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Medicines, Volume 6, Issue 1 (March 2019)

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Cover Story (view full-size image) A magnified image of the mechanism of action is shown. The various mechanisms of bacterial cell [...] Read more.
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Open AccessReview
The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease
Received: 18 February 2019 / Revised: 8 March 2019 / Accepted: 9 March 2019 / Published: 18 March 2019
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Abstract
Nonalcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of liver damage from the more prevalent (75%–80%) and nonprogressive nonalcoholic fatty liver (NAFL) category to its less common and more ominous subset, nonalcoholic steatohepatitis (NASH). NAFLD is now the most common cause of [...] Read more.
Nonalcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of liver damage from the more prevalent (75%–80%) and nonprogressive nonalcoholic fatty liver (NAFL) category to its less common and more ominous subset, nonalcoholic steatohepatitis (NASH). NAFLD is now the most common cause of chronic liver disease in the developed world and is a leading indication for liver transplantation in United States (US). The global prevalence of NAFLD is estimated to be 25%, with the lowest prevalence in Africa (13.5%) and highest in the Middle East (31.8%) and South America (30.4%). The increasing incidence of NAFLD has been associated with the global obesity epidemic and manifestation of metabolic complications, including hypertension, diabetes, and dyslipidemia. The rapidly rising healthcare and economic burdens of NAFLD warrant institution of preventative and treatment measures in the high-risk sub-populations in an effort to reduce the morbidity and mortality associated with NAFLD. Genetic, demographic, clinical, and environmental factors may play a role in the pathogenesis of NAFLD. While NAFLD has been linked with various genetic variants, including PNPLA-3, TM6SF2, and FDFT1, environmental factors may predispose individuals to NAFLD as well. NAFLD is more common in older age groups and in men. With regards to ethnicity, in the US, Hispanics have the highest prevalence of NAFLD, followed by Caucasians and then African-Americans. NAFLD is frequently associated with the components of metabolic syndrome, such as type 2 diabetes mellitus (T2DM), obesity, hypertension, and dyslipidemia. Several studies have shown that the adoption of a healthy lifestyle, weight loss, and pro-active management of individual components of metabolic syndrome can help to prevent, retard or reverse NAFLD-related liver damage. Independently, NAFLD increases the risk of premature cardiovascular disease and associated mortality. For this reason, a case can be made for screening of NAFLD to facilitate early diagnosis and to prevent the hepatic and extra-hepatic complications in high risk sub-populations with morbid obesity, diabetes, and other metabolic risk factors. Full article
(This article belongs to the Special Issue Potential Treatment Targets for Non-alcoholic Liver Disease)
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Open AccessTechnical Note
Ultra-Low-Level Laser Therapy and Acupuncture Libralux: What Is so Special?
Received: 19 February 2019 / Revised: 5 March 2019 / Accepted: 12 March 2019 / Published: 14 March 2019
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Abstract
Background: Contrary to the most credited theories on laser therapy that see power/energy as the major factors to its effectiveness, a technique using an extremely low power/energy laser stimulation to treat musculoskeletal pain and dysfunction is proposed. The stimulus consists of a [...] Read more.
Background: Contrary to the most credited theories on laser therapy that see power/energy as the major factors to its effectiveness, a technique using an extremely low power/energy laser stimulation to treat musculoskeletal pain and dysfunction is proposed. The stimulus consists of a 20 s train of modulated pulses with an average power below 0.02 mW and is applied on sequences of acupuncture points selected according to the impaired segment of the patient’s body. Methods: Modifications on the extracellular soft tissue matrix and on the “fascia” were sonographically demonstrated. Laboratory and clinical tests confirmed the effectiveness. Results: Responses similar to those experienced in acupuncture were observed. The device—a CE Class IIa certified medical device named Libralux—affords a clinically proven effectiveness exceeding 80% in the treatment of musculoskeletal conditions and associated motor dysfunctions. An average of just three application sessions was generally sufficient to overcome the dysfunction. Conclusions: The development of the method is supported by over 20 years of R&D activities, with a range of experiments discussed in several papers published in indexed peer-reviewed journals. A few considerations regarding the possible physiological action mechanisms involved are proposed in this paper. Full article
(This article belongs to the Special Issue Innovative Laser Medicine and Traditional Acupuncture Therapy)
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Open AccessReview
Green Nanotechnology: Advancement in Phytoformulation Research
Received: 30 November 2018 / Revised: 12 February 2019 / Accepted: 2 March 2019 / Published: 14 March 2019
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Abstract
The ultimate goal of any scientific development is to increase well-being and human health. Novel strategies are required for the achievement of safe and effective therapeutic treatments beyond the conventional ones, and society needs new requirements for new technologies, moving towards clean and [...] Read more.
The ultimate goal of any scientific development is to increase well-being and human health. Novel strategies are required for the achievement of safe and effective therapeutic treatments beyond the conventional ones, and society needs new requirements for new technologies, moving towards clean and green technology development. Green nanotechnology is a branch of green technology that utilizes the concepts of green chemistry and green engineering. It reduces the use of energy and fuel by using less material and renewable inputs wherever possible. Green nanotechnology, in phytoformulations, significantly contributes to environmental sustainability through the production of nanomaterials and nanoproducts, without causing harm to human health or the environment. The rationale behind the utilization of plants in nanoparticle formulations is that they are easily available and possess a broad variability of metabolites, such as vitamins, antioxidants, and nucleotides. For instance, gold (Au) nanoparticles have attracted substantial attention for their controllable size, shape, and surface properties. A variety of copper (Cu) and copper oxide (CuO) nanoparticles have also been synthesized from plant extracts. Titanium dioxide and zinc oxide nanoparticles are also important metal oxide nanomaterials that have been synthesized from a number of plant extracts. International and domestic laws, government and private-party programs, regulations and policies are being carefully reviewed and revised to increase their utility and nurture these nanoscale materials for commercialization. Inspiring debates and government initiatives are required to promote the sustainable use of nanoscale products. In this review, we will discuss the potential of the utilization of plant extracts in the advancement of nanotechnology. Full article
(This article belongs to the Special Issue Nanoparticle and Liposome based Novel Drug Delivery Systems)
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Open AccessReview
Synthetic Lethality in Lung Cancer—From the Perspective of Cancer Genomics
Received: 29 January 2019 / Revised: 5 March 2019 / Accepted: 8 March 2019 / Published: 12 March 2019
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Abstract
Cancer is a genetic disease, and this concept is now widely exploited by both scientists and clinicians to develop new genotype-selective anticancer therapeutics. Although the quest of cancer genomics is in its dawn, recognition of the widespread applicability of genetic interactions with biological [...] Read more.
