1
|
Sturiale A, Fralleone L, Cafaro D, Gallo G, Brusciano L, Celedon Porzio F, Venkataratnaiah Setty S, Naldini G. Safety and efficacy of topical drug-free cream in subjects with hemorrhoidal disease: a randomized, double blind, clinical trial. Minerva Gastroenterol (Torino) 2022; 68:407-414. [PMID: 35511655 DOI: 10.23736/s2724-5985.22.03173-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hemorrhoidal disease (HD) is one of the most common anorectal benign disorder affecting millions of people around the world. Grade I-II HD are generally treated with a conservative approach with topical products such as creams and ointments considered a safe and effective option to treat mild symptoms. The aim of the present study was to assess the safety and efficacy of a topical medical device (Lenoid™; International Health Science [IHS] - Biofarma Group, Mereto di Tomba, Udine, Italy) in patients affected by symptomatic HD. METHODS This study is a randomized, double blind, placebo-controlled, 2-weeks clinical trial. Patients affected by I-II grade symptomatic HD were enrolled in the study and then randomly assigned to Lenoid™ arm (LA) or placebo arm (PA), respectively. Patients were evaluated before and after intervention through clinical examination and disease-specific questionnaires assessing symptoms such as pain, tenesmus, pruritus and anal discharge. RESULTS A total of 68 patients were screened and 60 (30 in each group) were enrolled into the study. All patients belonging to LA showed a statistically significant improvement of each symptom after 7 and 14 days of treatment when compared to PA (P<0.001). Furthermore, subjective improvement of change in overall assessment of disease was observed in the LA but not in the PA. No serious adverse events were recorded. CONCLUSIONS The tested product was found safe and effective in improving clinical signs and symptoms in patients with grade I-II HD.
Collapse
Affiliation(s)
- Alessandro Sturiale
- Proctology and Pelvic Floor Clinical Center, Cisanello University Hospital, Pisa, Italy -
| | - Lisa Fralleone
- Proctology and Pelvic Floor Clinical Center, Cisanello University Hospital, Pisa, Italy
| | - Danilo Cafaro
- Unit of Proctology Surgery, Tropea Hospital, Vibo Valentia, Italy
| | - Gaetano Gallo
- Department of Medical and Surgical Sciences, The Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Luigi Brusciano
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Felipe Celedon Porzio
- Unit of Coloproctological Surgery, Hospital de la Fuerza Aerea de Chile, Santiago de Chile, Chile
| | | | - Gabriele Naldini
- Proctology and Pelvic Floor Clinical Center, Cisanello University Hospital, Pisa, Italy
| |
Collapse
|
2
|
Kuiper SZ, Tol RRV, Lataster A, Cleutjens JP, Melenhorst J, Dijk PV, van Kuijk SM, Breukink SO. A Morphometric Analysis of Pathological Alterations in Hemorrhoidal Disease Versus Normal Controls: A Controlled Trial. JOURNAL OF COLOPROCTOLOGY 2022. [DOI: 10.1055/s-0041-1742257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Objective Until today, the true pathophysiology of hemorrhoidal disease (HD) has not yet been unraveled. More and more evidence guides us towards the hypothesis that reduced connective tissue stability is associated with a higher incidence of hemorrhoids. The present study aimed to compare the quantity and quality of collagen, and vessel morphometrics, in patients with symptomatic HD compared with normal controls.
Methods Twenty-two samples of grade III and grade IV HD tissue from patients undergoing a hemorrhoidectomy between January 2004 and June 2015 were included in the study group. Samples of 15 individuals without symptomatic HD who donated their body to science and died a natural death served as controls. The quantity and quality of anal collagen, and anal vessel morphometrics were objectified. The quality of collagen was subdivided in young (immature) and old (mature) collagen.
