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  1. Article: Balneotherapy and hydrotherapy in chronic respiratory disease.

    Khaltaev, Nikolai / Solimene, Umberto / Vitale, Federico / Zanasi, Alessandro

    Journal of thoracic disease

    2020  Volume 12, Issue 8, Page(s) 4459–4468

    Abstract: Chronic respiratory diseases (CRD) belong to major noncommunicable diseases (NCD) targeted by World Health Organization (WHO) NCD Action Plan and United Nations (UN) Sustainable Development Goal (STG) 3.4 to achieve 30% decline of mortality by the year ... ...

    Abstract Chronic respiratory diseases (CRD) belong to major noncommunicable diseases (NCD) targeted by World Health Organization (WHO) NCD Action Plan and United Nations (UN) Sustainable Development Goal (STG) 3.4 to achieve 30% decline of mortality by the year 2030. Strong evidence is now available in the literature for therapeutic aquatic exercise interventions in improving health status of chronic obstructive pulmonary diseases (COPD) patients. However, gym-based exercises can be difficult for patients with COPD who are mainly elderly and often have co-morbidities-such as severe arthritis and obesity-which may impair their ability to exercise at an adequate intensity. Besides improving respiratory function and health status in COPD, exercise in water helps overcoming patient's fears and promote socialization, contrasting the risk of depression, which is a major condition often associated with long term COPD condition. Susceptibility to respiratory infections plays a role in exacerbations of COPD. Sulphur-rich water inhalations improve muco-ciliary clearance, reduce inflammatory cytokines production and inflammatory mucosal infiltration, reduce elastase secretion by neutrophils, preserving elastic properties of pulmonary interstitium and thus facilitating expectoration. Repeated cold water stimulations in COPD also reduce frequency of infections. Finally, sauna bathing reduces the risk of pneumonia. On the other side, hydrotherapy/balneotherapy also help obesity control, which is one of the most difficult NCD risk factors to modify and consequently is an important component of the WHO preventive strategy to achieve STG 3.4. Along with high prevalence and mortality, CRD cause increasing pharmaceutical and hospital costs. In this perspective, Health Resort Medicine should not be ignored as a resource in the WHO NCD strategy and Universal Health Coverage, providing a multi-stakeholder platform (including the network of health resorts and their facilities) able to give a real help to the achievement of UN goal STG 3.4 by the year 2030.
    Language English
    Publishing date 2020-09-09
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd-gard-2019-009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Mineral water inhalations for bronchial asthma: a meta-analysis.

    Fesyun, Anatoliy D / Solimene, Umberto / Grishechkina, Irina A / Lobanov, Andrey A / Andronov, Sergei V / Popov, Andrei I / Yakovlev, Maxim Yu / Ivanova, Elena / Sanina, Natalia P / Reverchuk, Igor V / Maccarone, Maria Chiara / Masiero, Stefano

    European journal of translational myology

    2023  Volume 33, Issue 2

    Abstract: Bronchial asthma (BA) is a common disease that contributes significantly to the incidence rate and death rate worldwide. A widespread treatment method is the use of inhalations of mineral waters, with conflicting information about their effectiveness. ... ...

