Integrated Treatment Research Articles

Apraxia: From Neuroanatomical Pathways to Clinical Manifestations.

Apraxia typically involves impairments in gesture production and tool use, affecting daily life activities. This article reviews current conceptualizations and developments in diagnostic and therapy. Apraxia has been studied in various neurological conditions, particularly stroke and dementia, but recent studies show gesturing deficits in psychiatric populations as well. Promising results have emerged from integrative treatment approaches involving intensive practice of gestures or daily activities. However, several reviews have noted the only marginal progress in apraxia therapy research despite new technologies, like virtual reality and brain stimulation, offering fresh opportunities for assessment and therapy. Advances in lesion-symptom mapping and connectivity analyses led to more detailed neuroanatomical models emphasizing parallel and gradual processing. These models facilitate the understanding of underlying mechanisms of motor cognitive performance and its decline. Finally, the digital era prompts the need to study digital tool use in apraxia, with initial efforts underway.

Recovery Horizons: Nature-Based Activities as Adjunctive Treatments for Co-Occurring Post-Traumatic Stress Disorder and Substance Use Disorders

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) frequently co-occur, and individuals with co-occurring PTSD and SUD often experience more complex treatment challenges and poorer outcomes compared to those with either condition alone. Integrative treatment approaches that simultaneously address both PTSD and SUD are considered the most effective and include both pharmacological and non-pharmacological strategies. In recent years, complementary interventions have garnered increased attention due to their broad appeal and potential therapeutic benefits in enhancing existing treatments for PTSD and SUD. This review explores the existing literature on the use of nature-based activities, such as hiking, camping, sailing, and surfing in treating individuals with co-occurring PTSD and SUD. Nature-based activities offer promising adjunctive benefits, including the reduction of PTSD symptoms and craving levels. While evidence supports the therapeutic value of nature-based activities, current research remains limited. Further research is needed to better understand their therapeutic role and to refine their implementation in clinical practice.

Treatment uptake among notified cases of hepatitis C virus infection in Norway, 1990 to 2022: a registry-based study to monitor progress towards elimination.

BackgroundHepatitis C virus (HCV) infection is targeted for elimination as a public health threat by 2030. The World Health Organization goal for treatment uptake is ≥ 80% among cases diagnosed with an active HCV infection (RNA- or core antigen-positive), maintained for 2 years.AimTo calculate treatment uptake, time from diagnosis to treatment start and complete treatment dispensation among notified cases of HCV infection in Norway.MethodWe linked national data on notified cases diagnosed from 1990-2022 to dispensed prescriptions for HCV treatment from January 2004-February 2023 and data on residence status at the end of 2022. We described treatment uptake by demographic and epidemiological characteristics. We calculated the median number of months from diagnosis to treatment start by year. For direct-acting antiviral treatment periods, complete dispensation was based on the treatment and number of defined daily doses.ResultsAmong 12,178 notified cases that had an active infection at diagnosis and were still resident, 10,091 (83%) had received treatment. Uptake among resident cases was > 80% in 2021 and 2022. The median number of months from diagnosis to treatment decreased over time to 3 (interquartile range: 1-5) among cases diagnosed in 2021 and 2022. From 2015-22, 89-93% of direct-acting antiviral treatment periods annually had complete treatment dispensed.ConclusionNorway has achieved the elimination goal for treatment uptake among notified cases diagnosed with an active HCV infection. This highlights the benefit of a strategy that includes unrestricted, simplified and integrated treatment options.

PANoptosis: A new era for anti-cancer strategies.

