Zinc, hydrochlorothiazide and sexual dysfunction

This study was designed to test the hypothesis that hydrochlorothiazide a diuretic used to treat hypertension depletes body zinc and thereby cause sexual dysfunction. Serum zinc and sexual dysfunction were measured in 39 middle aged hypertensive men who had been taking hydrochlorothiazide in average daily doses of between 25 and 50 mg daily for at least six months, and a control group of 27 unmedicated middle aged normotensive men. The medicated group had a higher incidence of sexual dysfunction (56 pc) as compared to 11 pc in the control group. The use of hydrochlorothiazide did affect serum zinc levels significantly in 20 patients. Sexual dysfunction occurred more often in older and overweight patients (p < 0.004). Three of the normotensive men experienced sexual dysfunction probably related to old age. Twenty two of the 39 on hydrochlorothiazide and experiencing sexual dysfunction were divided into two groups of 11 patients. Bloods were taken from the 27 normotensive and 22 hypertensive men receiving hydrochlorothiazide for the analyses of zinc. Subsequently one group of the patients were supplemented with zinc 500 mg daily for 30 days while the other group was supplemented with magnesium chloride 1 g daily for 30 days. The normotensive men were not treated. After 30 days, bloods were again taken from the three groups of analyses for zinc and magnesium. Serum zinc was significantly decreased (p < 0.05) by hydrochlorothiazide and a non significant decrease in serum magnesium (p = ns) was observed. After supplementation with zinc, the serum zinc levels returned to normal only in eight patients. There was improvement in the symptoms of sexual dysfunction in five patients. Two patients gained weight. Hydrochlorothiazide decreased serum zinc levels (p < 0.05) and was unchanged with magnesium supplementation but the serum magnesium returned to normal values. Improvement of symptoms of sexual dysfunction was positive in one patient. This study shows that low serum zinc levels may be associated with sexual dysfunction but the definitive role of zinc in the pathogenesis of sexual dysfunction will remain controversial.

Transient zinc deficiency in a breast-fed premature infant

Symptomatic zinc deficiency developed in a breast-fed premature male infant of 31 weeks gestation. At 13 weeks of age he presented with diarrhoea, irritability and an eruption identical to acrodermatitis enteropathica. Breast milk zinc concentrations were low. His course was complicated by milk protein intolerance. After 7 weeks, zinc supplementation was ceased without recurrence of disease.

Efficacy of zinc therapy in prevention of crisis in sickle cell anemia: a double blind, randomized controlled clinical trial

145 patients were recruited in the trial while 130 completed it. Patients were randomized to receive zinc sulphate capsules. 220 mgm three times a day or identical placebo. Major outcome variable was 'Sickle cell crisis'. After a follow up of 1.5 years, the mean number of episodes of crisis was 2.46 +/- 1.04 in the intervention group and 5.29 +/- 2.58 in the control group (p < 0.025; 95% CI for difference between groups: 1.98, 3.42). Mean duration of hospital stay was 4.3 +/- 2.2 days in the intervention group and 3.9 +/- 1.6 days in the control group. The difference was not significant (p > 0.05). There was a significant reduction of the mean number of infective episodes and associated morbidity in patients with sickle cell anaemia.

[Clinical double-blind trial of topical zinc sulfate for herpes labialis recidivans]

In a placebo controlled, double-blind clinical trial in patients with herpes labialis recidivans, zinc sulfate (CAS 7733-02-0) as gel (Virudermin Gel) proved to be significantly more effective than the gel alone. With zinc sulfate as gel, the symptoms were less marked and healing was faster. This simple preparation can be applied in cases of herpes labialis recidivans without any risk of side effects. Due to the antiseptic properties of zinc sulfate superinfections can be prevented.

[Wilson disease with HCV infections]

In this paper we describe liver-related Wilson's disease in two sisters. The elder died of liver failure. Our patient, a 13-year old girl has hepatitis C coinfection. Gradual improvement was observed after Cuprenil, Zincteral and interferon (Intron A).