    Abstract Bronchial asthma (BA) is a common disease that contributes significantly to the incidence rate and death rate worldwide. A widespread treatment method is the use of inhalations of mineral waters, with conflicting information about their effectiveness. Purpose of the study was to assess the generalized effect power of the course of inhalations of mineral waters on the disease progress in patients with BA. A search of randomized clinical studies in data bases Pubmed, EMBASE, ELibrary, MedPilot amd CyberLeninka, according to PRISMA strategy, published between 1986 and July 2021. Standardized difference of mean values and their 95% of CI were employed for calculation using the random effects model. The meta-analysis drawing on 1266 sources included 14 studies, with 2 of them being randomized controlled clinical studies, including the results of the treatment of 525 patients. All 14 articles contain a conclusion that the inhalation of mineral water has a positive effect on the course of the disease in patients with BA. The analysis demonstrated that the group of patients after mineral water inhalations, compared with the control group, showed improvement of forced expiratory volume (FEV1), expressed both in % of the norm and in liters. The standardized difference of mean values FEV1 (%) (Hedge's g) was 8.2 (95% CI: 5.87 - 10.59; 100%), FEV1 values (liter.) (Hedge's g) was 0.69 (95% CI: -0.33-1.05). A significant heterogeneity of the results of individual studies was found (Q=124.96; tau2 = 14.55, I2 = 69.13%, p<0.0001 and Q=2.35; tau2 = 0, I2 = 0%, p<0.0001). Patients with mild, moderate, and hormone-dependent BA with a controlled and partially controlled disease course, after mineral water inhalations, compared with the control group, demonstrated a statistically significant decrease in the frequency and intensity of the cardinal symptoms of BA and improvement of FEV1.
    Language English
    Publishing date 2023-06-23
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2545577-1
    ISSN 2037-7460 ; 2037-7452
    ISSN (online) 2037-7460
    ISSN 2037-7452
    DOI 10.4081/ejtm.2023.11460
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  3. Article ; Online: Meteorological factors, air pollutants, and emergency department visits for otitis media: a time series study.

    Gestro, Massimo / Condemi, Vincenzo / Bardi, Luisella / Fantino, Claudio / Solimene, Umberto

    International journal of biometeorology

    2017  Volume 61, Issue 10, Page(s) 1749–1764

    Abstract: AbstractOtitis media (OM) is a very common disease in children, which results in a significant economic burden to the healthcare system for hospital-based outpatient departments, emergency departments (EDs), unscheduled medical examinations, and ... ...

    Abstract AbstractOtitis media (OM) is a very common disease in children, which results in a significant economic burden to the healthcare system for hospital-based outpatient departments, emergency departments (EDs), unscheduled medical examinations, and antibiotic prescriptions. The aim of this retrospective observational study is to investigate the association between climate variables, air pollutants, and OM visits observed in the 2007-2010 period at the ED of Cuneo, Italy. Measures of meteorological parameters (temperature, humidity, atmospheric pressure, wind) and outdoor air pollutants (particulate matter, ozone, nitrous dioxide) were analyzed at two statistical stages and in several specific steps (crude and adjusted models) according to Poisson's regression. Response variables included daily examinations for age groups 0-3, 0-6, and 0-18. Control variables included upper respiratory infections (URI), flu (FLU), and several calendar factors. A statistical procedure was implemented to capture any delayed effects. Results show a moderate association for temperature (T), age 0-3, and 0-6 with P < 0.05, as well as nitrous dioxide (NO
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 280324-0
    ISSN 1432-1254 ; 0020-7128
    ISSN (online) 1432-1254
    ISSN 0020-7128
    DOI 10.1007/s00484-017-1356-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Short-term air pollution exposure is a risk factor for acute coronary syndromes in an urban area with low annual pollution rates: Results from a retrospective observational study (2011-2015).

    Gestro, Massimo / Condemi, Vincenzo / Bardi, Luisella / Tomaino, Laura / Roveda, Eliana / Bruschetta, Antongiulio / Solimene, Umberto / Esposito, Fabio

    Archives of cardiovascular diseases

    2020  Volume 113, Issue 5, Page(s) 308–320

    Abstract: Background: Epidemiological data suggest that air pollutants are risk factors for cardiovascular disease. Recent studies have questioned the adequacy of current legal pollutant limits, because concentrations lower than those recommended still affect ... ...