Cancer cells possess an extraordinary ability to dodge cell death through various pathways, granting them a form of immortality-a key obstacle in oncotherapy. Thus, it's vital to unravel the intricate mechanisms behind newly discovered types of cell death that drive tumor suppression, going beyond apoptosis alone. The emergence of PANoptosis, a form of cell death intertwining necroptosis, pyroptosis, and apoptosis, offers a fresh perspective, integrating these pathways into one cohesive process. When cells detect damage signals, they assemble PANoptosome complexes that disrupt their balance, trigger immune responses, and lead to their eventual collapse. PANoptosis has been associated with multiple cellular pathways, including ferroptosis. Mitochondrial dysfunction also plays a critical role in sparking and advancing PANoptosis. In this review, we map out the molecular machinery and regulatory web controlling PANoptosis. We explore cutting-edge research and future trends in PANoptosis-centered tumor therapies, spotlighting promising innovations that could amplify cancer treatment effectiveness through harnessing this multifaceted cell death pathway. The development of nanomedicines and nanomaterials provides solutions to the therapeutic challenges of clinical drugs. Developing novel tumor nano-PANoptosis inducers by leveraging the advantages of nanomedicine is of research value. Traditional Chinese medicine (TCM) treatment is characterized by multiple targets, and it has distinct advantages in triggering PANoptosis through multiple pathways. Additionally, photodynamic Therapy (PDT) may offer new insights into promoting PANoptosis in tumor cells by increasing oxidative stress and reactive oxygen species levels. These will establish a solid theoretical groundwork for the development of integrated treatment methodologies.

Bufadienolides from Helleborus foetidus and their cytotoxic properties on MCF-7 breast cancer cells.

Twelve bufadienolides and six 19-norbufadienolides were isolated from the aerial parts of Helleborus foetidus. They consist of aglycons and glucosides and include nine previously undescribed compounds and a compound reported for the first time as a genuine natural product. Their structures were established by extensive spectroscopic analysis and the structure and absolute configuration of two previously unreported 3,4-epoxy derivatives were confirmed by single crystal X-ray diffraction analysis. The compounds were tested for their cytotoxicity on MCF-7 human breast cancer cells. They show differential cytotoxic activity with IC50 values in the range of 2.4 nM - >10 μM. The potency of the activity strongly correlates with the presence of a C-19 aldehyde group. The data complement the scientific basis underpinning the use of H. foetidus in anthroposophic medicine for the integrative treatment of cancer.

Current Status and Progress in Integrative Treatment of Acute Ischemic Cerebrovascular Disease

Acute ischemic cerebrovascular disease (AICD) poses a severe threat to human health, characterized by high incidence and disability rates. Western medicine currently offers multiple treatment methods, such as thrombolysis, anticoagulation, and cerebral circulation improvement, while traditional Chinese medicine demonstrates unique advantages in herbal prescriptions, proprietary Chinese medicines, acupuncture, and massage therapies. Integrative treatment approaches combining Chinese and Western medicine have become widespread in clinical practice, yet challenges remain in optimizing specific treatment plans and elucidating mechanisms of action. This paper aims to comprehensively analyze the current status of integrative treatment for AICD, outline its developmental trajectory, and provide insights for enhancing treatment efficacy.

Immediate effect of sunlight exposure through blue glass on blood pressure in hypertensive patients: a randomized controlled trial.

Hypertension affects approximately 1.28 billion adults worldwide, driving the search for integrative therapeutic approaches alongside conventional treatments. While chromotherapy, particularly blue light exposure, has historical roots in traditional medicine and its specific impact on blood pressure regulation remains understudied. So, the present study aims to investigate the immediate impact of exposure to blue glass through sunlight on blood pressure in hypertensive individuals. This randomized controlled trial was carried out with a sample of 60 hypertensive patients, who were divided into two groups: a study group that received blue glass exposure for 20 min and a control group that received exposure to colourless glass. The primary outcome measures were systolic and diastolic blood pressure, pulse rate, and oxygen saturation levels. The results of the study revealed statistically significant differences in systolic blood pressure (p=0.006) and pulse rate (p=0.005) after the intervention in the study group and no such changes were noted in the control group. The findings of this study suggest that blue glass exposure has a significant impact on reducing blood pressure and pulse rate in hypertensive patients, indicating its potential use as a integrative treatment in the management of hypertension.