Cancer is a genetic disease, and this concept is now widely exploited by both scientists and clinicians to develop new genotype-selective anticancer therapeutics. Although the quest of cancer genomics is in its dawn, recognition of the widespread applicability of genetic interactions with biological processes of tumorigenesis is propelling research throughout academic fields. Lung cancer is the most common cause of cancer death worldwide, with an estimated 1.6 million deaths each year. Despite the development of targeted therapies that inhibit oncogenic mutations of lung cancer cases, continued research into new therapeutic approaches is required for untreatable lung cancer patients, and the development of therapeutic modalities has proven elusive. The “synthetic lethal” approach holds the promise of delivering a therapeutic regimen that preferentially targets malignant cells while sparing normal cells. We highlight the potential challenges in synthetic lethal anticancer therapeutics that target untreatable genetic alterations in lung cancer. We also discuss both challenges and opportunities regarding the application of new synthetic lethal interactions in lung cancer. Full article
(This article belongs to the Special Issue Novel Therapeutic and Preventive Approaches for Cancer)
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Open AccessArticle
Antiproliferative Activity of (-)-Rabdosiin Isolated from Ocimum sanctum L.
Received: 31 January 2019 / Revised: 5 March 2019 / Accepted: 7 March 2019 / Published: 12 March 2019
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Abstract
Background: Ocimum sanctum L. (holy basil; Tulsi in Hindi) is an important medicinal plant, traditionally used in India. Methods: The phytochemical study of the nonpolar (dichloromethane 100%) and polar (methanol:water; 7:3) extracts yielded fourteen compounds. Compounds 6, 7, 9, 11 [...] Read more.
Background: Ocimum sanctum L. (holy basil; Tulsi in Hindi) is an important medicinal plant, traditionally used in India. Methods: The phytochemical study of the nonpolar (dichloromethane 100%) and polar (methanol:water; 7:3) extracts yielded fourteen compounds. Compounds 6, 7, 9, 11, 12, and 13, along with the methanol:water extract were evaluated for their cytotoxicity against the human cancer cell lines MCF-7, SKBR3, and HCT-116, and normal peripheral blood mononuclear cells (PBMCs). Results: Five terpenoids, namely, ursolic acid (1), oleanolic acid (2), betulinic acid (3), stigmasterol (4), and β-caryophyllene oxide (5); two lignans, i.e., (-)-rabdosiin (6) and shimobashiric acid C (7); three flavonoids, luteolin (8), its 7-O-β-D-glucuronide (9), apigenin 7-O-β-D-glucuronide (10); and four phenolics, (E)-p-coumaroyl 4-O-β-D-glucoside (11), 3-(3,4-dihydroxyphenyl) lactic acid (12), protocatechuic acid (13), and vanillic acid (14) were isolated. Compound 6 was the most cytotoxic against the human cancer lines assessed and showed very low cytotoxicity against PBMCs. Conclusions: Based on these results, the structure of compound 6 shows some promise as a selective anticancer drug scaffold. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessArticle
Development and Validation of an HPLC-PDA Method for Biologically Active Quinonemethide Triterpenoids Isolated from Maytenus chiapensis
Received: 24 January 2019 / Revised: 22 February 2019 / Accepted: 4 March 2019 / Published: 7 March 2019
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Abstract
Background: Quinonemethide triterpenoids, known as celastroloids, constitute a relatively small group of biologically active compounds restricted to the Celastraceae family and, therefore, they are chemotaxonomic markers for this family. Among this particular type of metabolite, pristimerin and tingenone are considered traditional medicines [...] Read more.
Background: Quinonemethide triterpenoids, known as celastroloids, constitute a relatively small group of biologically active compounds restricted to the Celastraceae family and, therefore, they are chemotaxonomic markers for this family. Among this particular type of metabolite, pristimerin and tingenone are considered traditional medicines in Latin America. The aim of this study was the isolation of the most abundant celastroloids from the root bark of Maytenus chiapensis, and thereafter, to develop an analytical method to identify pristimerin and tingenone in the Celastraceae species. Methods: Pristimerin and tingenone were isolated from the n-hexane-Et2O extract of the root bark of M. chiapensis through chromatographic techniques, and were used as internal standards. Application of a validated RP HPLC-PDA method was developed for the simultaneous quantification of these two metabolites in three different extracts, n-hexane-Et2O, methanol, and water, to determine the best extractor solvent. Results: Concentration values showed great variation between the solvents used for extraction, with the n-hexane–Et2O extract being the richest in pristimerin and tingenone. Conclusions: M. chiapensis is a source of two biologically active quinonemethide triterpenoids. An analytical method was developed for the qualification and quantification of these two celastroloids in the root bark extracts of M. chiapensis. The validated method reported herein could be extended and be useful in analyzing Celastraceae species and real commercial samples. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessReview
Mitragyna speciosa: Clinical, Toxicological Aspects and Analysis in Biological and Non-Biological Samples
Received: 31 January 2019 / Revised: 24 February 2019 / Accepted: 27 February 2019 / Published: 4 March 2019
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Abstract
The abuse of psychotropic substances is a well-known phenomenon, and many of them are usually associated with ancestral traditions and home remedies. This is the case of Mitragyna speciosa (kratom), a tropical tree used to improve work performance and to withstand great heat. [...] Read more.
