Propionyl-L-carnitine, L-arginine and niacin in sexual medicine: a nutraceutical approach to erectile dysfunction

The application of nutraceuticals in the field of male sexual function -in particular for erectile dysfunction (ED)--remains relatively underexplored. In a group of 54 unselected men (35-75 years), consecutively presenting to our ED clinic and naive to other ED treatments, we carried out a single-blind, one-arm study to evaluate the effects of a 3-month supplementation with propionyl-L-carnitine, L-arginine and niacin on their sexual performance. All patients had the short-international index of erectile function (IIEF) questionnaire, global assessment questions (GAQs) and routine laboratory testing, at baseline and 3 months afterward. 51 (92%) patients of 54 completed the entire study period. After 3 months of treatment, a small, but statistically significant improvement in total and single items of the IIEF was found (Δ = 5.7 ± 4.1 P < 0.01). Analyses on GAQs revealed that treatment improved erections in 40% of cases, with a partial response occurring in up to 77% of subjects enrolled. These preliminary findings indicate that the favourable cardiovascular effects of nutraceuticals might also reflect on male sexual function with possible implication in the treatment and prevention of ED. This study documents a considerable patient's interest toward nutritional supplementation--as first-line or adjunctive treatment to PDE5 inhibitors--that goes beyond the measurable increment in penile rigidity.     

Pellagra a review exploring causes and mechanisms,including isoniazid-induced pellagra

Pellagra is a clinical syndrome caused by a deficiency of niacin (nicotinic acid) and/or its precursor tryptophan. The cardinal manifestations are 4 D’s: dermatitis, diarrhoea, dementia and in worst case death. Increased use of isoniazid prophylaxis along with antiretroviral therapy in countries where latent tuberculosis is common has been associated with increased presentations with pellagra.     

Enteric gliopathy in niacin-deficiency induced by CNS glio-toxin

6-Aminonicotinamide (6-AN), an antagonist of niacin and a potent CNS glio-toxin, selectively caused degeneration of glial cells in the central nervous system (CNS) of rodents. Suckling mice treated with 6-AN developed diarrhea clinically and displayed vacuolated degenerating glial cells in the myenteric plexus as well as in the CNS. Myenteric neurons were well preserved. These findings provide further evidence for possible functional similarities between the glial cells in the central and enteric nervous systems.     

高效液相色谱法同时测定食品中的B族维生素

用HPLC法同时测定食品中的四种B族维生素(B_1,B_2,B_5,B_6)。实验用0.4mol/L盐酸,120℃、15psi水解样品。分析以μBondapakC18(300mm×3.9mm)为色谱柱,甲醇:重蒸水:庚烷磺酸(PIC-B_7)=30:68:2(V:V:V)为流动相,选择紫外254nm,对B_1、B_2和B_5以及荧光(EX295nm、EM395nm)对B_6的双通道检测,可得到很好的分离图形。B_1、B_2、B_5和B_6的线性范围与相关系数各为10～50ng(r=0.998),5～40ng(r=0.999),5～40ng(r=0.993),5～50ng(r=0.999),最小检出限各为5、5、2、2ng。回收率各为91.3％～102％,103％～105％,92％～100％和99％～100％。与参比实验相比,所得食物中B族维生素含量差异不大,并与食物成分表公布的数据十分接近。     

Combination therapy in the management of mixed dyslipidaemia

Whilst statin monotherapy is often sufficient to reach LDL-C goals, treatment may not reach all lipid goals in individuals with mixed dyslipidaemia typically associated with metabolic syndrome or type 2 diabetes. Double or triple combination therapy, which provides the opportunity to address multiple lipid abnormalities simultaneously, may be required to achieve targets in some patients. Addition of fenofibrate or niacin (nicotinic acid) to statin therapy is likely to be the first option, as recommended by national treatment guidelines; omega-3 fatty acids may also be useful. Careful monitoring is required when adding additional agents given the increased potential for drug interactions and side effects.     

Fixed-dose combination of extended-release niacin plus simvastatin for lipid disorders

Coronary heart disease (CHD) carries significant morbidity and mortality worldwide. Elevated LDL-cholesterol and reduced HDL-cholesterol levels are well-recognized CHD risk factors. Despite guideline recommendations for intensive therapy among patients at high risk for CHD to lower LDL-cholesterol, such lowering has failed to prevent approximately two-thirds of cardiovascular events. As a result of new data, guidelines have begun to focus on non-HDL-cholesterol, HDL-cholesterol and triglycerides as treatment targets, with the end result being a recommendation for combination therapy, such as niacin plus statin for the treatment of dyslipidemia. Compared with statin monotherapy, a combination of niacin and statin therapy provides beneficial effects on a broad range of lipid particles and some evidence suggests a further reduction in CHD risk. Recent studies have shown that the combination of a fixed dose of extended-release niacin plus simvastatin reduces non-HDL-cholesterol, LDL-cholesterol, triglycerides and total cholesterol:HDL-cholesterol ratio by approximately 50% while increasing HDL-cholesterol by 25%. The safety of this combination is consistent with the safety profiles of each individual component and is well tolerated. A long-term study is currently being conducted to evaluate whether this combination therapy confers an additive impact on clinical end points.     

烟酸缺乏症的研究进展

烟酸缺乏症又名糙皮病,是一种营养缺乏性疾病,同时也是累及多个系统的复杂性皮肤病,本文从流行病学、病因和发病机制、临床表现、实验室检查、诊断和鉴别诊断、治疗等方面对烟酸缺乏症的研究进展做一综述。     

调脂药物的联合应用及安全性监测

血脂异常是动脉粥样硬化性心脑血管疾病的重要危险因素。他汀类药物通过降低低密度脂蛋白胆固醇水平,使心血管事件明显减少。但是即使采用大剂量的他汀类药物仍难以达到指南要求的血脂水平标准,因此针对合并糖尿病、代谢综合征等心血管高危人群,他汀类药物联合贝特类、烟酸类、胆固醇吸收抑制药等药物成为临床上的重要选择。