acupuncture administered close to embryo transfer during in vitro fertilisation treatment improves the rates of pregnancy and live birth. In conclusion, there is no convincing evidence of the efficacy of acupuncture except for specific conditions, which include acupuncture administered with embryo transfer to improve the outcome of in vitro fertilisation and acupuncture for the management of chemotherapy-induced nausea and vomiting. More well-designed trials using rigorous methodology are required to evaluate the efficacy of acupuncture in treating gynaecologic conditions.     

Complementary and alternative medicine (CAM) for sexual dysfunction and erectile dysfunction in older men and women: an overview of systematic reviews

Older patients with sexual dysfunction (SD) and/or erectile dysfunction (ED) often use complementary and alternative medicine (CAM). The aim of this overview of systematic reviews is to critically evaluate the evidence for or against the effectiveness of CAM. Six electronic databases were searched to identify all relevant systematic reviews (SRs). Their methodological quality was assessed independently by two reviewers using the Oxman score. Four SRs met our inclusion criteria. They evaluated: acupuncture, ginseng, maca and yohimbine. The methodological quality of all of the SRs was good. However, the primary studies were often associated with considerable risk of bias. Cautiously positive conclusions were drawn for yohimbine and ginseng as treatment options for ED. For acupuncture and maca the evidence was insufficient for ED and SD respectively. It is concluded that there is some encouraging evidence but more and better studies are required to establish the value of CAM for SD and ED.     

Safety of varicella vaccination strategies: An overview of reviews

The safety of new vaccines under development as well as existing vaccines is a key priority for national and international public health agencies. A number of countries have implemented universal childhood varicella vaccination programmes over the past 30 years. However, strategies differ in terms of the number of doses, type of vaccine(s) recommended, age at vaccination and interval between doses for a two-dose schedule. An overview of reviews was undertaken to assess the existing systematic review evidence of the safety of varicella vaccination strategies. The review was restricted to immunocompetent children aged 9 months to 6 years inclusive. A comprehensive search of databases, registries and grey literature was conducted up to 2 February 2022. Two reviewers independently screened, extracted data and assessed the methodological quality of included reviews. Overlap of included reviews was also assessed. A total of 17 reviews, incorporating both the monovalent varicella only and quadrivalent measles-mumps-rubella-varicella (MMRV) vaccines were included in the overview; six assessed the safety of one-dose strategies, four assessed the safety of two-dose strategies and 14 reviews did not specify the dosing strategy. The evidence suggests that mild local and systemic reactions are relatively common with varicella vaccination. Febrile seizures are also possible adverse effects of both the monovalent and quadrivalent MMRV vaccine, but serious adverse reactions are rare. While most reviews contained methodological flaws, and analysis by vaccine type and dosing strategy was restricted due to lack of detail in reporting of the reviews, there was clear and consistent evidence from a substantial evidence base, comprising 34 randomised controlled trials and 62 other primary studies/reviews, that varicella vaccination is safe.     

Aromatherapy for health care: an overview of systematic reviews

Aromatherapy is the therapeutic use of essential oil from herbs, flowers, and other plants. The aim of this overview was to provide an overview of systematic reviews evaluating the effectiveness of aromatherapy. We searched 12 electronic databases and our departmental files without restrictions of time or language. The methodological quality of all systematic reviews was evaluated independently by two authors. Of 201 potentially relevant publications, 10 met our inclusion criteria. Most of the systematic reviews were of poor methodological quality. The clinical subject areas were hypertension, depression, anxiety, pain relief, and dementia. For none of the conditions was the evidence convincing. Several SRs of aromatherapy have recently been published. Due to a number of caveats, the evidence is not sufficiently convincing that aromatherapy is an effective therapy for any condition.     

beta-Sitosterol modulation of monocyte-endothelial cell interaction: a comparison to female hormones