[Wilson's disease; diagnosis with the aid of magnetic resonance tomography]

In a 21-year-old woman with a smaller and sloppy handwriting, drooling especially when stooping, sporadic choking, clumsiness, and frequent stumbling, Wilson's disease was diagnosed. The medical history disclosed a short period of haemolytic anaemia with transient hepatic failure, and irregular menstruation periods with infertility. On examination there were no signs of liver or spleen enlargement. She was slow, had an expressionless face and mild dysarthria, and slight impairment of the coordination of the limbs. Magnetic resonance imaging of the brain showed bilateral hyperintensive lesions of the basal ganglia on T2W images. Zinc therapy induced a good biochemical response and there was also some clinical improvement. Linkage analysis within the family identified one other asymptomatic homozygotically affected sister. A diagnostic delay occurs frequently due to relative unfamiliarity with this rare disease and due to its variable clinical expression.

Detoxification of paraquat poisoning: effects of alkylsulfates and alkylsulfonates on paraquat poisoning in mice and rats

The study revealed that high molecular polyvinyl sulfate (PVP) or sulfonate (PVS), and low molecular alkyldisulfonates (NaO3S(CH2)nSO3Na, n = 2--5: EDS, TDS, BDS and PDS) can alleviate acute toxicity of the herbicide, paraquat dichloride (PQ) in mice. Their activity as antidotes and the mode of the action varied depending on molecular size. The survival rate for mice receiving PQ at 200 mg/kg alone was increasingly improved when the dose of antidotes was increased from 8 to 10 times the dose of PQ; all the test compounds, except EDS (70% survival), achieved a survival rate of 100%. When test compounds were orally dosed to mice in a mixture with PQ, they improved LD50 of PQ alone. With the low molecular compounds EDS, TDS, BDS and PDS, the value increased to about 2 to 3 times (300-458 mg/kg) over that of PQ alone (140 mg/kg). With high molecular PVS and PVP, the combination reached about a 7 fold (900-1000 mg/kg) increase in LD50 value. The formation of lipid peroxide in lungs of rats due to PQ tended to be suppressed by concomitant administration of carbohydrate sulfate (DS and GS). PVP, BDS and TDS were more effective in depressing synthesis of lipid peroxide than DS or GS in the lungs, although BDS and TDS were less effective in suppressing PQ absorption from the rat small intestine than DS, GS or PVP.(ABSTRACT TRUNCATED AT 250 WORDS)

[Azoospermia in patients with kidney diseases taking immunosuppressants long term]

Ten sterile males of reproductive age previously treated with immunodepressants were examined andrologically. Azoospermia in them was treated with zinc sulfate (30-90 mg/day, 2-12 months), which was replaced by clomifen citrate in 6 of them (100 mg/day, 2-6.6 months). The response was recorded only in one male: zinc sulfate administration induced subnormal spermatogenesis improved by clomifen citrate as a result of which the patient became a father. In the rest cases azoospermia did not improve. Testicular biopsy performed in 3 patients detected the absence of cells of spermatogenic epithelium (del Castillo syndrome). The absence of response to stimulating therapy may indicate bad prognosis in azoospermia patients with renal diseases treated with immunodepressants.

Arresting amyloidosis in vivo using small-molecule anionic sulphonates or sulphates: implications for Alzheimer's disease

Amyloid is a term for extracellular protein fibril deposits that have characteristic tinctorial and structural properties. Heparan sulphate, or the heparan sulphate proteoglycan perlecan, has been identified in all amyloids and implicated in the earliest stages of inflammation-associated (AA) amyloid induction. Heparan sulphate interacts with the AA amyloid precursor and the beta-peptide of Alzheimer's amyloid, imparting characteristic secondary and tertiary amyloid structural features. These observations suggest that molecules that interfere with this interaction may prevent or arrest amyloidogenesis. We synthesized low-molecular-weight (135-1,000) anionic sulphonate or sulphate compounds. When administered orally, these compounds substantially reduced murine splenic AA amyloid progression. They also interfered with heparan sulphate-stimulated beta-peptide fibril aggregation in vitro.

Renal, thyroid and parathyroid function during lithium treatment: laboratory tests in 207 people treated for 1-30 years

A total of 207 patients (diagnoses revised according to DSM-III-R) attended our outpatient clinic and were treated with lithium for 1-30 years. They were subjected to conventional renal, thyroid and parathyroid function tests. With increasing treatment duration, the renal tests showed only moderate deviations from expected reference values. No patient developed renal insufficiency. Oversubstitution (thyrotropin < or = 0.1 mU/l) was suspected in 25% of the patients on thyroxine. Cross-sectionally unrecognized hypothyroidism was found in 6% of the patients. Elevated ionized serum calcium was found in 25% and elevated serum intact parathyroid hormone in 23% of the patients.

