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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 91 records · Page 5Linked to original sources
PubMed2004

Can St. John's wort trigger psychoses?

BACKGROUND: St. John's wort (SJW) is a popular herbal remedy often self-prescribed for depressed mood. It has recently been associated with psychotic events. AIM: To systematically review the clinical evidence associating SJW with psychotic events. METHODS: Five electronic databases were searched for all relevant reports. Data were extracted according to predefined criteria. RESULTS: Seventeen case reports associated the use of SJW with psychotic events. In 12 instances, the diagnosis was mania or hypomania. Causality is in most cases possible. In no case was a positive rechallenge reported. CONCLUSION: These case reports raise the possibility that SJW may trigger episodes of mania in vulnerable patients. Clinicians should be aware of this possibility and researchers should attempt to ascertain whether the association is causal.

Antidepressive Agents↗
PubMed2003

Systematic review: hepatotoxic events associated with herbal medicinal products.

BACKGROUND: Large proportions of patients use herbal medicinal products, and encouraging data in terms of effectiveness exist for some of these. One aspect, however, which is still largely under-investigated is the question of potential harm. AIM: To review the recent evidence on hepatotoxic events associated with the use of herbal medicinal products. METHODS: Systematic literature searches were performed on Medline, Embase, The Cochrane Library, Amed and Ciscom. To identify additional data, searches were conducted by hand in relevant medical journals and in our own files. The screening and selection of articles and the extraction of data were performed independently by the two authors. There were no restrictions regarding the language of publication. In order to be included articles were required to report data on hepatotoxic events associated with the therapeutic use of herbal medicinal products. RESULTS: Single medicinal herbs and combination preparations are associated with hepatotoxic events. Clinically, the spectrum ranges from transient elevations of liver enzyme levels to fulminant liver failure and death. In most instances hepatotoxic herbal constituents are believed to be the cause, while others may be due to herb-drug interactions, contamination and/or adulteration. CONCLUSIONS: A number of herbal medicinal products are associated with serious hepatotoxic events. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risk.

Chemical and Drug Induced Liver Injury↗
PubMed2003

Pharmacological effects of Cimicifuga racemosa.

Cimicifuga racemosa is widely employed to relieve menopause symptoms for its hormonal-like action. However, recent experimental studies have not found an estrogenic action by this plant. The purpose of this systematic review is to analyse all experimental studies (in vivo and in vitro) performed on C. racemosa to elucidate its mechanism of action. Animal and in vitro experiments on C. racemosa were identified through a computerised literature searches performed on Medline (PubMed), Embase, Amed, CISCOM and Cochrane Library databases. In addition, bibliographies of the articles thus located were scanned for further relevant publications and manufactures of commercial C. racemosa preparations were asked to contribute published and unpublished material. No language restrictions were imposed. A total of 15 animal and 15 in vitro studies on C. racemosa have been found. Their results suggest that C. racemosa possesses a central activity instead of a hormonal effect. Further biological and chemical investigations are required to define its mechanism of action and to identify the compounds responsible of its actions.

Animals↗
PubMed2003

The safety of massage therapy.

OBJECTIVES: After many years out of the limelight, massage therapy is now experiencing a revival. The aim of this systematic review is to evaluate its potential for harm. METHODS: Computerized literature searches were carried out in four databases. All articles reporting adverse effects of any type of massage therapy were retrieved. Adverse effects relating to massage oil or ice were excluded. No language restrictions were applied. Data were extracted and evaluated according to predefined criteria. RESULTS: Sixteen case reports of adverse effects and four case series were found. The majority of adverse effects were associated with exotic types of manual massage or massage delivered by laymen, while massage therapists were rarely implicated. The reported adverse events include cerebrovascular accidents, displacement of a ureteral stent, embolization of a kidney, haematoma, leg ulcers, nerve damage, posterior interosseous syndrome, pseudoaneurism, pulmonary embolism, ruptured uterus, strangulation of neck, thyrotoxicosis and various pain syndromes. In the majority of these instances, there can be little doubt about a cause-effect relationship. Serious adverse effects were associated mostly with massage techniques other than 'Swedish' massage. CONCLUSION: Massage is not entirely risk free. However, serious adverse events are probably true rarities.

