Digestive System Disorders Research Articles

Effect of levels of realism of mobile-based pedagogical agents on health e-learning

Background: One of the ways for effective communication between learners and instructional multimedia content in mobile learning systems is taking advantage of characters or pedagogical agents. The present study aimed to investigate the effect of the levels of realism in mobile-based pedagogical agents on health e-learning. Methods: The study was quasi-experimental with a pretest-posttest design involving three experimental groups. The target population included those participants who themselves or one of their relatives suffered from digestive disorders. The sample consisted of 48 participants selected through a convenience sampling procedure and were randomly assigned to either of the groups. The instruments and materials included instructional multimedia lessons and learning tests (pretest and posttest). The instructional multimedia content consisted of instructional materials related to familiarity with the human digestive system, its function, and relevant disorders. The participants in each group were exposed to the same instructional content but with a different level of realism related to the pedagogical agent (i.e., iconic, semi-iconic, and realistic). The instructional multimedia lessons were delivered through a mobile-based health leaning management system. For the data analysis, an analysis of covariance (ANCOVA) was applied. Results: The results showed that the group with the realistic pedagogical agent (M = 29.29, SD = 4.20), compared with the iconic pedagogical agent (M = 25.53, SD = 2.99), performed better on learning measurement (p = 0.20). Conclusion: The employment of pedagogical agents, as one of the influential tools in improving learners' motivation and learning, should receive greater attention in designing and developing instructional multimedia, especially in the field of health learning services.

English

The genus Acacia, mainly distributed in the tropical and subtropical regions, has been used in traditional medicines for the treatment of microbial infections, malaria, diarrhea, oedema and inflammation. The present study aims to provide a comprehensive data on the distribution and medicinal use of Acacia species. Ethnobotanical survey and phytogeographical study were undertook using field interviews. Informant consensus factor (ICF), frequency of citation (Fc), fidelity level (FL) and use value (UV) were also assessed. A total of 16 species belonging to genus Acacia were inventoried in Benin. A total of 108 informants were interviewed during ethnobotanical survey. Except Acacia auriculiformis, all inventoried species cited by informants were traditionally used to treat various ailments. This species were mostly used as medicinal treatments (93.75 % of the species) and to produce wood and fibers (6.25 %). Leaves, bark and roots were the most used parts and decoction was the most cited method of preparation. A. macrostachya (UV = 1.94), A. nilotica (UV = 1.21), A. hockii (UV = 1.20) and A. ataxacantha (UV = 1.17) and A. sieberiana (UV = 1.15) were the most used species. A. nilotica (75%), A. dudgeonii (67%) and A. seyal (50%). A. nilotica (FL = 75%) and A. dudgeonii (FL = 67%) were the most species cited by informants to treat Digestive System Disorder whereas A. Hockii (67%), A. Senegal (67%), A. ataxacantha (60%), A. erythrocalyx (50%) and A. gerrardii (50%) were cited for Infectious diseases. The extensive literature survey reveals 16 Acacia species distributed in 10 phytogeographic districts in Bénin. These species where mostly used in traditional medicine to treat infectious diseases and Digestive System Disorder. The results of this study open new research perspectives on Acacia species not yet studied. Key words: Acacia, ethnobotany, phytogeography, medicinal plants. &nbsp