The abuse of psychotropic substances is a well-known phenomenon, and many of them are usually associated with ancestral traditions and home remedies. This is the case of Mitragyna speciosa (kratom), a tropical tree used to improve work performance and to withstand great heat. According to several published studies, the main reasons for kratom consumption involve improving sexual performance and endurance, but also social and recreational uses for the feeling of happiness and euphoria; it is also used for medical purposes as a pain reliever, and in the treatment of diarrhea, fever, diabetes, and hypertension. However, this plant has gained more popularity amongst young people over the last years. Since it is available on the internet for purchase, its use is now widely as a drug of abuse, namely as a new psychoactive substance, being a cheaper alternative to opioids that does not require medical prescription in most countries. According to internet surveys by the European Monitoring Centre for Drugs and Drug Addiction in 2008 and 2011, kratom was one of the most widely supplied new psychoactive substances. The composition of kratom is complex; in fact, more than 40 different alkaloids have been identified in Mitragyna speciosa so far, the major constituent being mitragynine, which is exclusive to this plant. Besides mitragynine, alkaloids such as corynantheidine and 7-hydroxamitragynine also present pharmacological effects, a feature that may be attributed to the remaining constituents as well. The main goal of this review is not only to understand the origin, chemistry, consumption, and analytical methodologies for analysis and mechanism of action, but also the use of secondary metabolites of kratom as therapeutic drugs and the assessment of potential risks associated with its consumption, in order to aid health professionals, toxicologists, and police authorities in cases where this plant is present. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessReview
Kampo Therapies and the Use of Herbal Medicines in the Dentistry in Japan
Received: 13 February 2019 / Revised: 22 February 2019 / Accepted: 25 February 2019 / Published: 28 February 2019
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Abstract
Dental caries and periodontal disease are two major diseases in the dentistry. As the society is aging, their pathological meaning has been changing. An increasing number of patients are displaying symptoms of systemic disease and so we need to pay more attention to [...] Read more.
Dental caries and periodontal disease are two major diseases in the dentistry. As the society is aging, their pathological meaning has been changing. An increasing number of patients are displaying symptoms of systemic disease and so we need to pay more attention to immunologic aggression in our medical treatment. For this reason, we focused on natural products. Kampo consists of natural herbs—roots and barks—and has more than 3000 years of history. It was originated in China as traditional medicine and introduced to Japan. Over the years, Kampo medicine in Japan has been formulated in a way to suit Japan’s natural features and ethnic characteristics. Based on this traditional Japanese Kampo medicine, we have manufactured a Kampo gargle and Mastic Gel dentifrice. In order to practically utilize the effectiveness of mastic, we have developed a dentifrice (product name: IMPLA CARE) and treated implant periodontitis and severe periodontitis. Full article
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Open AccessArticle
The Membrane-Active Phytopeptide Cycloviolacin O2 Simultaneously Targets HIV-1-infected Cells and Infectious Viral Particles to Potentiate the Efficacy of Antiretroviral Drugs
Received: 21 January 2019 / Revised: 22 February 2019 / Accepted: 24 February 2019 / Published: 28 February 2019
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Abstract
Background: Novel strategies to increase the efficacy of antiretroviral (ARV) drugs will be of crucial importance. We hypothesize that membranes of HIV-1-infected cells and enveloped HIV-1 particles may be preferentially targeted by the phytopeptide, cycloviolacin O2 (CyO2) to significantly enhance ARV efficacy. Methods: [...] Read more.
Background: Novel strategies to increase the efficacy of antiretroviral (ARV) drugs will be of crucial importance. We hypothesize that membranes of HIV-1-infected cells and enveloped HIV-1 particles may be preferentially targeted by the phytopeptide, cycloviolacin O2 (CyO2) to significantly enhance ARV efficacy. Methods: Physiologically safe concentrations of CyO2 were determined via red blood cell (RBC) hemolysis. SYTOX-green dye-uptake and radiolabeled saquinavir (3H-SQV) uptake assays were used to measure pore-formation and drug uptake, respectively. ELISA, reporter assays and ultracentrifugation were conducted to analyze the antiviral efficacy of HIV-1 protease and fusion inhibitors alone and co-exposed to CyO2. Results: CyO2 concentrations below 0.5 μM did not show substantial hemolytic activity, yet these concentrations enabled rapid pore-formation in HIV-infected T-cells and monocytes and increased drug uptake. ELISA for HIV-1 p24 indicated that CyO2 enhances the antiviral efficacy of both SQV and nelfinavir. CyO2 (< 0.5 μM) alone decreases HIV-1 p24 production, but it did not affect the transcription regulatory function of the HIV-1 long terminal repeat (LTR). Ultracentrifugation studies clearly showed that CyO2 exposure disrupted viral integrity and decreased the p24 content of viral particles. Furthermore, direct HIV-1 inactivation by CyO2 enhanced the efficacy of enfuvirtide. Conclusions: The membrane-active properties of CyO2 may help suppress viral load and augment antiretroviral drug efficacy. Full article
(This article belongs to the Special Issue Plant-Derived Medicines and Biological Activity Evaluation)
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Open AccessReview
New Approaches to Detect Biosynthetic Gene Clusters in the Environment
Received: 26 January 2019 / Revised: 22 February 2019 / Accepted: 22 February 2019 / Published: 25 February 2019
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Abstract
Microorganisms in the environment can produce a diverse range of secondary metabolites (SM), which are also known as natural products. Bioactive SMs have been crucial in the development of antibiotics and can also act as useful compounds in the biotechnology industry. These natural [...] Read more.
Microorganisms in the environment can produce a diverse range of secondary metabolites (SM), which are also known as natural products. Bioactive SMs have been crucial in the development of antibiotics and can also act as useful compounds in the biotechnology industry. These natural products are encoded by an extensive range of biosynthetic gene clusters (BGCs). The developments in omics technologies and bioinformatic tools are contributing to a paradigm shift from traditional culturing and screening methods to bioinformatic tools and genomics to uncover BGCs that were previously unknown or transcriptionally silent. Natural product discovery using bioinformatics and omics workflow in the environment has demonstrated an extensive distribution of BGCs in various environments, such as soil, aquatic ecosystems and host microbiome environments. Computational tools provide a feasible and culture-independent route to find new secondary metabolites where traditional approaches cannot. This review will highlight some of the advances in the approaches, primarily bioinformatic, in identifying new BGCs, especially in environments where microorganisms are rarely cultured. This has allowed us to tap into the huge potential of microbial dark matter. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
Open AccessReview
Cannabis and Its Secondary Metabolites: Their Use as Therapeutic Drugs, Toxicological Aspects, and Analytical Determination
Received: 31 January 2019 / Revised: 16 February 2019 / Accepted: 18 February 2019 / Published: 23 February 2019
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Abstract
Although the medicinal properties of Cannabis species have been known for centuries, the interest on its main active secondary metabolites as therapeutic alternatives for several pathologies has grown in recent years. This potential use has been a revolution worldwide concerning public health, production, [...] Read more.