Obsessive-compulsive disorder, major depressive disorder, and addiction: the vicious relationship.

Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are prevalent psychiatric conditions, each affecting a substantial portion of the global population. When these conditions coexist with a Substance Use Disorder (SUD), the complexity of the clinical presentation is heightened. Herein, we describe two cases of individuals who have comorbid OCD and/or MDD and substance use disorder that highlight the importance of addressing the coexisting psychiatric illness when treating the SUD. These cases highlight the importance of tailored, multidisciplinary care, offering a potential therapeutic strategy based on medications for comprehensive recovery in individuals facing complex comorbid disorders. An integrated treatment approach, encompassing both psychiatric and substance treatment perspectives, is imperative.

Prevalence of restless genital syndrome and its impact on quality of life in women with restless legs syndrome

ABSTRACT Background Restless genital syndrome (RGS), also known as persistent genital arousal disorder, is a distressing condition characterized by unwanted genital arousal in the absence of sexual desire. This study explores the prevalence of RGS in women with restless legs syndrome (RLS), investigates the associated psychological impacts, and assesses the overall effect on quality of life. Methods This retrospective study included 69 female patients who were diagnosed with RLS at two university medical centers. Data were collected via the RGS diagnostic form, Beck Depression Inventory, Beck Anxiety Inventory, and WHOQOL-BREF quality of life scale. Statistical analyses were used to assess the correlation between RGS and psychological health measures. Results Approximately 44.9% of the participants with RLS also reported symptoms of RGS. Significant findings included increased nighttime and rest-related exacerbation of RGS symptoms. Compared with those without RGS, participants with RGS presented significantly higher anxiety and depression scores. Moreover, RGS significantly impacted physical health and social relationships, as indicated by lower WHOQOL-BREF scores. Conclusion This study highlights a significant overlap between RGS and RLS, with substantial impacts on psychological well-being and quality of life. These findings underscore the importance of considering RGS in the clinical management of RLS, suggesting a need for integrated treatment strategies to address both the neurological and the psychological aspects of these conditions.

Period integrals of smooth projective complete intersections as exponential periods

Let X be a smooth projective complete intersection over Q of dimension n−k in the projective space PQn defined by the zero locus of f_(x_)=(f1(x_),⋯,fk(x_)), for given positive integers n and k. For a given primitive homology cycle [γ]∈Hn−k(X(C),Z)0, the period integral is defined to be a linear map from the primitive de Rham cohomology group HdR,primn−k(X(C);Q) to C given by [ω]↦∫γω. The goal of this article is to interpret this period integral as Feynman's path integral of 0-dimensional quantum field theory with the action functional S=∑ℓ=1kyℓfℓ(x_) (in other words, the exponential period with the action functional S) and use this interpretation to develop a formal deformation theory of period integrals of X, which can be viewed as a modern deformation theoretic treatment of the period integrals based on the Maurer-Cartan equation of a dgla (differential graded Lie algebra).

Effects of chiropractic manipulations on behavioral and physiological parameters in healthy horses: A preliminary investigation