[Clinical and pathogenetic observation in a case of pulmonary hemosiderosis]

Pulmonary hemosiderosis is a rare disease of unknown aetiology, whose clinical, pathogenetic and prognostic aspects are still open to discussion. The authors report a case of pulmonary hemosiderosis in a 2 years and 3 months old girl. Peculiar features of this case include antibody deficiency (which may contribute to the pathogenesis of the disease) and severe and protracted melena. Fatal outcome, despite several therapeutic trials, confirms the poor prognosis of pulmonary hemosiderosis.

Wilson's disease: neurological and magnetic resonance imaging improvement on zinc treatment

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Quinacrine and copper, compounds with anticonceptive and antineoplastic activity

Changes in the evolution of a malignant transplantable tumor in mice to whom quinacrine, copper and zinc were supplied in drinking water are reported. Male AJ mice were inoculated in the right thigh with 1,000,000 TA3 or TA3 MTXR tumoral cells. Three experiments were designed with different types of tumors and different schedules of quinacrine and cations administered in drinking water. The animals that received quinacrine or quinacrine plus copper in drinking water had significantly smaller tumors, and some groups had a high rate of complete tumor regression (up to 60%). Quinacrine and copper have synergistic antineoplastic activity. Zinc salts do not improve the antitumoral effect of quinacrine. The relevant fact of this experiment lies in the fact that a large number of women using IUDs with copper could occasionally be treated with quinacrine.

A trial of oral zinc supplementation in psoriasis

A controlled double-blind study of oral zinc supplementation was performed in twenty-five patients with chronic plaque psoriasis over twelve weeks to assess changes in both psoriasis (using the psoriasis area and severity index) and neutrophil zinc content. There were no statistically significant differences in the psoriasis area and severity index during the trial between the placebo- and zinc-treated group, nor in the zinc levels. There was therefore no evidence of a benefit from zinc supplementation in patients with this disease.

Zinc salts for the treatment of olfactory and gustatory symptoms in psychiatric patients: a case series

BACKGROUND

Zinc salts have been used extensively in medical settings to treat disorders of gustatory and olfactory function. However, zinc supplements have not been tested in psychiatric patients with smell or taste symptoms.

METHOD

The authors examined the effects of zinc supplements on five consecutive patients with symptoms of abnormal taste and smell perception in the context of acute psychiatric illness or treatment.

RESULTS

All five patients had complete or partial amelioration of these olfactory and gustatory symptoms after treatment with zinc sulfate or zinc gluconate, apparently independent of the improvement in their underlying psychiatric disorder.

CONCLUSION

We recommend treating unusual olfactory and gustatory symptoms with zinc salts, independent of the treatment for the underlying psychiatric disorder.

The effect of mouthrinses containing zinc and triclosan on plaque accumulation and development of gingivitis in a 3-week clinical test

Experimental mouthrinses containing 0.4% zinc sulphate and 0.15% triclosan were compared with a chlorhexidine and a negative control mouthrinse in a 3-week clinical trial. The zinc/triclosan mouthrinses 1 and 2 differed in their ethanol and humectant contents used to deliver the triclosan. The experimental protocol employed the partial mouth gingivitis design, whereby participants wear a toothshield during toothbrushing. Gingival health at baseline was established by professional cleaning, oral hygiene instruction and effective toothbrushing 3 x per day during a pre-experimental period of 2 weeks. The mouthrinses were subsequently used 2x daily following normal toothbrushing during 3 weeks. The pre-experimental oral hygiene phase very effectively reduced plaque levels and gingival bleeding. During the rinsing period, in the absence of mechanical removal of plaque from the protected teeth, gingival bleeding rose to above the prestudy level in the negative control group. The increments (change from baseline to 21 days) of plaque and bleeding scores for the zinc/triclosan mouthrinse 1 were significantly lower than those in the negative control group. As expected, plaque and gingivitis scores were lowest in the group that rinsed with chlorhexidine. The results extend previous observations on the efficacy of the zinc/triclosan system to maintain gingival health.

