Changes in some female reproductive parameters of Albino wistar rats by hydroethanol leaf extract of fleurya aestuans

Background: This study investigated the effects of hydro-ethanolic leaf extract of Fleurya aestuans (FA) on some female reproductive hormones in female albino wistar rats.Methods: Thirty-two (32) rats weighing 120 to 200g were grouped into four of eight rats each. After two weeks of acclimatization, group 1 served as the control group. Groups 2, 3 and 4 served as the test groups and were orally administered with (75, 150 and 300) mg/kg body weight of hydro-ethanolic leaf extract of Fleurya aestuans (FA) respectively, for 42 days. The animals were allowed access to water and feeds ad libitum. At the end of treatment, the animals were properly sedated and blood samples were collected via cardiac puncture. The blood samples were centrifuged and serum obtained was used to determine the concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen and progesterone using the ELISA method. Also, the ovaries of each rat were harvested and fixed for histological studies. Raw data were analyzed using SPSS version 20.0.Results: The hydro-ethanolic leaf extract of F. aestuans significantly (P<0.05) increased serum concentrations of FSH and LH in all test groups. Whereas, estrogen and progesterone increased significantly (P<0.05) in test Groups 2 (75mg/kg) and 3 (150mg/kg) but were significantly (P<0.05) decreased in test Group 4 (300mg/kg). Histological examination of the ovaries showed only primary follicles in Groups 1 and 4, while, Graafian follicle and corpus luteum were seen in groups 2 and 3. This suggests that the hydro-ethanolic leaf extract of Fleurya aestuans contains possible biologically active properties that may be potent in enhancing serum concentrations of FSH, LH, estrogen and progesterone but may be ineffective at a higher dose.Conclusions: The current study showed that hydro-ethanolic leaf extract of Fleurya aestuans promotes fertility in females and suggests that caution be taken in the quantity of this extract consumed if to be considered for fertility enhancement purposes in females

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Changes in some female reproductive parameters of albino wistar rats by hydroethanol leaf extract of fleurya aestuans

Background: This study investigated the effects of hydro-ethanolic leaf extract of Fleurya aestuans (FA) on some female reproductive hormones in female albino wistar rats.Methods: Thirty-two (32) rats weighing 120 to 200g were grouped into four of eight rats each. After two weeks of acclimatization, group 1 served as the control group. Groups 2, 3 and 4 served as the test groups and were orally administered with (75, 150 and 300) mg/kg body weight of hydro-ethanolic leaf extract of Fleurya aestuans (FA) respectively, for 42 days. The animals were allowed access to water and feeds ad libitum. At the end of treatment, the animals were properly sedated and blood samples were collected via cardiac puncture. The blood samples were centrifuged and serum obtained was used to determine the concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen and progesterone using the ELISA method. Also, the ovaries of each rat were harvested and fixed for histological studies. Raw data were analyzed using SPSS version 20.0.Results: The hydro-ethanolic leaf extract of F. aestuans significantly (P&lt;0.05) increased serum concentrations of FSH and LH in all test groups. Whereas, estrogen and progesterone increased significantly (P&lt;0.05) in test Groups 2 (75mg/kg) and 3 (150mg/kg) but were significantly (P&lt;0.05) decreased in test Group 4 (300mg/kg). Histological examination of the ovaries showed only primary follicles in Groups 1 and 4, while, Graafian follicle and corpus luteum were seen in groups 2 and 3. This suggests that the hydro-ethanolic leaf extract of Fleurya aestuans contains possible biologically active properties that may be potent in enhancing serum concentrations of FSH, LH, estrogen and progesterone but may be ineffective at a higher dose.Conclusions: The current study showed that hydro-ethanolic leaf extract of Fleurya aestuans promotes fertility in females and suggests that caution be taken in the quantity of this extract consumed if to be considered for fertility enhancement purposes in females

Nanopatterns of molecular spoked wheels as giant homologues of benzene tricarboxylic acids

Molecular spoked wheels with D3h and Cs symmetry are synthesized by Vollhardt trimerization of C2v-symmetric dumbbell structures with central acetylene units and subsequent intramolecular ring closure. Scanning tunneling microscopy of the D3h-symmetric species at the solid/liquid interface on graphite reveals triporous chiral honeycomb nanopatterns in which the alkoxy side chains dominate the packing over the carboxylic acid groups, which remain unpaired. In contrast, Cs-symmetric isomers partially allow for pairing of the carboxylic acids, which therefore act as a probe for the reduced alkoxy chain nanopattern stabilization. This observation also reflects the adsorbate substrate symmetry mismatch, which leads to an increase of nanopattern complexity and unexpected templating of alkoxy side chains along the graphite armchair directions. State-of-the-art GFN-FF calculations confirm the overall structure of this packing and attribute the unusual side-chain orientation to a steric constraint in a confined environment. These calculations go far beyond conventional simple space-filling models and are therefore particularly suitable for this special case of molecular packing

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.Peer reviewe

Initiation of continuous renal replacement therapy versus intermittent hemodialysis in critically ill patients with severe acute kidney injury: a secondary analysis of STARRT-AKI trial

Background: There is controversy regarding the optimal renal-replacement therapy (RRT) modality for critically ill patients with acute kidney injury (AKI). Methods: We conducted a secondary analysis of the STandard versus Accelerated Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial to compare outcomes among patients who initiated RRT with either continuous renal replacement therapy (CRRT) or intermittent hemodialysis (IHD). We generated a propensity score for the likelihood of receiving CRRT and used inverse probability of treatment with overlap-weighting to address baseline inter-group differences. The primary outcome was a composite of death or RRT dependence at 90-days after randomization. Results: We identified 1590 trial participants who initially received CRRT and 606 who initially received IHD. The composite outcome of death or RRT dependence at 90-days occurred in 823 (51.8%) patients who commenced CRRT and 329 (54.3%) patients who commenced IHD (unadjusted odds ratio (OR) 0.90; 95% confidence interval (CI) 0.75-1.09). After balancing baseline characteristics with overlap weighting, initial receipt of CRRT was associated with a lower risk of death or RRT dependence at 90-days compared with initial receipt of IHD (OR 0.81; 95% CI 0.66-0.99). This association was predominantly driven by a lower risk of RRT dependence at 90-days (OR 0.61; 95% CI 0.39-0.94). Conclusions: In critically ill patients with severe AKI, initiation of CRRT, as compared to IHD, was associated with a significant reduction in the composite outcome of death or RRT dependence at 90-days

A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial

Background Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework. Methods We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero–one inflated beta regression. Results The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] − 3.30%; 3.40%], − 0.39% [95% CrI − 3.46%; 3.00%], and 0.64% [95% CrI − 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of − 3.55 days [95% CrI − 6.38; − 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% CrI − 1.87; 2.72) compared with the standard strategy and the probability that the accelerated strategy had more hospital-free days was 0.66. Conclusions In a Bayesian reanalysis of the STARRT-AKI trial, we found very low probability that an accelerated strategy has clinically important benefits compared with the standard strategy. Patients receiving the accelerated strategy probably have fewer days alive and KRT-free. These findings do not support the adoption of an accelerated strategy of KRT initiation