Results Patients with HD had an increased percentage of total anal collagen (62.1 ± 13.8 versus 18.7 ± 14.5%; p = 0.0001), a decreased percentage of young collagen (0.00009 ± 0.00008 versus 0.0008 ± 0.0008%; p = 0.001), and a smaller surface area of the anal vessels (795.1 ± 1215.9 micrometre2 versus 1219.0 ± 1976.1; p = 0.003) compared with controls. The percentage of old collagen did not differ between the control and study groups (0.588 ± 0.286% versus 0.389 ± 0.242%; p = 0.06).
Conclusion The outcomes of the present study suggest that alterations in anal collagen composition may play a role in the formation of hemorrhoids.
Collapse
Affiliation(s)
- Sara Z. Kuiper
- Department of Surgery, School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Robin R. van Tol
- Department of Surgery, Diakonessenhuis Medical Centre, Utrecht, The Netherlands
| | - Arno Lataster
- Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands
| | - Jack P.M. Cleutjens
- Department of Pathology, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jarno Melenhorst
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Paul van Dijk
- Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands
| | - Sander M.J. van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Stéphanie O. Breukink
- Department of Surgery, School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Surgery, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
3
|
Kong C, Beukema M, Wang M, de Haan BJ, de Vos P. Human milk oligosaccharides and non-digestible carbohydrates prevent adhesion of specific pathogens via modulating glycosylation or inflammatory genes in intestinal epithelial cells. Food Funct 2021; 12:8100-8119. [PMID: 34286788 DOI: 10.1039/d1fo00872b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Human milk oligosaccharides (hMOs) and non-digestible carbohydrates (NDCs) are known to inhibit the adhesion of pathogens to the gut epithelium, but the mechanisms involved are not well understood. Here, the effects of 2'-FL, 3-FL, DP3-DP10, DP10-DP60 and DP30-DP60 inulins and DM7, DM55 and DM69 pectins were studied on pathogen adhesion to Caco-2 cells. As the growth phase influences virulence, E. coli ET8, E. coli LMG5862, E. coli O119, E. coli WA321, and S. enterica subsp. enterica LMG07233 from both log and stationary phases were tested. Specificity for enteric pathogens was tested by including the lung pathogen K. pneumoniae LMG20218. Expression of the cell membrane glycosylation genes of galectin and glycocalyx and inflammatory genes was studied in the presence and absence of 2'-FL or NDCs. Inhibition of pathogen adhesion was observed for 2'-FL, inulins, and pectins. Pre-incubation with 2'-FL downregulated ICAM1, and pectins modified the glycosylation genes. In contrast, K. pneumoniae LMG20218 downregulated the inflammatory genes, but these were restored by pre-incubation with pectins, which reduced the adhesion of K. pneumoniae LMG20218. In addition, DM69 pectin significantly upregulated the inflammatory genes. 2'-FL and pectins but not inulins inhibited pathogen adhesion to the gut epithelial Caco-2 cells through changing the cell membrane glycosylation and inflammatory genes, but the effects were molecule-, pathogen-, and growth phase-dependent.
Collapse
Affiliation(s)
- Chunli Kong
- School of Food and Health, Beijing Engineering and Technology Research Center of Food Additives, Beijing Technology and Business University, Beijing, 100048, China.
| | | | | | | | | |
Collapse
|
4
|
Salgueiro P, Caetano AC, Oliveira AM, Rosa B, Mascarenhas-Saraiva M, Ministro P, Amaro P, Godinho R, Coelho R, Gaio R, Fernandes S, Fernandes V, Castro-Poças F. Portuguese Society of Gastroenterology Consensus on the Diagnosis and Management of Hemorrhoidal Disease. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2020; 27:90-102. [PMID: 32266306 PMCID: PMC7113592 DOI: 10.1159/000502260] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/21/2019] [Indexed: 12/17/2022]
Abstract
Hemorrhoidal disease (HD) is a frequent health problem with considerable repercussions on patients' quality of life. However, much of the clinical practice related to HD is based on knowledge without scientific evidence and supported largely by empirical experience of the physician who deals with this pathology. As in other countries, the goal of this consensus is to establish statements supported by solid scientific evidence and whose purpose will be to standardize and guide the diagnosis and management of HD both in the general population and in some particular groups of patients.
