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Herbal Medicine: Is it an Alternative or an Unknown? A Brief Review of Popular Herbals Used by Patients in a Pain and Symptom Management Practice Setting.

This article will briefly discuss herbals frequently used by patients in a pain and symptom management practice setting with regard to common indications, potential side effects, and drug interactions, as well as a review of available research on each substance. An overview of the regulatory morass that continues to surround the herbal products industry will be presented. The author will examine possible ethic implications of providing care to patients utilizing alternative therapies. Future developments and studies in the field of herbal therapies will be considered.

Journal Article↗

Benzodiazepines, the popular minor tranquilizers: dynamics of effect on driving skills.

The adverse effects of minor tranquilizers, and more specifically benzodiazepines, on psychomotor and cognitive performance have been documented repeatedly over the years, and epidemiological studies have provided sufficient evidence of their role in traffic accidents. These studies indicate that drug plasma level (DPL) is insufficiently correlated with impairment and that other factors need to be considered in determining the impairment vulnerability. This report reviews several sources of individual variability, particularly as they relate to differential impairment effects. These sources, which include such factors as acute peak effects, acute tolerance, chronic tolerance, benzodiazepine receptor affinity and individual sensitivity, need to be examined before quantification of DPL is introduced as a criterion for driving under the influence. Behavioral testing itself may become the critical means of assessing drug- and/or drug with alcohol-induced driving impairment if acceptable standardized procedures can be developed. Attention is drawn to the rapid onset of impairment associated with acute effects of more lipid soluble drugs. The discussion of impairment of benzodiazepines should be seen in the perspective of their relative overall safety compared to other drugs used as minor tranquilizers.

Accidents, Traffic↗

Relationships between the acidity and osmolality of popular beverages and reported postprandial heartburn.

BACKGROUND/AIMS: Although many beverages produce heartburn, the relationship between the acidity and osmolality of beverages and heartburn is unclear. The aim of this study was to relate the acidity and osmolality of beverages with their ability to cause heartburn. METHODS: We measured pH, total titratable acidity, and osmolality of 38 beverages in vitro and then correlated acidity and osmolality with the amount of heartburn reported by questionnaire in 394 people with heartburn. RESULTS: Among 17 citrus drinks and juices, titratable acidity correlated with reported heartburn scores (r = 0.65; P = 0.004). Soft drinks had the lowest pH readings of any beverages studied, and decreasing pH among soft drinks was correlated with reported heartburn scores (r = 0.82; P < 0.001). Alcoholic beverages (wines and beer), coffee, and (to a lesser extent) tea were associated with significant amounts of reported heartburn when compared with water. Milk was also associated with a modest amount of reported heartburn that was related to its fat content. Osmolality of beverages was unrelated to reported heartburn. CONCLUSIONS: High titratable acidity of citrus drinks and juices and low pH of soft drinks are associated with more reported heartburn. Our findings provide a foundation for dietary advice in patients with heartburn and reflux esophagitis.

Acids↗

Prostaglandin E2 vaginal suppository for induction of labour: an efficient, safe and popular method.

Two different methods for induction of labour were randomly used in 100 women with a favourable cervix. The patients were treated with either prostaglandin vaginal suppositories containing 2.5 mg PGE2 in a base of Witepsol S55 (Dynamit Nobel) or intravenous infusion of oxytocin. The PGE2 vaginal suppository was significantly more efficient than the intravenous infusion of oxytocin in relation to the time interval from the start of induction of labour to delivery. Also the percentage of women who delivered within 48 hours (success rate) was higher in the suppository group. Significantly more women in the suppository group found this induction method recommendable.

Dinoprostone↗

Why is humoral medicine so popular?

The hot/cold system is perhaps the most widely known medical belief system in the world. I propose that the wide acceptance of hot/cold ideas is due to the fact that they provide a particularly simple, economic coding for common human experience, such as hypothermia, heatstroke, and fevers. Coding of foods as heating or cooling can be understood in terms of a system of sensory cues that make the foods appear hot or cold. This paper deals primarily with data from Chinese culture.

