Efficacy of Raloxifen in treatment of fibromyalgia in menopausal women

BACKGROUND: This study compared Raloxifen (Evista) with placebo in treatment of fibromyalgia. METHODS: One hundred menopausal women with fibromyalgia enrolled in a double-blind randomized study from Feb 2005 until Oct 2006. We compared efficacy of Raloxifen, and placebo over 16 weeks of treatment. Fifty patients received Raloxifen 49 of which (98%) completed the study and 47 (94%) of 50 patients who received placebo completed the study. Raloxifen in 60 mg or identical placebo dose was given every other day over 16 weeks and patients were followed up. Improved recovery for a treatment group was assessed by a significantly higher mean score from baseline to the end of the treatment trial, compared with patients treated with placebo, on measures of Stanford Health Assessment Questionnaire (HAQ); Iranian version of Hospital Anxiety and Depression questionnaire (IHAD); sleep disturbance; number of tender points; reduction of pain and fatigue based on Visual Analogue Score (VAS). RESULTS: Raloxifen produced a significantly higher response rate than placebo in treating fibromyalgia by improving pain and fatigue, reducing of the tender point count, sleep disturbance and recovery of usual activities as measured by the Stanford Health Assessment Questionnaire (HAQ). The significant effect of Raloxifen on HAD score among patients with fibromyalgia was not seen. CONCLUSION: Raloxifen was superior to placebo in the treatment of menopausal patients with fibromyalgia.     

Voices from Flint: Community Perceptions of the Flint Water Crisis

We describe the self-reported socioeconomic and health impacts, as well as the coping mechanisms employed by a drug-using cohort of adults during the Flint water crisis (FWC) in Flint, Michigan. Participants from an ongoing longitudinal Emergency Department study were contacted between April 2016 and July 2016 and completed a survey focusing on exposure, consequences, and coping strategies. One hundred thirty-three participants (mean age = 26, 65% African-American, 61% public assistance) completed the survey (37.9% response rate). Of these, 75% reported exposure to water with elevated lead levels. Of these, 75% reported additional monthly expenses resulting from exposure. Almost 40% of parents reported changes in their children’s health and 65% reported changes to their health since the FWC. Participants indicated the use of both positive (e.g., advice from trusted neighbors, 99.0%) and negative coping mechanisms (e.g., increased substance use, 20.0%) in response to this public health emergency. High-risk Flint residents reported multiple social, economic, and health-related consequences stemming from the FWC. Policymakers should consider additional resources for those affected, including increased access to mental health to aid recovery within the community.     

The significant impact of apigenin on different aspects of autoimmune disease

Autoimmune diseases are among the highest diseases to diagnose and treat. The current “gold standard” of care for these diseases is immunosuppressive drugs which interfere with overall immune responses; their long-term high-dose treatments would expose the patient to opportunistic, life-threatening and long-term malignant infections. Considering the side effects and toxicity of these drug and also the beneficial effects of herbal compounds among their consumers, the professional investigation on the exact mechanism of the plant’s major element has grown much attention in the last years. Apigenin as an extracting compound of plants, such as parsley and celery, which has a variety of biological effects, such as anti-inflammatory, anti-cancer and antioxidant effects. This review is intended to summarize the various effects of Apigenin on several autoimmune diseases which have been worked on so far. The pluralization of the obtained results has revealed Apigenin?s effects on pro-inflammatory cytokines such as IL-1β, chemokines such as ICAM-1, immune cells proliferation such as T cells, apoptosis, and various signaling pathways. According to these preclinical findings, we recommend that further robust unbiased studies should be done to use Apigenin as a supplementary or therapeutic element in autoimmune disease.     

General dentists’, pediatric dentists’, and endodontists’ diagnostic assessment and treatment strategies for deep carious lesions: A comparative analysis

Background

There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists’ (GDs), pediatric dentists’ (PDs), and endodontists’ (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs.

Intense migraines secondary to percutaneous closure of atrial septal defects

In this study we evaluated the development of migraine after percutaneous closure of atrial septal defect. An abrupt and excruciating form of migraine developed shortly after shunt closure in 5 of 13 consecutive patients undergoing this procedure. A dramatic relief of pain was achieved almost instantaneously after administration of 300 mg of clopidogrel.     

Starch digestion, large-bowel fermentation and intestinal mucosal cell proliferation in rats treated with the alpha-glucosidase inhibitor acarbose

Acarbose (Glucobay; Bayer) is an alpha-glucosidase inhibitor used to treat diabetes and which may have a role in the prevention of type 2 diabetes. The present study investigated the effects of acarbose treatment on the site and extent of starch digestion, large-bowel fermentation and intestinal mucosal cell proliferation. Eighteen young male Wistar rats were fed "Westernised" diets containing 0, 250 and 500 mg acarbose/kg (six rats/diet) for 21 d. For most variables measured, both acarbose doses had similar effects. Acarbose treatment suppressed starch digestion in the small bowel but there was compensatory salvage by bacterial fermentation in the large bowel. This was accompanied by a substantial hypertrophy of small- and large-bowel tissue and a consistent increase in crypt width along the intestine. Caecal total SCFA pool size was increased more than 4-fold, with even bigger increases for butyrate. These changes in butyrate were reflected in increased molar proportions of butyrate in blood from both the portal vein and heart. There was little effect of acarbose administration on crypt-cell proliferation (significant increase for mid-small intestine only). This is strong evidence against the hypothesis that increased fermentation and increased supply of butyrate enhances intestinal mucosal cell proliferation. In conclusion, apart from the increased faecal loss of starch, there was no evidence of adverse effects of acarbose on the aspects of large-bowel function investigated.