Collapse
Affiliation(s)
- Paulo Salgueiro
- Serviço Gastroenterologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Ana Célia Caetano
- Serviço de Gastrenterologia, Hospital de Braga, Braga, Portugal
- Instituto de Investigações em Ciência da Vida e Saúde, Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Ana Maria Oliveira
- Serviço Gastroenterologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Bruno Rosa
- Serviço de Gastrenterologia, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | | | - Paula Ministro
- Serviço de Gastrenterologia, Hospital de São Teotónio, Viseu, Portugal
| | - Pedro Amaro
- Serviço de Gastrenterologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rogério Godinho
- Serviço de Gastrenterologia, Hospital do Espírito Santo, Évora, Portugal
| | - Rosa Coelho
- Serviço de Gastrenterologia, Centro Hospitalar de São João, Porto, Portugal
| | - Rúben Gaio
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Samuel Fernandes
- Serviço de Gastrenterologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa Norte, Portugal
| | - Vítor Fernandes
- Serviço de Gastrenterologia, Hospital Garcia de Orta, Almada, Portugal
| | - Fernando Castro-Poças
- Serviço Gastroenterologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
5
|
Kong C, Elderman M, Cheng L, de Haan BJ, Nauta A, de Vos P. Modulation of Intestinal Epithelial Glycocalyx Development by Human Milk Oligosaccharides and Non-Digestible Carbohydrates. Mol Nutr Food Res 2019; 63:e1900303. [PMID: 31140746 PMCID: PMC6771538 DOI: 10.1002/mnfr.201900303] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 03/26/2019] [Indexed: 12/11/2022]
Abstract
SCOPE The epithelial glycocalyx development is of great importance for microbial colonization. Human milk oligosaccharides (hMOs) and non-digestible carbohydrates (NDCs) may modulate glycocalyx development. METHODS AND RESULTS The effects of hMOs and NDCs on human gut epithelial cells (Caco2) are investigated by quantifying thickness and area coverage of adsorbed albumin, heparan sulfate (HS), and hyaluronic acid (HA) in the glycocalyx. Effects of hMOs (2'-FL and 3-FL) and NDCs [inulins with degrees of polymerization (DP) (DP3-DP10, DP10-DP60, DP30-DP60) and pectins with degrees of methylation (DM) (DM7, DM55, DM69)] are tested using immunofluorescence staining at 1 and 5 days stimulation. HMOs show a significant enhancing effect on glycocalyx development but effects are structure-dependent. 3-FL induces a stronger albumin adsorption and increases HS and HA stronger than 2'-FL. The DP3-DP10, DP30-60 inulins also increase glycocalyx development in a structure-dependent manner as DP3-DP10 selectively increases HS, while DP30-DP60 specifically increases HA. Pectins have less effects, and only increase albumin adsorption. CONCLUSION Here, it is shown that 2'-FL and 3-FL and inulins stimulate glycocalyx development in a structure-dependent fashion. This may contribute to formulation of effective hMO and NDC formulations in infant formulas to support microbial colonization and gut barrier function.
