101
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Jacobsson I, Jönsson AK, Gerdén B, Hägg S. Spontaneously reported adverse reactions in association with complementary and alternative medicine substances in Sweden. Pharmacoepidemiol Drug Saf 2010; 18:1039-47. [PMID: 19650152 DOI: 10.1002/pds.1818] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
PURPOSE Although the safety information is limited, use of complementary and alternative medicine (CAM) products is not without risks. Spontaneous reporting systems may be used in the surveillance of these products. We describe the pattern of spontaneously reported CAM related adverse reactions submitted to the Swedish Medical Products Agency (MPA) and highlight areas of safety concern. METHODS All adverse reactions spontaneously reported to MPA between 1987 and 2006, where at least one CAM substance was a suspected agent, were scrutinised. From each report information about the patient, adverse reaction/s, drug treatment/s, dosage, time relationship and outcome was retrieved. RESULTS Among a total of 64 493 reports, 778 reports concerned 967 suspected adverse reactions related to 175 different CAM products. The main distribution of suspected adverse reactions was: urticaria (8.3%), exanthema (7.4%) and contact dermatitis (5.7%). The most reported CAM substances were purple coneflower (Echinacea purpurea) (8.1%), purple coneflower + siberian ginseng (Eleutherococcus senticosus) + malabar nut (Adhatoda vasica) (7.3%) and ginkgo leaf (Ginkgo biloba) (6.7%). In 221 reports, at least one reaction was categorised as serious, the most frequent being pulmonary embolism (1.7%), mixed liver reaction (2.8%), and anaphylactic reaction (2.0%). Eleven of the serious adverse reactions had a fatal outcome. CONCLUSIONS CAM substances were associated with a variety of adverse reactions. Some of these have previously been unrecognised or poorly documented and suggest further investigations. By stimulating the reporting of adverse reactions of CAM products, the signal detection power of the spontaneous reporting system may increase further.
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Affiliation(s)
- Ingela Jacobsson
- Division of Clinical Pharmacology, Linköping University Hospital, Linköping, Sweden
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102
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Ali SE, Ibrahim MIM, Palaian S. Medication storage and self-medication behaviour amongst female students in Malaysia. Pharm Pract (Granada) 2010; 8:226-32. [PMID: 25126145 PMCID: PMC4127060 DOI: 10.4321/s1886-36552010000400004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 11/22/2010] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The aims of this study are to determine the prevalence, attitudes and behaviours of medication storage and self-medication amongst female students at Universiti Sains Malaysia (USM). METHODS A cross-sectional survey was conducted and cluster random sampling technique was used for respondent selection. A pre-piloted questionnaire was administered to female respondents so as to collect the data. Data was analyzed using SPSS version 12 and analysis was conducted using descriptive analysis procedures. RESULTS Of the 481 participants (mean age; SD was 22.1; 3.3), 93.1% (n=448) students stated that they stored medicine in their rooms, while 70.7% (n=340) stated that they stopped taking a prescribed medicine without consulting a doctor. The prevalence of self-medication was 80.9% (n=389). The most common reasons for self-medication were related to their knowledge of their ailment and its treatment (58.0%), 14.4% thought it saved time and 8.5% mentioned that medication given by provider was not effective. The most common symptoms were otorhinolaryngology problems (22.5%), followed by respiratory disease (19.6%), Gastro Intestinal Tract (GIT) disease (18.1%) and headache/fever (16.8%). Commonly used medicines were analgesics & antipyretics (30.2%), ear, nose & throat drugs (10.8%), vitamins & minerals (10.8%), GIT drugs (8.5%), anti-infections (7.3%) and herbal medicines (3.5%). Prevalence of medicine storage and self-medication practice is high among educated female students in USM. CONCLUSIONS There is a need to educate the students to ensure safe practice by increasing their awareness. Strict policies need to be implemented on the unrestricted availability of medicines so as to prevent the wastage of medicines.
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Affiliation(s)
- Sohair E Ali
- School of Pharmaceutical Sciences, Universiti Sains Malaysia . Penang ( Malaysia )
| | - Mohamed I M Ibrahim
- Department of Pharmacy Practice. College of Pharmacy, Qassim University . Buraidah, Al Qassim ( Saudi Arabia )
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Awareness of allergy patients about herbal remedies: a cross-sectional study of residents of Ankara, Turkey. Allergol Immunopathol (Madr) 2010; 38:78-82. [PMID: 20188453 DOI: 10.1016/j.aller.2009.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 07/19/2009] [Accepted: 07/19/2009] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The use of herbs in patients with allergic diseases is a special problem and still controversial. The objective of this questionnaire-based study was to determine the rate of herbal use in allergy clinic outpatients as well as to explore patient knowledge. METHODS Patients with respiratory and/or skin disease, either atopic or non-atopic were assigned to a prospective questionnaire study conducted in allergy clinic outpatients. RESULTS Three hundred and ninety-five patients enrolled in the study. The mean age was 33.50+/-12.14 years. Participants generally had a high educational level (40.5% college and 39% university graduated). The rate of herbal use was 14.2%. All characteristics were similar within herbal user and non-user patients, except gender and age. The number of female patients who use herbal products was greater than for males (p=0.043). Herbal use was common in patients in their late thirties (p=0.024). Three main rationales for herbal use were revealed: (i) acting upon advice of someone (41.1%); (ii) the belief that "herbals are always more beneficial than chemicals" (37.5%); and (iii) the trust that "herbals are always safe" (21.4%). Most of the participants have "no idea" (41.5%) or are "not sure" (33.7%) about potential harmful effects of herbs to allergic people. CONCLUSION People will continue to use herbals for one reason or another. Allergists and clinical immunologists need to become more knowledgeable about herbal therapies so that they can inform patients about either the benefits or possible harmful effects of herbs.
