The Efficacy of Pharmacotherapy for Decreasing the Expansion Rate of Abdominal Aortic Aneurysms: A Systematic Review and Meta-Analysis

BACKGROUND: Pharmacotherapy may represent a potential means to limit the expansion rate of abdominal aortic aneurysms (AAAs). Studies evaluating the efficacy of different pharmacological agents to slow down human AAA-expansion rates have been performed, but they have never been systematically reviewed or summarized. METHODS AND FINDINGS: Two independent reviewers identified studies and selected randomized trials and prospective cohort studies comparing the growth rate of AAA in patients with pharmacotherapy vs. no pharmacotherapy. We extracted information on study interventions, baseline characteristics, methodological quality, and AAA growth rate differences (in mm/year). Fourteen prospective studies met eligibility criteria. Five cohort studies raised the possibility of benefit of beta-blockers [pooled growth rate difference: -0.62 mm/year, (95%CI, -1.00 to -0.24)], but this was not confirmed in three beta-blocker RCTs [pooled RCT growth rate difference: -0.05 mm/year (-0.16 to 0.05)]. Statins have been evaluated in two cohort studies that yield a pooled growth rate difference of -2.97 (-5.83 to -0.11). Doxycycline and roxithromycin have been evaluated in two RCTs that suggest possible benefit [pooled RCT growth rate difference: -1.32 mm/year (-2.89 to 0.25)]. Studies assessing NSAIDs, diuretics, calcium channel blockers and ACE inhibitors, meanwhile, did not find statistically significant differences. CONCLUSIONS: Beta-blockers do not appear to significantly reduce the growth rate of AAAs. Statins and other anti-inflammatory agents appear to hold promise for decreasing the expansion rate of AAA, but need further evaluation before definitive recommendations can be made

Melaleuca alternifolia Essential Oil against the Lesser Mealworm (Alphitobius diaperinus) and Its Possible Effect on the Soil Fauna

ABSTRACT The aim of this study was to evaluate the in vitro bioactivity of tea tree (Melaleuca alternifolia) essential oil against larvae and adult forms of lesser mealworms (Alphitobius diaperinus) and its influence on the soil fauna. Tests were performed in triplicate using pure tea tree oil (TTO; 1, 5, 10, 25, 50, and 100%), TTO nanoparticles (1, 3, and 7.5%), or terpinen-4-ol, the main compound of the tea tree oil, at the same concentrations of TTO. Larvae and adult mortality occurred at concentrations up to 10 and 50% of TTO, respectively. No larvicidal or insecticidal effect of TTO nanoparticles was observed. Terpinen-4-ol showed insecticidal and larvicidal effect at concentrations higher than 25%. The evaluation of TTO effect on soil organisms was performed by standard ecotoxicological tests (ISO) with the springtail species Folsomia candida. Only TTO was used for ecotoxicological tests in doses of 1, 5, 10, 25, 50, and 100 mg kg-1 of soil. TTO had no negative effects on F. candida survival or reproduction. Therefore, it was concluded that M. alternifolia oil may be a new alternative for control of the lesser mealworm