Collapse
Affiliation(s)
- Chunli Kong
- Immunoendocrinology GroupDivision of Medical BiologyDepartment of Pathology and Medical BiologyUniversity Medical Center Groningen, University of GroningenHanzeplein 19700 RBGroningenThe Netherlands
| | - Marlies Elderman
- Immunoendocrinology GroupDivision of Medical BiologyDepartment of Pathology and Medical BiologyUniversity Medical Center Groningen, University of GroningenHanzeplein 19700 RBGroningenThe Netherlands
| | - Lianghui Cheng
- Immunoendocrinology GroupDivision of Medical BiologyDepartment of Pathology and Medical BiologyUniversity Medical Center Groningen, University of GroningenHanzeplein 19700 RBGroningenThe Netherlands
| | - Bart J. de Haan
- Immunoendocrinology GroupDivision of Medical BiologyDepartment of Pathology and Medical BiologyUniversity Medical Center Groningen, University of GroningenHanzeplein 19700 RBGroningenThe Netherlands
| | - Arjen Nauta
- FrieslandCampinaStationsplein 43818 LEAmersfoortThe Netherlands
| | - Paul de Vos
- Immunoendocrinology GroupDivision of Medical BiologyDepartment of Pathology and Medical BiologyUniversity Medical Center Groningen, University of GroningenHanzeplein 19700 RBGroningenThe Netherlands
| |
Collapse
|
6
|
Sharifi-Rad J, Salehi B, Varoni EM, Sharopov F, Yousaf Z, Ayatollahi SA, Kobarfard F, Sharifi-Rad M, Afdjei MH, Sharifi-Rad M, Iriti M. Plants of the Melaleuca Genus as Antimicrobial Agents: From Farm to Pharmacy. Phytother Res 2017; 31:1475-1494. [PMID: 28782167 DOI: 10.1002/ptr.5880] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 11/08/2022]
Abstract
Plants belonging to Melaleuca genus (Myrtaceae family) are native to Oceania, where they have been used for ages by Aborigine people in Australian traditional medicine, mainly because of their broad-spectrum antimicrobial activity. Although, M. linariifolia, M. dissitiflora, and other species of Melaleuca can also be used, the tea tree oil, an essential oil obtained from M. alternifolia shows the longest history of medicinal uses. Tea tree oil contains for the 80-90% several monoterpenes (terpinen-4-ol, α-terpinene, 1,8-cineol, p-cymene, α-terpineol, α-pinene, terpinolene, limonene, and sabinene). Sesquiterpenes and aromatic compounds further compose this oil. The essential oil of Melaleuca spp. has been reported to possess effective antibacterial and antifungal properties in vitro. In particular, data show that 1,8-cineol, terpinen-4-ol and methyl eugenol play the key role in mediating this oil's antimicrobial activity. Copyright © 2017 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahare Salehi
- Young Researchers and Elites Club, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, Milan State University, via Beldiletto 1/3, Milan, 20142, Italy
| | - Farukh Sharopov
- Department of Pharmaceutical Technology, Avicenna Tajik State Medical University, Rudaki 139, 734003, Dushanbe, Tajikistan
| | - Zubaida Yousaf
- Department of Botany, Lahore College for Women University, Jail Road Lahore, Lahore, Pakistan
| | - Seyed Abdulmajid Ayatollahi
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Kobarfard
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Sharifi-Rad
- Department of Medical Parasitology, Zabol University of Medical Sciences, Zabol, 61663-335, Iran
| | | | - Majid Sharifi-Rad
- Department of Range and Watershed Management, Faculty of Natural Resources, University of Zabol, Zabol, Iran
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, Milan, Italy
| |
Collapse
|
7
|
Thomas J, Carson CF, Peterson GM, Walton SF, Hammer KA, Naunton M, Davey RC, Spelman T, Dettwiller P, Kyle G, Cooper GM, Baby KE. Therapeutic Potential of Tea Tree Oil for Scabies. Am J Trop Med Hyg 2016; 94:258-266. [PMID: 26787146 PMCID: PMC4751955 DOI: 10.4269/ajtmh.14-0515] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 05/08/2015] [Indexed: 11/20/2022] Open
Abstract
Globally, scabies affects more than 130 million people at any time. In the developed world, outbreaks in health institutions and vulnerable communities result in a significant economic burden. A review of the literature demonstrates the emergence of resistance toward classical scabicidal treatments and the lack of effectiveness of currently available scabicides in reducing the inflammatory skin reactions and pyodermal progression that occurs in predisposed patient cohorts. Tea tree oil (TTO) has demonstrated promising acaricidal effects against scabies mites in vitro and has also been successfully used as an adjuvant topical medication for the treatment of crusted scabies, including cases that did not respond to standard treatments. Emerging acaricide resistance threatens the future usefulness of currently used gold standard treatments (oral ivermectin and topical permethrin) for scabies. The imminent development of new chemical entities is doubtful. The cumulative acaricidal, antibacterial, antipruritic, anti-inflammatory, and wound healing effects of TTO may have the potential to successfully reduce the burden of scabies infection and the associated bacterial complications. This review summarizes current knowledge on the use of TTO for the treatment of scabies. On the strength of existing data for TTO, larger scale, randomized controlled clinical trials are warranted.