Effectiveness of adjunctive irrigation in early periodontitis: multi-center evaluation

The purpose of this study was to determine the effect of daily water irrigation versus regular oral hygiene alone on gingival and periodontal health in periodontitis patients receiving supportive periodontal treatment. The study also sought to determine if there are enhanced benefits from using an antiplaque zinc sulfate rinse as an irrigant. One hundred fifty-five patients who have had periodontitis and had been treated either surgically or non-surgically completed the 6-month multi-center multi-national study. Patients with at least two 5 mm sites demonstrating bleeding on probing were assigned to 3 equal groups by balanced randomization. In all centers Group A (n = 57) performed regular oral hygiene only, and Group B (n = 58) irrigated with 500 ml water once daily after regular oral hygiene. Group C (n = 40) patients irrigated with a total of 500 ml once daily; following irrigation with 300 ml water, the patients then irrigated with an additional 200 ml with a zinc sulfate solution. The irrigants were diluted to provide the manufacturer's recommended daily dosage. The supragingival irrigation was performed with a commercially available oral irrigator. Bacterial measurements at baseline, 3 months, and 6 months were taken to determine the effect of irrigation on the target organisms and will be reported elsewhere. Gingival index: irrigation with water (Group B) was significantly better than normal oral hygiene (Group A) and irrigation with zinc sulfate (Group C) (P < 0.05) in reducing gingival inflammation. Bleeding on probing: significant reductions in bleeding on probing occurred for water (Group B) compared to normal oral hygiene (Group A) (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Pregnancy in a patient with Wilson's disease treated with D-penicillamine and zinc sulfate. A case report and review of the literature

A case of successful pregnancy in a patient with Wilson's disease treated with D-penicillamine and zinc sulfate is presented. Experience with D-penicillamine, triethylene tetramine dihydrochloride (trien) and zinc salts during pregnancy is reviewed and discussed.

Modulation of the neuroendocrine system and immune functions by zinc supplementation in children with Down's syndrome

Plasma levels of TSH, T4, T3, and reversal T3 (rT3) were measured in 51 children with trisomy of the chromosome 21 and in 15 controls. Levels of TSH were higher in children with DS than in controls and rT3 levels were decreased. However, T3 and T4 levels were in the normal range. Plasmic zinc and thymulin, a zinc-dependent thymic hormone, were also decreased. After dietary supplementation with ZnSO4, levels of plasmic zinc, thymulin, TSH and rT3 were restored. A follow up of DS children one year after the cessation of zinc therapy showed that plasma levels of zinc decreased and TSH lightly increased. Zinc deficiency may play a crucial role in the pathogenesis of thyroid gland disfunction which leads to the autoimmune hypothyroidism often observed in this syndrome.

Wilson's disease with cerebral manifestation: monitoring therapy by CSF copper concentration

The clinical courses, cerebrospinal fluid (CSF) and serum copper concentrations and urinary copper excretions under different schemes of drug treatment in four patients with cerebral manifestations of Wilson's disease were monitored over 6-11 years. CSF copper concentration measurements were performed from the beginning of therapy onwards in three patients and from 16 months after initial treatment onwards in the fourth. CSF copper levels decreased slowly over the years in parallel with clinical improvements, and increased in one patient who interrupted therapy for 2 years. These findings confirm our hypothesis that the concentration of copper in the CSF is a valuable quantitative parameter reflecting the normalization of copper in the brain. Copper measurements during phases of initial neurological deterioration in two patients receiving D-penicillamine, and in one patient receiving D-penicillamine and zinc sulphate, revealed decreased free serum copper and CSF copper levels.

The effect of mangxiao (natrii sulphas) in the relief of stasis and swelling after implantation of cardiac pacer

Sixteen patients with local stasis and swelling after implanting cardiac pacemaker were treated with Mangxiao (Natrii Sulphas) on the implanted local surface for 4-14 days. The effect was satisfactory. Reopening of the skin for the cleaning of the stasis and swelling and removal of the pacemakers could thus be avoided in these patients. The mechanism of action of Mangxiao in relieving stasis and swelling was studied preliminarily.