    Abstract Background: Epidemiological data suggest that air pollutants are risk factors for cardiovascular disease. Recent studies have questioned the adequacy of current legal pollutant limits, because concentrations lower than those recommended still affect cardiovascular morbidity and mortality.
    Aim: To investigate the association between short-term exposure to air pollutants and the daily diagnosis of acute coronary syndrome (ACS) at the emergency department (ED) of S. Croce Hospital (Cuneo, Italy), between 2011 and 2015.
    Methods: We evaluated the effect of particulate matter (PM
    Results: ED admissions for ACS were 1625/391,689, with 298 in 2011 (0.183%), 305 in 2012 (0.188%), 347 in 2013 (0.214%), 341 in 2014 (0.21%) and 334 in 2015 (0.206%), with a general growth rate of 2.08% (from 2011 to 2015). The CRFs examined were confirmed to be highly associated with occurrence of ACS. Our study identified PM
    Conclusion: This study confirms the importance of PM
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/epidemiology ; Adult ; Age Factors ; Aged ; Air Pollutants/adverse effects ; Air Pollution/adverse effects ; Environmental Exposure/adverse effects ; Environmental Monitoring ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Particulate Matter/adverse effects ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Urban Health
    Chemical Substances Air Pollutants ; Particulate Matter
    Language English
    Publishing date 2020-04-28
    Publishing country Netherlands
    Document type Journal Article ; Observational Study
    ZDB-ID 2408778-6
    ISSN 1875-2128 ; 1875-2136
    ISSN (online) 1875-2128
    ISSN 1875-2136
    DOI 10.1016/j.acvd.2020.03.013
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  5. Article: Association with meteo-climatological factors and daily emergency visits for renal colic and urinary calculi in Cuneo, Italy. A retrospective observational study, 2007–2010

    Condemi, Vincenzo / Gestro, Massimo / Dozio, Elena / Tartaglino, Bruno / Corsi Romanelli, Massimiliano Marco / Solimene, Umberto / Meco, Roberto

    International journal of biometeorology. 2015 Mar., v. 59, no. 3

    2015  

    Abstract: The incidence of nephrolithiasis is rising worldwide, especially in women and with increasing age. Incidence and prevalence of kidney stones are affected by genetic, nutritional, and environmental factors. The aim of this study is to investigate the link ...

    Abstract The incidence of nephrolithiasis is rising worldwide, especially in women and with increasing age. Incidence and prevalence of kidney stones are affected by genetic, nutritional, and environmental factors. The aim of this study is to investigate the link between various meteorological factors (independent variables) and the daily number of visits to the Emergency Department (ED of the S. Croce and Carle Hospital of Cuneo for renal colic (RC) and urinary stones (UC) as the dependent variable over the years 2007–2010.The Poisson generalized regression models (PGAMs) have been used in different progressive ways. The results of PGAMs (stage 1) adjusted for seasonal and calendar factors confirmed a significant correlation (p < 0.03) with the thermal parameter. Evaluation of the dose–response effect [PGAMs combined with distributed lags nonlinear models (DLNMs)—stage 2], expressed in terms of relative risk (RR) and cumulative relative risk (RRC), indicated a relative significant effect up to 15 lag days of lag (RR > 1), with a first peak after 5 days (lag ranges 0–1, 0–3, and 0–5) and a second weak peak observed along the 5–15 lag range days. The estimated RR for females was significant, mainly in the second and fourth age group considered (19–44 and >65 years): RR for total ED visits 1.27, confidence interval (CI) 1.11–1.46 (lag 0–5 days); RR 1.42, CI 1.01–2.01 (lag 0–10 days); and RR 1.35, CI 1.09–1.68 (lag 0–15 days). The research also indicated a moderate involvement of the thermal factor in the onset of RC caused by UC, exclusively in the female sex. Further studies will be necessary to confirm these results.
    Keywords bioclimatology ; colic ; confidence interval ; dose response ; environmental factors ; females ; meteorological parameters ; nonlinear models ; observational studies ; regression analysis ; relative risk ; renal calculi ; women ; Italy
    Language English
    Dates of publication 2015-03
    Size p. 249-263.
    Publishing place Springer-Verlag
    Document type Article
    ZDB-ID 127361-9
    ISSN 0067-8902 ; 0020-7128
    ISSN 0067-8902 ; 0020-7128
    DOI 10.1007/s00484-014-0861-1
    Database NAL-Catalogue (AGRICOLA)

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  6. Article: Comparative chemical composition and antioxidant activity of Calamintha nepeta (L.) Savi subsp. glandulosa (Req.) Nyman and Calamintha grandiflora (L.) Moench (Labiatae)

    Conforti, Filomena / Marrelli, Mariangela / Statti, Giancarlo / Menichini, Federica / Uzunov, Dimitar / Solimene, Umberto / Menichini, Francesco

    Natural product research. 2012 Jan. 1, v. 26, no. 1

    2012  

    Abstract: The two studied Calamintha species showed different polyphenolic content and sterol composition. Calamintha grandiflora possessed twice the polyphenolic content of Calamintha nepeta subsp. glandulosa, while the latter contained a higher number of sterols. ...

