DOCSLIB.ORG

(SOGC) Clinical Practice Guideline

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Journal of Obstetrics and Gynaecology Canada The official voice of reproductive health care in Canada Le porte-parole officiel des soins génésiques au Canada Journal d’obstétrique et gynécologie du Canada Volume 36, Number 9 • volume 36, numéro 9 September • septembre 2014 Supplement 2 • supplément 2 Abstract . S1 Chapter 1: Assessment and Risk Management of Menopausal Women . S6 Chapter 2: Cardiovascular Disease . S16 Chapter 3: Menopausal Hormone Therapy and Breast Cancer . S23 Chapter 4: Vasomotor Symptoms . S31 Chapter 5: Urogenital Health . S35 Chapter 6: Managing Prescription Therapeutic Agents . S42 Chapter 7: Menopause Ongoing Management of Menopausal Women and Those With Special Considerations . S51 Chapter 8: Sexuality and Menopause . S59 Chapter 9: Complementary and Alternative Medicine (CAM) . S74 Publications mailing agreement #40026233. Return undeliverable Canadian copies and change of address notifications to SOGC Subscriptions Services, 780 Echo Dr. Ottawa, Ontario K1S 5R7. Editor-in-Chief / Rédacteur en chef Timothy Rowe CPL Editor / Rédactrice PPP Vyta Senikas Translator / Traducteur Martin Pothier Assistant Editor / Rédactrice adjointe Jane Fairbanks Editorial Assistant / Adjointe à la rédaction Daphne Sams Editorial Office / Bureau de la rédaction Journal of Obstetrics and Gynaecology Canada Room D 405A BC Women's Hospital 4500 Oak Street Vancouver BC V6H 3N1 [email protected] Tel: (604) 875-2424 ext. 5668 Fax: (604) 875-2590 http://www.jogc.com The Journal of Obstetrics and Gynaecology Canada (JOGC) is owned by the Society of Obstetricians and Gynaecologists of Canada (SOGC), published by the Canadian Psychiatric Association (CPA), and printed by The Lowe-Martin Group, Ottawa, ON. Le Journal d’obstétrique et gynécologie du Canada (JOGC), qui relève de la Société des obstétriciens et gynécologues du Canada (SOGC), est publié par l’Association des psychiatres du Canada (APC), et imprimé par The Lowe-Martin Group, Ottawa (Ontario). Publications Mail Agreement no. 40026233. Return undeliverable Canadian copies and change of address notices to SOGC, JOGC Subscription Service, 780 Echo Dr., Ottawa ON K1S 5R7. USPS #021-912. USPS periodical postage paid at Champlain, NY, and additional locations. Return other undeliverable copies to International Media Services, 100 Walnut St., #3, PO Box 1518, Champlain NY 12919-1518. Numéro de convention poste-publications 40026233. Retourner toutes les copies canadiennes non livrées et les avis de changement d’adresse à la SOGC, Service de l’abonnement au JOGC, 780, promenade Echo, Ottawa (Ontario), K1S 5R7. Numéro USPS 021-912. Frais postaux USPS au tarif des périodiques payés à Champlain (NY) et autres bureaux de poste. Retourner les autres copies non livrées à International Media Services, 100 Walnut St., #3, PO Box 1518, Champlain (NY) 12919-1518. The cover image was obtained through the: ISSN 1701-2163 Society of Obstetricians and Gynaecologists of Canada (SOGC) SOGC CLINICAL PRACTICE GUIDELINE No. 311, September 2014 (Replaces No. 222, January 2009) Managing Menopause This clinical practice guideline has been prepared by the The literature searches and bibliographic support for this Menopause and Osteoporosis Working Group, reviewed guideline were undertaken by Becky Skidmore, Medical by the Clinical Practice Gynaecology and Family Physician Research Analyst, Society of Obstetricians and Gynaecologists Advisory Committees, and approved by the Executive and of Canada . Council of the Society of Obstetricians and Gynaecologists Acknowledgement: Claudio N . Soares, MD, PhD, Toronto ON of Canada. Disclosure statements have been received from all contributors . PRINCIPAL AUTHORS Robert Reid, MD, Kingston ON Abstract Beth L . Abramson, MD, Toronto ON Jennifer Blake, MD, Toronto ON Objective: To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women Sophie Desindes, MD, Sherbrooke QC as well as in women presenting with vasomotor or urogenital Sylvie Dodin, MD, Quebec QC symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality . Shawna Johnston, MD, Kingston ON Outcomes: Lifestyle interventions, prescription medications, and Timothy Rowe, MB BS, Vancouver BC complementary and alternative therapies are presented according Namrita Sodhi, MD, Toronto ON to their efficacy in the treatment of menopausal symptoms. Counselling and therapeutic strategies for sexuality concerns in Penny Wilks, ND, Dundas ON the peri- and postmenopausal years are reviewed . Approaches Wendy Wolfman, MD, Toronto ON to the identification and