Synergistic effect between catechin and ciprofloxacin on chronic bacterial prostatitis rat model

Abstract Background: Chronic bacterial prostatitis (CBP) is the most common urological disease in adult men. Antibiotic therapy is the gold standard of treatment. However, long‐term therapy resulted in many side‐effects and bacterial resistance. Because of these reasons, we need new treatment modality that could replace traditional antibiotic therapy. Catechin, an extract of green tea, has antimicrobial effect against various bacteria and synergy effect to antibiotics. We evaluate the synergistic effects of catechin on the treatment of CBP in an animal model. Methods: An experimental CBP model was induced in 70 male Wistar rats by instillation of 0.2 mL bacterial suspension (E‐coli Z17, O2:K1:H‐) containing 1 × 108 CFU/mL into the prostatic urethra. Microbiologically and histologically proven CBP model was demonstrated in 58.6% (41 of 70) of the rats after 4 weeks of bacterial instillation. The 41 rats demonstrating CBP were randomly divided into four groups; the control, catechin, ciprofloxacin and catechin with ciprofloxacin groups. All drug treatments were conducted over a period of 2 weeks. After treatment, the results were analyzed with microbiological cultures and histological findings of the prostate and urine samples to compare each group. Results: Microbiological cultures and histological findings of the prostate and urine samples demonstrated reduced bacterial growth and improved inflammatory responses in all three experimental groups compared with the control group. The catechin group showed coherent trends of decrease in bacterial growth and improvements in prostatic inflammation compared with the control group, but not to a statistically significant degree (P > 0.05). However, the ciprofloxacin and catechin with ciprofloxacin groups showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (P < 0.05). The catechin with ciprofloxacin group showed a statistically significant decrease in bacterial growth and improvements in prostatic inflammation compared with the ciprofloxacin group (P < 0.05). Conclusions: These results suggest that catechin may be an effective material in CBP treatment. Particularly, combination treatment of catechin and ciprofloxacin has synergistic effect. Therefore, we suggest that the combination of catechin and ciprofloxacin may be effective in treating CBP with a higher success rate.     

Identification of Key Cost Generating Events for Idiopathic Pulmonary Fibrosis: A Systematic Review

Background

Idiopathic pulmonary fibrosis (IPF) is an incurable, debilitating disease which impairs lung function and eventually leads to death. Currently, there is a lack of effective modifying therapies and treatments for IPF as the underlying epidemiological mechanism is not clearly understood. This leads to difficulty in diagnosing and managing IPF, which results in a high incurment of disease-associated cost. Even though IPF poses a substantial economic burden, there is a lack of research available on cost triggers and healthcare utilization, which can be a barrier to future economic evaluations of new medicines for IPF.

Objectives

We aimed to conduct a systematic literature review (SLR) to identify the key cost-generating events of IPF and to gather any related costing information.

Results

The data showed that the main events triggering high resource use in patients were the symptoms of IPF progression along with comorbidities and lung transplantations. These events result in a high economic impact through the use of medications, health care professionals, and hospital stays.

Conclusion

More research is needed to identify the direct, and indirect, relationships between IPF events and the costs they generate. This would help to further evaluate the area of need for future health technologies and to understand what events should be targeted to reduce the global economic burden of IPF.

     

Magnetic Resonance Imaging of Pulmonary Embolism: Diagnostic Accuracy of Unenhanced MR and Influence in Mortality Rates

Objectives

We evaluated the diagnostic value for pulmonary embolism (PE) of the True fast imaging with steady-state precession (TrueFISP) MRI, a method that allows the visualization of pulmonary vasculature without breath holding or intravenous contrast.

Methods

This is a prospective investigation including 93 patients with suspected PE. All patients underwent TrueFISP MRI after undergoing CT pulmonary angiography (CTPA). Two independent readers evaluated each MR study, and consensus was obtained. CTPA results were analysed by a third independent reviewer and these results served as the reference standard. A fourth radiologist was responsible for evaluating if lesions found on MRI for both analysis were the same and if these were the correspondent lesions on the CTPA. Sensitivity, specificity, predictive values and accuracy were calculated. Evidence for death from PE within the 1-year follow-up was also assessed.