Human chiropractic is a well-established, evidence-based complementary medicine. Contrariwise, there is a lack of research on its impact on horses. This study aimed to evaluate the effects of chiropractic treatment on healthy horses by measuring behavior, maximum temperature of the eyes (MaxTE), salivary cortisol (SC), and heart rate variability (HRV). Eight mares were selected and exposed to a 15-day habituation period. Then, they were randomly assigned to a grooming (GROOM) or chiropractic (CHIRO) session, performed by the same qualified chiropractor. The experiment was designed as a cross-over study and repeated after a 10-day washout (i.e., Week 1 and Week 2). During-CHIRO, the chiropractor treated and recorded joint hypomobility. During-GROOM, the mares were subjected to a standardized grooming session. MaxTE and SC were obtained before (T0), immediately after (T1), and one day after (T24) both sessions. In addition, before (Pre), during (During), and after (Post) both sessions, the mares were video recorded, and heart rate for HRV analysis was taken. Videos were analyzed using a specific ethogram and a Behavioral Discomfort Score (BDS) was obtained. Results showed that the mares manifested temporary signs of discomfort During-CHIRO, highlighted by an increase of ‘avoidance movements’ (p < 0.001) and ‘alert’ (p = 0.038). This was confirmed by an increase in BDS During-CHIRO (p = 0.044). No sympathetic shift was shown by MaxTE, SC, and HRV. A significant increase in the standard deviation of RR intervals (SDNN) suggested a parasympathetic shift in Post-CHIRO (p = 0.040). Joint hypomobility tended to decrease between the first and second CHIRO (p = 0.09). Our results showed that equine chiropractic could be performed by a qualified veterinary chiropractor, leading to transient discomfort behavior, not accompanied by acute stress response. On the contrary, there seems to be a subsequent relaxation, demonstrated by an autonomic nervous system shift toward the parasympathetic branch. Consequently, chiropractic manipulation could be considered as an integrative treatment to improve the horses’ welfare.

Embracing complexity in psychiatry-from reductionistic to systems approaches.

The understanding and treatment of psychiatric disorders present unique challenges due to these conditions' multifaceted nature, comprising dynamic interactions between biological, psychological, social, and environmental factors. Traditional reductionistic approaches often simplify these conditions into linear cause-and-effect relationships, overlooking the complexity and interconnectedness inherent in psychiatric disorders. Advances in complex systems approaches provide a comprehensive framework to capture and quantify the non-linear and emergent properties of psychiatric disorders. This Personal View emphasises the importance of identifying rules for generative models that govern brain and behaviour over time, which might contribute to personalised assessments and interventions for psychiatric disorders. For instance, mood fluctuations in bipolar disorder can be understood through dynamical systems modelling, which identifies modifiable parameters, such as circadian disruption, that can be addressed through targeted therapies such as light therapy. Similarly, recognition of depression as an emergent property arising from complex interactions highlights the need for integrated treatment strategies that enhance adaptive reactions in the individual. A framework for quantifying multilevel interactions and network dynamics can help researchers and clinicians to understand the interplay between neural circuits, behaviours, and social contexts. Probabilistic models and self-organisation concepts contribute to building concrete dynamical systems models of mental disorders, facilitating early identification of risk states and promoting resilience through adaptive interventions delivered with optimal timing. Embracing these complex systems approaches in psychiatry could capture the true nature of psychiatric disorders as properties of a dynamic complex system and not the manifestation of any lesion or insult. This line of thinking might improve diagnosis and treatment, offering new hope for individuals affected by psychiatric conditions and paving the way for more effective, personalised mental health care.

Alternative therapy for lymphoma with febrile neutropenia using traditional Chinese medicine: A case report

IntroductionFebrile neutropenia is a common complication in patients undergoing chemotherapy for hematologic malignancies and is associated with significant morbidity and mortality. Primary granulocyte colony-stimulating factor (G-CSF) prophylaxis is consistently associated with a notable reduction in the risk of febrile neutropenia. However, the use of G-CSF in patients who are already neutropenic from chemotherapy remains controversial. Studies have shown that 12.9% of cancer patients incorporate traditional Chinese medicine (TCM) to alleviate chemotherapy side effects in Taiwan; thereby providing an alternative management strategy for neutropenic fever in cancer patients. Case presentationThis is an 18-year-old female with newly diagnosed precursor T-lymphoblastic lymphoma. After chemotherapy, the patient developed febrile neutropenia. Despite the use of antibiotics and G-CSF, the febrile neutropenia persisted for two months. Approximately ten days after the initiation of traditional Chinese medicine decoction with the strategy of tonifying the spleen and stomach, clearing yin fire, and uplifting yang, her absolute neutrophil count (ANC) had gradually increased. Additionally, after two weeks of treatment, her fever subsided. The patient continued with chemotherapy and was discharged in stable condition. DiscussionAntibiotic use aligns with the TCM perspective of an “attack” approach. Conversely, our TCM decoction was designed to raise the ANC by tonifying the spleen and stomach, clearing Yin Fire, and uplifting Yang. Li Dongyuan, one of the four great masters of the Jin Yuan Dynasty, created the formula: Bupiwei Shengyang Sanhuo Decoction that is notable in this regard. The herbs in our decoction have shown hematopoietic and myelosuppression-alleviating effect. For many patients who do not respond adequately to G-CSF alone, integrative treatments involving both TCM and Western medicine can offer additional therapeutic benefits by increasing blood cell counts.