Medicinal plants in homegardens of four ethnic groups in Thailand

Ethnopharmacological relevanceHomegardens are important habitats for medicinal plants and traditional knowledge, especially among indigenous groups in remote areas. In homegardens, medicinal plants and traditional knowledge are well conserved through human management and ease of access. Aim of the studyTo understand the drivers of diversity and the composition of homegardens with focus on medicinal plants, including exotic species, and their uses. We compare the homegardens of four ethnic groups in northern Thailand (Thai Yuan, Lahu, Karen, and Lisu). MethodsWe inventoried all medicinal species in 195 homegardens from four villages belonging to the four ethnic groups. The owners were asked to point out all useful species in their homegardens. For any medicinal species, they were then interviewed about their main and secondary uses, medicinal properties, plant part used, preparation methods, and route of administrations. ResultsWe recorded 95 medicinal homegarden plant species ranging from 20–59 species per village and ethnic group. Most of the medicinal plants had a primary use as food plants, which demonstrated the close relationship between local food and medicine in the lives of these ethnic groups. Many of the medicinal plants were also used as food additives, ornamentals, or materials, showing that medicinal plants are not an exclusive category in the homegardens. The number of homegarden plants varied almost four-fold from 58 species in one village to 211 in the most species rich village. The number of medicinal homegarden plants varied accordingly from 20 to 59 in the poorest and the richest villages. Five medicinal species were found in all villages, but 70% of the medicinal plants were found in only one village. Infection & infestation, Nutritional disorders, and Digestive system disorders were the three most important medicinal use categories for plants in the homegardens, and all three categories were found in most of the studied homegardens. Of the 95 species with medicinal uses, 26 (27%) were exotic, which shows that local people amplify the spectrum of alternative ways to treat their illnesses. ConclusionHomegardens are an important source of ethnomedicinal species and knowledge. These species are beneficial for treating acute and common ailments; they are easy to access and can be prepared by simple methods, which are suitable for treating disorders, such as infections or any digestive system ailments. Medicinal plants in homegardens have been important in improving health, at least, at the family level.

Herbal remedies and traditional knowledge of the Tuareg community in the region of Illizi (Algerian Sahara)

This study is the first ethnobotanical investigation of Tuareg communities from the region of Illizi in the Algerian Sahara. The study aims to highlight the unique floristic diversity used in their traditional medicine. Ethnobotanical surveys were conducted with 120 Tuareg nomads, mostly old and illiterate men, using free listing and structured interviews. Field data were organised in Use Reports (URs) and analysed using the Informant Consensus Factor. We identified 118 medicinal plants belonging to 43 botanical families dominated by Asteraceae, Fabaceae and Poaceae. The Tuareg use leaves in infusion as the most common preparation method. The species most often mentioned in the surveys are Salvadora persica L., Peganum harmala L. and Anvillea garcinii subsp. radiata (Coss. & Durieu) Anderb. Gastrointestinal system disorders are the ailments most commonly treated with herbal medicine. The treatment of cancer has the highest consensus among the community. This pathology is treated only by Ephedra alata subsp. alenda (Stapf) Trab. The analysis of the results in comparison with the available literature in Algeria and neighbouring countries led us to identify 21 new medicinal plants as well as 65 plants with new uses. We evaluated the originality of the ethnobotanical knowledge of the Tuareg community using a comparative approach with two populations geographically close, the Arabic-speaking nomads of the Algerian steppe and the Egyptian Bedouins with whom they share a nomadic way of life. Plants shared with Algerian nomad neighbours are those available in markets and used also for culinary and aromatic purposes, but plants shared with Bedouin communities are mostly non-cultivated desert plants. We conclude that Tuareg use medicinally many plants specific to their environment in unique ways.

Mesenchymal Stem Cells to Treat Digestive System Disorders: Progress Made and Future Directions

The purpose of this review is to summarize the results from clinical trials that evoked promise and discouragement for the use of mesenchymal stem cells (MSCs) to treat digestive system disorders. Adult MSCs are defined as a non-homogeneous population of pluripotent progenitor cells, which can be isolated and expanded in vitro from different tissues. The differentiation capacity of MSC along mesenchymal lineages and their immunomodulatory properties have been considered a new therapeutic approach for intestinal disorders. A dysregulated immune response is the cause and sustainment of these disorders, as they are characterized by progressive tissue damage with no available curative treatment. Up to now, 130 clinical trials on MSC-based therapy are registered to treat conditions affecting the digestive system. The results from completed or underway clinical studies are encouraging, showing both benefit for those digestive disorders refractory to any conventional therapy and progression toward end-stage liver disease. However, the absence of large, robust controlled, and randomized clinical trials to assess MSC clinical efficacy limits MSC-based therapy translation to bedside reality to completely cure digestive disorders.

