Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis.

BACKGROUND: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief. OBJECTIVE: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries. MATERIALS AND METHODS: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke. RESULTS: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17). CONCLUSION: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

An intensive nurse-led, multi-interventional clinic is more successful in achieving vascular risk reduction targets than standard diabetes care.

BACKGROUND: The aim of this research was to determine whether an intensive, nurse-led clinic could achieve recommended vascular risk reduction targets in patients with type 2 diabetes as compared to standard diabetes management. METHOD: Two hundred patients with type 2 diabetes were recruited to receive either intensive nurse-led or standard diabetes care in a 1-year open study. RESULTS: In each group 94 patients completed the study. The groups were matched for age and baseline HbA1c, blood pressure and lipid profiles. More patients in the intensive group achieved vascular risk targets than in the standard group: SBP (<130 mmHg) 33 versus 12.1%, (P < 0.001); DBP (<80 mmHg) 75.5 versus 40.2%, (P < 0.001); cholesterol (<4.8 mmol/L) 84.8 versus 63.6% (P = 0.003); LDL (<2.6 mmol/L) 73.4 versus 54.5% (P = 0.007); HbA1c (<6.5%) 53.2 versus 32.9% (P = 0.005). CONCLUSION: An intensive nurse-led clinic is more successful in achieving vascular risk targets than standard diabetes care.

UK-69,753, a novel member of the efrotomycin family of antibiotics. I. Taxonomy of the producing organism, fermentation and isolation.

UK-69,753 is a novel antibiotic structurally related to efrotomycin and factumycin, produced by a new strain of Amycolatopsis orientalis (ATCC 53550). The antibiotic potency in the fermentation broth was monitored by HPLC with diode array detection. A six tube counter current distribution was used to purify UK-69,753.

UK-63,052 complex, new quinomycin antibiotics from Streptomyces braegensis subsp. japonicus; taxonomy, fermentation, isolation, characterisation and antimicrobial activity.

UK-63,052 complex, a new group of quinomycin-like antibiotics comprising UK-63,052 (factor A), UK-63,598 (factor C), UK-65,662 (factor B) and several uncharacterised minor components, is produced by a new subspecies of the genus Streptomyces for which the name Streptomyces braegensis Dietz subsp. japonicus, is proposed. The strain, N617-29, is characterised by a negative melanin reaction, grey aerial mycelium, spiral spore chains and smooth or slightly warty spores. Structure determination has identified UK-63,052, C56H68N10O14S2, UK-63,598, C53H62N10O14S2 and UK-65,662, C55H66N10O14S2 as quinaldic acid substituted quinomycins with unusual bridgehead sulfur substitution as shown in Fig. 3.

Subchronic oral administration of gossypol-acetic acid (GAA) alters the distribution and utilization of radioiron in male rats.

Gossypol-acetic acid (GAA) has been shown to be a powerful chelator of iron. To determine how subchronic administration of GAA affects the distribution and utilization of radioiron, male Holtzman rats, which had received a daily oral dose of GAA (20 mg/kg body weight) for 16 weeks, were injected i.p. with [59Fe]citrate (activity = 16.5 muCi/kg body weight) and [59Fe] incorporation into circulating erythrocytes, bone marrow, liver, spleen, skeletal muscle, and urine was measured 6, 12, or 24 h after [59Fe] administration. Iron [59Fe] incorporation was enhanced in the spleens, livers, bone marrow, and blood of the GAA-treated rats, and increased as the time post-[59Fe] injection increased. Hematological parameters remained within normal limits throughout the 16-week treatment period, suggesting an erythropoietic compensation in the GAA-treated rats. Iron status was markedly different in the GAA-treated rats at the end of the 16 week treatment period, suggesting altered iron utilization. The data suggest that [59Fe] is preferentially distributed to the erythroid tissues of GAA-treated rats for utilization in erythropoiesis.

CP-54,883 a novel chlorine-containing polyether antibiotic produced by a new species of Actinomadura: taxonomy of the producing culture, fermentation, physico-chemical and biological properties of the antibiotic.

The novel chlorine-containing acidic polycyclic ether antibiotic CP-54,883 (C41H62O12Cl2) [corrected] is produced by the fermentation of Actinomadura routienii Huang sp. nov. This report presents the taxonomy and the fermentation conditions for the antibiotic-producing culture. The antibiotic is mainly active against Gram-positive bacteria. It protects chickens against Eimeria challenge in vivo and enhances rumen propionic acid in vitro. The physico-chemical properties are also characterized.

Radioiron utilization and gossypol acetic acid in male rats.

The 24-h incorporation of 59Fe into circulating red blood cells, bone marrow, urine, liver, spleen, and skeletal muscle was measured in splenectomized and sham-splenectomized rats which had received a daily, oral dose of gossypol acetic acid (20 mg GAA/kg body wt) for 91 days. A significant decrease in total body weight gain was observed in all GAA treated animals. Splenectomized rats dosed with GAA exhibited a significant decrease in hemoglobin concentration, hematocrit and erythrocyte count. A significant increase in 59Fe incorporation by red blood cells and a decrease in hepatic incorporation of 59Fe indicate a preferential utilization of iron in erythropoiesis among GAA treated animals.