Characterization of Sulfur Oxidizing Bacteria and Their Effect on Growth Promotion of Brassica napus L.

Oil seeds sector is one of the major dynamic components of the agriculture world. Oil seeds such as canola (Brassica napus) require a higher quantity of sulfur (S), which is supplied through inorganic fertilizers. However, the overapplication of agro-chemicals to get higher yields of crops is harming the soil health. Therefore, the application of bacterial cultures with plant growth-promoting activity as biofertilizers ensures soil health maintenance and enhances crop productivity. To achieve this aim, the present research was initiated by procuring three sulfur-oxidizing bacteria (SOBs), namely, SOB 5, SOB 10, and SOB 38, from the Microbiology Department, PAU. In the initial assessment, all three SOB cultures showed resilience to pesticide toxicity at the recommended dosage, with the exception of ridomil. These cultures were later characterized morphologically, biochemically, and at the molecular level using 16s rRNA resulting in their identification as Enterobacter ludwigii strain Remi_9 (SOB 5), Enterobacter hormaechei strain AUH-ENM30 (SOB 10), and Bacillus sp. 5BM21Y12 (SOB 38). Functional characterization of these SOB cultures revealed their ability to exhibit multifarious plant growth-promoting traits. Bacillus sp. 5BM21Y12 showed greater functional activity, including high P solubilization (14.903 µg/mL), IAA production (44.28 µg/mL), siderophore production (13.89 µg/mL), sulfate ion production (0.127 mM), ammonia excretion (2.369 µg/mL), and Zn solubilization (22.62 mm). Based on the results of functional and molecular characterization, Bacillus sp. 5BM21Y12 was selected for field trials by formulating different treatments. Composite treatment, T8 (100% S + Bacillus sp. + pesticides) significantly enhanced growth parameters (plant height, root, and shoot biomass), yield attributes (siliqua length, test weight, number of siliqua/plant), yield parameter (total biomass and seed yield), quality parameter (crude protein and oil) as compared to all other sole treatments employed in the field. A combined application of non-pathogenic Bacillus sp. 5BM21Y12, with good functional activity enhanced yield of crop due to synergistic and additive interaction with fertilizer/pesticides. As biofertilizer application reduces the input of pesticides/fertilizers new inoculant formulations with cell protectors and the development of compatible pesticides should be searched to assure the benefits of integrated treatment.

Family therapy and EMDR after child abuse and neglect: moderating effects of child attachment style and PTSD symptoms on treatment outcome

