Nutritional and Plasma Antioxidant Status Assessment in a Group of Old Alzheimer\u2019s Inpatients

This study was carried out to assess the nutritional and plasma antioxidant status of Alzheimer\u2019s inpatients compared to age-matched controls by means of anthropometric measurements, neuropsychological and nutritional tests and plasma biomarkers. Assessment of nutritional biomarkers of prooxidant/antioxidant balance in patients with AD as well as nutritional status and neuropsychological evaluation are important since many studies have demonstrated their association with cognitive impairment. This cross sectional study was carried out in 35 subjects recruited in a geriatric institution in Pavia, Northern Italy. Cases mean Body Mass Index (BMI) was lower than controls\u2019 one as well as mid arm circumference, triceps skinfold and arm muscle circumference. Both inpatients MNA and MMSE mean scores were lower than controls ones. Plasma levels of lutein plus zeaxanthin, beta-cryptoxanthin, lycopene, alfa tocopherol, ascorbic acid were significantly lower (p < 0.05) in AD in patients as well as superoxide desmutase and glutathione peroxidase concentrations, while all the other biochemical markers levels did not differ. Plasma antioxidant levels and activities were decreased in AD and could be biologically predictive of an early mild cognitive decline, suggesting early intervention on dietary antioxidant intake

Combinations of QT-prolonging drugs: towards disentangling pharmacokinetic and pharmaco-dynamic effects in their potentially additive nature.

Background: Whether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research on Therapeutics (AZCERT) classification defines the risk of QT prolongation for exposure to single drugs. We aimed to investigate how combining AZCERT drug categories impacts QT duration and how relative drug exposure affects the extent of pharmacodynamic drug–drug interactions. Methods: In a cohort of 2558 psychiatric inpatients and outpatients, we modeled whether AZCERT class and number of coprescribed QT-prolonging drugs correlates with observed rate-corrected QT duration (QTc) while also considering age, sex, inpatient status, and other QTc-prolonging risk factors. We concurrently considered administered drug doses and pharmacokinetic interactions modulating drug clearance to calculate individual weights of relative exposure with AZCERT drugs. Because QTc duration is concentration-dependent, we estimated individual drug exposure with these drugs and included this information as weights in weighted regression analyses. Results: Drugs attributing a ‘known’ risk for clinical consequences were associated with the largest QTc prolongations. However, the presence of at least two versus one QTc-prolonging drug yielded nonsignificant prolongations [exposure-weighted parameter estimates with 95% confidence intervals for ‘known’ risk drugs + 0.93 ms (–8.88;10.75)]. Estimates for the ‘conditional’ risk class increased upon refinement with relative drug exposure and coadministration of a ‘known’ risk drug as a further risk factor. Conclusions: These observations indicate that indiscriminate combinations of QTc-prolonging drugs do not necessarily result in additive QTc prolongation and suggest that QT prolongation caused by drug combinations strongly depends on the nature of the combination partners and individual drug exposure. Concurrently, it stresses the value of the AZCERT classification also for the risk prediction of combination therapies with QT-prolonging drugs

Light therapy as a treatment for sexual dysfunctions -beyond a pilot study

Summary Aim. Seasonal trends were demonstrated in reproduction and sexual activity. Through the secretion of melatonin the pineal gland plays an important role, in the neuroendocrine control of sexual function and reproductive physiology. We hypothesized that inhibition of the pineal gland activity through a light treatment may favorably affect sexual function. Method. We recruited 24 subjects with a diagnosis of hypoactive sexual desire disorder and / or primary sexual arousal disorder. The subjects were randomly assigned to either active light treatment (ALT) or placebo light treatment (L-PBO). Participants were assessed during the first evaluation and after 2 weeks of treatment, using the Structured Clinical Interview for Sexual Disorders DSM-IV (SCID-S) and a self-administered rating scale of the level of sexual satisfaction (1 to 10). Repeated measures ANOVA were performed to compare the two groups of patients. Post-hoc analysis was performed by Holm-Sidak test for repeated comparisons. Results. At baseline the two groups were comparable. After 2 weeks the group treated with Light Therapy showed a significant improvement in sexual satisfaction, about 3 times higher than the group that received placebo, while no significant improvement was observed in the group L-PBO. Conclusions. Our results confirm a potentially beneficial effect of Light Therapy on primary sexual dysfunction. In the future, we propose to correlate clinical findings with testosterone levels pre / post treatment