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[Gynecological, hematological and metabolic studies during therapy with an estrogen-gestagen combination preparation].

Twenty women after menopause were submitted to substitution treatment with a biphasic hormone combination (Cyclacur¿). Nine of these had undergone hysterectomy + ovarectomy. Through 11 days each of the women was administered a daily dose of 2 mg estradiol-valerianate as estrogen. Subsequently, for another 10 days each was given the identical dose of estrogen plus 0.5 mg DL-norgestrel as gestagen. Upon this followed an intermission of 7 days without any medication. After 1 cycle of placebo, 7 cycles of medication were followed by 1 cycle of placebo again with regular controls. Climacteric signs and symptoms were eliminated entirely. In those women without hysterectomy withdrawal-menorrhagia occurred promptly 2--3 days after discontinuing medication. During the entire period of investigation there was no significant change in serum lipids, blood sugar values, or serum enzyme tests used as parameter of hepatic function. As far as hematology is concerned there was a moderate rise of hematocrit. No change of serum protein-bound iodine was observed.

Alanine Transaminase↗

[Achievements, disappointments and hopes in neurological therapy in the 20th century].

Only in the second half of the 20th century a breakthrough occurred in the traditional neurological therapeutic methods based up to that time mainly on bromine with valerian extract and vitamins B. Later on in that century several great discoveries were made which improved greatly the effectiveness of the neurological therapy: psychopharmacology which began with the introduction of chlorpromazine and reserpine, the use of corticosteroids for which the Nobel award was given, levodopa introduction for Parkinson's disease, non-steroid antiinflammatory agents and the demonstration of their action mechanism /also Nobel award/, immunotherapy, botulin toxin for the treatment of dystonias and thrombolytic drugs possibly the drugs of the future. The main disappointment is the broad chasm between the progress made in diagnostic methods and the low effectiveness of therapy in strokes, amyotrophic lateral sclerosis, Alzheimer's disease and other degenerative neurological diseases. Many problems arose with the introduction of levodopa changing the course and clinical pattern of Parkinson's disease. The problem of our times are the adverse effects of pharmacotherapy. The low effectiveness of the new drugs used in epilepsy is also disappointing. A hope for the future is the new direction in therapy--the use of genes and also the use of monoclonal antibodies and neurotrophic agents. It is to be expected that in the near future medicine will find effective methods for the treatment of malignant neoplasms.

Antibodies, Monoclonal↗

[Drug for the treatment of sleep disorders--review].

For the treatment of insomnia/sleep disturbances, drugs are indicated only if non-drug-procedures alone are not sufficiently successful or not successful at all. To facilitate sleep, sedative-hypnotic agents are used clinically. Because of favorable risk-benefit ratio, non-benzodiazepines with benzodiazepine-like action (zolpidem, zopiclon) or benzodiazepines themselves (dependent on their pharmacokinetic profil) are administered in the most cases. Sedative-hypnotic drugs reducing the electric activity of the CNS sufficiently to produce coma and even death are not recommended at present. To assess the clinical relevance of amino acid L-tryptophan for the treatment of insomnia/sleep disturbances, more controlled clinical studies are necessary. The nonprescription antihistamines (Doxylamin, Diphenhydramin) are only suitable for short-term administration in adults. Under certain conditions, antidepressant and antipsychotic drugs can be taken. Because of potential risks, the intake demands caution. Different herbal remedies are recommended, but only for extracts of valerian a sleep-inducing effect can be assumed. Melatonin, an endogenous hormone and tryptophan-metabolite is thought to be involved with the sleep-wake cycle. Therefore the exogenous intake of melatonin may influence vigilance and sleep. This is particularly true for patients with jet-lag symptoms.

Anti-Anxiety Agents↗

[Attention deficit and infantile hyperactivity].

Hyperactivity is a very common disorder in children (specially males) that today is considered as a clinical syndrome by scientific medicine. American Psychiatric Association establishes 10 symptoms to diagnose it, but they can be resumed in three characteristics: Impulsivity, Distraction, and Hyperactivity. There are different ways to treat it, but psychiatric medication has major risks in children. From complementary medicine we can find several aids in changing diet patterns and supplementing with vitamins or minerals. Chocolate, sugar, sweeteners, additives, preservatives, dyes, can enhance the incidence of this syndrome; instead the supplementation with lipids rich in PUFA's can prevent it. B complex vitamins, magnesium, copper, manganese or calcium can be interesting and in herbal medicine, sedative plants like passion flower, valerian or lemon balm are useful aids. Also liquorice, fennel and berries can be used for different physiological actions.