ABSTRACT Background: Effective and appropriate care and treatment for children in order to decrease the psychosocial problems that arose after experiencing child abuse and neglect (CAN) is of vital importance, given the severity of symptomatology that may develop. Objective: The purpose of the present study was to examine whether attachment style and core cluster Posttraumatic Stress Disorder symptoms acted as moderators for treatment outcomes of a new integrative treatment model for trauma and attachment. In this treatment model, family therapy is combined with EMDR and obstacles for trauma processing are tackled first. Method: we included children, ages 6–12 years, with a history of CAN, who did not respond to evidence-based trauma treatment. Target treatment outcomes were problems in attachment, posttraumatic stress symptoms, behaviour, and emotion regulation. We conducted a multiple-baseline ABC Single-Case Experimental Design (SCED). We categorized 12 participants into four groups of attachment style and core cluster PTSD symptoms: (1) non-disorganized & re-experiencing; (2) non-disorganized & avoidance/hyperarousal; (3) disorganized & re-experiencing; & (4) disorganized & avoidance/hyperarousal. We compared the four groups with each other and across time, and the interaction between groups and effect over time. We conducted non-parametric permutation tests and estimated q-values for false discovery rate control. Results: Children with a disorganized attachment style had more severe symptomatology in general, except for posttraumatic stress symptoms. The treatment appeared more effective in targeting and successfully treating children with a non-disorganized attachment style, and specifically children with a non-disorganized attachment style and re-experiencing as core cluster PTSD symptoms. Conclusion: Our study underlines the complexity of treating children who developed a complicated combination of symptomatology after CAN and calls for the continuous development of innovative interventions.

Role of Chikitsa Sutrani to Formulation a Treatment Protocol

The "Role of Chikitsa Sutras in Formulating Treatment Protocols" bridges ancient Ayurvedic wisdom with modern medical practices. Ayurvedic Samhitas, foundational texts, offer therapeutic principles in Chikitsa Sutras. This abstract explores the integration of these guidelines into contemporary protocols, aiming to enhance therapeutic efficacy, optimize patient outcomes, and foster a holistic healthcare approach. MATERIALS AND METHODS: This study employs a multifaceted approach, drawing insights from Ayurvedic Samhitas and contemporary medical literature. The ancient texts, including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya, are meticulously reviewed to extract Chikitsa Sutras relevant to various ailments. Additionally, modern medical databases are searched for evidence-based treatment protocols corresponding to these conditions. By juxtaposing Ayurvedic principles with modern therapeutic strategies, this study elucidates synergies and disparities, facilitating the formulation of integrated treatment protocols. RESULTS: The combination of Ayurvedic Chikitsa Sutras with modern treatment paradigms yields profound insights and practical implications. Analysis reveals congruencies in fundamental principles such as holistic patient assessment, personalized treatment approaches, and emphasis on preventive healthcare. Ayurvedic guidelines offer nuanced perspectives on disease aetiology, classification, and management, supplementing modern diagnostic and therapeutic modalities. Integration of Ayurvedic principles into treatment protocols enhances therapeutic efficacy, minimizes adverse effects, and promotes patient-centred care. Moreover, the holistic framework of Ayurveda fosters a comprehensive understanding of health and disease, encouraging lifestyle modifications and preventive measures to augment long-term wellness.

Exploring temporal congruence in motor imagery and movement execution in non-specific chronic low back pain

Chronic non-specific low back pain (NSCLBP) is linked to sensorimotor dysfunctions and altered motor planning, likely due to neuroplastic changes. Motor imagery (MI) and movement execution share neural pathways, but the relationship between imagined and executed movements in NSCLBP patients remains underexplored. This study aimed to assess the temporal congruence between imagined and executed movements in NSCLBP sufferers, with secondary goals of investigating group differences in movement chronometry, psychological well-being, and disability, as well as possible correlations among these factors. Fifty-six participants, including 28 NSCLBP patients and 28 asymptomatic subjects (AS), performed lumbar flexion and Timed Up and Go (TUG) tasks. NSCLBP patients showed significant temporal incongruence in both tasks, executing movements more slowly than imagined, whereas AS displayed incongruence only in the TUG task. NSCLBP patients also took longer to imagine and execute lumbar flexion movements compared to AS, with correlations observed between execution delays, higher disability, and greater fear of movement. The findings highlight a lack of temporal congruence in NSCLBP patients, especially in lumbar flexion, emphasizing the complex relationship between chronic pain, motor ability, and psychological factors. These results suggest that integrated treatment approaches addressing cognitive and emotional aspects are crucial for managing NSCLBP.