Androgen Receptor (NR3C4) regulator potential of Ceratonia siliqua extract and its signaling pathways

Aim/Background: Androgen receptor (AR/NR3C4) regulates growth, development, reproduction, metabolism, and homeostasis. Since it has multifunctional properties, disrupting of the functions can cause many diseases such as cancer and neurodegenerative diseases. Therefore, AR modulators and blockers are very important therapy of androgen-dependent diseases. Furthermore, mechanisms and signaling pathways of AR on the diseases are unclear. Ceratonia siliqua was shown to have preventative effects against digestive system disorders, diabetes mellitus, asthma-bronchitis, and oxidative stress in various studies. Materials and Methods: In the present study, its AR regulator potential was investigated in AR-deficient HEK293 cells. Results: While C. siliqua extract increased >2 folds of NR3C4 gene expression in the cells, it induced a decrease in AKT1 and kynureninase genes expression levels. On the other hand, it increased p38 gene expression, but it did not change FUS gene expression. These results support a regulating role on the receptor and also that the compounds specifically affect NR3C4 signaling pathways. Conclusion: Determination of the molecules and their various combinations with each other can contribute to discover new therapeutic agents for diseases dependent on AR signaling pathways.

Two PBDEs exposure inducing feeding depression and disorder of digestive and antioxidative system of Daphnia magna

2,2′,4,4′-tetrabrominated diphenyl ether (BDE-47) and 2,2′,4,4′,5-pentabromodiphenyl ether (BDE-99) are two typical polybrominated diphenyl ethers (PBDEs), and studies have proven that these PBDs can disrupt the behaviors and physical function of aquatic organisms. However, little is known about the compositional impacts of BDE-47/BDE-99 compound pollution on the feeding behavior of Daphnia magna. In this study, a response surface methodology (RSM) was introduced into the combined toxicity assessment of BDE-47 and BDE-99 on the feeding depression of D. magna. Low concentrations of BDE-47 (9.2 μg/L) and BDE-99 (5.4 μg/L) had no effect on the feeding behavior of D. magna; nevertheless, the feeding depression was strengthened, and a concentration-dependent effect was observed with increasing concentrations of BDE-47 and BDE-99. The results of RSM indicated that the mixture of BDE-47 and BDE-99 can enhance their toxicity on the feeding behavior of D. magna. Moreover, real-time PCR (qPCR) analysis showed that the down-regulation of α-amylase (AMS) appeared in most of the exposed D. magna. However, there were significant different in the gene expression of trypsin, superoxide dismutase (SOD) and catalase (CAT) between the exposure and control groups. The change in the enzyme activity of AMS, trypsin, SOD and CAT implied that BDE-47 and BDE-99 cause damage to the digestive and antioxidative systems of D. magna. Correlation analysis indicated that a significant positive correlation existed between the gene expression and enzyme activity of SOD and CAT. Our results contribute to the understanding of toxicity caused by BDE-47/BDE-99 compound pollution in D. magna and help to improve traditional toxicity assessment methods for aquatic environments.

REVIEW OF MEDICINAL USES, PHYTOCHEMISTRY, AND PHARMACOLOGICAL PROPERTIES OF DRIMIA ELATA

Drimia elata is an important and well-known medicinal plant in tropical Africa. This study critically reviewed the medicinal applications, phytochemistry, and pharmacological activities of D. elata. Literature on medicinal applications, phytochemical, and pharmacological activities of D. elata was collected from multiple internet sources including Elsevier, Google Scholar, SciFinder, Web of Science, PubMed, BMC, ScienceDirect, and Scopus. Complementary information was gathered from pre-electronic sources such as books, book chapters, theses, scientific reports, and journal articles obtained from the university library. This study showed that D. elata is used for treating several medical conditions, particularly general ailments, blood and cardiovascular system, reproductive system and sexual health, urinary system, infections and infestations, digestive system, respiratory system, and muscular-skeletal system disorders. Phytochemical compounds identified from the species include bufadienolides, alkaloids, aromatic acids, flavonoids, phlobatannins, saponins, steroids, tannins, and terpenoids. Ethnopharmacological research revealed that D. elata extracts have acetylcholinesterase enzyme inhibitory, antibacterial, antifungal, antimycobaceterial, anticancer, anti-inflammatory, antioxidant, hemagglutinating, and cytotoxicity activities. D. elata should be subjected to extensive in vivo experiments and also future studies should focus on how potential toxic components of the species can be managed when it is used as herbal medicine.

