Chemical Composition, Market Survey, and Safety Assessment of Blue Lotus (Nymphaea caerulea Savigny) Extracts.

Blue lotus, also known as Nymphaea caerulea (Nymphaeaceae), is a water lily found globally in lakes and rivers. With its long history of use in Egyptian culture, blue lotus has been associated with spiritual rituals and health benefits. Nowadays, blue lotus is still consumed as a tea or tincture to induce relaxation and heightened spiritual awareness. In this study, six authentic N. caerulea extracts from trusted sources and eleven commercial products were analyzed using gas chromatography-mass spectrometry (GC-MS). Authentic blue lotus extracts were produced in industrial settings. Overall, the extracts were a mixture of aliphatic hydrocarbons, aromatic alcohols, fatty acids, phenyl derivatives, diterpenoids, phytosterols, and stigmastanes. Apomorphine and nuciferine, which are responsible for psychoactive effects of the blue lotus flower, were virtually absent from the authentic blue lotus extract. Although blue lotus has a long history of use, the safety data on the plant and its extracts is limited; however, together with the analytical data, the available information does not indicate major safety concerns for the topical application of authentic blue lotus flower concrete or absolute when diluted as a fragrance ingredient.

Obesity diagnoses in children and adolescents in Norway by immigrant background.

AIM: Relatively few obese children and adolescents receive specialist treatment. Our aim was to assess associations between risk of receiving an obesity diagnosis in secondary/tertiary health services by socio-economic position and immigrant background in order ultimately to improve equity in health services. METHODS: The study population comprised Norwegian-born children aged 2-18 years between 2008 and 2018 (N=1,414,623), identified via the Medical Birth Registry. Cox regressions were used to calculate hazard ratios (HR) of an obesity diagnosis from secondary/tertiary health services (Norwegian Patient Registry) by parental education and household income and by immigrant background. RESULTS: Higher parental education and household income were associated with a lower hazard of obesity diagnosis regardless of Norwegian versus immigrant background. Compared to having a Norwegian background, having a Latin American (HR=4.12; 95% confidence interval (CI) 3.18-5.34), African (HR=1.54; 95% CI 1.34-1.76) and Asian (HR=1.60; 95% CI 1.48-1.74) background was associated with higher hazard of obesity diagnosis. Adjusted for parental education and household income, corresponding HRs were 3.28 (95% CI 2.95-3.65) for Latin America, 0.95 (95% CI 0.90-1.01) for Africa and 1.08 (95% CI 1.04-1.11) for Asia. Within Asia, those with a background from Pakistan, Turkey, Iraq and Iran had higher hazards than those with a Norwegian background, while those with a background from Vietnam had lower hazards, even after adjusting for parental education and household income. CONCLUSIONS: To ensure more equitable treatment, more knowledge is warranted about health-service access and referral patterns, and underlying population prevalence rates, for obese children and adolescents with different immigrant backgrounds.

Purple urine bag syndrome: A case report.

INTRODUCTION: Purple Urine Bag Syndrome (PUBS) is purple discoloration of urine and is common in bedridden patients with long-term urinary catheter. Although typically benign, the purple discoloration is alarming to both the patients and their attendants. CASE REPORT: This case report presents an uncommon case of PUBS in a 74-year-old lady with hypertension, type II diabetes and ischemic stroke from last 2 years. She has neurogenic bladder and has been catheterized from last 2 years. Her last catheter was changed 15 days back. She presented to the emergency room with complaints of change in color of urine with low grade fever from last 1 week. on clinical examination there was one bed sore on lumbar region that was grade 1 with pus oozing from base of ulcer. CLINICAL DISCUSSION: PUBS is generally associated with alkaline urine and in patients who was chronically catheterized as was observed in this patient, although it has also been reported in acidic urine. CONCLUSION: PUBS is a rare manifestation of urinary tract infection with an alarming appearance and can be a source of anxiety for patients and their families. Being asymptomatic and comparatively benign, purple discoloration is simply an indicator of underlying bacteriuria and is of no prognostic value.

Can extra-short dental implants serve as alternatives to bone augmentation? A preliminary longitudinal randomized controlled clinical trial.