evaluation of women at high risk of osteoporosis, along with options for prevention and treatment, are MENOPAUSE AND OSTEOPOROSIS WORKING GROUP presented in the companion osteoporosis guideline . Michel Fortier, MD (Co-Chair), Quebec QC Evidence: Published literature was retrieved through searches of PubMed and The Cochrane Library in August and September Robert Reid, MD (Co-Chair), Kingston ON 2012 with the use of appropriate controlled vocabulary (e .g ., Beth L . Abramson, MD, Toronto ON hormone therapy, menopause, cardiovascular diseases, and sexual function) and key words (e .g ., hormone therapy, Jennifer Blake, MD, Toronto ON perimenopause, heart disease, and sexuality) . Results Sophie Desindes, MD, Sherbrooke QC were restricted to clinical practice guidelines, systematic Sylvie Dodin, MD, Quebec QC reviews, randomized control trials/controlled clinical trials, and observational studies . Results were limited to publication dates Lisa Graves, MD, Toronto ON of 2009 onwards and to material in English or French . Searches Bing Guthrie, MD, Yellowknife NT were updated on a regular basis and incorporated in the guideline until January 5, 2013. Grey (unpublished) literature was identified Aliya Khan, MD, Hamilton ON through searching the websites of health technology assessment Shawna Johnston, MD, Kingston ON and health technology assessment-related agencies, national and international medical specialty societies, and clinical practice Timothy Rowe, MB BS, Vancouver BC guideline collections . Namrita Sodhi, MD, Toronto ON Penny Wilks, ND, Dundas ON Key Words: Menopause, estrogen, vasomotor symptoms, urogenital symptoms, mood, memory, cardiovascular diseases, Wendy Wolfman, MD, Toronto ON breast cancer, lifestyle, nutrition, exercise, estrogen therapy, complementary therapies, progestin, androgen, menopausal hormone therapy, hormones, estrogen, testosterone, menopause, depression, antidepressants, sexuality J Obstet Gynaecol Can 2014;36(9 eSuppl A):S1–S80 This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the SOGC. SEPTEMBER JOGC SEPTEMBRE 2014 l S1 Managing Menopause Values: The quality of the evidence in this document was rated using Recommendations for Health Care Providers the criteria described by the Report of the Canadian Task Force on 1. A waist circumference ≥ 88 cm (35 in) for women is associated Preventive Health Care (Table 1) . with an increased risk of health problems such as diabetes, heart disease, and hypertension and should be part of the initial SUMMARY STATEMENTS AND RECOMMENDATIONS assessment to identify risk . (II-2A) Chapter 1: 2 . Tobacco-use status should be updated for all patients on a regular basis, (I-A) health care providers should clearly advise patients to Assessment and Risk Management quit, (I-C) the willingness of patients to begin treatment to achieve of Menopausal Women abstinence (quitting) should be assessed, (I-C) and every tobacco user who expresses the willingness to begin treatment to quit Recommendations for Patients should be offered assistance . (I-A) 1 . Women aged 51 to 70 should consume 7 servings of vegetables 3 . Blood pressure should be assessed and controlled as women and fruits, 6 of grain products, 3 of milk and alternatives, and 2 of go through menopause . (II-2B) If the systolic blood pressure is meat and alterna tives daily . (III-A) ≥ 140 mmHg and/or the diastolic blood pressure is ≥ 90 mmHg, a specific visit should be scheduled for the assessment of 2 . A diet low in sodium and simple sugars, with substitution of hypertension . (III-A) unsaturated fats for saturated and trans fats, as well as increased consumption of fruits, vegetables, and fibre, is recommended. (I-A) 4. Women ≥ 50 years of age or postmenopausal and those with addi- tional risk factors, such as current cigarette smoking, diabetes, and 3 . Routine vitamin D supplementation and calcium intake for all arterial hypertension, should have lipid-profile screening done. (II-2A) Canadian adults year round is recommended . (I-A) 5 . A cardiovascular risk assessment using the Framingham Risk 4 . Achieving and maintaining a healthy weight throughout life is Score should be completed every 3 to 5 years for women aged recommended . (I-A) 50 to 75 . (II-2A) 5 . Women aged 18 to 64 should accumulate at least 150 minutes of 6 . A history of past pregnancy complications (preeclampsia, moderate to vigorous aerobic physical activity per week in bouts of gestational hypertension, gestational diabetes, placental abruption, 10 minutes or more . (I-A) idiopathic preterm
Recommended publications
  • Dehydroepiandrosterone – Is the Fountain of Youth Drying Out?