Although the medicinal properties of Cannabis species have been known for centuries, the interest on its main active secondary metabolites as therapeutic alternatives for several pathologies has grown in recent years. This potential use has been a revolution worldwide concerning public health, production, use and sale of cannabis, and has led inclusively to legislation changes in some countries. The scientific advances and concerns of the scientific community have allowed a better understanding of cannabis derivatives as pharmacological options in several conditions, such as appetite stimulation, pain treatment, skin pathologies, anticonvulsant therapy, neurodegenerative diseases, and infectious diseases. However, there is some controversy regarding the legal and ethical implications of their use and routes of administration, also concerning the adverse health consequences and deaths attributed to marijuana consumption, and these represent some of the complexities associated with the use of these compounds as therapeutic drugs. This review comprehends the main secondary metabolites of Cannabis, approaching their therapeutic potential and applications, as well as their potential risks, in order to differentiate the consumption as recreational drugs. There will be also a focus on the analytical methodologies for their analysis, in order to aid health professionals and toxicologists in cases where these compounds are present. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessEditorial
Announcing the 2019 Medicines Travel Award for PostDocs
Received: 20 February 2019 / Accepted: 20 February 2019 / Published: 21 February 2019
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Abstract
For the Medicines Travel Award 2019, we received a total of 38 applications from all over the world [...] Full article
Open AccessReview
Medicinal Potentialities of Plant Defensins: A Review with Applied Perspectives
Received: 31 January 2019 / Revised: 16 February 2019 / Accepted: 18 February 2019 / Published: 19 February 2019
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Abstract
Plant-based secondary metabolites with medicinal potentialities such as defensins are small, cysteine-rich peptides that represent an imperative aspect of the inherent defense system. Plant defensins possess broad-spectrum biological activities, e.g., bactericidal and insecticidal actions, as well as antifungal, antiviral, and anticancer activities. The [...] Read more.
Plant-based secondary metabolites with medicinal potentialities such as defensins are small, cysteine-rich peptides that represent an imperative aspect of the inherent defense system. Plant defensins possess broad-spectrum biological activities, e.g., bactericidal and insecticidal actions, as well as antifungal, antiviral, and anticancer activities. The unique structural and functional attributes provide a nonspecific and versatile means of combating a variety of microbial pathogens, i.e., fungi, bacteria, protozoa, and enveloped viruses. Some defensins in plants involved in other functions include the development of metal tolerance and the role in sexual reproduction, while most of the defensins make up the innate immune system of the plants. Defensins are structurally and functionally linked and have been characterized in various eukaryotic microorganisms, mammals, plants, gulls, teleost species of fish, mollusks, insect pests, arachnidan, and crustaceans. This defense mechanism has been improved biotechnologically as it helps to protect plants from fungal attacks in genetically modified organisms (GMO). Herein, we review plant defensins as secondary metabolites with medicinal potentialities. The first half of the review elaborates the origin, structural variations, and mechanism of actions of plant defensins. In the second part, the role of defensins in plant defense, stress response, and reproduction are discussed with suitable examples. Lastly, the biological applications of plant defensins as potential antimicrobial and anticancer agents are also deliberated. In summary, plant defensins may open a new prospect in medicine, human health, and agriculture. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessArticle
An Explorative Study of Qualities in Interactive Processes with Children and Their Parents in Music Therapy during and after Pediatric Hematopoietic Stem Cell Transplantation
Received: 1 December 2018 / Revised: 29 January 2019 / Accepted: 11 February 2019 / Published: 18 February 2019
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Abstract
Background: Hematopoietic stem cell transplantation (HSCT) is an established treatment for severe disorders of the pediatric hematopoietic system. However, there is a need for supportive interventions due to physiological and psychological strain. Music therapy is used in health care to help patients through [...] Read more.
Background: Hematopoietic stem cell transplantation (HSCT) is an established treatment for severe disorders of the pediatric hematopoietic system. However, there is a need for supportive interventions due to physiological and psychological strain. Music therapy is used in health care to help patients through difficult experiences and enable well-being. Our previous randomized studies showed significantly reduced heart rates four to eight hours after intervention as well as increased health-related quality of life. Methods: The aim of this qualitative study was to explore the participants’ and parents’ own experiences of the interactive processes during the music therapy intervention. Six families were included. The data collection used collaborative research interviews. An independent psychologist facilitated the interviews with the children, the parents, and the music therapist and also performed the analysis. Results: Three main themes emerged: experiences of competency and recognition of self, interactive affect regulation as change potential, and importance of the therapeutic relationship. Conclusions: For the participants, music therapy developed into a significant and helpful experience, an important ingredient in coping with and managing the treatment period at the hospital. Full article
(This article belongs to the Special Issue Music Therapy)
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Open AccessBrief Report
Nutraceutical Characteristics of Ancient Malus x domestica Borkh. Fruits Recovered across Siena in Tuscany
Received: 24 January 2019 / Revised: 9 February 2019 / Accepted: 12 February 2019 / Published: 18 February 2019
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Abstract
Background: A diet rich in fruits and vegetables contributes to lowering the risk of chronic diseases. The fruits of Malus x domestica are a rich dietary source of bioactive compounds, namely vitamins and antioxidants, with recognized action on human health protection. Tuscany is [...] Read more.
Background: A diet rich in fruits and vegetables contributes to lowering the risk of chronic diseases. The fruits of Malus x domestica are a rich dietary source of bioactive compounds, namely vitamins and antioxidants, with recognized action on human health protection. Tuscany is known for its rich plant biodiversity, especially represented by ancient varieties of fruit trees. Particularly noteworthy are the many ancient Tuscan varieties of apple trees. Methods: Sugar quantification via HPLC and spectrophotometric assays to quantify the antioxidant power and total polyphenol content revealed interesting differences in 17 old varieties of Malus x domestica Borkh. recovered in Siena (Tuscany). Results: The quantification of antioxidants, polyphenols, and the main free sugars revealed that their content in the old fruits was often superior to the widespread commercial counterparts (‘Red Delicious’ and ‘Golden Delicious’). Such differences were, in certain cases, dramatic, with 8-fold higher values. Differences were also present for sugars and fibers (pectin). Most ancient fruits displayed low values of glucose and high contents of xylitol and pectin. Conclusions: The results reported here suggest the possible use of ancient apple varieties from Siena for nutraceutical purposes and draw attention to the valorization of local old varieties. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
Open AccessArticle
PharmActa: Empowering Patients to Avoid Clinical Significant Drug–Herb Interactions
Received: 11 January 2019 / Revised: 15 February 2019 / Accepted: 15 February 2019 / Published: 16 February 2019
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Abstract
Herbal medicinal products (HMPs) are the subject of increasing interest regarding their benefits for health. However, a serious concern is the potential appearance of clinically significant drug–herb interactions in patients. This work provides an overview of drug–herb interactions and an evaluation of their [...] Read more.
