Preterm birth is a worldwide tragedy with a high incidence. Several medications are used to inhibit acute preterm labor, but tocolysis by these medicines do not extend pregnancy beyond 1-2 days.The purpose of this study was to discover new medications from plant extracts or their active compounds which inhibit the uterine contractions in order to treat preterm labor.PubMed, Google Scholar, Scopus and IranMedex databases were searched up to 1st February 2012 with the most relevant keywords.All studies in which plant extracts or their active compounds inhibited the uterine contractions both in vivo and in vitro were included.Of initial search, 259 records were reviewed and finally 72 were included among which only 31 studies isolated an active compound from the plants extract belonging mostly to classes of flavonoids and terpenes classes. Flavonoids have been known as a phosphodiesterase (PDE) and a protein kinase C (PKC) inhibitor. It seems that the uterolytic activity of reviewed flavonoids such as naringenin, kaempferol and quercetin, especially in a calcium free solution, was via these inhibitory pathways.Laboring uterus response to dissimilar tocolytics differs from that of non-laboring uterus. In order to find a treatment for preterm labor, future studies should focus on the laboring uterus and also determine the structure activity relationship of the different tocolytics. This systematic review was registered to the PROSPERO with code number CRD42015027551.
Inflammatory bowel disease (IBD) is a chronic condition of the intestine with unknown etiology involving multiple immune, genetic and environmental factors. We were interested in examining the effect of a total extract from Ziziphora clinopoides, an Iranian folk herbal medicine, in the prevention and control of experimental mouse IBD. Z. clinopoides was administered (75, 150, 300 mg/kg) through drinking water to mice, which dispensed a toxic dose of acetic acid intrarectally. Prednisolone was used as the standard drug for comparison. Biochemical, macroscopic and microscopic examinations of the colon were performed. Biochemical evaluation of the inflamed colon was carried out using assays of myeloperoxidase (MPO) activity and thiobarbituric acid reacting substances (TBARS) as indicators of free radical activity and cellular lipid peroxidation. Results indicated that the activity of MPO and lipid peroxidation products (TBARS) increased in acetic acidtreated groups, while recovered by pretreatment of animals with Z. clinopoides (75-300 mg/kg) and prednisolone. All doses of Z. clinopoides and prednisolonetreated groups showed significant lower score values of macroscopic and microscopic characters when compared to the acetic acid-treated group. The beneficial effect of Z. clinopoides (300 mg/kg) was comparable to that of prednisolone. It is concluded that Z. clinopoides inhibits acetic acid toxic reactions in the mouse bowel through inhibition of cellular oxidative stress. Proper clinical investigation should be carried out to confirm the same activity in human.
Breast cancer poses significant challenges due to its high incidence and prevalence, necessitating heightened attention. Understanding how patients prioritize different treatment options based on various attributes can assist healthcare decision-makers in maximizing patient utility. The discrete choice experiment, a conjoint method, facilitates preference elicitation by presenting different attributes and choices. This systematic review aims to identify key factors in patient preference research related to adjuvant treatment for early breast cancer characterized by hormone receptor-positive, HER2-negative status. PubMed, Embase, Web of Science, and Scopus were searched from 01.01.2000 to 31.03.2023. Original English articles reporting patient preferences in adjuvant breast cancer treatment were retrieved based on predefined inclusion and exclusion criteria. Included studies were examined through a narrative synthesis approach, with descriptive statistics employed for analysis. Out of 1163 articles reviewed, four met the inclusion criteria and were conducted in the USA, Canada, and the Netherlands. Attributes extracted from all studies included alopecia, sensory neuropathy, motor neuropathy, myalgia/arthralgia, nausea, vomiting, fatigue, neutropenia, mucositis/stomatitis, hand-foot syndrome, diarrhea, prevention of breast cancer recurrence, osteoporosis, risk of endometrial cancer, joint and muscle pain, fluid retention, libido decrease, hot flashes, ECG monitoring, efficacy, treatment regimen, 5-year invasive disease-free survival (iDFS), dosing schedule, and treatment duration. The most frequently reported attributes were side effects, efficacy, and treatment regimen. Systematic review was commonly used to determine which attributes and levels to include. The minimum number of attributes identified per study was seven, and the maximum was 12. Sample sizes ranged from 102 to 300, with none of the studies mentioning the method of sample size estimation. Ordinary Least Squares, logistic regression, and hierarchical Bayes regression were the most frequent analysis methods. Side effects, 5-year iDFS, and treatment regimen are three attributes identified for conducting discrete choice experiment studies. Utilizing conjoint analysis to assess patient preferences for breast cancer treatment can aid in selecting optimal treatment regimens and improving patient adherence. Moreover, adhering to guidelines for developing experimental designs and conducting data analysis is essential for yielding robust results when employing preference elicitation methods.
This article presents a systematic review of the recent literature on the scientific support of electromyography (EMG) and nerve conduction velocity (NCV) in diagnosing the exposure and toxicity of organophosphorus pesticides (OP). Specifically, this review focused on changes in EMG, NCV, occurrence of intermediate syndrome (IMS), and OP-induced delayed polyneuropathy (OPIDN) in human. All relevant bibliographic databases were searched for human studies using the key words “OP poisoning”, “electromyography”, “nerve conduction study,” and “muscles disorders”. IMS usually occurs after an acute cholinergic crisis, while OPIDN occurs after both acute and chronic exposures. Collection of these studies supports that IMS is a neuromuscular junction disorder and can be recorded upon the onset of respiratory failure. Due to heterogeneity of reports on outcomes of interest such as motor NCV and EMG amplitude in acute cases and inability to achieve precise estimation of effect in chronic cases meta-analysis was not helpful to this review. The OPIDN after both acute and low-level prolonged exposures develops peripheral neuropathy without preceding cholinergic toxicity and the progress of changes in EMG and NCV is parallel with the development of IMS and OPIDN. Persistent inhibition of acetylcholinesterase (AChE) is responsible for muscle weakness, but this is not the only factor involved in the incidence of this weakness in IMS or OPIDN suggestive of AChE assay not useful as an index of nerve and muscle impairment. Although several mechanisms for induction of this neurodegenerative disorder have been proposed as were reviewed for this article, among them oxidative stress and resulting apoptosis can be emphasized. Nevertheless, there is little synchronized evidence on subclinical electrophysiological findings that limit us to reach a strong conclusion on the diagnostic or prognostic use of EMG and NCV for acute and occupational exposures to OPs.