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Fibromyalgia (FM) and climacteric conditions share common epidemiological and clinical features, with FM symptoms often beginning during menopause. Musculoskeletal pain, arthralgia, myalgia and other symptoms are frequently seen in both conditions. Some research suggests a link between the cessation of sex hormones and FM symptoms. Women with FM tend to experience more severe symptoms after menopause, and the severity of FM symptoms can worsen in women who have had a hysterectomy with or without oophorectomy. Despite these similarities, it is essential to treat FM and climacteric conditions separately and follow established guidelines for management. However, it is also important to recognize that both conditions can coexist in the same patient. It is crucial to note that there is limited evidence supporting the effectiveness of menopausal hormone therapy for primary FM management. Therefore, menopausal hormone therapy should not be recommended for FM unless the patient also has climacteric syndrome.

Competing Interests: The authors declare no conflict of interest.

The production of waxes from vegetable oils, such as palm oil, for use as a base material in products for human applications is an alternative to those derived from petroleum and animals. Seven palm oil-derived waxes, called biowaxes (BW1-BW7) in this work, were obtained by catalytic hydrotreating of refined and bleached African palm oil and refined palm kernel oil. They were characterized by three properties: compositional, physicochemical (melting point, penetration value, and pH), and biological (sterility, cytotoxicity, phototoxicity, antioxidant, and irritant). Their morphologies and chemical structures were studied by SEM, FTIR, UV-Vis, and 1 H NMR. The BWs presented structures and compositions similar to natural biowaxes (beeswax and carnauba). They had a high concentration of waxy esters (17%-36%) with long alkyl chains (C, 19-26) per carbonyl group, which are related to high melting points (<20-47.9 °C) and low penetration values (2.1-3.8 mm). They also proved to be sterile materials with no cytotoxic, phototoxic, antioxidant, or irritant activity. The biowaxes studied could be used in cosmetic and pharmacological products for human use.

Background: Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA and there is no effective treatment to stop its progression. Current pharmacologic treatments such as analgesics and non-steroidal anti-inflammatory drugs may improve the pain and offer some relief but they do not affect the progression of the disease. The chronic intake of these drugs may result in severe adverse events. The aim of this review is to revise the effects of nutrition on cartilage metabolism and OA progression., Methods: A systematic literature search was performed including those related to macro- and micro-nutrients' actions on cartilage and OA outcome. We selected peer-reviewed articles reporting the results of human clinical trials., Results: Glucosamine and chondroitin sulfate have shown to delay OA knee progression in several clinical trials. The effectiveness of some products considered nutraceuticals has been widely reviewed in the literature. This article presents a general description of the effectiveness and mechanism of action of nutrients, vitamins, antioxidants and other natural components considered as part of the normal diet. Many in vitro studies indicate the efficacy of specific nutrients in cartilage metabolism and its involvement in OA. However, rigorous clinical studies needed to evaluate the efficacy of these compounds in humans are still missing. The influence of nutrients and diet on the metabolism of cartilage and OA could represent a long-term coadjuvant alternative in the management of patients with OA. Effects of diet modifications on lipid and cholesterol profiles, adequate vitamin levels and weight reduction in obese patients could influence the course of the disease., Conclusion: This review demonstrates that nutrition can improve the symptoms of OA. Glucosamine and chondroitin sulfate have shown robustly to delay the progression of knee OA in several well-designed studies, however more controlled clinical trials are needed to conclude that nutritional changes slow down the progression of the disease.