    Dehydroepiandrosterone – Is the Fountain of Youth Drying Out?

    Physiol. Res. 52: 397-407, 2003 MINIREVIEW Dehydroepiandrosterone – Is the Fountain of Youth Drying Out? P. CELEC 1,2, L. STÁRKA3 1Faculty of Medicine, 2Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia and 3Institute of Endocrinology, Prague, Czech Republic Received September 15, 2002 Accepted October 7, 2002 Summary Dehydroepiandrosterone (DHEA) and its sulphate-bound form (DHEAS) are important steroids mainly of adrenal origin. Their physiological and pathophysiological functions are not yet fully identified, although a number of various possible features have been hypothesized. Most popular is the description of the “hormone of youth” as the long-term dynamics of DHEA levels are characterized by a sharp age-related decline in the late adulthood and later. Low levels of DHEA are, however, associated not only with the ageing process but also with diabetes mellitus, cardiovascular diseases and some neurological or immunological entities. In the past decade, a number of brief studies have concentrated on these relationships and also on the role of exogenous DHEA in health, disease and human well-being. This article tries to summarize some of the most important facts achieved recently. Key words Dehydroepiandrosterone • Intracrinology • Hormone replacement therapy • Steroids Introduction functions: 1) DHEA is an endogenous metabolite that cannot be patented so that pharmaceutical companies are In 1934 Butenandt and Dannenbaum isolated not interested in supporting research in this field. dehydroepiandrosterone (DHEA) from urine and in 1944 2) DHEA can be described as a “human molecule” Munson and colleagues identified its 3β-sulphate because other investigated species have much lower (DHEAS). Even now, nearly 70 years later, we still do concentrations.
  • Pinoresinol Reductase 1 Impacts Lignin Distribution During Secondary Cell Wall Biosynthesis in Arabidopsis

    Pinoresinol Reductase 1 Impacts Lignin Distribution During Secondary Cell Wall Biosynthesis in Arabidopsis

    Phytochemistry xxx (2014) xxx–xxx Contents lists available at ScienceDirect Phytochemistry journal homepage: www.elsevier.com/locate/phytochem Pinoresinol reductase 1 impacts lignin distribution during secondary cell wall biosynthesis in Arabidopsis Qiao Zhao a, Yining Zeng b,e, Yanbin Yin c, Yunqiao Pu d,e, Lisa A. Jackson a,e, Nancy L. Engle e,f, Madhavi Z. Martin e,f, Timothy J. Tschaplinski e,f, Shi-You Ding b,e, Arthur J. Ragauskas d,e, ⇑ Richard A. Dixon a,e,g, a Plant Biology Division, Samuel Roberts Noble Foundation, 2510 Sam Noble Parkway, Ardmore, OK 73401, USA b Biosciences Center, National Renewable Energy Laboratory, Golden, CO 80401, USA c Department of Biological Sciences, Northern Illinois University, DeKalb, IL 60115, USA d Institute of Paper Science and Technology, Georgia Institute of Technology, Atlanta, GA, USA e BioEnergy Science Center (BESC), Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA f Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA g Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA article info abstract Article history: Pinoresinol reductase (PrR) catalyzes the conversion of the lignan (À)-pinoresinol to (À)-lariciresinol in Available online xxxx Arabidopsis thaliana, where it is encoded by two genes, PrR1 and PrR2, that appear to act redundantly. PrR1 is highly expressed in lignified inflorescence stem tissue, whereas PrR2 expression is barely detect- Keywords: able in stems. Co-expression analysis has indicated that PrR1 is co-expressed with many characterized Lignan genes involved in secondary cell wall biosynthesis, whereas PrR2 expression clusters with a different Lignin set of genes.
  • Nutraceuticals Brian Lockwood