Results

Two patients could not undergo the real-time MRI and were excluded from the study. PE prevalence was 22%. During the 1-year follow-up period, eight patients died, whereas PE was responsible for 12.5% of cases. Between patients who developed PE, only 5% died due to this condition. There were no differences between MR and CT embolism detection in these subjects. MR sequences had a sensitivity of 85%, specificity was 98.6% and accuracy was 95.6%. Agreement between readers was high (κ=?0.87).

Conclusions

Compared with contrast-enhanced CT, unenhanced MR sequences demonstrate good accuracy and no differences in the mortality rates in 1 year were detected.

     

Repository corticotropin for Chronic Pulmonary Sarcoidosis

Purpose

The dose of repository corticotropin (RCI) and need for a loading dose in sarcoidosis patients receiving chronic corticosteroids are unclear. We performed a single-blind prospective study, comparing two doses of RCI in sarcoidosis.

Methods

Chronic pulmonary sarcoidosis patients receiving prednisone therapy with deterioration by 5% in FVC in the previous year were studied. RCI was administered subcutaneously at a loading dose of 80 units RCI for 10 days. Patients were randomized at day 14 to receive either 40- or 80-unit RCI twice a week. The dose of prednisone was modified by the clinician who was blinded to the patient’s dosage of RCI.

Results

Sixteen patients completed the full 24 weeks of the study. At week 24, there was a decrease in the dose of prednisone, and improvements in DLCO, King’s Sarcoidosis Questionnaire health status and fatigue score. There was no significant change in FVC % predicted. For the PET scan, there was a significant fall in the standard uptake value (SUV) of the lung lesions. Only 3/8 patients remained on 80 units RCI for full 24 weeks. There was no significant difference in the response to therapy for those treated with 40- versus 80-unit RCI.

Conclusions

Repository corticotropin treatment was prednisone-sparing and associated with significant improvement in DLCO, PET scan, and patient-reported outcome measures. A dose of 40-unit RCI twice a week was as effective as 80-unit RCI and was better tolerated.

     

An insertion mutation of the CHRNA4 gene in a family with autosomal dominant nocturnal frontal lobe epilepsy

Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is the first, and to date only, idiopathic epilepsy for which a specific mutation has been found. A missense mutation in the critical M2 domain of the alpha4 subunit of the neuronal nicotinic acetylcholine receptor (CHRNA4) has been recently identified in one large Australian pedigree. Here we describe a novel mutation in the M2 domain of the CHRNA4 gene in a Norwegian family. Three nucleotides (GCT) were inserted at nucleotide position 776 into the coding region for the C-terminal end of the M2 domain. Physiological investigations of the receptor reconstituted with the mutated CHRNA4 subunit reveal that this insertion does not prevent the receptor function but increases its apparent affinity for ACh. In addition, this mutant receptor shows a significantly lower calcium permeability that, at the cellular level, may correspond to a loss of function. Comparison of the two mutations identified so far in families with ADNFLE illustrates that different mutations can result in similar phenotypes.      

An open study comparing manual therapy with the use of cold packs in the treatment of post-traumatic headache

One year after head trauma, 23 patients with post-traumatic headache entered a prospective clinical controlled trial to find out if specific manual therapy on the neck could reduce the headache. The study was completed by 19 patients (83%). Ten patients were treated twice with manual therapy and nine patients were treated twice with cold packs on the neck. The pain index was calculated blindly. Two weeks after the last treatment the mean pain index was significantly reduced to 43% in the group treated with manual therapy compared with the pretreatment level. At follow-up five weeks later, the pain index was still lower in this group compared with the group treated with cold packs, but this difference was not statistically significant. The pain index for all 19 patients was significantly correlated to the use of analgesics as well as to the frequency of associated symptoms (number of days per week with dizziness, visual disturbances and ear symptoms). It is concluded that the type of manual therapy used in this study seems to have a specific effect in reducing post-traumatic headache. The result supports the hypothesis of a cervical mechanism causing post-traumatic headache and suggests that post-traumatic dizziness, visual disturbances and ear symptoms could be part of a cervical syndrome.