The effect of gossypol acetic acid on female reproduction.

The effects of gossypol acetic acid (GAA) on various aspects of female rat reproduction were evaluated. Forty sexually mature, nulliparous female Holtzman rats received a daily, oral dose of GAA (20 mg GAA/Kg body wt) for 60 days. Nineteen control animals were utilized. Throughout the treatment period, GAA treated rats had significantly more irregular estrous cycles than did controls, and the mean duration of an estrous cycle in the GAA rats was significantly longer than that of controls. A significantly lower body weight gain was observed in all GAA treated animals. A prolonged time for mating, a decrease in incidence of pregnancy, and a reduction in number of viable embryos at Day 13 of gestation were noted among GAA treated animals. Weaning weights of offspring from GAA dams were significantly less than weaning weights of offspring from control dams.

Deposition pattern of the antifertility agent, gossypol, in selected organs of male rats.

Male rats received daily, oral doses of gossypol-acetate (40 mg/kg body wt) for 2, 4, or 8 weeks to determine patterns of gossypol deposition in the spleen, liver, heart, kidneys, lungs, and testes during establishment of a gossypol-induced infertility. Infertility was exhibited at the end of the 4-week dosing period. Free and bound gossypol accumulated in all of the organs.

Scanning electron microscopic study of spermatozoa from gossypol-treated rats.

Spermatozoa from the cauda epididymidis of gossypol-treated rats exhibit distinctive departures from the morphology of spermatozoa from control rats: wrinkled and disorganized cell membrane in the head and tail regions, cell membrane missing from segments of the tail midpiece and principal piece regions, malformed heads, decapitate spermatozoa, retention of a cytoplasmic droplet at variable loci along tail midpieces, and looped tails. The observations suggest that gossypol exerts its contraceptive effect during spermatocytogenesis and spermiogenesis, including the posttesticular development and maturation of spermatozoa in the epididymis.

Effect of gossypol on the ultrastructure of rat spermatozoa.

Gossypol was found to induce sterility in male rats when administered orally. A reduction in the number of spermatozoa in the epididymis from the gossypol-treated rats was observed when compared to the control animals. An examination of the spermatozoa from the treated rats showed the following ultrastructural modifications: disorganization of the mitochondiral sheath and missing cell membrane from the middle piece, broken cell membrane and missing members of both outer fibers and inner microtubules of the principal piece, and broken cell membrane of the sperm head. Serial mating experiments proved that gossypol-treated males were indeed sterile. The results suggest that gossypol at low concentrations is able to affect the motility of spermatozoa, thus contributing to its contraceptive action.

Quantitative and qualitative determinations of the combined effect of tetracycline and oleandomycin. I. In vitro effect.

Growth inhibitory effect of combined treatment of tetracycline (TC) and oleandomycin (OM), at a ratio of 2:1, on certain species of pathogenic bacteria including drug-resistant ones was examined. By the crossed paper strip method, synergistic effects were demonstrated against 9 of the 16 strains of Staphylococcus aureus, and all of the 5 strains of Escherichia coli studied. Antagonism was observed with none of the strains and with 2 strains of Streptococcus pyogenes and 2 strains of Streptococcus pneumoniae tested in the present experiments. The MICs determined by the agar dilution method, also gave similar results, although synergism was not conclusively demonstrated by this method. With representative strains of S. aureus, synergism was evidenced by quantitative measurement of growth inhibition. In some strains, 1.0 mug of one drug per ml of medium inhibited the induction of resistance to the second drug. Such a small dose of one drug also inhibited the development of a mutant resistant to the second drug. These inhibitory actions were thought to be one of the important factors causing the synergistic effect of TC and OM on drug resistant bacteria.

Quantitative and qualitative determinations of the combined effect of tetracycline and oleandomycin. II. In vivo effect.

The combination effect of tetracycline (TC) and oleandomycin (OM) on acute infection of mice with four strains of Staphylococcus aureus including TC or OM resistant ones was examined by the quantitative determination of protective potencies of single and combined drugs. The grade of synergism was expressed by the synergistic ratio (SR), a ratio of experimentally determined potency of the combined drug over a hypothetical potency in which additive effect of the both drugs is assumed. With 3 out of the 4 strains of S. aureus synergism between TC and OM or triacetyloleandomycin (TAO) was demonstrated by the determination of the 50% effective dose and by statistical examination of the SR. The grade of synergistic protection by these drugs varied with the strains infected and it did not depend upon the sensitivity to antibiotics or grade of synergism in vitro. There was no synergistic enhancement of acute toxic action in the combined administration of TC and OM to mice.

The accumulation pattern of ingested gossypol in selected organs of the rat.

Bound gossypol levels in the spleen and kidney of rats ingesting dietary gossypol (0.98%) varied directly with the feeding intervals of 6, 14, 28 and 35 days. Free gossypol level in the kidney, spleen and lungs increased for 14 days and then tended to decrease as the feeding period was extended.