Collapse
Affiliation(s)
- Jackson Thomas
- University of Canberra, Faculty of Health, Bruce, Canberra, Australia; Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Queensland, Australia; School of Medicine and Pharmacology, The University of Western Australia and Translational Renal Research Group, Harry Perkins Institute of Medical Research, Nedlands, Western Australia; Burnet Institute, Melbourne, Victoria, Australia; School of Medicine, Flinders University, Katherine, Northern Territory, Australia; Private Practice, Charnwood, Canberra, Australia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Merolla G, Dellabiancia F, Ingardia A, Paladini P, Porcellini G. Co-analgesic therapy for arthroscopic supraspinatus tendon repair pain using a dietary supplement containing Boswellia serrata and Curcuma longa: a prospective randomized placebo-controlled study. Musculoskelet Surg 2015; 99 Suppl 1:S43-S52. [PMID: 25957549 DOI: 10.1007/s12306-015-0364-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The cuff tendon that is most prone to full-thickness rotator cuff tears is the supraspinatus (SSP). Arthroscopic SSP repair ensures good to satisfactory mid- to long-term clinical outcomes. However, the intense postoperative pain reduces rehabilitation compliance and is cause of patient dissatisfaction. Many natural compounds act by inhibiting inflammatory pathways in a similar way to anti-inflammatory drugs MATERIALS AND METHODS This was a prospective randomized trial designed to assess the analgesic effect of a dietary supplement (DS) containing Boswellia serrata and Curcuma longa in a population of subjects with full-thickness SSP tendon tear treated by arthroscopy. Three weeks before surgery, patients were randomized to receive Tendisulfur(®) (group T) or a placebo (group P) for 2 months. The primary outcome measure was subjective VAS pain. Secondary outcomes measures were Constant-Murley score simple shoulder test, and patient global assessment (PGA) scores. Patients were assessed immediately at baseline and subsequently at 1, 2, 4, 6, 8, 12, and 24 weeks. RESULTS Stratification of pain scores and subscores demonstrated significantly lower overall pain scores in group T versus group P at 1 week (p = 0.0477), and lower but not significantly different scores on week 2 (p = 0.0988); at subsequent time points, differences were not significant (p > 0.05). PGA scores were good in all subjects. CONCLUSIONS In conclusion, this study provides objective data on the effect of a DS containing natural substances, added to standard analgesics, on postoperative RC pain. DS alleviated short and partially mid-term pain, while long-term pain was unchanged. This limitation can probably be addressed by a dosage increase over the first 4 weeks and by extending treatment by 1 or 2 months.
Collapse
Affiliation(s)
- G Merolla
- Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Via L. v. Beethoven 5, 47841, Cattolica, Italy.
- "Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica, Cattolica, Italy.