Herbal medicinal products (HMPs) are the subject of increasing interest regarding their benefits for health. However, a serious concern is the potential appearance of clinically significant drug–herb interactions in patients. This work provides an overview of drug–herb interactions and an evaluation of their clinical significance. We discuss how personalized health services and mobile health applications can utilize tools that provide essential information to patients to avoid drug–HMP interactions. There is a specific mention to PharmActa, a dedicated mobile app for personalized pharmaceutical care with information regarding drug–HMPs interactions. Several studies over the years have shown that for some HMPs, the potential to present clinically significant interactions is evident, especially for many of the top selling HMPs. Towards that, PharmActa presents how we can improve the way that information regarding potential drug–herb interactions can be disseminated to the public. The utilization of technologies focusing on medical information and context awareness introduce a new era in healthcare. The exploitation of eHealth tools and pervasive mobile monitoring technologies in the case of HMPs will allow the citizens to be informed and avoid potential drug–HMPs interactions enhancing the effectiveness and ensuring safety for HMPs. Full article
(This article belongs to the Special Issue Safety of Complementary Medicines)
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Open AccessReview
Music Therapy and Other Music-Based Interventions in Pediatric Health Care: An Overview
Received: 30 November 2018 / Revised: 1 February 2019 / Accepted: 11 February 2019 / Published: 14 February 2019
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Abstract
Background: In pediatric health care, non-pharmacological interventions such as music therapy have promising potential to complement traditional medical treatment options in order to facilitate recovery and well-being. Music therapy and other music-based interventions are increasingly applied in the clinical treatment of children and [...] Read more.
Background: In pediatric health care, non-pharmacological interventions such as music therapy have promising potential to complement traditional medical treatment options in order to facilitate recovery and well-being. Music therapy and other music-based interventions are increasingly applied in the clinical treatment of children and adolescents in many countries world-wide. The purpose of this overview is to examine the evidence regarding the effectiveness of music therapy and other music-based interventions as applied in pediatric health care. Methods: Surveying recent literature and summarizing findings from systematic reviews, this overview covers selected fields of application in pediatric health care (autism spectrum disorder; disability; epilepsy; mental health; neonatal care; neurorehabilitation; pain, anxiety and stress in medical procedures; pediatric oncology and palliative care) and discusses the effectiveness of music interventions in these areas. Results: Findings show that there is a growing body of evidence regarding the beneficial effects of music therapy, music medicine, and other music-based interventions for children and adolescents, although more rigorous research is still needed. The highest quality of evidence for the positive effects of music therapy is available in the fields of autism spectrum disorder and neonatal care. Conclusions: Music therapy can be considered a safe and generally well-accepted intervention in pediatric health care to alleviate symptoms and improve quality of life. As an individualized intervention that is typically provided in a person-centered way, music therapy is usually easy to implement into clinical practices. However, it is important to note that to exploit the potential of music therapy in an optimal way, specialized academic and clinical training and careful selection of intervention techniques to fit the needs of the client are essential. Full article
(This article belongs to the Special Issue Music Therapy)
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Open AccessReview
Differential Methylation and Acetylation as the Epigenetic Basis of Resveratrol’s Anticancer Activity
Received: 11 January 2019 / Revised: 10 February 2019 / Accepted: 11 February 2019 / Published: 13 February 2019
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Abstract
Numerous studies support the potent anticancer activity of resveratrol and its regulation of key oncogenic signaling pathways. Additionally, the activation of sirtuin 1, a deacetylase, by resveratrol has been known for many years, making resveratrol perhaps one of the earliest nutraceuticals with associated [...] Read more.
Numerous studies support the potent anticancer activity of resveratrol and its regulation of key oncogenic signaling pathways. Additionally, the activation of sirtuin 1, a deacetylase, by resveratrol has been known for many years, making resveratrol perhaps one of the earliest nutraceuticals with associated epigenetic activity. Such epigenetic regulation by resveratrol, and the mechanism thereof, has attracted much attention in the past decade. Focusing on methylation and acetylation, the two classical epigenetic regulations, we showcase the potential of resveratrol as an effective anticancer agent by virtue of its ability to induce differential epigenetic changes. We discuss the de-repression of tumor suppressors such as BRCA-1, nuclear factor erythroid 2-related factor 2 (NRF2) and Ras Associated Domain family-1α (RASSF-1α) by methylation, PAX1 by acetylation and the phosphatase and tensin homologue (PTEN) by both methylation and acetylation, in addition to the epigenetic regulation of oncogenic NF-κB and STAT3 signaling by resveratrol. Further, we evaluate the literature supporting the potentiation of HDAC inhibitors and the inhibition of DNMTs by resveratrol in different human cancers. This discussion underlines a robust epigenetic activity of resveratrol that warrants further evaluation, particularly in clinical settings. Full article
(This article belongs to the Special Issue Natural Compounds as New Cancer Treatments)
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Open AccessArticle
Assessment of Artemisinin Contents in Selected Artemisia Species from Tajikistan (Central Asia)
Received: 15 January 2019 / Revised: 30 January 2019 / Accepted: 31 January 2019 / Published: 31 January 2019
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Abstract
Background: Central Asia is the center of origin and diversification of the Artemisia genus. The genus Artemisia is known to possess a rich phytochemical diversity. Artemisinin is the shining example of a phytochemical isolated from Artemisia annua, which is widely used in [...] Read more.
Background: Central Asia is the center of origin and diversification of the Artemisia genus. The genus Artemisia is known to possess a rich phytochemical diversity. Artemisinin is the shining example of a phytochemical isolated from Artemisia annua, which is widely used in the treatment of malaria. There is great interest in the discovery of alternative sources of artemisinin in other Artemisia species. Methods: The hexane extracts of Artemisia plants were prepared with ultrasound-assisted extraction procedures. Silica gel was used as an adsorbent for the purification of Artemisia annua extract. High-performance liquid chromatography with ultraviolet detection was performed for the quantification of underivatized artemisinin from hexane extracts of plants. Results: Artemisinin was found in seven Artemisia species collected from Tajikistan. Content of artemisinin ranged between 0.07% and 0.45% based on dry mass of Artemisia species samples. Conclusions: The artemisinin contents were observed in seven Artemisia species. A. vachanica was found to be a novel plant source of artemisinin. Purification of A. annua hexane extract using silica gel as adsorbent resulted in enrichment of artemisinin. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessArticle
Guggulsterone Activates Adipocyte Beiging through Direct Effects on 3T3-L1 Adipocytes and Indirect Effects Mediated through RAW264.7 Macrophages
Received: 19 December 2018 / Revised: 18 January 2019 / Accepted: 27 January 2019 / Published: 31 January 2019
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Abstract
Background: Plant-derived phytochemicals have been of emerging interest as anti-obesity compounds due to their apparent effects on promoting reduced lipid accumulation in adipocytes. Despite such promising evidence, little is known about the potential mechanisms behind their anti-obesity effects. The aim of this study [...] Read more.