    Nutraceuticals Brian Lockwood

    CjigVXZji^XVah HZXdcYZY^i^dc 7g^VcAdX`lddY 00 Prelim 2/3/07 18:51 Page i Nutraceuticals 00 Prelim 2/3/07 18:51 Page ii 00 Prelim 2/3/07 18:51 Page iii Nutraceuticals A guide for healthcare professionals Second edition Brian Lockwood BPharm, PhD, MRPharmS Senior Lecturer in Pharmacy, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK London • Chicago 00 Prelim 2/3/07 18:51 Page iv Published by the Pharmaceutical Press An imprint of RPS Publishing 1 Lambeth High Street, London SE1 7JN, UK 100 South Atkinson Road, Suite 200, Grayslake, IL 60030–7820, USA © Pharmaceutical Press 2007 is a trade mark of RPS Publishing RPS Publishing is the publishing organisation of the Royal Pharmaceutical Society of Great Britain First edition published 2002 Second edition published 2007 Typeset by Type Study, Scarborough, North Yorkshire Printed in Great Britain by TJ International, Padstow, Cornwall ISBN 978 0 85369 659 9 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the copyright holder. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. The right of Brian Lockwood to be identified as the author of this work has been asserted by him in accordance with sections 77 and 78 and subject to section 79(6) of the Copyright, Designs and Patents Act, 1988.
  • Study Protocol and Statistical Analysis Plan

    Study Protocol and Statistical Analysis Plan

    Confidential Clinical study protocol number: J1228 Page 1 Version Date: May 7, 2018 IRB study Number: NA_00067315 A Trial of maintenance Rituximab with mTor inhibition after High-dose Consolidative Therapy in CD20+, B-cell Lymphomas, Gray Zone Lymphoma, and Hodgkin’s Lymphoma Principal Investigator: Douglas E. Gladstone, MD The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins 1650 Orleans Street, CRBI-287 Baltimore, MD 21287 Phone: 410-955-8781 Fax: 410-614-1005 Email: [email protected] IRB Protocol Number: NA_00067315 Study Number: J1228 IND Number: EXEMPT Novartis Protocol Number: CRAD001NUS157T Version: May 7, 2018 Co-Investigators: Jonathan Powell 1650 Orleans Street, CRBI-443 Phone: 410-502-7887 Fax: 443-287-4653 Email: [email protected] Richard Jones 1650 Orleans Street, CRBI-244 Phone: 410-955-2006 Fax: 410-614-7279 Email: [email protected] Confidential Clinical study protocol number: J1228 Page 2 Version Date: May 7, 2018 IRB study Number: NA_00067315 Satish Shanbhag Johns Hopkins Bayview Medical Center 301 Building, Suite 4500 4940 Eastern Ave Phone: 410-550-4061 Fax: 410-550-5445 Email: [email protected] Statisticians: Gary Rosner Phone: 410-955-4884 Email: [email protected] Marianna Zahurak Phone: 410-955-4219 Email: [email protected] Confidential Clinical study protocol number: J1228 Page 3 Version Date: May 7, 2018 IRB study Number: NA_00067315 Table of contents Table of contents ......................................................................................................................... 3 List of abbreviations
  • Daidzein and Genistein Content of Cereals

    Daidzein and Genistein Content of Cereals

    European Journal of Clinical Nutrition (2002) 56, 961–966 ß 2002 Nature Publishing Group All rights reserved 0954–3007/02 $25.00 www.nature.com/ejcn ORIGINAL COMMUNICATION Daidzein and genistein content of cereals J Liggins1, A Mulligan1,2, S Runswick1 and SA Bingham1,2* 1Medical Research Council Dunn Human Nutrition Unit, Hills Road, Cambridge, UK; and 2European Prospective Investigation of Cancer, University of Cambridge, Cambridge, UK Objective: To analyse 75 cereals and three soy flours commonly eaten in Europe for the phytoestrogens daidzein and genistein. Design: The phytoestrogens daidzein and genistein were extracted from dried foods, and the two isoflavones quantified after hydrolytic removal of any conjugated carbohydrate. Completeness of extraction and any procedural losses of the isoflavones 0 0 were accounted for using synthetic daidzin (7-O-glucosyl-4 -hydroxyisoflavone) and genistin (7-O-glucosyl-4 5-dihydroxyiso- flavone) as internal standards. Setting: Foods from the Cambridge UK area were purchased, prepared for eating, which included cooking if necessary, and freeze dried. Three stock soy flours were also analysed. Results: Eighteen of the foods assayed contained trace or no detectable daidzein or genistein. The soy flours were rich sources, containing 1639 – 2117 mg=kg. The concentration of the two isoflavones in the remaining foods ranged from 33 to 11 873 mg=kg. Conclusion: These analyses will supply useful information to investigators determining the intake of phytoestrogens in cereal products in order to relate intakes to potential biological activities. Sponsorship: This work was supported by the United Kingdom Medical Research Council, Ministry of Agriculture Fisheries and Food (contract FS2034) and the United States of America Army (contract DAMD 17-97-1-7028).
  • St. John's Wort 2018

