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At least 649 records · Page 36Linked to original sources
PubMed2002

Anti-inflammatory compounds from the bitter mushroom, Sarcodon scabrosus.

A bioassay-guided purification procedure from the methanol extract of Sarcodon scabrosus led to the isolation of several anti-inflammatory compounds: sarcodonin A (1) and G (2), and related compounds (3, 4 and 5). We named these related compounds neosarcodonin A (3), B (4) and C (5) and elucidated their structures on the basis of spectral data. Topical application of each of these compounds to mouse ears suppressed TPA-induced inflammation. Neosarcodonin C (5) exhibited the highest activity and inhibited the TPA-induced edema on mouse ears by up to 87% with a 200-microg application.

Agaricales↗
PubMed2006

Consumption of dietary supplements containing Citrus aurantium (bitter orange)--2004 California Behavioral Risk Factor Surveillance Survey (BRFSS).

BACKGROUND: Following the marketing ban of ephedra-containing supplements in April 2004, many manufacturers substituted the herb Citrus aurantium for ephedra and marketed the products as "ephedra-free" supplements. Extracts of C. aurantium contain synephrine, a sympathomimetic alkaloid. OBJECTIVE: To determine the prevalence of consumption of dietary supplements containing C. aurantium in California during 2004. METHODS: We used the 2004 California Behavioral Risk Factor Surveillance Survey to determine the prevalence of consumption of dietary supplements containing C. aurantium in California during 2004. RESULTS: Two percent (n = 70) of the 4140 survey respondents reported taking a dietary supplement containing C. aurantium in the previous year. Reasons stated included energy enhancement, weight loss, and appetite suppression. Compared with nonusers, users were more likely to report being single, aged 18-34 years, and Hispanic; consuming 3 or more alcoholic drinks on days that they imbibed; and having a heavier body mass index. Among the 5 users who reported experiencing an adverse event that they attributed to the supplement, 3 indicated that the severity was mild. CONCLUSIONS: Given that supplements containing ephedra were banned in April 2004, the results from this study may serve as a baseline estimate against which future studies of the use of C. aurantium products may be compared.

Adolescent↗
PubMed2004

A bitter pill: attempting change in a pediatric morning report.

OBJECTIVE: To assess and address participants' dissatisfaction with departmental morning report (MR). METHODS: Three consecutive MR sessions were observed, and those data, in combination with findings from the literature, were used to guide creation of a quantitative survey. The survey was administered to all faculty and housestaff. Survey items addressed the educational focus, leadership, and format of MR and the value of specific educational conferences. Subsequently, 2 interventions were developed to increase participants' level of satisfaction with MR. The interventions' effect was measured 1 year later using a second survey. RESULTS: Eighty-two percent of housestaff and 43% of faculty responded to the first survey. Our findings are contrary to those in the literature. For example, respondents rated the presence of all faculty at MR as desirable, and both subspecialty and general pediatric contributions were considered important. Housestaff assigned greater educational value to all teaching conferences than did faculty. Similarly, housestaff believed more strongly than faculty that MR leadership should be changed. A follow-up survey demonstrated a decrease in mean perceived value of MR after our interventions. CONCLUSIONS: Despite aggressive research, we failed to identify the source of participants' dissatisfaction. Although our interventions were based on research data and reflected participants' perceptions and concerns related to MR, they were not supported by the faculty. This demonstrates the inherent difficulties in changing an "institution" such as MR. Thus, examination of MR goals and satisfaction by individual training programs should be conducted within the confines of the conference's preexisting structure, without attempt to apply literature-driven expectations.

Attitude of Health Personnel↗
PubMedDate not supplied

[More than thirty years of illicit drugs in Spain: a bitter story with some messages for the future].

The phenomenon of illicit drug use in Spain during the last thirty years has been marked by the extremely serious consequences of heroin use (mainly injecting). More than 300,000 persons were treated for heroin dependence, 20,000-25,000 died from overdose, 100,000 became infected with HIV through drug injection and quite more with hepatitis virus. Some of these consequences can be attributed to the delay in the implementation of effective interventions, such as methadone maintenance treatment (MMT). Currently, the decreasing number of injectors and the positive effects of interventions, mainly MMT, have led to an important decline of the mentioned health problems. However, overdose mortality remains very high (more than 700 deceased per year), prevalence of both HIV and HCV are still high among injectors, and consequences of chronic liver diseases are emerging. In the last years the use of cocaine and associated problems have increased a lot. Nowadays there are more than 100,000 weekly cocaine users, 25.000 persons are annually treated from cocaine abuse or dependence, and cocaine has an important impact on medical emergency services, while its impact on mortality is unknown. Both cannabis use and related problems are increasing too (there are half a million of daily users). We propose to maintain and to strengthen harm reduction programs (MMT, syringe exchange, save-use and injection rooms, hepatitis A and B vaccination, etc.), to urgently develop specific strategies targeted to reduce overdose mortality and cocaine related problems, and to re-evaluate the effectiveness of preventive and supply control strategies.