Age Factors↗

[Estradiol-17beta, estrone, LH and FSH in serum after administration of estradiol-17beta, estradiolbenzoate, estradiol-valeriate and estradiol-undecylate in the female (author's transl)].

Estradiol-17beta, estradiol-benzoate, estradiol-valerianate, and estradiol-undecylate were injected intravenously and intramuscularly to postmenopausal woman and to female castrates. Equal doses were used corresponding to 20 mg of free estradiol-17beta. Estradiol-17beta, estrone, FSH and LH were measured in serum by radioimmunoassay before and after application of the hormone and the estradiol esters. Thus the depot effect of the different esters could be compared.

Adult↗

Herbal medicine. What is the evidence?

This is the final in the series of 13 articles looking at current herbal therapy. It reviews those plants with clinical and scientific evaluation sufficient to consider adoption into orthodox medicine. Surprisingly some commonly used herbs, such as the purple coneflower (Echinacea purpura), valerian and ginseng, do not as yet pass the test, but others such as St John's wort, ginkgo, saw palmetto now have sufficient clinical studies to consider orthodox use. With the huge interest in herbal treatment it is likely that other plants will join the list following adequate clinical evaluation.

Evidence-Based Medicine↗

[Examination of the olfactory analyzer].

A method of threshold olfactometry is proposed consisting in the use of three olfactive substances (tincture of valerian, acetic acid, liquid ammonia) in selected concentrations. This allows to investigate the thresholds of certain modality. Each concentration of the olfactive substance is placed into a glass bottle (100 ml) and stored at the temperature 18-20 degrees C. The examination of the state of the olfactory analyzer within a 24-h working day showed stability of threshold olfactometry when the organism is tired. Utilization of threshold olfactometry in some diagnostic areas is shown.

Adult↗

An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations.

Herbal medication in the United States is a popular form of therapy. This paper provides an overview of the utilization of herbal supplements with particular emphasis on possible interactions with oral health drugs and oral manifestations. Herbal supplements are regulated by the Dietary Supplement Health and Education Act (DSHEA), which limits their regulation by the U.S Food and Drug Administration (FDA). A number of studies indicate that there is a progressive increase in the utilization of herbal supplements. The majority of consumers of these products are white, middle-aged women who have some college education. Many of the consumers use pharmaceutical drugs concurrently, but most do not inform their health-care providers about their use of herbal supplements. Various herbal supplements have been reported or are suspected to interact with certain oral health drugs, the most important one being 1) bromelain, cayenne, chamomile, feverfew, dong quai, eleuthro/Seberian ginseng, garlic, ginkgo, ginger, ginseng and licorice interacting with aspirin; 2) aloe latex, ephedra, ginseng, rhubarb, cascara sagrada, licorice, and senna interacting with corticosteriods; 3) kava, St. John's wort, chamomile, and valerian interacting with central nervous system (CNS) depressant drugs; and 4) herbs acting on the gastrointestinal system, altering the absorption of several orally administered drugs. Further, the use of some herbal supplements has been reported to be associated with oral manifestations, including aphthous ulcers, lip and tongue irritation, and swelling with feverfew; gingival bleeding with feverfew and ginkgo; tongue numbness with echinacea; xerostomia with St. John's wort; oral and lingual dyskinesia with kava; and salivation with yohimbe. These potential effects of herbal supplements in conjunction with factors related to regulation restrictions suggest that the use of these products may be associated with various adverse reactions that can affect oral health and treatment. Dental hygienists should inform themselves about herbal supplements in order to offer appropriate oral health care to individuals who take these substances.

Blood Coagulation↗

Dietary supplements in primary care. Botanicals can affect surgical outcomes and follow-up.