Background: Plant-derived phytochemicals have been of emerging interest as anti-obesity compounds due to their apparent effects on promoting reduced lipid accumulation in adipocytes. Despite such promising evidence, little is known about the potential mechanisms behind their anti-obesity effects. The aim of this study is to establish potential anti-obesity effects of the phytochemical guggulsterone (GS). Methods: Mature 3T3-L1 adipocytes were treated with GS, derived from the guggul plant native in northern India, to investigate its effects on mitochondrial biogenesis and adipocyte “beiging.” Further, to explore the relationship between macrophages and adipocytes, 3T3-L1s were treated with conditioned media from GS-treated RAW264.7 macrophages. Markers of mitochondrial biogenesis and beiging were measured by western blot. Results: GS treatment in adipocytes resulted in increased mitochondrial density, biogenesis (PGC1α and PPARγ), and increased markers of a beige adipocyte phenotype (UCP1, TBX1, and β-3AR). This upregulation in mitochondrial expression was accompanied by increases oxygen consumption. In GS-treated macrophages, markers of M2 polarization were elevated (e.g., arginase and IL-10), along with increased catecholamine release into the media. Lastly, 3T3-L1 adipocytes treated with conditioned media from macrophages induced a 167.8% increase in UCP1 expression, suggestive of a role of macrophages in eliciting an anti-adipogenic response to GS. Conclusions: Results from this study provide the first mechanistic understanding of the anti-obesity effects of GS and suggests a role for both direct GS-signaling and indirect stimulation of M2 macrophage polarization in this model. Full article
(This article belongs to the Special Issue Safety of Complementary Medicines)
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Open AccessReview
Promising Recent Strategies with Potential Clinical Translational Value to Combat Antibacterial Resistant Surge
Received: 6 December 2018 / Revised: 10 January 2019 / Accepted: 26 January 2019 / Published: 31 January 2019
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Abstract
Multiple drug resistance (MDR) for the treatment of bacterial infection has been a significant challenge since the beginning of the 21st century. Many of the small molecule-based antibiotic treatments have failed on numerous occasions due to a surge in MDR, which has claimed [...] Read more.
Multiple drug resistance (MDR) for the treatment of bacterial infection has been a significant challenge since the beginning of the 21st century. Many of the small molecule-based antibiotic treatments have failed on numerous occasions due to a surge in MDR, which has claimed millions of lives worldwide. Small particles (SPs) consisting of metal, polymer or carbon nanoparticles (NPs) of different sizes, shapes and forms have shown considerable antibacterial effect over the past two decades. Unlike the classical small-molecule antibiotics, the small particles are less exposed so far to the bacteria to trigger a resistance mechanism, and hence have higher chances of fighting the challenge of the MDR process. Until recently, there has been limited progress of clinical treatments using NPs, despite ample reports of in vitro antibacterial efficacy. In this review, we discuss some recent and unconventional strategies that have explored the antibacterial efficacy of these small particles, alone and in combination with classical small molecules in vivo, and demonstrate possibilities that are favorable for clinical translations in near future. Full article
(This article belongs to the Special Issue Nanoparticle and Liposome based Novel Drug Delivery Systems)
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Open AccessArticle
Xanthine Oxidase Inhibitory Potential, Antioxidant and Antibacterial Activities of Cordyceps militaris (L.) Link Fruiting Body
Received: 10 January 2019 / Revised: 26 January 2019 / Accepted: 28 January 2019 / Published: 29 January 2019
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Abstract
Background: Cordyceps militaris is a medicinal mushroom and has been extensively used as a folk medicine in East Asia. In this study, the separation of constituents involved in xanthine oxidase (XO) inhibitory, antioxidant and antibacterial properties of C. militaris was conducted. Methods: The [...] Read more.
Background: Cordyceps militaris is a medicinal mushroom and has been extensively used as a folk medicine in East Asia. In this study, the separation of constituents involved in xanthine oxidase (XO) inhibitory, antioxidant and antibacterial properties of C. militaris was conducted. Methods: The aqueous residue of this fungus was extracted by methanol and then subsequently fractionated by hexane, chloroform, ethyl acetate and water. The ethyl acetate extract possessed the highest XO inhibitory and antioxidant activities was separated to different fractions by column chromatography. Each fraction was then subjected to anti-hyperuricemia, antioxidant and antibacterial assays. Results: The results showed that the CM8 fraction exhibited the strongest XO inhibitory activity (the lowest IC50: 62.82 μg/mL), followed by the CM10 (IC50: 68.04 μg/mL) and the CM7 (IC50: 86.78 μg/mL). The level of XO inhibition was proportional to antioxidant activity. In antibacterial assay, the CM9 and CM11 fractions showed effective antibacterial activity (MIC values: 15–25 mg/mL and 10–25 mg/mL, respectively). Results from gas chromatography-mass spectrometry (GC-MS) analyses indicated that cordycepin was the major constituent in the CM8 and CM10 fractions. Conclusions: This study revealed that C. militaris was beneficial for treatment hyperuricemia although in vivo trials on compounds purified from this medicinal fungus are needed. Full article
(This article belongs to the Special Issue Biological Potential and Medical Use of Secondary Metabolites)
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Open AccessReview
Search for Drugs Used in Hospitals to Treat Stomatitis
Received: 4 January 2019 / Revised: 22 January 2019 / Accepted: 26 January 2019 / Published: 29 January 2019
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Abstract
Stomatitis is an inflammatory disease of the oral mucosa, often accompanied by pain. Usually it is represented by aphthous stomatitis, for which treatment steroid ointment is commonly used. However, in the cases of refractory or recurrent stomatitis, traditional herbal medicines have been used [...] Read more.
