Treatment of periocular wrinkles with topical nifedipine

The appearance of facial expression wrinkles is the result of chronic contraction of mimic muscles. Nifedipine is a dihydropyridinic calcium antagonist which blocks muscular cells' calcium channels, therefore inhibiting their contraction. We assumed that topical nifedipine was able to relax mimic muscular fibres in the same way, thus reducing the depth of wrinkles. We performed a clinical and experimental study, enrolling 64 female patients with periocular wrinkles. They applied a cream containing 0.5% nifedipine (Antrox; Bracco, Milan, Italy) once daily for 90 days. The length and depth of wrinkles (measured by a digital profilometer), moisturizing of periocular skin (measured by a corneometer), and trans-epidermal water loss (TEWL; measured by a tewameter), were evaluated. All parameters were measured before the beginning of treatment, and 45 and 90 days later. At the end of the study, topical nifedipine proved statistically effective in reducing the depth of wrinkles. No significant differences in the length of wrinkles were recorded. No significant changes were observed in moisturizing. TEWL gradually improved, although without statistical significance. On the basis of the results of this study, 0.5% nifedipine cream seems to be effective in reducing the depth of periocular wrinkles. Other studies are necessary in order to confirm these results

High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease

AIM: To investigate in symptomatic uncomplicated diverticular disease the efficacy of symbiotics associated with a high-fibre diet on abdominal symptoms. METHODS: This study was a multicentre, 6-mo randomized, controlled, parallel-group intervention with a preceding 4-wk washout period. Consecutive outpatients with symptomatic uncomplicated diverticular disease, aged 40-80 years, evaluated in 4 Gastroenterology Units, were enrolled. Symptomatic uncomplicated diverticular disease patients were randomized to two treatment arms A or B. Treatment A (n = 24 patients) received 1 symbiotic sachet Flortec (c) (Lactobacillus paracasei 821060) once daily plus high-fibre diet for 6 mo. Treatment B (n = 21 patients) received high-fibre diet alone for 6 mo. The primary endpoint was regression of abdominal symptoms and change of symptom severity after 3 and 6 mo of treatment. RESULTS: In group A, the proportion of patients with abdominal pain 24 h decreased from 60% to 20% then 5% after 3 and 6 mo, respectively in group A (P < 0.001) and from 33.3% to 9.5% at both 3 and 6 mo in group B (P = 0.03). In group A the proportion of patients with abdominal bloating significantly decreased from 95% to 60% after 3 mo, and remained stable (65%) at 6-mo follow-up (P = 0.005) while in group B, no significant changes in abdominal bloating was observed (P = 0.11). After 6 mo of treatment, the mean visual analogic scale (VAS) values of both short-lasting abdominal pain (VAS, mean SD, group A: 4.6 +/- 2.1 vs 2.2 +/- 0.8, P = 0.02; group B: 4.6 +/- 2.9 vs 2.0 +/- 1.9, P = 0.03) and abdominal bloating (VAS, mean SD, group A: 5.3 +/- 2.2 vs 3.0 +/- 1.7, P = 0.005; group B: 5.3 +/- 3.2 vs 2.3 +/- 1.9, P = 0.006) decreased in both groups, whilst the VAS values of prolonged abdominal pain decreased in the Flortec group, but remained unchanged in the high-fibre diet group (VAS, mean +/- SD, group A: 6.5 +/- 1.5 vs 4.5 +/- 2.1, P = 0.052; group B: 4.5 +/- 3.8 vs 5.5 +/- 3.5). CONCLUSION: A high-fibre diet is effective in relieving abdominal symptoms in symptomatic uncomplicated diverticular disease. This treatment may be implemented by combining the high-fibre diet with Flortec (c). (C) 2012 Baishideng. All rights reserved