    St. John's Wort 2018

    ONLINE SERIES MONOGRAPHS The Scientific Foundation for Herbal Medicinal Products Hyperici herba St. John's Wort 2018 www.escop.com The Scientific Foundation for Herbal Medicinal Products HYPERICI HERBA St. John's Wort 2018 ESCOP Monographs were first published in loose-leaf form progressively from 1996 to 1999 as Fascicules 1-6, each of 10 monographs © ESCOP 1996, 1997, 1999 Second Edition, completely revised and expanded © ESCOP 2003 Second Edition, Supplement 2009 © ESCOP 2009 ONLINE SERIES ISBN 978-1-901964-61-5 Hyperici herba - St. John's Wort © ESCOP 2018 Published by the European Scientific Cooperative on Phytotherapy (ESCOP) Notaries House, Chapel Street, Exeter EX1 1EZ, United Kingdom www.escop.com All rights reserved Except for the purposes of private study, research, criticism or review no part of this text may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without the written permission of the publisher. Important Note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment may be required. In their efforts to provide information on the efficacy and safety of herbal drugs and herbal preparations, presented as a substantial overview together with summaries of relevant data, the authors of the material herein have consulted comprehensive sources believed to be reliable. However, in view of the possibility of human error by the authors or publisher of the work herein, or changes in medical knowledge, neither the authors nor the publisher, nor any other party involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for results obtained by the use of such information.
  • Medicinal Properties of Selected Asparagus Species: a Review Polo-Ma-Abiele Hildah Mfengwana and Samson Sitheni Mashele

    Medicinal Properties of Selected Asparagus Species: a Review Polo-Ma-Abiele Hildah Mfengwana and Samson Sitheni Mashele

    Chapter Medicinal Properties of Selected Asparagus Species: A Review Polo-Ma-Abiele Hildah Mfengwana and Samson Sitheni Mashele Abstract Asparagus species are naturally distributed along Asia, Africa, and Europe and are known to have numerous biological properties. This review article was aimed to provide an organized summary of current studies on the traditional uses, phy- tochemistry, and pharmacological and toxicological studies of Asparagus laricinus Burch., Asparagus africanus Lam., Asparagus officinalis L., Asparagus racemosus Willd., and Asparagus densiflorus (Kunth) Jessop to attain and establish new insights for further researches. Information used in this review was obtained from electronic database including PubMed central, Google scholars, Science direct, Scopus, and Sabinet. Based on the present findings, the existing literature still presents some breaches about the mechanism of action of various constituents of these plants, and their relation to other plant compounds in poly-herbal formulations, as well as their long-term use and safety. More in-depth studies are still needed for active compounds and biological activities of Asparagus laricinus, Asparagus africanus, and Asparagus densiflorus. Therefore, innumerable opportunities and possibilities for investigation are still available in novel areas of these plants for future research stud¬ies. It can be concluded that all selected Asparagus species have tremendous potential to improve human health and the pharmacological activities of these plants can be attributed to bioactive phytochemicals they possess. Keywords: Asparagaceae, Asparagus africanus lam., Asparagus densiflorus (kunth) Jessop, Asparagus laricinus Burch., Asparagus officinalis L., Asparagus racemosus Willd., pharmacological actions, phytochemistry 1. Introduction Historically, plants were used for numerous purposes for mankind in general, inter alia, feeding and catering, culinary spices, medicine, various forms of cosmetics, symbols in worship and for a variety of ornamental goods.
  • Mindy Goldman, MD Clinical Professor Dept