Post-infectious Irritable Bowel Syndrome: A Narrative Review.

The Irritable bowel syndrome (IBS) is a functional disorder of alimentary system, which may be caused by infectious gastroenteritis determined as post infectious irritable bowel syndrome (PI-IBS). The prevalence of PI-IBS is reported to be 4-36% in patients with infectious gastroenteritis. The exact mechanism leading to PI-IBS is not fully understood and some factors pertaining to infectious agent and host response may have a role. Rome IV diagnostic criteria provided new definition for PI-IBS. Though it is now considered a well-defined functional disorder of gastrointestinal system, no specific treatment is yet available for PI-IBS. This article reviews the latest issues on these heading about PI-IBS.

Treating drug-resistant irritable bowel syndrome with hypnosis: A case report

Irritable Bowel Syndrome (IBS) is a functional disorder of gastrointestinal system, characterized by abdominal pain, bowel habit change, bloating and etc. Pharmacological treatments usually have limited effect on IBS. IBShas high comorbidity with mood and anxiety disorders which are seems related to bowel symptoms . Treatment choices for managing IBS are pharmacological, dietary, lifestyle change, physical activity and psychotherapy. Effectiveness of psychotherapeutic procedures for IBS was demonstrated before. In this case report, patient with resistant IBS, gone under hypnotherapy and this trial serves as little contribution to the evidence base for the treatment of IBS by applying psychological approach.

Validity of guided inquiry-based modules on digestive system to improve argumentation skill

Students tend to be passive in learning activities if the media is less supportive. Module development as a learning medium can overcome the passivity of students. The purpose of this research was to determine the validity and feasibility of the guided inquiry-based module on Human Digestive System materials to improve students' argumentation skill. This research is Research and Development. The research was conducted at class VIII of State Junior High School 3 of Surakarta. The module comprised of into three parts, namely the introduction, content, and closing. The contents section consisted of three sub-materials, namely: 1) food substances; 2) food digestion organs and processes; and 3) food digestive system disorders. The module feasibility was tested through the assessments of media, subject matter, learning experts and linguists. The results of experts’ evaluation toward the module showed that the module was feasible with the percentages were 88.28% (media design), 90.125% (material), 91.15% (learning aspect), and 94.8% (language). Therefore, the module is feasible to be used as a learning medium to improve students' argumentation skill.

General hospital admission rates in people diagnosed with personality disorder.

To determine the frequency of all-cause general hospital admissions for individuals with personality disorder (PD) in a large clinical population using linked secondary mental healthcare and hospitalisation data. A retrospective cohort study, using anonymised electronic mental health records from South London and Maudsley NHS Foundation Trust (SLaM), linked to Hospital Episodes Statistics in England. People with PD aged 15years or older, receiving care within SLaM between April 2007 and March 2013, were identified and compared to residents from the local catchment area. Standardised admission ratios (SARs) were calculated for all major categories of causes of general hospital admission for this defined group, with local residents in 2011 UK Census as the standard population. For the 7677 people identified with PD, SAR for all causes of admission was 2.75 (95% CI: 2.70, 2.81). Both men and women with PD had increased SARs across multiple ICD-10 categories, including circulatory, respiratory, digestive, nervous, and musculoskeletal system disorders and endocrine, blood and infectious disorders. Sensitivity analysis (removing the impact of repeated admissions by same individual for same diagnosis in the same year) yielded similar findings. By comparison with members of the general population, individuals with a diagnosis of personality disorder are at significantly higher risk of hospital admission resulting from a wide range of physical health problems.