OBJECTIVE: A randomized trial to assess clinical and radiographic outcomes of short versus standard dental implants placed with concomitant vertical bone augmentation. METHOD AND MATERIALS: Patients requiring dental implants were randomized to receive either 6-mm implants (experimental) or 10-mm implants with vertical augmentation (control). Custom load-bearing healing abutments were connected to allow for indirect resonance frequency analysis measurements. Standardized radiographs were taken at implant placement (baseline), and at 3 and 12 months. Implants were restored at 3 to 6 months, and final measurements were taken at 12 months. RESULTS: Fifty patients with 25 implants per group were included. Five implants failed, four experimental and one control (84% and 96% cumulative survival rate, respectively). Short implants required significantly less surgical time (51.6 ± 23 versus 68.5 ± 35 minutes, P = .05). Implant stability quotients at baseline (67.9 ± 8.3 experimental and 70.8 ± 7.6 control, P = .215) and 12 weeks (70.17 ± 7.4 and 72.03 ± 5.9, respectively, P = .513) were similar and unchanged. Positive correlation was found between the two measurement methods (r2 = .6, P = .025). One-year average marginal bone loss was slightly lower for the experimental group (0.6 ± 0.16 mm) compared to the control group (0.86 ± 0.19 mm); however, this was not statistically significant (P = .287). CONCLUSION: Short dental implants may offer an alternative for implant placement in an atrophic jaw; however, they are associated with reduced first-year survival rate. Short dental implants should be used judiciously in light of this potential predicament, and alternatives assessed.

Radiation Safety During Interventions of Coronary Chronic Total Occlusion

During percutaneous coronary interventions (PCI) for chronic total occlusion (CTO), prolonged procedures increase the risk of excessive radiation exposure. These situations harbor a major concern to protect patients and personnel in the cardiac interventional laboratory (CCL). Important questions regarding radiation safety for interventional cardiologists performing PCI for CTO lesions are discussed and concrete applications are suggested.

Applied Pathology for Interventions of Coronary Chronic Total Occlusion

Percutaneous coronary intervention of chronically occluded vessels can result in significant improvement in symptoms, relieve myocardial ischemia, and affect a reduction in major adverse cardiac events. Likelihood of achieving successful revascularization can be significantly enhanced with a thorough understanding of the pathology of these occluded coronary arteries. In this chapter, various steps and techniques to cross the CTO lesion and recanalize it are discussed in details.

A regulatory governance perspective on health technology assessment (HTA) in France: the contextual mediation of common functional pressures.

The new regulatory governance perspective has introduced several insights to the study of health technology assessment (HTA): it has broadened the scope for the analysis of HTA; it has provided a more sophisticated account of national diversity and the potential for cross-border policy learning; and, it has dissolved the distinction between HTA assessment and appraisal processes. In this paper, we undertake a qualitative study of the French process for HTA with a view to introducing a fourth insight: that the emergence and continuing function of national agencies for HTA follows a broadly evolutionary pattern in which contextual factors play an important mediating role. We demonstrate that the French process for HTA is characterised by distinctive institutions, processes and evidential requirements. Consistent with the mediating role of this divergent policy context, we argue that even initiatives for the harmonisation of national approaches to HTA are likely to meet with divergent national policy responses.

A regulatory governance perspective on Health Technology Assessment (HTA) in Sweden.

Independent regulatory agencies (IRAs) for Health Technology Assessment (HTA) are a key means by which national governments have responded to the challenge of ensuring equitable public access to a new range of medicines and treatment options within the context of limited national budgets for healthcare. In this paper, we apply a regulatory governance frame to the study of the Swedish process for HTA. Based on qualitative interviews with key institutional stakeholders, we suggest that the major challenge for Swedish IRAs for HTA is successfully communicating nationally produced research outputs to the regional authorities responsible for the delivery of health services. We conclude that a regulatory governance approach to the analysis of national processes for HTA has the capacity to draw attention to a new range of challenges and issues which have direct relevance to improving the conduct of HTA within national regulatory spaces.