| | - F Dellabiancia
- "Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica, Cattolica, Italy
| | - A Ingardia
- Unit of Anesthesiology and Intensive Care, Riccione and Cattolica Hospitals - AUSL della Romagna Ambito Territoriale di Rimini, Cattolica, Italy
| | - P Paladini
- Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Via L. v. Beethoven 5, 47841, Cattolica, Italy
| | - G Porcellini
- Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Via L. v. Beethoven 5, 47841, Cattolica, Italy
| |
Collapse
|
9
|
Hammer KA. Treatment of acne with tea tree oil (melaleuca) products: a review of efficacy, tolerability and potential modes of action. Int J Antimicrob Agents 2014; 45:106-10. [PMID: 25465857 DOI: 10.1016/j.ijantimicag.2014.10.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 10/31/2014] [Indexed: 01/10/2023]
Abstract
Over-the-counter acne treatments containing tea tree oil from the plant Melaleuca alternifolia are widely available, and evidence indicates that they are a common choice amongst those self-treating their acne. The aims of this review were to collate and evaluate the clinical evidence on the use of tea tree oil products for treating acne, to review safety and tolerability and to discuss the underlying modes of therapeutic action.
Collapse
Affiliation(s)
- K A Hammer
- School of Pathology and Laboratory Medicine (M504), Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, 35 Stirling Hwy, Crawley, Perth 6009, WA, Australia.
| |
Collapse
|
10
|
Abstract
PURPOSE To report the first case of presumed bilateral acute angle closure (AAC) secondary to ingestion of the dietary supplement, methyl-sulfonyl-methane (MSM). PATIENT A 35-year-old woman presented with bilateral AAC 1 week after starting multiple dietary supplements, one of which contained MSM. Ultrasound biomicroscopy demonstrated bilateral anterior rotation of the iris-lens diaphragm, ciliary body edema, and choroidal effusion. Four days after discontinuation of the supplements, her angle closure and uveal effusion resolved, and her best-corrected vision recovered to 20/20 bilaterally. DISCUSSION Sulfa-based drugs have been reported to cause AAC, choroidal effusion, and ciliary body edema. In our patient, the coincidence of bilateral AAC with choroidal and ciliary body effusion that began 1 week after starting dietary supplements was suspicious for drug-induced AAC. The dietary supplement Basic Detox Nutrients contains MSM, the only constituent in the patient's medication list with a sulfonyl moiety. Given the similarities in chemical structure and clinical presentation, we postulate that MSM induces AAC in a manner similar to mechanisms previously described for other sulfa-based drugs. CONCLUSIONS As MSM continues to be used and studied for its anti-inflammatory and antioxidative properties, investigators and marketers will need to be cognizant of its potential to cause AAC and provide proper warning to consumers.
Collapse
|
11
|
Altomare DF, Giannini I. Pharmacological treatment of hemorrhoids: a narrative review. Expert Opin Pharmacother 2013; 14:2343-9. [PMID: 24024752 DOI: 10.1517/14656566.2013.836181] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Hemorrhoid disease is the cause of most proctologic complaints and hundreds of medical and surgical therapies have been proposed to relieve symptoms. However, the role and the correct indication of medical treatments are still controversial. Further, the utility of conservative measures are rarely scientifically supported by adequate trials. AREAS COVERED This narrative review is based on the search and analysis of full papers in English language selected from PubMed in the past 30 years using the following MeSH Editing: hemorrhoids, conservative treatment, medical treatment and hemorrhoids, pregnancy and hemorrhoids, thrombosed hemorrhoids, randomized trials and hemorrhoids, postoperative pain and hemorrhoids. EXPERT OPINION Early stages (I/II degrees) of this disease could be effectively managed conservatively with several approaches as lifestyle changes, fiber supplement, topical ointments and phlebotonic drugs. The more advanced hemorrhoid stages (III/IV degrees) need some type of surgery, but medical therapy is still useful to minimize anal symptoms as a bridge-to-surgery treatment. Further, post-hemorrhoidectomy pain, hemorrhoidal crisis even in pregnancy could benefit from the adjunct of local and systemic medical treatment. This expert opinion, based also on long-lasting clinical practice, also supports the use of medical treatment in symptoms relief in patients with hemorrhoid disease.
Collapse
Affiliation(s)
- Donato F Altomare
- University Aldo Moro of Bari, Department of Emergency and Organ transplantation , Policlinico, piazza G Cesare, 11, 70124 Bari , Italy +3397593066 ; +39 0805478735 ;
| | | |
Collapse
|