Clinical and morphological studies of reactions of oral mucosa patients with digestive system disorders

Impaired functioning of various body systems have a significant effect on the morphofunctional state of the oral organs and, in particular, the periodontal complex. This effect is primarily due to significant metabolic disorders, systemic or local hemodynamic disorders, changes in the neurohumoral regulation of the immunological status. Among the diseases that have a direct impact on the state of periodontal disease, the leading position is occupied by lesions of the digestive system. In patients with gastric ulcer and duodenal ulcer, chronic gastritis and chronic cholecystitis, a high susceptibility of the teeth, periodontal and oral mucosa was detected. The dependence of the growth of pathological processes in the periodontium on the age of patients with various diseases of the gastrointestinal tract. According to a survey of patients with diseases of the gastrointestinal tract, 96 % needed treatment for dental and periodontal diseases, 51.1 % of removable and 62.8 % of bridges were considered unfit for use, 77.6-85.3 % of patients needed orthopedic dental care, of which 35.6 % had no dentures. In the study of proliferative processes of the oral mucosa of persons using removable prostheses in the pathology of the gastrointestinal tract, the prevalence of the average index of labeled nuclei, the label index, mitotic index and pathological mitoses in women was established, which indicates a more intensive regeneration process in them, in comparison with men, and is connected, apparently, with the sexual demorphism of the studied tissues.

Qualitative and quantitative ethnobotanical study of the Pangkhua community in Bilaichari Upazilla, Rangamati District, Bangladesh

BackgroundThe present study documents the ethnomedicinal knowledge among the traditional healers of the Pangkhua indigenous community of Bangladesh. The documented data from this area was quantitatively analyzed for the first time. We aimed to record ethnomedicinal information from both the traditional healers and also the elderly men and women of the community, in order to compile and document all available information concerning plant use and preserve it for the coming generations. We aimed to compare how already known species are used compared to elsewhere and particularly to highlight new ethnomedicinal plant species alongside their therapeutic use(s).MethodsAll ethnomedicinal information was collected following established techniques. Open-ended and semi-structured techniques were primarily utilized. Data was analyzed using different quantitative indices. The level of homogeneity between information provided by different informants was calculated using the Informant Consensus Factor. All recorded plant species are presented in tabular format, alongside corresponding ethnomedicinal usage information.ResultsThis investigation revealed the traditional use of 117 plant species, distributed among 104 genera and belonging to 54 families. There was strong agreement among the informants regarding ethnomedicinal uses of plants, with Factor of Informant Consensus (FIC) values ranging from 0.50 to 0.66, with the highest number of species (49) being used for the treatment of digestive system disorders (FIC 0.66). In contrast, the least agreement (FIC = 0.50) between informants regarding therapeutic uses was observed for plants used to treat urinary disorders. The present study was compared with 43 prior ethnomedicinal studies, conducted both nationally and in neighboring countries, and the results revealed that the Jaccard index (JI) ranged from 1.65 to 33.00. The highest degree of similarity (33.00) was found with another study conducted in Bangladesh, while the lowest degree of similarity (1.65) was found with a study conducted in Pakistan. This study recorded 12 new ethnomedicinal plant species, of which 6 have never been studied pharmacologically to date.ConclusionsThis study showed that the Pangkhua community still depends substantially on ethnomedicinal plants for the treatment of various ailments and diseases and that several of these plants are used in novel ways or represented their first instances of use for medicinal applications.

Systems Pharmacology Dissection of Multi-Scale Mechanisms of Action of Huo-Xiang-Zheng-Qi Formula for the Treatment of Gastrointestinal Diseases

