Effect of D-chiro-inositol on hormonal parameters and insulin resistance in women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age, characterized by hormonal imbalance and insulin resistance. D-chiro-inositol, a naturally occurring inositol isomer, has been suggested as a potential treatment option for PCOS. This study aimed to investigate the effects of D-chiro-inositol supplementation on hormonal parameters, and insulin resistance in women with PCOS. Methods: This randomized controlled study was conducted among 60 women of PCOS with insulin resistance, who were assigned to either Group A (D-chiro-inositol) or Group B (placebo) for 12 weeks. S. FSH, LH, S. total testosterone, fasting blood glucose, fasting insulin, and insulin resistance (HOMA-IR) were measured at baseline and after 12 weeks of treatment. Statistical analyses were performed using SPSS version 23.0 for Windows. Results: After 12 weeks of treatment, significant reductions in serum luteinizing hormone, serum total testosterone, fasting insulin, and HOMA-IR were observed in the D-chiro-inositol group compared to the placebo group. However, no significant changes were observed in fasting blood glucose levels. D-chiro-inositol was well-tolerated, with no significant differences in side effects between the two groups. Conclusions: D-chiro-inositol supplementation for 12 weeks significantly improved hormonal parameters, and insulin resistance in women with PCOS. The treatment was well-tolerated, suggesting that D-chiro-inositol can be an effective therapeutic option for patients with PCOS

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Secretome from Magnetically Stimulated Muscle Exhibits Anticancer Potency: Novel Preconditioning Methodology Highlighting HTRA1 Action

Briefly (10 min) exposing C2C12 myotubes to low amplitude (1.5 mT) pulsed electromagnetic fields (PEMFs) generated a conditioned media (pCM) that was capable of mitigating breast cancer cell growth, migration, and invasiveness in vitro, whereas the conditioned media harvested from unexposed myotubes, representing constitutively released secretome (cCM), was less effective. Administering pCM to breast cancer microtumors engrafted onto the chorioallantoic membrane of chicken eggs reduced tumor volume and vascularity. Blood serum collected from PEMF-exposed or exercised mice allayed breast cancer cell growth, migration, and invasiveness. A secretome preconditioning methodology is presented that accentuates the graded anticancer potencies of both the cCM and pCM harvested from myotubes, demonstrating an adaptive response to pCM administered during early myogenesis that emulated secretome-based exercise adaptations observed in vivo. HTRA1 was shown to be upregulated in pCM and was demonstrated to be necessary and sufficient for the anticancer potency of the pCM; recombinant HTRA1 added to basal media recapitulated the anticancer effects of pCM and antibody-based absorption of HTRA1 from pCM precluded its anticancer effects. Brief and non-invasive PEMF stimulation may represent a method to commandeer the secretome response of muscle, both in vitro and in vivo, for clinical exploitation in breast and other cancers