Stomatitis is an inflammatory disease of the oral mucosa, often accompanied by pain. Usually it is represented by aphthous stomatitis, for which treatment steroid ointment is commonly used. However, in the cases of refractory or recurrent stomatitis, traditional herbal medicines have been used with favorable therapeutic effects. Chemotherapy, especially in the head and neck region, induces stomatitis at higher frequency, which directly affects the patient’s quality of life and treatment schedule. However, effective treatment for stomatitis has yet to be established. This article presents the clinical report of Kampo medicines on the stomatitis patients in the Nihon university, and then reviews the literature of traditional medicines for the treatment of stomatitis. Among eighteen Kampo medicines, Hangeshashinto has been the most popular for the treatment of stomatitis, due to its prominent anti-inflammatory activity. It was unexpected that clinical data of Hangeshashinto on stomatitis from Chinese hospital are not available. Kampo medicines have been most exclusively administered to elder person, as compared to pediatric population. Supplementation of alkaline plant extracts rich in lignin-carbohydrate complex may further extend the applicability of Kampo medicines to viral diseases. Full article
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Open AccessCase Report
Salvia mellifera—How Does It Alleviate Chronic Pain?
Received: 27 November 2018 / Revised: 16 January 2019 / Accepted: 19 January 2019 / Published: 24 January 2019
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Abstract
Black sage, Salvia mellifera, can be made into a sun tea that is used as a foot soak to treat pain patients. The monoterpenoids and diterpenoids in the preparation penetrate the skin of the feet and stop the pain chemokine cycle, which [...] Read more.
Black sage, Salvia mellifera, can be made into a sun tea that is used as a foot soak to treat pain patients. The monoterpenoids and diterpenoids in the preparation penetrate the skin of the feet and stop the pain chemokine cycle, which may be the basis of chronic pain. Several chronic pain patients have reported long-term improvements in their pain after treatment with the preparation. Full article
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Open AccessReview
Ginsenoside Rg3: Potential Molecular Targets and Therapeutic Indication in Metastatic Breast Cancer
Received: 20 December 2018 / Revised: 21 January 2019 / Accepted: 23 January 2019 / Published: 23 January 2019
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Abstract
Breast cancer is still one of the most prevalent cancers and a leading cause of cancer death worldwide. The key challenge with cancer treatment is the choice of the best therapeutic agents with the least possible toxicities on the patient. Recently, attention has [...] Read more.
Breast cancer is still one of the most prevalent cancers and a leading cause of cancer death worldwide. The key challenge with cancer treatment is the choice of the best therapeutic agents with the least possible toxicities on the patient. Recently, attention has been drawn to herbal compounds, in particular ginsenosides, extracted from the root of the Ginseng plant. In various studies, significant anti-cancer properties of ginsenosides have been reported in different cancers. The mode of action of ginsenoside Rg3 (Rg3) in in vitro and in vivo breast cancer models and its value as an anti-cancer treatment for breast cancer will be reviewed. Full article
(This article belongs to the Special Issue Natural Compounds as Potential Anticancer Agents)
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Open AccessArticle
Emotional Effects of Live and Recorded Music in Various Audiences and Listening Situations
Received: 13 December 2018 / Revised: 14 January 2019 / Accepted: 19 January 2019 / Published: 22 January 2019
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Abstract
Background: We assume that the emotional response to music would correspond to increased levels of arousal, and that the valence of the music exemplified by sad or joyful music would be reflected in the listener, and that calming music would reduce anxiety. This [...] Read more.
Background: We assume that the emotional response to music would correspond to increased levels of arousal, and that the valence of the music exemplified by sad or joyful music would be reflected in the listener, and that calming music would reduce anxiety. This study attempts to characterize the emotional responses to different kinds of listening. Methods: Three experiments were conducted: (1) School children were exposed to live chamber music, (2) two adult audiences who were accustomed to classical music as a genre listened to chamber music, and (3) elderly listeners were exposed to recorded classical music of a sad character with and without words. Participants were asked to fill in visual analogue 10-cm scales along dimensions of: tiredness-arousal, sadness-joy, and anxiety-calmness. Ratings before exposure were compared with ratings after exposure. Results: The strongest positive emotional responses were observed in the live performances for listeners accustomed to classical music. School children tended to become tired during the concert, particularly the youngest children. There was a calming effect among school children, but in the oldest category increased joy was reported. Conclusions: The findings indicate that emotional response to music varies by type of audience (young, old, experience of classical music), and live or recorded music. Full article
(This article belongs to the Special Issue Music Therapy)
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Open AccessArticle
An Investigation of Potential Sources of Nutraceuticals from the Niger Delta Areas, Nigeria for Attenuating Oxidative Stress
Received: 18 December 2018 / Revised: 14 January 2019 / Accepted: 15 January 2019 / Published: 20 January 2019
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Abstract
Background: Diets rich in fruits, vegetables, and medicinal plants possess antioxidants potentially capable of mitigating cellular oxidative stress. This study investigated the antioxidant, anti-acetylcholinesterase (AChE), and total phenolic and flavonoids contents (TPC/TFC) of dietary sources traditionally used for memory enhancing in Niger Delta, [...] Read more.