ObjectiveTo investigate the effect of β-sitosterol, 17β-estradiol and progesterone on oxidized LDL (oxLDL)-stimulated human umbilical venous endothelial cell (HUVEC) expression of intercellular adhesion molecule-1 (ICAM-1), THP-1 monocyte chemotactic activity, migration and adhesion of THP-1 cells co-cultured with HUVECs.MethodsICAM-1 expression was determined by immunofluorescence in HUVEC monolayers treated with LDL or oxLDL and 17β-estradiol, progesterone or β-sitosterol. Monocyte chemotactic activity was performed in Transwell chambers by culturing HUVECs with different stimuli and steroids, THP-1 cells labeled with [³H] thymidine were added to the upper chamber and the radioactivity was measured. Migration assays were performed using Transwell chambers but monocytes were labeled with BCECF-AM and THP-1 cells adhered to HUVECs were visualized by fluorescence microscopy. MCP-1 was quantified by ELISA.ResultsICAM-1 expression was inhibited by β-sitosterol alone, when combined with 17β-estradiol or progesterone, or with both hormones. It was shown that 7.5 μM β-sitosterol decreased migration and adhesion of THP-1 cells to HUVECs cultured in the presence of oxLDL. This effect was also observed in HUVEC cultures in the presence of β-sitosterol, the 17β-estradiol and progesterone mixture, and in the presence of the two hormones. It was shown that 7.5 μM β-sitosterol significantly inhibited chemotaxis of [³H] thymidine labeled THP-1 cells in oxLDL-stimulated HUVEC cultures. MCP-1 concentrations in the supernatants of oxLDL-stimulated HUVEC cultures were inhibited by 7.5 μM β-sitosterol as well as by progesterone and the mixture of the two female hormones.     

The effects of neonatal stress on brain development: implications for psychopathology.

Recent studies have focused on the behavioral and neurobiological sequella of exposure to early adverse events. We hypothesize that early adverse experiences result in an increased sensitivity to the effects of stress later in life and render an individual vulnerable to stress-related psychiatric disorders. This vulnerability may be mediated by persistent changes in corticotropin-releasing-factor (CRF)-containing neurons, the hypothalamic-pituitary-adrenal axis, and the sympathetic nervous system. We therefore present an overview of the CRF system and its role as a mediator in the development of the stress response, major depression, and posttraumatic stress disorder. The literature pertaining to behavioral and neurobiological alterations associated with exposure to early adverse life events in rodents, nonhuman primates, and humans is reviewed. We focus on animal models that precipitate depressive and anxiety symptoms while producing neuroendocrine alterations that mimic those seen in adults with those disorders. The literature integrating neurobiological and behavioral consequences of early life stress is also reviewed, focusing primarily on infants born to mothers with depression and on infants who were abused or neglected.     

Current status of 5alpha-reductase inhibitors in the treatment of benign hyperplasia of prostate

Benign prostatic hyperplasia (BPH) is a common problem in aging men, which is associated with lower urinary tract symptoms. This condition is dependent on the presence of androgens for its progression, and medical therapy is the first-line treatment for BPH patients with moderate-to-severe symptoms and includes the use of either alpha 1-adrenergic blockers or 5alpha-reductase inhibitors. Adrenergic blocking drugs reduce the dynamic component while the 5alpha-reductase inhibitors reduce the static component of bladder outlet obstruction in BPH. By inhibiting the generation of active form of testosterone, viz., dihydrotestosterone, the 5alpha-reductase inhibitors not only reduce the symptoms of BPH but also decrease the need for surgery and further progression of BPH. Besides, prolonged use of combination of 5alpha-reductase inhibitors and alpha 1-adrenergic blockers has been found to be more beneficial than either of the two drugs given alone. This review gives a brief account of rationale and efficacy of treatment by 5alpha-reductase inhibitors in the management of BPH.     