    Mindy Goldman, MD Clinical Professor Dept

    Managing Menopause Medically and Naturally Mindy Goldman, MD Clinical Professor Dept. of Ob/Gyn and Reproductive Sciences Director, Women’s Cancer Care Program, UCSF Breast Care Center and Women’s Health University of California, San Francisco I have nothing to disclose –Mindy Goldman, MD CASE STUDY 50 yr. old G2P2 peri-menopausal woman presents with complaints of significant night sweats interfering with her ability to sleep. She has mild hot flashes during the day. She has never had a bone mineral density test but her mother had a hip fracture at age 62 due to osteoporosis. Her 46 yr. old sister was diagnosed with breast cancer at age 43, treated with lumpectomy and radiation and currently is doing well. There is no other family history of cancer. Questions 1. Would you offer her MHT? 2. If yes, how long would you continue it? 3. If no, what would you offer for alternative treatments? 4. Would your treatment differ if you knew she had underlying heart disease? Is it safe? How long can I take it? What about Mymy Bones?bones? Will it protect my heart? MHT - 2015 What about my brain? Will I get breast cancer? What about my hot flashes? Menopausal Symptoms Hot flashes Night sweats Sleep disturbances Vaginal dryness/Sexual dysfunction Mood disturbances How to Treat Menopausal Symptoms Hormone therapy Alternatives to hormones Complementary and Integrative Techniques Prior to Women’s Health Initiative Hormone therapy primary treatment of menopausal hot flashes Few women would continue hormones past one year By 1990’s well known
  • Anticancer Activity of Lignan from the Aerial Parts of Saussurea Salicifolia (L.) DC

    Anticancer Activity of Lignan from the Aerial Parts of Saussurea Salicifolia (L.) DC

    Vol. 27, 2009, Special Issue Czech J. Food Sci. Anticancer Activity of Lignan from the Aerial Parts of Saussurea salicifolia (L.) DC. G. CHUNSRiiMYATAV1, 2*, I. HOZA1, P. VALÁšEK1, S. SKROVANKOVÁ1, D. BANZRAgcH2 and N. TsEVEgsUREN3 1Department of Food Engineering, Tomas Bata University in Zlin, 760 01 Zlín, Czech Republic; 2 Institute of Chemistry and Chemical Technology, Mongolian Academy Sciences, Ulaanbaatar, MON 51 Mongolia; 3Department of Organic Chemistry, Faculty of Chemistry, National University of Mongolia, Ulaanbaatar, Mongolia, *E-mail: [email protected] Abstract: Aerial parts of Saussurea salicifolia (L.) DC were studied for their lignan and flavonoids in solvent chloroform and n-butanol of ethanolic extract. Isolation and identification of phenolic compounds of the chloroform and n-butanol fractions were performed with Dionex HPLC-DAD system with water-methanol gradients in 4 different wave lengths (235 nm, 254 nm, 280 nm and 340 nm), using online UV and LC-MS as described previously. 9-OH-pinoresinol which is a lignan with anticancer activity was dominated in the chloroform fraction, whereas mainly flavonoid glycosides like quercetin-3-O-galactoside, apigenin-7-O-rhamnoside with anti-inflammatory effect were detected in the n-butanol fraction. Additionally, 9-OH-pinoresinol was also found in the n-butanol fraction. Anticancer tests were conducted in leukemia mouse lymphoma cells L5178Y at a concentration of 10 μg/ml of test compound. Crude ethanol extract of S. salicifolia reduced the growth of leukemia mouse lymphoma cells L5178Y to 23.8%. Keywords: flavonoids; Saussurea salicifolia; anticancer activity; Dionex HPLC-DAD system INTRODUCTION several species of Saussurea by other scientists in the world have revealed the presence of interest- Saussurea salicifolia is a medicinal plant belong- ing bioactive compounds like flavonoids (Jiang ing to genus of Saussurea of Asteraceae family.
  • Simultaneous Determination of Daidzein, Genistein and Formononetin in Coffee by Capillary Zone Electrophoresis