Objectives: Topical treatment for cutaneous leishmaniasis (CL) would be useful for treatment of some forms of the disease. The aim of this study was to develop and then evaluate a topical miltefosine gel for anti-leishmanial activity and toxicity in BALB/c mice infected with New World (NW)-CL species., Methods: A Carbopol-based gel of 0.5% miltefosine was prepared and physicochemical (colour, pH, consistency and antioxidant activity) and stability properties were determined using standard methodologies. Anti-leishmanial activities for Leishmania (Viannia) braziliensis and Leishmania (Viannia) panamensis were determined both in cultured parasites and in infected BALB/c mice after topical miltefosine gel treatment administered for 20 days. The gel was evaluated for its capacity to inhibit parasites at a 50% level after 3 days of treatment in vitro, and its capacity to reduce lesion size (mm2) and parasitic load after 20 days of treatment. Dermal irritation, contact hypersensitivity (CHS), clinical biochemical profile and the weight of the animals were determined after treatment., Results: The 0.5% miltefosine gel was transparent, homogeneous, colourless, of neutral pH, spreadable and stable at 4°C for at least 3 months. It was active against parasites in vitro and in vivo, reducing CL lesion size by 84%-100% with no detected parasites. No signs of irritation, CHS or changes in weight, food intake, urea or transaminase serum levels were observed after treatment., Conclusions: The topical 0.5% miltefosine gel formulation was efficacious and non-toxic when administered topically in NW-CL murine models. This miltefosine formulation could be an appropriate candidate for further development., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Ultradeformable liposomes (UDLs) containing sodium cholate as edge activator could be an appropriate skin drug-delivery system for chloroaluminum phthalocyanine (ClAlPc) during photodynamic therapy (PDT) against cutaneous leishmaniasis (CL). The aim of this work was to study cell internalization, reactive oxygen species (ROS) production, and toxicity/genotoxicity and transdermal delivery of UDL-ClAlPc, and to determine whether PDT was able to induce anti-leishmanial activity in Leishmania (Viannia) braziliensis experimental models. Prepared liposomes had an average size of 118.39 nm, zeta potential of -37.83 mV, and polydispersity index of 0.15. Liposomal internalization (red fluorescence inside cells), ROS generation (green fluorescence by 2,7-dichlorodihydrofluorescein diacetate [DCFH-DA] cleavage) and non-specific DNA damage (photo-comets) were observed after PDT. Transdermal delivery of ClAlPc, measured by in vitro diffusion experiments through BALB/c skin, showed that UDL-ClAlPc was able to deliver very low quantities of ClAlPc (<1%) to deep skin layers. PDT using UDL-ClAlPc induced photodamage in mammalian cells (J774, THP-1, and NIH-3T3), promastigotes, and intracellular amastigotes without a selective response against amastigotes (selective index ≥1). Topical once-daily ClAlPc-UDL plus visible-light irradiation (20 J/cm 2 ) twice weekly for 3 weeks was ineffective against L. (V.) braziliensis-infected BALB/c mice, whereas miltefosine 30 mg/kg/day orally for 10 days healed the lesions and scars, without parasites observed on the slides. Even though UDLs preserved ClAlPc photoactivities and were able to deliver ClAlPc to dermis, they were unable to result in healing of CL-infected mice after PDT. Experiments using different CL animal models and liposomes with increased skin permeability abilities are recommended., (Copyright © 2018. Published by Elsevier Inc.)

Aims: The aim of this study was to determine the prevalence of migraine and its implications in the occupational and outside employment/daily activities of the workers at a regional hospital in the Cundiboyacense Plateau in Colombia., Patients and Methods: The available members of the house staff at this institution were interviewed by applying the neuroepidemiological protocol drawn up by the World Health Organization (WHO); general doctors performed the initial screening and the determination of neurological disease was carried out by a clinical neurologist, both in patients who were positive and negative for neurological disease. Quality of life was evaluated by means of the MIDAS (Migraine Disability Assessment) survey, MIDASELA (in Spanish for Latin America); the analysis was performed using the EPI 6.04 software application., Results: A total of 238 people were studied: 188 females and 50 males; the prevalence of migraine was 22.5% (15.5% by the WHO protocol and 7% false negatives), with predominance in females (OR: 5.49; p< 0.005). In the MIDASELA questionnaire, 47.2% of the patients had a 50% alteration in their productivity, with regard to their occupational and outside employment/daily activities. A minimum number of patients (3.8%) were unable to work because of migraine, as compared to the figures for outside employment/daily activities (29.7%) or those involving leisure/family (66.4%). The average work, outside employment/daily and family time lost per patient because of migraine was 0.3, 2 and 5.2 days, respectively., Conclusion: A sub register in the prevalence of migraine could be reported in places where the WHO protocol is used. This pathology will have to be taken well into account in Colombian hospital workers due to its individual, occupational, family, social and economic impact. It is necessary to introduce health policies and programmes aimed at evaluating, controlling and treating this type of pathology in an appropriate manner, in order to improve the quality of life of those whose job it is to look after and improve that of the other Colombians.

We studied 14 patients with PSS, 12 females and 2 males with a mean age of 43.6 and a medium of 8 years disease. All of the patients were selected for this study according to updated ARA criteria and were included in a prospective protocol to investigate digestive involvement. This protocol consists of a complete medical history, physical examination, radiologic and endoscopic studies, parasitological and microbial flora investigation. The symptoms more frequently seen were: pyrosis (78%), gastroesophageal regurgitation (50%), flatulence (50%), dysphagia (42%) and chronic diarrhea (21%). The radiologic findings commonly seen were: distal esophageal aperistalsis (78%), gastroesophageal reflux (57%), dilatation of intestinal loops (35%), changes of the mucosal folds (35%). A mild esophagitis was seen endoscopically in 64% of the patients, moderate and severe in 7% respectively. The study of the microbial flora showed contaminations with enterobacteria in 5 patients (35%). After statistical analysis we concluded that the digestive compromise by PSS is frequent, being the esophagus more commonly affected (80%), at the beginning in the form of reflux esophagitis and later in esophageal stenosis, the compromise of the small intestine (40%) is manifested by chronic diarrhea or dyspeptic flatulence, which correlates well the radiologic findings and the bacterial overgrowth in this organ. The colonic compromise generally is asymptomatic, and the common finding is dilatation os the colonic loops. Finally, the bacterial overgrowth in the small intestine is a secondary involvement to the intestinal compromise of Progressive Systemic Sclerosis.