Adult↗
PubMed2003

Avocado-soybean unsaponifiables (ASU) for osteoarthritis - a systematic review.

Patients suffering from osteoarthritis (OA) are often tempted to try 'alternative' treatment options. Avocado/soybean unsaponifiables (ASU) have shown some promise for OA. This systematic review is aimed at critically evaluating the data from rigorous clinical trials of ASU. Six databases were searched for randomised, placebo-controlled, double-blind trials of ASU. Four studies could be included. Key data were extracted according to predefined criteria and tabulated as well as discussed in narrative form. The methodological quality of the four studies was high. They included patients with OA of the knee and hip. The dose of ASU was 300 mg/day and one trial also included a group treated with 600 mg/day. Three of the four trials suggested efficacy of ASU for improving the symptoms of OA. The majority of rigorous trial data available to date suggest that ASU is effective for the symptomatic treatment of OA and more research seems warranted. However, the only real long-term trial yielded a largely negative result.

Aged↗
PubMed2003

The benefits of Arnica: 16 case reports.

Following the publication of a randomised controlled trial of Arnica in hand surgery, a number of reports of apparently beneficial effects of Arnica came to the author's attention. Many of these apparent responses could have been due to other factors including the use of herbal (non-diluted) Arnica, placebo response and natural course of disease.

Animals↗
PubMed2003

The current position of complementary/alternative medicine in cancer.

Complementary/alternative medicine is a tempting option for many cancer patients. Unfortunately, reliable information is not always easy to obtain and some cancer patients may be misled by interested parties. Research in this area is scarce and with numerous therapies we cannot be sure about efficacy or safety. It follows that our current knowledge gaps urgently needs to be filled.

Clinical Trials as Topic↗
PubMed2003

Reflexologists' responses to a patient with abdominal pain-a survey on Internet advice.

OBJECTIVE: To generate preliminary data on how individual reflexologists deal with patients seeking medical advice on the Internet. DESIGN: E-mail survey involving reflexologists who were partly blinded for their advice on the Internet. SETTING: Cyberspace. PARTICIPANTS: Two hundred and seventy-seven members of the Association of Reflexologists. Of 842 e-mails sent out we received 323 responses (38% response rate) of which 46 participants later withdrew their responses (14% withdrawal rate). INTERVENTION: Participants were asked to advise a fictitious patient via e-mail who presented various health problems. MAIN OUTCOME MEASURE: Rating of responses according to safety and claims made by reflexologist sample. RESULTS: Eighty-five percent of all respondents advised the fictitious patient to present the health problems to a medical professional. Fifty-eight percent expressed urgency to see a primary care physician or other health care professional and 95% pointed out that a diagnosis cannot and should not be made by a reflexologist. Twenty-nine percent of responders suggested a differential diagnosis or underlying causes for the patient's condition. CONCLUSIONS: In this survey reflexologists from the UK Association of Reflexologists have responded in an encouraging manner to a fictitious patient's request for health advice via electronic mail as only 5% (or possibly 15%) of reflexologists from this survey need to be more cautious about the advice they give their patients. We hope that our study will further encourage therapists to be more cautious giving Internet health advice in the future.

Abdominal Pain↗
PubMed2003

CAM research funding in the UK: surveys of medical charities in 1999 and 2002.

A custom-made questionnaire was sent to all UK medical charities in 1999 and again in 2002. Its primary aim was to assess the commitment of these institutions towards funding research in complementary and alternative medicine (CAM). Sixty-two (1999) and 60 (2002) answers were received corresponding to response rates of 62% and 55%. The total CAM research funds have increased from pound 70,000 in 1999 to pound 412,755 in 2002. In terms of total research budgets, this amounts to 0.05% and 0.31%, respectively. The number of CAM research projects has increased but so has the number of charities who do not fund CAM research. We conclude from these data that CAM research funding by UK medical charities has increased. In relative terms it does, however, remain low and out of proportion to the prevalence of CAM use in the UK.

Charities↗
PubMed2003

The lecture from hell.

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Attitude of Health Personnel↗