    Abstract The two studied Calamintha species showed different polyphenolic content and sterol composition. Calamintha grandiflora possessed twice the polyphenolic content of Calamintha nepeta subsp. glandulosa, while the latter contained a higher number of sterols. Among them, stigmast-5-en-3β-ol was found to be the major constituent. The methanolic extract of C. grandiflora was more potent than the C. nepeta subsp. glandulosa methanolic extract in a DPPH assay, while the activity of the C. grandiflora EtOAc fraction was weaker than its C. nepeta subsp. glandulosa counterpart. Fractions of C. nepeta subsp. glandulosa showed higher activity using a β-carotene bleaching test. The petrol ether fraction of C. grandiflora showed significant inhibition of NO production.
    Keywords Calamintha grandiflora ; Clinopodium nepeta ; antioxidant activity ; beta-carotene ; bleaching ; chemical composition ; ethyl acetate ; gasoline ; nitric oxide ; sterols
    Language English
    Dates of publication 2012-0101
    Size p. 91-97.
    Publishing place Taylor & Francis Group
    Document type Article
    ZDB-ID 2185747-7
    ISSN 1478-6427 ; 1478-6419
    ISSN (online) 1478-6427
    ISSN 1478-6419
    DOI 10.1080/14786419.2010.545356
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  7. Article: Studies on the potential antioxidant properties of Senecio stabianus Lacaita (Asteraceae) and its inhibitory activity against carbohydrate-hydrolysing enzymes

    Tundis, Rosa / Menichini, Federica / Loizzo, Monica R / Bonesi, Marco / Solimene, Umberto / Menichini, Francesco

    Natural product research. 2012 Mar. 1, v. 26, no. 5

    2012  

    Abstract: This study showed for the first time the antioxidant and hypoglycaemic properties of the methanol, n-hexane and ethyl acetate extracts from Senecio stabianus Lacaita, a plant that belongs to the Asteraceae family. The antioxidant activities were carried ... ...

    Abstract This study showed for the first time the antioxidant and hypoglycaemic properties of the methanol, n-hexane and ethyl acetate extracts from Senecio stabianus Lacaita, a plant that belongs to the Asteraceae family. The antioxidant activities were carried out using two different in vitro assays, namely 2,2-diphenyl-1-picrylhydrazyl (DPPH) test and 2,2′-azinobis(3-ethylbenzthiazoline-6-sulphonate) (ABTS) test. The ethyl acetate extract showed the highest activity with inhibitory concentration 50% (IC₅₀) values of 35.5 and 32.7 µg mL⁻¹ on DPPH test and ABTS test, respectively. This activity may be related to a good total phenol and flavonoid content. All extracts were also tested for their potential inhibitory activity of α-amylase and α-glucosidase digestive enzymes. The n-hexane extract exhibited the highest α-amylase inhibition with an IC₅₀ value of 0.21 mg mL⁻¹. Through bioassay-guided fractionation processes seven fractions (A–G) were obtained and tested. Based on the phytochemical analysis, the activity of n-hexane extract may be related to the presence of monoterpenes and sesquiterpenes.
    Keywords 2,2-diphenyl-1-picrylhydrazyl ; Senecio ; alpha-amylase ; alpha-glucosidase ; antioxidant activity ; antioxidants ; ethyl acetate ; flavonoids ; fractionation ; hexane ; in vitro studies ; inhibitory concentration 50 ; methanol ; monoterpenoids ; sesquiterpenoids
    Language English
    Dates of publication 2012-0301
    Size p. 393-404.
    Publishing place Taylor & Francis Group
    Document type Article
    ZDB-ID 2185747-7
    ISSN 1478-6427 ; 1478-6419
    ISSN (online) 1478-6427
    ISSN 1478-6419
    DOI 10.1080/14786419.2010.488233
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  8. Article: Beneficial effect of refined red palm oil on lipid peroxidation and monocyte tissue factor in HCV-related liver disease: a randomized controlled study.