Multi-components Traditional Chinese Medicine (TCM) treats various complex diseases (multi-etiologies and multi-symptoms) via herbs interactions to exert curative efficacy with less adverse effects. However, the ancient Chinese compatibility theory of herbs formula still remains ambiguous. Presently, this combination principle is dissected through a systems pharmacology study on the mechanism of action of a representative TCM formula, Huo-xiang-zheng-qi (HXZQ) prescription, on the treatment of functional dyspepsia (FD), a chronic or recurrent clinical disorder of digestive system, as typical gastrointestinal (GI) diseases which burden human physical and mental health heavily and widely. In approach, a systems pharmacology platform which incorporates the pharmacokinetic and pharmaco-dynamics evaluation, target fishing and network pharmacological analyses is employed. As a result, 132 chemicals and 48 proteins are identified as active compounds and FD-related targets, and the mechanism of HXZQ formula for the treatment of GI diseases is based on its three function modules of anti-inflammation, immune protection and gastrointestinal motility regulation mainly through four, i.e., PIK-AKT, JAK-STAT, Toll-like as well as Calcium signaling pathways. In addition, HXZQ formula conforms to the ancient compatibility rule of “Jun-Chen-Zuo-Shi” due to the different, while cooperative roles that herbs possess, specifically, the direct FD curative effects of GHX (serving as Jun drug), the anti-bacterial efficacy and major accompanying symptoms-reliving bioactivities of ZS and BZ (as Chen), the detoxication and ADME regulation capacities of GC (as Shi), as well as the minor symptoms-treating efficacy of the rest 7 herbs (as Zuo). This work not only provides an insight of the therapeutic mechanism of TCMs on treating GI diseases from a multi-scale perspective, but also may offer an efficient way for drug discovery and development from herbal medicine as complementary drugs.

Probiyotikler ve Yara İyileşme Sürecine Etkileri: Anjiyogenez Üzerine Etki Mekanizması

Probiyotikler, gastrointestinal sistem hastalıklarından depresyona kadar çok sayıda hastalık grubunda çalışılmış ve bu hastalıklar üzerinde probiyotiklerin olumlu etkiler gösterebildiği bildirilmiştir. Probiyotiklerin bildirilen olumlu etkilerini, hastalık gelişimi ve tedavi sürecinde canlı mikrobiyotasını zenginleştirerek gerçekleştirdiği düşünülmektedir. Yara iyileşmesi ise birçok farklı mekanizmanın etkisi altında bulunan bir süreçtir. Bakterilerin bu süreçte faydalı etkileri olduğu gibi farklı bakteri türlerine bağlı olarak olumsuz etkileri de olabilmektedir. Son yapılan çalışmalarda bazı probiyotik bakteri türlerinin topikal uygulaması ya da sistemik etkileri ile yara iyileşmesi üzerine etkili olduğu saptanmıştır. Özellikle gastrik ülserler üzerinde yapılan çalışmalarda probiyotik bakterilerin antibiyotikler ile karşılaştırıldığında, antibiyotik direncinin olduğu durumlarda anjiyogenezanjiyogenez üzerinden etki ederek daha etkili sonuçlar gösterdiği belirtilmiştir. Probiyotiklerin etki mekanizmaları ve hangi bakteri türlerinin etkin olduğuna dair daha fazla çalışma yapılması gerekmektedir.

Systemic comorbidities associated with rosacea: a multicentric retrospective observational study.

Once considered a disorder limited to the skin, rosacea is now known to be associated with systemic disorders. The aim of this study was to determine what systemic comorbidities accompany rosacea and to determine the relationship between the type, severity, and duration of rosacea, and the presence of and type of systemic comorbidities. This retrospective multicenter study was conducted by the Turkish Society of Dermatology Acne Study Group. Thirteen dermatology clinics throughout Turkey participated in the study. A structured physician-administered questionnaire was used to collect patient demographics, clinical findings, and lifestyle data. The principal rosacea subtype, physician global assessment of severity, and duration of rosacea were recorded. Physicians recorded each participant's medical history, including current and past comorbidities, duration of any such comorbidity, and the use of medications to treat any comorbidities. The study included 1,195 rosacea patients and 621 controls without rosacea aged 18-85years. As compared to the controls, more of the rosacea patients had respiratory tract, gastrointestinal system, and metabolic and hepatobiliary system disorders in a rosacea's severity- and duration-dependent manner. Clinicians must be aware of the potential for systemic comorbidities in rosacea patients, which becomes more likely as disease duration and severity increase.