Background: Diets rich in fruits, vegetables, and medicinal plants possess antioxidants potentially capable of mitigating cellular oxidative stress. This study investigated the antioxidant, anti-acetylcholinesterase (AChE), and total phenolic and flavonoids contents (TPC/TFC) of dietary sources traditionally used for memory enhancing in Niger Delta, Nigeria. Methods: Dacroydes edulis methanolic seed extract (DEMSE), Cola lepidota methanolic seed extract (CLMSE), Terminalia catappa methanolic seed extract (TeCMSE), Tricosanthes cucumerina methanolic seed extract (TrCMSE), Tetrapleura tetraptera methanolic seed extract (TTMSE), and defatted Moringa oleifera methanolic seed extract (DMOMSE); Dennettia tripetala methanolic fruit extract (DTMFE), Artocarpus communis methanolic fruit extract (ACMFE), Gnetum africana methanolic leaf extract (GAMLE), Musa paradisiaca methanolic stembark extract (MPMSE), and Mangifera indica methanolic stembark extract (MIMSE) were evaluated for free radical scavenging antioxidant ability using 2,2-Diphenyl-1-picrylhydrazyl (DPPH), reducing power capacity (reduction of ferric iron to ferrous iron), AChE inhibitory potential by Ellman assay, and then TPC/TFC contents determined by estimating milli-equivalents of Gallic acid and Quercetin per gram, respectively. Results: The radical scavenging percentages were as follows: MIMSE (58%), MPMSE (50%), TrCMSE (42%), GAMLE (40%), CLMSE (40%), DMOMSE (38%), and DEMFE (37%) relative to β-tocopherol (98%). The highest iron reducing (antioxidant) capacity was by TrCMSE (52%), MIMSE (40%) and GAMLE (38%). Extracts of MIMSE, TrCMSE, DTMFE, TTMSE, and CLMSE exhibited concentration-dependent AChE inhibitory activity (p < 0.05–0.001). At a concentration of 200 µg/mL, the AChE inhibitory activity and IC50 (µg/mL) exhibited by the most potent extracts were: MIMSE (≈50%/111.9), TrCMSE (≈47%/201.2), DTMFE (≈32%/529.9), TTMSE (≈26%/495.4), and CLMSE (≈25%/438.4). The highest TPC were from MIMSE (156.2), TrCMSE (132.65), GAMLE (123.26), and CLMSE (119.63) in mg gallic acid equivalents/g, and for TFC were: MISME (87.35), GAMLE (73.26), ACMFE (69.54), CLMSE (68.35), and TCMSE2 (64.34) mg quercetin equivalents/gram. Conclusions: The results suggest that certain inedible and edible foodstuffs, most notably MIMSE, MPMSE, TrCMSE, GAMLE, and CLMSE may be beneficial to ameliorate the potentially damaging effects of redox stress. Full article
(This article belongs to the Special Issue Antioxidant and Anti-aging Action of Plant Polyphenols)
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Open AccessReview
Current Status and Major Challenges to the Safety and Efficacy Presented by Chinese Herbal Medicine
Received: 19 December 2018 / Revised: 12 January 2019 / Accepted: 15 January 2019 / Published: 18 January 2019
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Abstract
Traditional Chinese medicine (TCM) is not only used prevalently in Asian countries but has also gained a stable market globally. As a principal form of TCM, Chinese herbal medicine (CHM) is comprised of treatments using multiple Chinese herbs which have complex chemical profiles. [...] Read more.
Traditional Chinese medicine (TCM) is not only used prevalently in Asian countries but has also gained a stable market globally. As a principal form of TCM, Chinese herbal medicine (CHM) is comprised of treatments using multiple Chinese herbs which have complex chemical profiles. Due to a lack of understanding of its modality and a lack of standardization, there are significant challenges associated with regulating CHM’s safety for practice and understanding its mechanisms of efficacy. Currently, there are many issues that need to be overcome in regard to the safety and efficacy of CHM for the further development of evidence-based practices. There is a need to better understand the mechanisms behind the efficacy of CHM, and develop proper quality standards and regulations to ensure a similar safety standard as Western drugs. This paper outlines the status of CHM in terms of its safety and efficacy and attempts to provide approaches to address these issues. Full article
(This article belongs to the Special Issue Safety of Complementary Medicines)
Open AccessProtocol
Effects of Qigong Exercise on Non-Motor Symptoms and Inflammatory Status in Parkinson’s Disease: A Protocol for a Randomized Controlled Trial
Received: 2 December 2018 / Revised: 4 January 2019 / Accepted: 16 January 2019 / Published: 18 January 2019
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Abstract
Background: Non-motor symptoms such as sleep disturbance, cognitive decline, fatigue, anxiety, and depression in Parkinson’s disease (PD) impact quality of life. Increased levels of pro-inflammatory cytokines in individuals with PD have been reported, which may contribute to non-motor symptoms. A mind-body exercise, Qigong, [...] Read more.
Background: Non-motor symptoms such as sleep disturbance, cognitive decline, fatigue, anxiety, and depression in Parkinson’s disease (PD) impact quality of life. Increased levels of pro-inflammatory cytokines in individuals with PD have been reported, which may contribute to non-motor symptoms. A mind-body exercise, Qigong, has demonstrated benefits across different medical conditions. However, a lack of evidence causes clinicians and patients to be uncertain about the effects of Qigong in individuals with PD. This study will examine the effects of Qigong on non-motor symptoms and inflammatory status in individuals with PD. Methods: Sixty individuals with PD will be recruited. Qigong and sham Qigong group (n = 30 for each) will receive a 12-week intervention. Participants will practice their assigned exercise at home (2×/day) and attend routinely group exercise meetings. Results: Clinical questionnaires and neuropsychological tests will measure non-motor symptoms including sleep quality (primary outcome). Biomarker assays will measure inflammatory status. A two-way mixed-design analysis of variance (ANOVA) will be utilized. Conclusions: This study may generate evidence for the benefits of Qigong on non-motor symptoms of PD and the effect on inflammatory status. Findings may lead to the development of a novel, safe, and cost-effective rehabilitation approach for individuals with PD. Full article
(This article belongs to the Special Issue Mind-body Medicine Approaches)
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Open AccessArticle
Systematic Use of Music as an Environmental Intervention and Quality of Care in Nursing Homes: A Qualitative Case Study in Norway
Received: 7 December 2018 / Revised: 7 January 2019 / Accepted: 15 January 2019 / Published: 18 January 2019
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Abstract
Background: The systematic use of music as an environmental intervention in nursing homes shows beneficial effects on patients’ health, safety, and quality of life in a care-related perspective. A county in Norway and a Nursing Education Department in a region of Norway collaborated [...] Read more.
Background: The systematic use of music as an environmental intervention in nursing homes shows beneficial effects on patients’ health, safety, and quality of life in a care-related perspective. A county in Norway and a Nursing Education Department in a region of Norway collaborated on the project “systematic use of music as environmental intervention and quality of care in nursing homes” for nursing students. Methods: This study from Norway (2017) had a qualitative and explorative approach. The sample (n = 33) was strategically and conveniently selected. Seven different focus group interviews consisted of nursing students, practice counselors, teachers, and project leaders, representing three nursing homes and healthcare centers. Passive observation lasting two days in each of the six departments was executed in order to observe environmental treatment in practice. Results: The beneficial aspects of using music as an environmental intervention in nursing homes increased among the students, and contributed to improved interaction, communication, and development of care with the patients. Students who participated actively in musical interaction such as improvisation, singing, and music listening with the patients were committed and motivated. The staff and management showed varied enthusiasm for the project. Conclusions: If the systematic use of music as environmental therapy and quality of care in elderly care is to be successful, it seems vital to include this theme early in nursing education. By creating early involvement among nurses, it might influence, inspire, and encourage involvement among employees and management. Full article
(This article belongs to the Special Issue Music Therapy)
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