Opening the floodgates: benign prostatic hyperplasia may represent another disease in the compendium of ailments caused by the global sympathetic bias that emerges with aging

We have previously posited that the global sympathetic bias that emerges with aging may constitute the common etiologic thread that links a myriad of ailments associated with aging. Recent data suggests that benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) may also be caused by sympathetic bias as an independent etiology from androgen dysfunction. The association of BPH with heart disease, independent of other variables, supports the view that both entities represent downstream manifestations of global sympathetic bias. The risk for development of BPH increases with caffeine intake and decreases with alcohol consumption, factors which wield opposing effects on autonomic balance. Heavy smoking, which induces chronic sympathetic bias, also increases the risk of BPH, a link also previously attributed to hormonal alterations. Sympathetic dysfunction appears to have a mitogenic effect on the prostate. The high prevalence of prostate cancer, a condition detected in the autopsy of many elderly men, may arise from this activity combined with a Th2 shift induced by sympathetic bias, leading to decreased cancer surveillance by the immune system. Exercise may improve BPH by restoring autonomic balance and normalizing the sympathovagal ratio. The benefits of alpha-adrenergic blockers on BPH, generally felt to achieve symptomatic relief afforded by bladder wall and sphincter remodeling, may independently exert a direct effect on prostate growth and enlargement. Sympathetic bias may play a role in adaptive enlargement of other organs such as the salivary glands, heart, liver, spleen, and skeletal muscles in response to stress. We envision novel pharmacologic and device-based neuromodulation therapies for BPH and related urologic dysfunctions based on these principles.     

Allergen-specific immunotherapy in birch- and grass-pollen-allergic rhinitis. II. Side-effects

BACKGROUND: Allergen-specific immunotherapy (IT) involves the risk of side-effects. Different side-effect profiles have been reported for different allergens, and it would be of great benefit to be able more precisely to predict patient- and allergen-related risk factors. METHODS: Fifty-two patients with rhinoconjunctivitis and allergy to birch as well as grass pollen participated in a 3-year IT study, with a baseline year followed by 2 years of treatment. During the first treatment year, the patients received double-blinded IT with either birch (Betula verrucosa) or grass (Phleum pratense) pollen extracts adsorbed to aluminum hydroxide. The following year, the other allergen extract was added. Assessment of systemic reactions (SRs) was performed, and related to patient pretreatment parameters such as seasonal symptoms and medication requirement, skin prick test (SPT), conjunctival provocation test (CPT), nasal provocation test (NPT), total and specific IgE, basophil histamine release (HR), eosinophil count (EOS), eosinophil cationic protein (ECP), and eosinophil protein X (EPX). RESULTS: In total, 44 and 47 patients started IT with birch- and grass-pollen extracts, respectively. All SRs occurred during the dose-increase phase. No life-threatening SRs were observed. There were a higher number of patients with SRs during IT with grass pollen than IT with birch pollen, 21 vs five patients (P<0.001), with SRs to 3.3% of grass-pollen injections compared to 0.7% of birch-pollen injections (P<0.0001). The SRs of birch-pollen IT were mild, consisting of rhinoconjunctivitis and oral-pharyngeal itching, whereas asthma and urticaria episodes were observed in the grass-pollen IT. No difference was found in sensitivity to birch and grass, when measured by SPT, CPT, NPT, specific IgE, or HR, and no difference was found in age, duration of allergic symptoms, prevalence of asthma, mean seasonal birch/grass symptom score, eye-drop use, or antihistamine or prednisolone intake between the group with and without subsequent SRs to IT. No difference was found in EOS, serum ECP, or EPX, between the group with and without subsequent SRs to IT. CONCLUSIONS: IT with grass-pollen extract seems to be associated with a higher number and more severe SRs than birch-pollen IT. Neither demographic data nor diagnostic tests of allergy such as specific IgE, HR, SPT, CPT, and NPT could identify the patients with subsequent SRs.     