Cold Temperature↗

Medical and popular traditions of nerves.

We question the assumption that the common complaint of nerves in small Newfoundland fishing villages is a legacy of the late 19th century syndrome called weak nerves or neurasthenia, and instead trace the development of a Western medical science of nerves from the early 1700s to the present. Native descriptions of the physical, especially tonic, nature of nerves and of the moral strength needed to fight nerves are correlated with 18th century medical notions. Less resemblance exists between Newfoundland nerves and concepts of neurasthenia in the late 19th century. Moreover, the contemporary descriptions of nerves as a generalized response to stress and anxiety do not account for the culture-specific aspects of nerves which shape Newfoundland regional identity and shed light on their present day sociocultural adaptations.

Anxiety Disorders↗

The cultural logic of Indian medicine: prognosis and etiology in Rajasthani popular therapeutics.

This paper considers certain ways of describing and treating sickness in rural Rajasthan, and the representations of sickness and of the body on which they are based. Two indigenous medical or 'ethnomedical' perspectives on illness and its treatment emerge from the analysis of ethnographic material collected during field research in northern India. In the first part of the paper various characterizations of South Asian medicine are discussed, and I suggest that Western preconceptions about the nature and purpose of 'medicine' itself has led one of these perspectives to be highlighted in anthropological considerations at the expense of the other. A further dimension of ethnomedicine emerges through discussions of local therapeutic rituals and discourses about sickness and the body. This consideration of one domain of local therapeutics reveals its underlying cultural logic and highlights ethnomedical formulations that have heretofore been analytically neglected. It does not address the formal or textually based Indian medical traditions to any extent. It is concerned with the cultural construction of sickness and medicine among Hindu lay people and folk healers and employs folkloric material that, though rarely considered in anthropological writings on South Asia, may be fruitful guide to the meanings which sickness has for those experiencing and treating it.

Culture↗

Blood is hotter than water: popular use of hot and cold in Kel Tamasheq illness management.

Ethnographic data on Malian Kel Tamasheq use of hot-cold classification in illness management within the household show that, although hot and cold vocabulary is known by most people, the concepts of opposition and balance are only one of several approaches to treating illness and are rarely used in practice. This differs from the importance ascribed to hot and cold by Tamasheq traditional healer specialists as cited in the literature. The logic of the classification is based on symptoms rather than foods, and is associated with the presence or absence of blood or water. Many people are able to reproduce this symptomatic logic without being able to articulate its details. Because of their more frequent contact with blood through menstruation and childbirth, women are more susceptible to cold symptoms which are most frequently and clearly articulated in relation to gynaecological illnesses. Knowledge and understanding of the classification varies by social class, with those groups more recently assimilated into the Tamasheq population less likely to subscribe to this interpretation of illness. The influence of data collection methodology to the apparent importance of hot and cold as an explanatory system is also discussed.

Africa, Western↗

Screening of antimicrobial activity of plants popularly used in Guatemala for the treatment of dermatomucosal diseases.

Ethnobotanical surveys were conducted among traditional healers and local market vendors; about 200 plants used in Guatemala for the treatment of dermatomucosal diseases were detected. By literature review and according to local availability, 89 plants were selected for in vitro screening for antimicrobial activity against the microorganisms usually causing skin and mucosal infections. Ethanolic macerations were prepared and impregnated in absorbent paper; once dried, these were applied over standardized inocula of Candida albicans, Escherichia, coli, Pseudomonas aeruginosa and Staphylococcus aureus. After incubation, inhibition zones were measured, demonstrating that 28 of the plants exhibited some in vitro inhibition of the tested microorganisms.

Anti-Infective Agents↗

Medicinal plants in Mozambique and their popular use.

