Weight gain in menopause: systematic review of adverse events in women treated with black cohosh

Weight gain is a frequent problem in perimenopausal and postmenopausal women. Cimicifuga racemosa (CR) is a popular treatment option for menopausal symptoms. The aim of this review was to investigate whether there is scientific evidence that CR causes weight gain. We searched our database for medically confirmed, spontaneous adverse events regarding weight gain, literature for case reports and randomized controlled trials. Thirty cases in total were spontaneously reported in 15 years. The causality was not considered certain/likely in any of the cases. A nurse (consumer) assessed the causality as possible. Only one case was published in the literature. However, no change in body fat composition was reported, and the causality seems unlikely. Of the 31 identified studies, 17 were double-blind placebo-controlled, five were double-blind reference-controlled and nine were open reference-controlled. In total, 1839 women were treated with CR for up to 12 months. Two studies reported weight gain as an adverse event; however, no significant differences in weight changes were observed between the groups. One case of weight gain (about 2 kg) was reported, but the authors did not specify in which treatment group. In conclusion, this study provides no scientific evidence that the use of Cimicifuga racemosa causes weight gain in menopausal women.

A randomized, double-blind, placebo-controlled, clinical dose-response trial of an extract of Baptisia, Echinacea and Thuja for the treatment of patients with common cold

The aim of this study was to verify the efficacy and safety of an herbal medication containing an extract of a mixture of Baptisiae tinctoriae radix, Echinaceae pallidae/purpureae radix and Thujae, occidentalis herba (SB-TOX) in the treatment of upper respiratory tract infections (URIs), and to test whether SB-TOX's clinical efficacy is dose dependent. A total of 91 adults (mean age 42.1 +/- 13.0 years) were randomised to receive 19.2 mg of SB-TOX (n=31), 9.6 mg SB-TOX (n=29) or placebo (n=31) three times daily for 3-12 days. Since a "running nose" is the main symptom of a common cold, the total number of facial tissues used throughout the clinical duration of their cold was the primary efficacy parameter. In the intention-to-treat analysis, this total number of tissues decreased with increasing extract dose. The slope across groups according to the Jonckheere test was significant (p = 0.0259). In the high-dose group, the standardised effect size delta/SD was 0.46 compared with placebo. Time to relevant improvement in cold symptoms (measured as the time until less than 30 tissues per day were used) was 1.1 days (95% CI 0.52; 1.67), 0.76 days (95% CI 0.28; 1.24) and 0.52 days (95% CI 0.22; 0.82) in the placebo, low-dose and high-dose groups, respectively (p(LogRank) = 0.0175). No adverse events were reported. This study demonstrates the efficacy and safety of SB-TOX in the treatment of URIs, and that its efficacy is dose dependent.

Effect of alkali therapy with NaHCO3 or THAM on cardiac contractility

We examined the impact of alkali therapy on myocardial contractility in a model of myocardial ischemia in dogs using direct measurements of myocardial contractile function. Myocardial ischemia in the left anterior descending (LAD) artery territory was induced using a perfusion circuit from the internal carotid artery to the LAD artery. Myocardial contractile function was assessed using sonomicrometry for measurement of percent systolic shortening (%SS), preload recruitable stroke work (PRSW) slope, and end-systolic pressure-length relationship (ESPLR) area. Because the blood flow in LAD artery was diminished by approximately 70%, there was a significant decrease in O2 delivery and uptake by the ischemic myocardium. Ischemia led to a significant fall in LAD regional contractile function with %SS decreasing from 15 +/- 2 to 7 +/- 2%, PRSW slope from 82 +/- 10 to 37 +/- 5 mmHg, and ESPLR area from 121 +/- 2 to 48 +/- 14 mmHg.mm (P < 0.05). In six dogs, the intracoronary administration of NaHCO(3) resulted in a significant increase in pH in LAD arterial and venous blood. There was, however, no significant increase in %SS (6 +/- 2), PRSW slope (43 +/- 10 mmHg), or ESPLR area (60 +/- 13 mmHg.mm). Since administration of NaHCO(3) resulted in a significant increase in PCO2 in LAD arterial and venous blood, similar experiments were carried out in five dogs, but with the intracoronary infusion of the amine buffer THAM [tris(hydroxymethyl)aminomethane (Tris) buffer; 2-amino-2-hydroxyl-1,3-propandiol] instead of NaHCO3. Although administration of THAM resulted in a significant increase in pH and a significant decrease in PCO2, in both LAD arterial and venous blood, there was no significant improvement in any of the parameters used to assess myocardial contractile function. In conclusion, administration of alkali (NaHCO3 or THAM) does not enhance the contractile function of the ischemic myocardium.

Cerebral microemboli during coronary artery bypass using different cardioplegia techniques

Larger numbers of microemboli detected by transcranial Doppler echocardiography have been linked to adverse neuropsychological outcome after coronary artery bypass grafting. Differences in neurologic outcome have been attributed to different cardioplegia techniques. Transcranial Doppler-detected microembolic events were recorded during coronary artery bypass grafting using different cardioplegia techniques. Patients received cold antegrade (n = 20), warm antegrade (n = 17), or warm retrograde (n = 20) cardioplegia. Continuous monitoring was divided into stages: aortic cannulation, initiation of cardiopulmonary bypass, aortic cross-clamping, aortic declamping and decannulation until chest closure. Rate of embolic events and number of total and immediate embolic events were tabulated. Total embolic events ranged from 22 to 2,072 per patient and were similar among groups. The rate and total at each stage were similar. Total embolic events were highest during aortic clamping; the rate was highest at initiation of bypass. The immediate embolic events were higher in the warm retrograde group than both antegrade groups at aortic declamping. In summary, a high total and rate of embolic events were detected and differences between cardioplegia techniques were detected.

[Elastomers and peripheral seal in complete maxillary dentures]

First the various physical factors involved in retention are discussed. Adhesion is designed by the Gibert formula: [formula: see text] bringing the notion of interfacial surface delimited by the fluid meniscus (epsilon) and the thickness of the salivary film at the site of formation of the meniscus (h). Atmospheric pressure plays a role by the formation of a periphery seal ensuring the creation of a depression of the interfacial fluid in order to oppose the forces of pulling. As a summary, it is important to achieve the formation of a salivary meniscus: with the smallest curvature; continuous despite the mobility of the mucosa; beyond the limit between the free mucosa and the attached mucosa and the "farthest" possible from this area. The purpose of recording the periphery borders is to obtain the highest and widest possible denture flanges without any over-extension or over-thickness. The authors then propose performing a comparative study of the various materials available for recording the periphery of maxillary full dentures, in order to determine which best responds to the criteria of quality mentioned. Several recording techniques are possible, depending on the material used: either a segmented border recording (widely described); or a recording of the periphery seal in one or several stages which is then illustrated by the use of Impregum. For each patient, recordings of the periphery was made according to a protocol always identical and precise; only the material used for this purpose (Kerr compound, regular Neo-Plex and Impregum) varied. The measure taken from these recordings showed that Impregum demonstrates the highest and thickness borders as opposed to Neo-Plex and Kerr compound which provided intermediary results. Thus, Impregum appears to be the material of choice for the optimal recording of the functional periphery seal in maxillary full dentures.(ABSTRACT TRUNCATED AT 400 WORDS)