Dietary supplements are commonly used by patients of all ages, yet few patients reveal use of these products to their medical providers. Certain dietary supplements can react or interact with frequently used surgical medications--including anesthesia--and may cause serious unforeseen consequences or complications. Arrhythmias, poor wound healing, bleeding, photosensitivity reaction, and prolonged sedation are among the serious reactions during and after surgical and diagnostic procedures that have been attributed to these products. This article reviews the effects of the Few Gs (feverfew, ginkgo biloba, garlic, ginseng, and ginger), valerian, kava, St. John's wort, ephedra (Ma huang or metabolite), and echinacea. We recommend that all patients be advised to stop all dietary supplements at least 1 week prior to major surgical or diagnostic procedures; if a complication is noted, continued use of these products should be reviewed with patients.

Dietary Supplements↗

[Preoperative psychopharmacological correction in women with focal breast diseases].

The paper presents the results of a study dealing with the choice of an agent to correct the psychoemotional state in women with dyshormonal focal breast diseases (DFBD). The correction involved dimedrol, valerian extract, Novopassite, diazepam, phenazepam, amitryptiline, coaxil, grandaxine, alprozam (Xanax), or atarax. To assess the results, clinical, psychopathological, clinicopsychological, anamnestic, and experimental psychological studies were used. The use of alprozam and atarax yielded the best results of correcting the psychoemotional state in women with DFBD, by producing minimum adverse reactions.

Adult↗

[Natural remedies and hormone preparations--potential risk for breast cancer patients. A study surveys the use of agents which possibly counteract with the treatment].

We have studied the use of complimentary alternative medicine (CAM) among 233 consecutive breast cancer patients operated on at the Lund University Hospital, Sweden between 2002 and 2004. Questionnaires were administered preoperatively (n = 233), and again 3-6 months post-operatively (n = 167) and one year after surgery (n = 88). At baseline, 14,5% used CAM, 3-6 months post-operatively 14,4% used CAM and one year after surgery 18,2% used CAM. The most common products contained omega-3, garlic, ginseng and roseroot. We identified use of 35 different types of CAM products and seven of these could potentially increase the risk of breast cancer or interact with tamoxifen or aromatase inhibitors: soy, garlic, ginko biloba, echinacea, ginseng, valerian and phytoestrogens (excluding soy). Five and a half percent of the patients used either hormone replacement therapy (HRT) or hormonal contraception at the pre-operative visit, after they had received their breast cancer diagnosis. In conclusion, it is important that doctors discuss the use of CAM and exogenous hormone therapy with their breast cancer patients given the prevalence of these drugs.

Antineoplastic Agents↗

[Toxicological approach to evaluation of bioavailability of powdered medicinal herbs].

Neurotoxicity manifestations related to the extraction of active ingredients from "natural" powdered Atropa belladonna (NPB) and Leonurus cardiaca (NPL) in gastrointestinal tract and respectively of their bioavailability were studied in mice. The symptoms were compared with action of approved officinal extracts. In response to orally administered NPB suspension mice displayed well-defined symptoms of typical cholinolytic appearance. On p.o. administration NPB appeared approximately twice as active as officinal concentrated extract. Sequential administration of NPB and of neostigmine eliminated CNS toxicity confirming the bioavailability and notable cholinolytic activity of NPB. Behavioral, neurological and autonomic profiles developed in response to elevated p.o. doses of NPL were typical of sedative - hypnotic drugs, while maximum prolongation of barbiturate- induced sleep was achieved when "no-effect" doses of NPL and powdered valerian root suspensions were administered concurrently, demonstrating mutual potentiation of specific activity of these natural (non-processed) powders, and respectively excellent bioavailability of their active principles.

Administration, Oral↗

[Acute sedative effect of a herbal relaxation tablet as compared to that of bromazepam].

The relaxing effect and the systemic tolerance of a single oral dose of Valverde relaxation dragées have been examined double-blinded against 3 mg of bromazepam and placebo in groups of 20 healthy male volunteers each treatment. The systemic tolerance was assessed at the end of the examination, relying on spontaneous remarks or comments made on side effects upon questioning. As the four plants from which Valverde has been extracted (valerian, balm, passion-flower, and pestilence wort) have a reputation of being tranquilizing agents with spasmolytic effect, not only this effect needs to be demonstrated, but also sedative side effects and impairment of vigilance must be assessed to explore the risk for accident proneness. We expected that the relaxing-tranquilizing effect of bromazepam as well as of Valverde relaxation dragées compared with placebo is perceived subjectively. A potentially existing impairment of performance due to Valverde was assumed to be milder than impairment due to bromazepam. The study, however, inspite of a sophisticated test battery with extended testing, could not detect any effect for either of the two drugs; nor could it detect a side effect. The sedation and reduction of vigilance observed in a pre-study without placebo controls (Gerhard and Hobi, unpublished) was explained by natural fatigue which appeared in the course of the morning also under placebo. Therefore, sedative side effects, leading to an impairment in performance, can be excluded for both drugs at the studied dose level.