    Catanzaro, Roberto / Zerbinati, Nicola / Solimene, Umberto / Marcellino, Massimiliano / Mohania, Dheeraj / Italia, Angelo / Ayala, Antonio / Marotta, Francesco

    Hepatobiliary & pancreatic diseases international : HBPD INT

    2016  Volume 15, Issue 2, Page(s) 165–172

    Abstract: Background: A large amount of endotoxin can be detected in the peripheral venous blood of patients with liver cirrhosis, contributing to the pathogenesis of hepatotoxicity because of its role in oxidative stress. The present study aimed to test the ... ...

    Abstract Background: A large amount of endotoxin can be detected in the peripheral venous blood of patients with liver cirrhosis, contributing to the pathogenesis of hepatotoxicity because of its role in oxidative stress. The present study aimed to test the effect of the supplementation with red palm oil (RPO), which is a natural oil obtained from oil palm fruit (Elaeis guineensis) rich in natural fat-soluble tocopherols, tocotrienols and carotenoids, on lipid peroxidation and endotoxemia with plasma endotoxin-inactivating capacity, proinflammatory cytokines profile, and monocyte tissue factor in patients with chronic liver disease.
    Methods: The study group consisted of sixty patients (34 males and 26 females; mean age 62 years, range 54-75) with Child A/B, genotype 1 HCV-related cirrhosis without a history of ethanol consumption, randomly enrolled into an 8-week oral daily treatment with either vitamin E or RPO. All patients had undergone an upper gastrointestinal endoscopy 8 months before, and 13 out of them showed esophageal varices.
    Results: Both treatments significantly decreased erythrocyte malondialdehyde and urinary isoprostane output, only RPO significantly affected macrophage-colony stimulating factor and monocyte tissue factor. Liver ultrasound imaging did not show any change.
    Conclusions: RPO beneficially modulates oxidative stress and, not least, downregulates macrophage/monocyte inflammatory parameters. RPO can be safely advised as a valuable nutritional implementation tool in the management of chronic liver diseases.
    MeSH term(s) Aged ; Cells, Cultured ; Dietary Supplements/adverse effects ; Erythrocytes/drug effects ; Erythrocytes/metabolism ; Female ; Hepatitis C/complications ; Hepatitis C/diagnosis ; Hepatitis C/metabolism ; Humans ; Inflammation Mediators/metabolism ; Isoprostanes/urine ; Italy ; Lipid Peroxidation/drug effects ; Liver/drug effects ; Liver/metabolism ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/metabolism ; Liver Cirrhosis/virology ; Macrophage Colony-Stimulating Factor/metabolism ; Male ; Malondialdehyde/metabolism ; Middle Aged ; Monocytes/drug effects ; Monocytes/metabolism ; Oxidative Stress/drug effects ; Palm Oil ; Plant Oils/adverse effects ; Plant Oils/therapeutic use ; Thromboplastin/metabolism ; Time Factors ; Treatment Outcome
    Chemical Substances Inflammation Mediators ; Isoprostanes ; Plant Oils ; Malondialdehyde (4Y8F71G49Q) ; Palm Oil (5QUO05548Z) ; Macrophage Colony-Stimulating Factor (81627-83-0) ; Thromboplastin (9035-58-9)
    Language English
    Publishing date 2016-03-28
    Publishing country Singapore
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2241386-8
    ISSN 1499-3872
    ISSN 1499-3872
    DOI 10.1016/s1499-3872(16)60072-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Oral Administration of Interleukin-10 and Anti-IL-1 Antibody Ameliorates Experimental Intestinal Inflammation.

    Cardani, Diego / Dusio, Giuseppina F / Luchini, Patrizia / Sciarabba, Michele / Solimene, Umberto / Rumio, Cristiano

    Gastroenterology research

    2013  Volume 6, Issue 4, Page(s) 124–133

    Abstract: Background: To elucidate the effects of a solution containing interleukin-10 and anti-IL-1 antibody in modulating experimental intestinal inflammation.: Methods: Colitis was induced in BALB/c mice by oral administration of dextran sodium sulphate; ... ...