The interplay between osteoarthritis and osteoporosis: Mechanisms, implications, and treatment considerations – A narrative review

This comprehensive review examines the relationship between osteoarthritis (OA) and osteoporosis (OP), two common disorders in the elderly. OA involves joint cartilage degeneration and pain, while OP leads to fractures due to reduced bone mass. Despite different pathologies, both conditions share risk factors such as age and genetics. Studies reveal mixed results: some show higher bone mineral density (BMD) in OA patients, suggesting an inverse relationship, while others find no significant link. Proposed mechanisms include mechanical loading, bone remodeling, and inflammation. Clinical strategies focus on maintaining bone health in OA and monitoring joint health in OP, with treatments like bisphosphonates and exercise. Understanding these interactions is crucial for developing integrated treatments to improve patient outcomes and quality of life. Further research is needed to clarify these complex mechanisms.

Exploring the link between comorbid insomnia and sleep apnea (COMISA) and erectile dysfunction: implications for male sexual health.

This review explores the interplay between comorbid insomnia and sleep apnea (COMISA) and erectile dysfunction (ED), 2 conditions that significantly impact men's health. COMISA, a recently recognized condition characterized by the coexistence of insomnia and obstructive sleep apnea, has been shown to disrupt sleep architecture and cause intermittent hypoxia. These disturbances are increasingly linked to the exacerbation of ED, a prevalent issue among men. Understanding the connection between COMISA and ED is crucial for developing integrated treatment approaches that address both sleep and sexual health. We aim to explore the epidemiological, physiological, and potential therapeutic intersections of COMISA and ED. This review sets out to develop a better understanding of the relationship between these conditions and to emphasize the need for an integrated diagnostic and therapeutic approach that addresses both sleep and sexual health. Through a comprehensive analysis, including a detailed examination of extant studies, we address the hormonal imbalances and alterations in neural pathways that collectively contribute to the complex pathophysiology of ED and how these are particularly susceptible to the concurrent presence of COMISA. Our analysis indicates that disruptions in sleep architecture and intermittent hypoxia associated with COMISA can exacerbate ED. Hormonal imbalances, endothelial dysfunction, autonomic imbalance, and increased inflammation and oxidative stress are key mechanisms through which COMISA influences ED. These factors collectively impair vascular health, reduce testosterone levels, disrupt neural control of erections, and contribute to the severity of ED. This review underscores the necessity for an integrated approach to diagnosis and therapy that considers both sleep and sexual health to improve overall outcomes. These insights should foster a deeper understanding of the relationship between COMISA and ED, encourage further research in this area, and potentially lead to the development of innovative treatment strategies to manage these closely intertwined health concerns.

Astragalus membranaceus: A Traditional Chinese Medicine with Multifaceted Impacts on Breast Cancer Treatment

Breast cancer, the most prevalent malignant tumor among women globally, remains a critical area of focus for researchers striving to refine therapeutic approaches. As an important component of traditional Chinese medicine, Astragalus membranaceus (AM) has demonstrated potential for multifaceted impacts on breast cancer treatment through various mechanisms. To guide clinical practice and further explore the under-researched field of AM in breast cancer treatment, this paper mainly reviews the regulatory roles of AM-derived compounds and extracts on breast cancer cell proliferation, migration, invasion, and chemoresistance. Furthermore, this study delves into the synergistic effects observed when AM is co-administered with chemotherapeutic agents, including the enhancement of chemosensitivity, mitigation of toxic side effects, and reversal of drug resistance. This review indicates that AM holds promise not only as a therapy in breast cancer treatment but also paves the way for innovative integrated treatment approaches that combine the benefits of traditional medicine with modern pharmaceuticals. Nevertheless, future research endeavors are also urged to elucidate the in vivo pharmacological effects and underlying mechanisms of AM to inform more effective clinical treatment strategies.