Inhaled short‐acting bronchodilators for managing emergency childhood asthma: an overview of reviews

International guidelines provide conflicting recommendations on how to use bronchodilators to manage childhood acute wheezing conditions in the emergency department (ED), and there is variation within and among countries in how these conditions are managed. This may be reflective of uncertainty about the evidence. This overview of systematic reviews (SRs) aimed to synthesize, appraise, and present all SR evidence on the efficacy and safety of inhaled short‐acting bronchodilators to treat asthma and wheeze exacerbations in children 0–18 years presenting to the ED. Searching, review selection, data extraction and analysis, and quality assessments were conducted using methods recommended by The Cochrane Collaboration. Thirteen SRs containing 56 relevant trials and 5526 patients were included. Results demonstrate the efficacy of short‐acting beta‐agonist (SABA) delivered by metered‐dose inhaler as first‐line therapy for younger and older children (hospital admission decreased by 44% in younger children, and ED length of stay decreased by 33 min in older children). Short‐acting anticholinergic (SAAC) should be added to SABA for older children in severe cases (hospital admission decreased by 27% and 74% when compared to SABA and SAAC alone, respectively). Continuous nebulization, addition of magnesium sulfate to SABA, and levosalbutamol compared to salbutamol cannot be recommended in routine practice.     

Steroid transformations by a strain of Arthrobacter oxydans incapable of steroid ring degradation

Arthrobacter oxydans 317 which is able to bring about the complete degradation of β-sitosterol was treated with acridine orange to obtain a plasmid cured strain Arthrobacter 317AL, incapable of producing steroid ring degradation. The strain was neither able to form 4-androstene-3,17-dione(AD) from β-sitosterol nor to convert AD to 1,4-androstadiene-3,17-dione(ADD). It was, however, able to hydroxylate AD and ADD at the C-17 position to form testosterone and 1,4-androstadiene-17β-ol-3-one respectively. The strain could grow on β-sitosterol presumably utilizing the degradation products of the sterol side chain. Partial degradation of the β-sitosterol side chain was demonstrated by the isolation of 27-norcholest-4-en-3,24-dione, a metabolic product of the side chain degradation. The existence of metabolic blocks in a further degradation of the side chain to AD, in 1,2-dehydrogenation and 9α-hydroxylation of the steroid ring structure was postulated.     

一期手术治疗良性前列腺增生症合并膀胱结石21例

目的探讨前列腺增生合并膀胱结石患者一期施行经尿道前列腺电切术及经尿道输尿管镜膀胱结石气压弹道碎石取石术的可行性。方法回顾性分析一期施行经尿道前列腺电切术及经尿道输尿管镜膀胱结石气压弹道碎石取石术的21例前列腺增生合并膀胱结石患者的临床资料。结果该组患者均顺利康复,无电切综合征、膀胱穿孔和结石残留等并发症发生,排尿通畅。结论前列腺增生合并膀胱结石患者同期行经尿道手术,不增加合并症,是一种安全、有效的治疗方法。     

Stressors and Child and Adolescent Psychopathology: Measurement Issues and Prospective Effects

This article reviews existing research on the association between stressors and symptoms of psychopathology in children and adolescents with a focus on measurement issues and prospective effects. The first half of the article focuses on the measurement of stressors, emphasizing checklists and interviews. Available measures of stressful experiences are reviewed and critiqued. Results of this review reveal both substantial progress (i.e., development of valid stressor assessment tools) and remaining problems (i.e., inconsistent measurement across studies). The second half of this article reviews studies that have tested for prospective associations between stressors and symptoms of psychopathology in children and adolescents. Studies that have examined the prospective effects of recent or prior stressors on current psychological symptoms, while controlling for prior psychological symptoms, are reviewed. Results overall suggest that stressors predict changes in rates of symptoms of psychopathology in children and adolescents over time. Results also suggest that symptoms of psychopathology predict changes in rates of stressors over time. Implications of these findings are that conclusive evidence now exists for the importance of stressors in the development of child and adolescent psychopathology.     

Stressors and child and adolescent psychopathology: measurement issues and prospective effects.