    Abstract Background: To elucidate the effects of a solution containing interleukin-10 and anti-IL-1 antibody in modulating experimental intestinal inflammation.
    Methods: Colitis was induced in BALB/c mice by oral administration of dextran sodium sulphate; mice were then treated with interleukin-10 plus anti-IL-1 antibody at low dosage. Transepithelial electrical resistance of isolated mouse colon and colon lengths were evaluated. Cytokines concentrations in organocultures supernatants and plasma samples were evaluated by Enzyme-Linked Immuno Sorbent Assay. Tight junction proteins were evaluated by immunofluorescence, respectively.
    Results: Oral administration of tested products restores intestinal barrier function during experimental intestinal inflammation in association with reduced levels of proinflammatory cytokines, increased interleukin-10 plasma concentrations and a tight junction architecture restoration.
    Conclusion: Obtained results may contribute to modelling an interesting strategy for the treatment of patients with inflammatory bowel diseases.
    Language English
    Publishing date 2013-09-09
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2475913-2
    ISSN 1918-2813 ; 1918-2805
    ISSN (online) 1918-2813
    ISSN 1918-2805
    DOI 10.4021/gr556w
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  10. Article ; Online: Comparative chemical composition and antioxidant activity of Calamintha nepeta (L.) Savi subsp. glandulosa (Req.) Nyman and Calamintha grandiflora (L.) Moench (Labiatae).

    Conforti, Filomena / Marrelli, Mariangela / Statti, Giancarlo / Menichini, Federica / Uzunov, Dimitar / Solimene, Umberto / Menichini, Francesco

    Natural product research

    2012  Volume 26, Issue 1, Page(s) 91–97

    Abstract: The two studied Calamintha species showed different polyphenolic content and sterol composition. Calamintha grandiflora possessed twice the polyphenolic content of Calamintha nepeta subsp. glandulosa, while the latter contained a higher number of sterols. ...

    Abstract The two studied Calamintha species showed different polyphenolic content and sterol composition. Calamintha grandiflora possessed twice the polyphenolic content of Calamintha nepeta subsp. glandulosa, while the latter contained a higher number of sterols. Among them, stigmast-5-en-3β-ol was found to be the major constituent. The methanolic extract of C. grandiflora was more potent than the C. nepeta subsp. glandulosa methanolic extract in a DPPH assay, while the activity of the C. grandiflora EtOAc fraction was weaker than its C. nepeta subsp. glandulosa counterpart. Fractions of C. nepeta subsp. glandulosa showed higher activity using a β-carotene bleaching test. The petrol ether fraction of C. grandiflora showed significant inhibition of NO production.
    MeSH term(s) Antioxidants/analysis ; Antioxidants/chemistry ; Antioxidants/metabolism ; Ethanol ; Free Radical Scavengers/metabolism ; Inhibitory Concentration 50 ; Lamiaceae/chemistry ; Methanol ; Nitric Oxide/metabolism ; Phytosterols/analysis ; Phytosterols/metabolism ; Plant Extracts/chemistry ; Plant Extracts/pharmacology ; Polyphenols/analysis ; Polyphenols/metabolism ; Species Specificity ; Stigmasterol/analysis
    Chemical Substances Antioxidants ; Free Radical Scavengers ; Phytosterols ; Plant Extracts ; Polyphenols ; Nitric Oxide (31C4KY9ESH) ; Ethanol (3K9958V90M) ; Stigmasterol (99WUK5D0Y8) ; Methanol (Y4S76JWI15)
    Language English
    Publishing date 2012
    Publishing country England
    Document type Journal Article
    ZDB-ID 2185747-7
    ISSN 1478-6427 ; 1478-6419
    ISSN (online) 1478-6427
    ISSN 1478-6419
    DOI 10.1080/14786419.2010.545356
    Database MEDical Literature Analysis and Retrieval System OnLINE

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