Adult↗

[Combination of cyproterone acetate and natural estrogens in the treatment of hirsutism].

The effects of oral administration of cyproterone acetate (CPA) (50 mg) associated with natural estrogens, was investigated in two groups of hirsute women. One group received 17-beta estradiol valerianate (E2) (2 mg) (n = 22) and the other, micronized E2 (2 mg) plus estriol (E3) (1 mg) daily (n = 22) for 21 days every month. After a six month period of treatment, hirsutism improved in 70% of the patients. The more frequent adverse effect was amenorrhea. Except in one, weight gain was prevented by a low calorie diet in overweight patients. During treatment, the plasma concentration of E2 was within the normal range for the follicular phase, whereas estrone was higher, and significantly (p less than 0.001) higher under E2 + E3 than under E2 alone (43.5 +/- 29.1 vs 23.9 +/- 6.1 ng/dl). The binding capacity of sex-steroid binding-protein (SBP) was increased by E2 + E3, and was not affected by E2; transcortin levels were unchanged during treatment. The plasma levels of SBP-unbound testosterone and of delta 4-androstenedione were significantly suppressed by CPA, while DHEAS was not significantly reduced. We concluded that oral administration of CPA and natural estrogens, is a well tolerated and efficient treatment of hirsutism.

Adolescent↗

The influence of gonadic hormones on skull differences in rats malnourished during lactation.

One hundred and twenty five Holtzman rats of both sexes were submitted to malnutrition during suckling with or without periodic injections of testosterone enantate in males and estradiol valerianate in females. Ten cranial measurements were made, and morphological differences within and between sexes were calculated by multivariate Mahalanobis D2-distances. Malnutrition delayed the cranial difference between sexes, which was restored by hormonal treatment. Testosterone arrested the skull size difference between sham and malnourished males. Estradiol stimulated the skull size difference between sham and malnourished females. This counteracting effect indicates that at early ages, both hormones stimulate sexual cranial dimorphism when a protein-calorie malnutrition acts on both sexes.

Animals↗

[Casein-like immunoreactivity in the male rat].

A substance presenting a beta-casein-like immunoreactivity (beta-cas-LI) was found in male serum and tissues. This beta-cas-LI was measured by a specific radioimmunoassay using a purified beta-casein and an anti beta-casein kindly supplied by L. M. Houdebine. Serial dilutions of serum or tissues samples showed a good parallelism to the standard curve. In male rat, beta-cas-Li was found in all sera and in some tissues = mammary gland, prostate and testis which contained respectively 6,200, 408 and 38 ng per organ. beta-cas-LI value in the serum was regulatable. Hypophysectomy and long-term castration strongly reduced basal levels. Insertion of testosterone silastic capsules (25 mg/capsule) was able to restore control values, while estradiol (E2) (4 mg/kg E2 valerianate) to castrated or intact rats increased serum beta-cas-LI above basal values. In conclusion, these results showed, for the first time, the presence in male rat serum and tissues of a beta-casein immunoreactive-like substance. Moreover, this beta-cas-LI seemed to be under pituitary and gonad regulation.

Animals↗

[Vertebrate hormones influence on the reproduction of Biomphalaria glabrata and on Schistosoma mansoni infection (author's transl)].

The influence of fifteen vertebrate hormones on the B. glabrata reproduction and on S. mansoni infection have been studied. Hecogenine and pregnadienolone significantly increased the snail's number of eggs; testosterone, diethylstilbestrol and estradiol valerianate decreased their number of eggs and the mesterolone and progesterone produced a slight decrease in the number of eggs. Crude hecogenine, pregnenolone, prednisone, estradiol, cholic acid, diosgenin, estrone and pregnadione have not shown any significant alteration on the snail reproduction. None of these hormones presented any influence upon the S. mansoni cycle in B. glabrata. Molluscicidal, oocidal and cercarcidal activities have been observed with diethylstilbestrol in concentrations below 10 ppm.

Animals↗