This article reviews existing research on the association between stressors and symptoms of psychopathology in children and adolescents with a focus on measurement issues and prospective effects. The first half of the article focuses on the measurement of stressors, emphasizing checklists and interviews. Available measures of stressful experiences are reviewed and critiqued. Results of this review reveal both substantial progress (i.e., development of valid stressor assessment tools) and remaining problems (i.e., inconsistent measurement across studies). The second half of this article reviews studies that have tested for prospective associations between stressors and symptoms of psychopathology in children and adolescents. Studies that have examined the prospective effects of recent or prior stressors on current psychological symptoms, while controlling for prior psychological symptoms, are reviewed. Results overall suggest that stressors predict changes in rates of symptoms of psychopathology in children and adolescents over time. Results also suggest that symptoms of psychopathology predict changes in rates of stressors over time. Implications of these findings are that conclusive evidence now exists for the importance of stressors in the development of child and adolescent psychopathology.     

Effects of exergames and cognitive-motor dual-task training on cognitive,physical and dual-task functions in cognitively healthy older adults: An overview

This overview aims to summarize the effectiveness of cognitive-motor dual-task and exergame interventions on cognitive, physical and dual-task functions in healthy older adults, as well as the feasibility, safety, adherence, transfer and retention of benefits of these interventions. We searched for systematic reviews or meta-analyses assessing the effects of cognitive-motor dual-task and exergame interventions on cognitive, physical and dual-task functions in cognitively healthy older adults through eight databases (CDSR (Cochrane), MEDLINE (PubMed), Scopus, EMBASE, CINAHL, PsycINFO, ProQuest and SportDiscus). Two reviewers performed the selection, data extraction and risk of bias evaluation independently (PROSPERO ID: CRD42019143185). Eighteen reviews were included in this overview. Overall, positive effects of cognitive-motor dual-task interventions on cognitive, physical and dual-task functions, as well as exergames on cognitive functions only, were observed in cognitively healthy older adults. In contrast, the effects of exergames on physical functions are more controversial, and their effects on dual-task functions have not been studied. The feasibility, safety, adherence, transfer and retention of benefits for both intervention types are still unclear. Future studies should follow more rigorous methodological standards in order to improve the quality of evidence and provide guidelines for the use of cognitive-motor dual-task and exergame interventions in older adults.     

Systemic reactions occurring during immunotherapy with standardized pollen extracts.

Specific immunotherapy with standardized extracts administered by a rush protocol can induce systemic reactions (SRs). A prospective study was conducted in 454 pollen-allergic patients (aged 5 to 62 years) (1) to compare the incidence of SRs during a 3-day rush or step protocol, (2) to determine if patients presenting pollen asthma or those allergic to multiple pollen species would have an increased incidence of SRs, and (3) to attempt to decrease SRs. According to their sensitivity, patients received standardized extracts of orchard grass, and/or Parietaria, and/or olive, and/or plane-tree pollen with the same allergenically bioequivalent maintenance dose. Patients 10 years of age and older received 2000 BU; patients younger than 10 years, 1000 BU. The occurrence of SRs was carefully monitored. The incidence of SRs per patient ranged from 2.6% to 31.1%. With the rush protocol, there was a significant decrease in SRs after premedication (p less than 0.015). Severe SRs decreased further when the increase in doses was stopped because large local reactions occurred. Step protocol was only slightly better tolerated than rush protocol. Bronchial adverse reactions occurred more often in patients presenting asthma during previous pollen seasons. No reaction started 45 minutes or later after the last injection.     

Systematic reviews and meta-analyses in infectious diseases: topics that merit special attention

As in other disciplines in medicine, systematic reviews (SR) and meta-analyses (MA) in infectious diseases are an important aid to clinical decision-making. In the present article we review features important to SRs in infectious diseases that should be addressed in most SRs and MAs. We stress the need to include in the SR analysis all patients that were randomized; and all studies that were performed. Authors of SRs should choose one main outcome that matters to patients, and base their conclusions mainly on this outcome. Resistance as an outcome is a topic that should be addressed in all SRs of antibiotic treatment. Ethical aspects and especially patients’ safety should be addressed in SRs.