Upper Gastrointestinal Endoscopy: Basic Upper Endoscopy

Since the beginning of the 1970s, flexible endoscopy of the gastrointestinal tract has been the dominant modality for the diagnosis of gastrointestinal disease. Over the same period, developments in technology and methodology have made possible the use of endos-copy to treat a host of conditions that once were considered to be manageable only by means of surgical intervention. The concept of performing endoscopic surgery has become a reality with the advancement of endoscopic therapies to control hemorrhage and perform mucosal ablations, resections, and tissue approximation. In addition, investigation into intra-abdominal interventions has begun with the progression of natural orifice transluminal endoscopic surgery (NOTES). The tools created for both intraluminal and transluminal procedures will allow the endoscopist to continue to supplant surgical therapies for numerous gastrointestinal diseases. The integration of flexible endoscopic techniques into the armamentarium of the gastrointestinal surgeon permits a more multidi-mensional approach to the treatment of digestive system disorders. The modern surgeon must continue to stay abreast of these en-doscopic advances to provide appropriate patient care. This review contains 12 figures, 2 tables, and 21 references. Key words: optical biopsy, chromoendoscopy, over the scope clips, endoscopic suturing techniques

Metabolomics Research Reveals the Mechanism of Action of Astragalus Polysaccharide in Rats with Digestive System Disorders.

With the diversity of modern dietary lifestyles, digestive system disorders (DSD) have become a frequently occurring disease in recent years. Astragalus polysaccharide (APS) is a homogeneous polysaccharide extracted from Astragalus, which might ameliorate the digestive and absorptive functions. However, the treatment mechanisms remain unclear. In this study, rats with DSD were fed a high-fat–low-protein diet and subjected to weight-bearing swimming until exhaustion. When body weight and autonomous activities of the rats decreased, they were administered APS. After two weeks, serum metabolomics analysis based on LC-MS was performed to validate the therapeutic effect of APS and explore its mechanism. APS pharmacodynamics was determined in this study, and serum metabolomics analysis discovered and identified 16 significant, differentially produced metabolites involved in energy, amino acid, and lipid metabolism, including citric acid, lactic acid, alanine, phosphatidylcholine, phenylalanine. After treatment with APS, the levels of the above small-molecule metabolites were reversed. Our results show the efficacy of APS in DSD treatment through the regulation of perturbed metabolic pathways related to energy, amino acid, and lipid metabolism.

Serious Adverse Events Reported with Dietary Supplement Use in the United States: A 2.5 Year Experience

Dietary supplement marketers assure the safety of their products by complying with current good manufacturing practices and a host of federal regulations, including those enforced by the Food and Drug Administration (FDA). Post-market surveillance is a key part of identifying safety problems associated with dietary supplement products. FDA requires dietary supplement marketers to provide a domestic address or phone number on product labels for consumers, family members, or health care professionals to report adverse events (AEs) associated with product use and to report all serious adverse events (SAEs) to the agency within 15 business days of receipt. We aimed to evaluate the characteristics of AEs reported with dietary supplement use, including dietary supplement type and Medical Dictionary for Regulatory Activities (MedDRA) system organ class (SOC) that occur with reported SAEs. A total of 41,121 unique adverse event cases reported to two large, U.S.-based dietary supplement marketers in a 2.5-year period (March 1, 2014–August 31, 2016) were assessed for seriousness using established criteria. Each SAE was assigned one or more MedDRA preferred terms and system organ classes (SOC). The types of supplements most responsible for SAEs were assessed. Of the 41,121 AE cases reported, 203 (0.48%) were SAEs. SAEs tended to occur with products marketed for weight loss (69.0%) and glycemic control (19.2%). SAEs occurred most commonly in the cardiovascular, gastrointestinal, and nervous system disorder SOCs. The percentage of SAEs reported to dietary supplement marketers is low, predominantly among consumers of two types of supplements. Further study is needed among a larger cohort of supplement users to determine causal associations between types of supplement products and serious adverse events.