The authors give a review about plants used in the folk medicine of Mozambique, according to the literature and the personal experiences of the first author in dealing with people there. This paper shows their known active compounds and treatment of the therapeutical values as well as methods of application in Mozambique and in its neighbouring countries.

Humans↗

The stability in liver homogenates of indium-111 and yttrium-90 attached to antibody via two popular chelators.

To investigate the influence of chelator on the stability in liver homogenates of 111In and 90Y-labeled antibodies, the C110 antibody was conjugated with the cyclic anhydride of DTPA (cDTPA) and with isocyanatobenzyl-DTPA (SCN-Bz-DTPA) and labeled with both radionuclides. After incubation in fresh liver homogenates at 37 degrees C for 1-2 days, the soluble fraction was analyzed by filtration, HPLC and TLC to determine the nature and extent of transchelation of the label and catabolism of the antibody. The loss of activity from antibody, as shown by passage through a low molecular weight (10 kDa cut-off) filter, was 3-5 times more pronounced for 90Y (51 and 68% at 1 and 2 days) than 111In (11 and 29%, respectively). No significant difference was observed between chelators. Furthermore, analysis of these low molecular weight species showed that even at 1 day, 90Y in contrast to 111In was present as one or more weak complexes and therefore no longer chelated to either DTPA or Bz-DTPA. Little evidence was observed for instability in liver of the thiourea bond whereby SCN-Bz-DTPA is attached to the antibody. By contrast the identification of 111In-DTPA in the homogenates demonstrates the instability of the amide bond generated by cDTPA conjugation. In conclusion, as expected, 90Y was shown to form less stable chelates than 111In, however, in this investigation the greater denticity of Bz-DTPA over DTPA did not improve stability with either radiolabel.

Animals↗

Celsior preserved cardiac mechanoenergetics better than popular solutions in canine hearts.

BACKGROUND: Better protective effects of Celsior on cardiac function than the other conventional solutions have been reported in acute experiments and in clinical trials for at-risk patients. However, no study has yet precisely elucidated how these preservation solutions affect cardiac mechanoenergetics. Therefore, we evaluated the effects of St. Thomas' Hospital solution No. 2, University of Wisconsin solution, and Celsior on left ventricular contractility (Emax: end-systolic pressure-volume ratio) and oxygen consumption. METHODS: We used 32 canine excised cross-circulated hearts. Twenty-three hearts served as donor hearts after hypothermic ischemia with one of the three solutions, and the remaining 9 served as controls. After arrest with each solution, the hearts were preserved for 4 hours at 4 degrees C. Then, we measured left ventricular pressure, volume, and oxygen consumption to obtain Emax and the relation between ventricular pressure-volume area (a measure of total mechanical energy) and oxygen consumption. We also evaluated the oxygen cost of Emax by changing Emax with calcium administration. RESULTS: Celsior did not significantly affect E(max) (6.3 +/- 2.4 in control versus 5.3 +/- 1.3 mm Hg.mL(-1).100 g with Celsior) nor the oxygen cost of Emax (1.2 +/- 0.6 versus 1.6 +/- 0.5 mL O2.mL.mm Hg(-1).beat(-1).100 g(-2), respectively). In contrast, St. Thomas' Hospital and University of Wisconsin solutions significantly decreased Emax (4.5 +/- 1.1 and 3.5 +/- 0.9 mm Hg.mL(-1).100 g, respectively) and increased the oxygen cost of Emax (2.5 +/- 0.8 and 2.4 +/- 0.9 mL O2.mL.mm Hg(-1).beat(-1).100 g(-2), respectively) compared with control and Celsior-preserved hearts. The slope and intercept of the oxygen consumption versus pressure-volume area relation showed no significant difference among the four groups. CONCLUSIONS: Celsior showed better protective effects on cardiac mechanoenergetics than St. Thomas' Hospital and University of Wisconsin solutions in the acute phase of heart transplantation.

Animals↗