Thoracic Outlet Syndrome Part II: Consensus on the Management of Neurogenic Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery

peer reviewedBACKGROUND: In the first part of this report, the European Association of Neurosurgical Societies' section of peripheral nerve surgery presented a systematic literature review and consensus statements on anatomy, classification, and diagnosis of thoracic outlet syndrome (TOS) along with a subclassification system of neurogenic TOS (nTOS). Because of the lack of level 1 evidence, especially regarding the management of nTOS, we now add a consensus statement on nTOS treatment among experienced neurosurgeons. OBJECTIVE: To document consensus and controversy on nTOS management, with emphasis on timing and types of surgical and nonsurgical nTOS treatment, and to support patient counseling and clinical decision-making within the neurosurgical community. METHODS: The literature available on PubMed/MEDLINE was systematically searched on February 13, 2021, and yielded 2853 results. Screening and classification of abstracts was performed. In an online meeting that was held on December 16, 2021, 14 recommendations on nTOS management were developed and refined in a group process according to the Delphi consensus method. RESULTS: Five RCTs reported on management strategies in nTOS. Three prospective observational studies present outcomes after therapeutic interventions. Fourteen statements on nonsurgical nTOS treatment, timing, and type of surgical therapy were developed. Within our expert group, the agreement rate was high with a mean of 97.8% (± 0.04) for each statement, ranging between 86.7% and 100%. CONCLUSION: Our work may help to improve clinical decision-making among the neurosurgical community and may guide nonspecialized or inexperienced neurosurgeons with initial patient management before patient referral to a specialized center. Copyright © Congress of Neurological Surgeons 2022. All rights reserved

High catechin concentrations detected in Withania somnifera (ashwagandha) by high performance liquid chromatography analysis

<p>Abstract</p> <p>Background</p> <p><it>Withania somnifera </it>is an important medicinal plant traditionally used in the treatment of many diseases. The present study was carried out to characterize the phenolic acids, flavonoids and 1,1-diphenyl-2-picrylhydrazyl radical (DPPH) scavenging activities in methanolic extracts of <it>W. somnifera </it>fruits, roots and leaves (WSFEt, WSREt and WSLEt).</p> <p>Methods</p> <p>WSFEt, WSREt and WSLEt was prepared by using 80% aqueous methanol and total polyphenols, flavonoids as well as DPPH radical scavenging activities were determined by spectrophotometric methods and phenolic acid profiles were determined by HPLC methods.</p> <p>Results</p> <p>High concentrations of both phenolics and flavonoids were detected in all parts of the plant with the former ranging between 17.80 ± 5.80 and 32.58 ± 3.16 mg/g (dry weight) and the latter ranging between 15.49 ± 1.02 and 31.58 ± 5.07 mg/g. All of the three different plant parts showed strong DPPH radical scavenging activities (59.16 ± 1.20 to 91.84 ± 0.38%). Eight polyphenols (gallic, syringic, benzoic, p-coumaric and vanillic acids as well as catechin, kaempferol and naringenin) have been identified by HPLC in parts of the plant as well. Among all the polyphenols, catechin was detected in the highest concentration (13.01 ± 8.93 to 30.61 ± 11.41 mg/g).</p> <p>Conclusion</p> <p>The results indicating that <it>W. somnifera </it>is a plant with strong therapeutic properties thus further supporting its traditional claims. All major parts of <it>W. somnifera </it>such as the roots, fruits and leaves provide potential benefits for human health because of its high content of polyphenols and antioxidant activities with the leaves containing the highest amounts of polyphenols specially catechin with strong antioxidant properties.</p

Epiphytic lichens as bioindicators of air pollution by heavy metals in an urban area (northern Poland)

The capability of accumulating lead (Pb), zinc (Zn), nickel (Ni), cooper (Cu), manganese (Mn) and iron (Fe) by tree lichen species was compared. Samples of lichens were taken in the autumn of 2013, from Betula pendula Roth, Fraxinus excelsior L., Acer platanoides L., Acer Pseudoplatanus L., Populus sp. trees and other broad-leaved trees growing within the city limits of Słupsk. The sampling stations were located in housing estates, green urban parks, near streets with heavy traffic and close to industrial plants. The aim of the study was to evaluate the pollution of the municipal environment of Słupsk with selected heavy metals using for this purpose thalli of three lichen species: Hypogymnia physodes, Parmelia sulcata and Xanthoria parietina, and to compare their accumulative properties. The heavy metal content in lichens was determined by atomic absorption spectrometry. The highest concentration of heavy metals was discovered in lichens collected in the city centre, while the lowest concentrations were found in parks and green areas. The largest quantities of Ni and Pb were accumulated by the lichen species H. physodes, most Zn and Fe accumulated in the lichen X. parietina, whereas Mn accumulated in similar amounts in all the tested species. A strong direct proportional relationship between the content of Zn and Fe, Fe and Cu, Zn and Cu in thalli of lichens was revealed. Some similarity between the Pb-Cu and Pb-Fe correlations was found as well as that of Pb-Mn in thalli of P. sulcata and X. parietina, along with a series of statistically significant differences between the examined species of lichen related to pH and the volume of accumulated heavy metals in thalli. The most significant differences in the content of heavy metals in thalli assessed in series of pairwise comparisons including (i) H. physodes vs P. sulcata, (ii) P. sulcata vs X. parietina and (iii) H. physodes vs X. parietina were found for (i') Pb, Cu and Fe, (ii') Ni and (iii') Pb, Ni, Cu and Fe, respectively

Usefulness of flaxseed oil in the limitation of diet induced metabolic disturbances.

Celem pracy było porównanie wpływu różnego typu tłuszczów, tj. smalcu wieprzowego, rafinowanego oleju sojowego i nierafinowanego, tłoczonego na zimno oleju lnianego, na status przeciwutleniający, wskaźniki stanu zapalnego oraz profil lipidowy krwi szczurów żywionych dietą o wysokiej zawartości fruktozy. Po 4 tygodniach doświadczalnego żywienia zaobserwowano, że dodatek oleju lnianego do diety (16%) spowodował istotne obniżenie stopnia peroksydacji lipidów w tkance wątroby w porównaniu do szczurów żywionych analogiczną ilością smalcu wieprzowego. Dodatek oleju sojowego lub lnianego do diety (16%) doprowadził ponadto do obniżenia poziomu triglicerydów i cholesterolu całkowitego we krwi oraz zmniejszenia wskaźnika aterogenności osocza. W przypadku oleju lnianego, w przeciwieństwie do oleju sojowego, doszło także do korzystnego zachowania wysokiego poziomu cholesterolu HDL.The aim of this study was to compare the effects of different fats, that is pork lard, refined soybean oil, and unrefined, cold pressed flaxseed oil, on the antioxidant status, inflammatory markers and blood lipid profile of rats fed diets rich in fructose. Four week of experimental feeding with flaxseed oil enriched diet (16%) led to a significant decrease in the degree of lipid peroxidation in liver, when compared with rats fed the same amount of pork lard. Moreover, the addition of soybean oil or flaxseed oil to the diet (16%) decreased significantly triglyceride and total cholesterol blood levels, as well as reduced atherogenic index of plasma. The concentration of HDL cholesterol was retained on a higher blood level in rats fed flaxseed oil enriched diet, when compared with the soybean oil group