Regulatory space and the contextual mediation of common functional pressures: analyzing the factors that led to the German Efficiency Frontier approach.

There are no automatic links between the functional advantages and pressures associated with delegation to independent agencies for Health Technology Assessment (HTA) and their emergence in national regulatory spaces. We argue that the rise of these organizations is mediated by contextual factors, which must be explained. Accordingly, we analyze the German 'regulatory space' for health policy decision-making, identifying contextual factors relevant to the adoption of the Efficiency Frontier approach. Based on qualitative interviews with key stakeholders, we argue that the development of the Efficiency Frontier can be associated with cultural reluctance to frame healthcare prioritization decisions around cost based valuations of human health and related doubts about the validity of metrics for human health gain. Based on this finding, we conclude that the delegation of authority to independent HTA agencies follows a broadly evolutionary pattern, in which contextual factors allow for significant variation in institutional and methodological responses to the functional pressures and advantages leading to their establishment.

Biomimetic calcium-silicate cements support differentiation of human orofacial mesenchymal stem cells.

INTRODUCTION: Human orofacial bone mesenchymal stem cells (OFMSCs) from maxilla and mandible have robust osteogenic regenerative properties on the basis of our previous reports that demonstrate phenotypic and functional differences between jaw and axial bone mesenchymal stem cells in same individuals. Furthermore, a combination of OFMSCs with bioactive calcium-releasing cements can potentially improve OFMSC multilineage differentiation capacity, but biocompatibility of calcium-silicate cements with OFMSCs is still unclear. We tested the hypothesis that material extracts of calcium-releasing calcium-silicate cements support biomimetic microenvironment for survival and differentiation of human OFMSCs. METHODS: Two experimental calcium-silicate cements, (1) calcium-silicate mineral powder (wTC) containing dicalcium and tricalcium-silicate, calcium sulfate, and calcium chloride and (2) wTC doped with alpha-tricalcium phosphate (wTC-αTCP), were designed and prepared. Cement setting times were assessed by Gilmore needles, ability to release calcium and hydroxyl ions was assessed by potentiometric methods, and OFMSC attachment to calcium-silicate discs was assessed. Calcium-silicate material extracts were tested for ability to support OFMSC survival and in vitro/in vivo differentiation. RESULTS: Fewer OFMSCs attached to calcium-silicate discs relative to tissue culture plastic (P = .001). Extracts of calcium-silicate cements sustained OFMSC survival, maintained steady state levels of vascular cell adhesion molecule-1, alkaline phosphatase, and bone sialoprotein while up-regulating their respective gene transcripts. Adipogenic and in vivo bone regenerative capacities of OFMSCs were also unaffected by calcium-silicate extracts. CONCLUSIONS: Ion-releasing calcium-silicate cements support a biomimetic microenvironment conducive to survival and differentiation of OFMSCs. Combination of OFMSCs and calcium-silicate cement can potentially promote tissue regeneration in periapical bone defects.

Ghrelin's quick inhibition of androgen-dependent behaviors of male house mice (Mus musculus).

Ghrelin is a peptide hormone released by the stomach that stimulates hunger. Ghrelin also suppresses reproductive physiology by inhibiting the HPG axis. However, to our knowledge, our results are the first to demonstrate ghrelin's quick suppression of sex-hormone-regulated behaviors. In experiment 1, 2 orexigenic i.p. ghrelin injections (0.165 mg/kg and 0.33 mg/kg) suppressed male courtship behavior (ultrasonic calling to a female) and intermale aggression (latency to attack a stimulus male) 20 min following administration. Experiment 2 (examining only the 0.33 mg/kg dose ) replicated ghrelin's suppression of ultrasonic calling and intermale aggression; however, a third behavior, preference for volatile female odors (20 min following administration), was not significantly inhibited. In experiment 2, ghrelin treatment did not affect general locomotor activity (distance traveled 20 min following injection) or seminal vesicle weight (measured 5 days after completing ghrelin injections). We hypothesize that ghrelin's quick suppression of male aggression and ultrasonic mating calls was mediated through its effects on the brain (rather than indirectly through inhibition of the HPG axis).