Adolescent↗
PubMed1981

Medical drugs of limited commercial interest: profit alone is a bitter pill.

Medical drugs of limited commercial interest frequently are unavailable to the public even though their therapeutic efficacy is well established. At present, availability of a particular drug is unpredictable, and determined largely by pharmaceutical industry willingness to produce the drug potentially at no profit. Anticipated profitability also profoundly guides drug development decisions by industry. Federal efforts by both the executive and legislative branches to develop policy aimed at facilitating development and distribution of medical drugs of limited commercial interest have intensified. Thorough analysis of the problems and of proposed plans for their amelioration is necessary to effect a policy which takes into account the social, political, and scientific factors, as well as the profit motive.

Commerce↗
PubMed1999

Should people with nocturnal leg cramps drink tonic water and bitter lemon?

A literature search from 1993 to 1997 using MEDLINE and key-words beverages, muscle cramp, and quinine was performed. Three beverages containing quinine were examined in grocery stores. Analysis indicate that leg cramps are a common phenomenon associated with many comorbid disorders especially peripheral vascular and neurologic disorders. Thus, evaluation of a patient's complaining of leg cramps appropriately includes vascular, neurologic, and musculoskeletal examinations. Laboratory investigation of the symptom of leg cramps warrants as a minimum, assessment of thyroid function and determination of platelet counts and serum levels of electrolytes, calcium, and magnesium. A few small studies suggest that quinine is effective in decreasing the frequency of nocturnal leg cramps but not their severity or duration. Quinine consumed in commercial beverages has been reported to cause potentially fatal immunologically mediated hypersensitivity reactions. The concentration of quinine in commercial beverages varies greatly. Although commercial beverages containing quinine generally are labeled "Contains quinine," they typically lack both nutritional information about the amount of quinine and warnings of the health risks. It appears that 325 milligrams of quinine taken by mouth at bedtime typically relieves nocturnal leg cramps, but lower starting doses are appropriate for senior citizens and individuals with impaired renal function. In general, quinine in any form should be avoided by pregnant women and people with hepatic failure. Quinine consumed for the treatment of leg cramps should be prescribed and monitored by physicians, and people who consume quinine in commercial beverages must be warned of the health risks.

Carbonated Beverages↗
PubMedDate not supplied

A bitter pill: formulary variability and the challenge to prescribing physicians.

BACKGROUND: Multitiered, incentive-based formularies have been increasingly used as a mechanism to control prescription drug expenditures. Prescribing physicians who manage patients from multiple insurers must be familiar with the variability in their patients' formulary incentives to help patients choose therapy wisely. However, the degree of formulary variability among and within health plans over time is unclear. METHODS: In 6 major health plans in California, we evaluated formulary incentive variability in 4 of the 5 drug classes with the highest expenditures in California: proton pump inhibitors, hydroxymethylglutaryl coenzyme A reductase inhibitors ("statins"), calcium channel blockers, and angiotensin-converting enzyme inhibitors. We categorized 20 branded members of these classes into either "preferred" or nonpreferred/uncovered categories. We calculated the consistency that brands were preferred across health plans and the frequency of changes in formulary status for each drug within plans between 2000 and 2002. RESULTS: None of the branded drugs evaluated were preferred on all formularies in 2002, and 10% were not available on any of the formularies. Formulary status varied greatly across plans, and more than 60% of drugs were preferred on 2 to 4 of the 6 formularies studied. Formulary status within health plans varied between 2000 and 2002 in more than half of the plans in the drug classes evaluated. CONCLUSIONS: In the drug classes evaluated, over a 2-year period, considerable variability was seen among and within formularies over time. This variability poses a challenge to physicians who wish to reduce patients' expenditures by prescribing the least expensive among similarly effective drugs within a drug class. This variability is especially relevant because recent legislation increases the likelihood that more Medicare beneficiaries will receive their medications from private health plans.

Angiotensin-Converting Enzyme Inhibitors↗