    Simultaneous Determination of Daidzein, Genistein and Formononetin in Coffee by Capillary Zone Electrophoresis

    separations Article Simultaneous Determination of Daidzein, Genistein and Formononetin in Coffee by Capillary Zone Electrophoresis Feng Luan *, Li Li Tang, Xuan Xuan Chen and Hui Tao Liu College of Chemistry and Chemical Engineering, Yantai University, Yantai 264005, China; [email protected] (L.L.T.); [email protected] (X.X.C.); [email protected] (H.T.L.) * Correspondence: fl[email protected]; Tel.: +86-535-6902063 Academic Editor: Doo Soo Chung Received: 29 October 2016; Accepted: 20 December 2016; Published: 1 January 2017 Abstract: Coffee is a favorite and beverage in Western countries that is consumed daily. In the present study, capillary zone electrophoresis (CE) was applied for the separation and quantification of three isoflavones including daidzein, genistein and formononetin in coffee. Extraction of isoflavones from the coffee sample was carried out by extraction and purification process using ether after the acid hydrolysis with the antioxidant butylated hydroxy-toluene (BHT). The experimental conditions of the CE separation method were: 20 mmol/L Na2HPO4 buffer solution, 25 kV applied voltage, 3 s hydrodynamic injection at 30 mbar, and UV detection at 254 nm. The results show that the three compounds can be tested within 10 min with a linearity of 0.5–50 µg/mL for all three compounds. The limits of detection were 0.0642, 0.134, and 0.0825 µg/mL for daidzein, formononetin and genistein, respectively. The corresponding average recovery was 99.39% (Relative Standard Detection (RSD) = 1.76%), 98.71% (RSD = 2.11%) and 97.37% (RSD = 3.74%). Keywords: capillary zone electrophoresis (CE); daidzein; genistein; formononetin; acid hydrolysis 1.
  • Assessment Report on Hypericum Perforatum L., Herba

    Assessment Report on Hypericum Perforatum L., Herba

    European Medicines Agency Evaluation of Medicines for Human Use London, 12 November 2009 Doc. Ref.: EMA/HMPC/101303/2008 COMMITTEE ON HERBAL MEDICINAL PRODUCTS (HMPC) ASSESSMENT REPORT ON HYPERICUM PERFORATUM L., HERBA 7 Westferry Circus, Canary Wharf, London, E14 4HB, UK Tel. (44-20) 74 18 84 00 Fax (44-20) 75 23 70 51 E-mail: [email protected] http://www.emea.europa.eu © European Medicines Agency, 2009. Reproduction is authorised provided the source is acknowledged TABLE OF CONTENTS I. REGULATORY STATUS OVERVIEW...................................................................................4 II. ASSESSMENT REPORT............................................................................................................5 II.1 INTRODUCTION..........................................................................................................................6 II.1.1 Description of the herbal substance(s), herbal preparation(s) or combinations thereof 6 II.1.1.1 Herbal substance:........................................................................................................ 6 II.1.1.2 Herbal preparation(s): ................................................................................................ 7 II.1.1.3 Combinations of herbal substance(s) and/or herbal preparation(s)........................... 9 Not applicable. ................................................................................................................................9 II.1.1.4 Vitamin(s) ...................................................................................................................
  • Dihydrotestosterone (Adractim®) 2.5% Gel for Topical Application

    Dihydrotestosterone (Adractim®) 2.5% Gel for Topical Application

    d g t squeezin l aa StSt gelgel Star gel from this en 0mg0m0mg 2.2.55 5mg5mg 7.7.55 10m1 mg l l 12.12.55 ge g ge ) 15m15mg f 17.17.55 ® 20m20mg g g o 22.22.55 25 25m25mg 1.25 g of g 1.25 1 1.25 1 1 1.25 g of g 1.25 27.5 30mg300mm 32.32.5.5 35m35mg drotestosterone hy 37.5 Put on a pair of gloves Gently squeeze the gel onto the mark on the ruler illustrated below – as instructed on the dispensing label. Leave for five minutes Wipe this laminated information sheet with a damp piece of kitchen paper ready for the next dose. Remove the gloves and wash them in warm soapy water ready for the next dose. of di 40m40mg © GOSH NHS Foundation Trust January 2016 © GOSH NHS Foundation Trust How is it used? Dihydrotestosterone 2.5% gel is for external It should be applied over the use only. required area of skin after washing. The gel should be left to dry for five minutes or so before putting on clothes. 1. 2. 3. Spread over the required area evenly 4. 5. Note: Dihydrotestosterone 2.5% gel should not be applied to any broken areas of skin. 42.42.55 l l 45mg45m45m ge ge 47.47.55 , ® 50mg50mm 52.52.55 55mg55mm 57.57.55 2.5 g of g 2 2.5 2 2.5 g of g 2.5 60mg600m0m 62.62.5.5 Dihydrotestosterone is a synthetic version of a hormone called testosterone.