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Boneberger S, Rupec RA, Ruzicka T. Complementary therapy for atopic dermatitis and other allergic skin diseases: facts and controversies. Clin Dermatol 2010; 28:57-61. [DOI: 10.1016/j.clindermatol.2009.03.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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105
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Gold JI, Nicolaou CD, Belmont KA, Katz AR, Benaron DM, Yu W. Pediatric acupuncture: a review of clinical research. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2009; 6:429-39. [PMID: 18955306 PMCID: PMC2781770 DOI: 10.1093/ecam/nem181] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 11/28/2007] [Indexed: 11/12/2022]
Abstract
Practiced in China for more than 2000 years, acupuncture has recently gained increased attention in the United States as an alternative treatment approach for a variety of medical conditions. Despite its growing prevalence and anecdotal reports of success among pediatric populations, few empirically based studies have assessed the efficacy of acupuncture for children and adolescents. This article presents a review of the current literature, including a systematic appraisal of the methodological value of each study and a discussion of potential benefits and adverse effects of acupuncture. While acupuncture holds great promise as a treatment modality for diverse pediatric conditions, a significant amount of additional research is necessary to establish an empirical basis for the incorporation of acupuncture into standard care.
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Affiliation(s)
- Jeffrey I Gold
- Childrens Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Collateral Meridian Acupressure Therapy Effectively Relieves Postregional Anesthesia/Analgesia Backache. South Med J 2009; 102:1179-82. [DOI: 10.1097/smj.0b013e3181b48351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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107
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Chon SU, Heo BG, Park YS, Kim DK, Gorinstein S. Total phenolics level, antioxidant activities and cytotoxicity of young sprouts of some traditional Korean salad plants. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2009; 64:25-31. [PMID: 19016328 DOI: 10.1007/s11130-008-0092-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
UNLABELLED The aim of this investigation was to study the antioxidant and anticancer activities of young sprouts of some traditional Korean salad plants. Total phenolics, antioxidant and anticancer activities of the methanol extracts from young sprouts of 11 salad plants were determined. The highest amount of phenolics was found in methanol extracts of Euonymus alatus (235.7 mg kg(-1)), followed by Hypericum ascyron (197.1 mg kg(-1)), Zanthoxylum piperitum (194.1 mg kg(-1)) and Zanthoxylum schinifolium (142.5 mg kg(-1)). Methanol extracts of E. alatus, H. ascyron, and Z. piperitum at 63 mg kg(-1) exhibited the highest dose-depend DPPH radical scavenging activity by 91.2, 91.2 and 83.9%, respectively. According to the MTT results, the methanol extracts from Stellaria aquatica, Eleutherococcus sessilifolrus and Z. schinifolium showed the highest anticancer activities against Calu-6 (IC50<25.0 microg ml(-1)) and from S. aquatica-the highest anticancer activities against SNU-601 (153.3 microg ml(-1)), following by E. sessilifolrus (196.7 microg ml(-1)) and Amaranthus mangostanus (303.1 microg ml(-1)). Total phenolics were highly correlated with the DPPH, suggesting that they contribute to the antioxidant properties of the studied plants. IN CONCLUSION young sprouts of Korean salad possess antioxidant and anticancer properties and could be used as a supplement to proper drugs.
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Affiliation(s)
- Sang-Uk Chon
- EFARINET Co. Ltd., BI Center, Chosun University, Gwangju, 501-759, South Korea
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108
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Smith LL, Brent RL, Cohen SM, Doerrer NG, Goodman JI, Greim H, Holsapple MP, Lightfoot RM. Predicting Future Human and Environmental Health Challenges: The Health and Environmental Sciences Institute's Scientific Mapping Exercise. Crit Rev Toxicol 2008; 38:817-45. [DOI: 10.1080/10408440802486378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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109
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Kuo ML. Attempts to bridge the gap between scientific mechanism-based medicine and Chinese herbal extract treatment for asthma. Pediatr Neonatol 2008; 49:101-2. [PMID: 19054913 DOI: 10.1016/s1875-9572(08)60022-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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110
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Standish LJ, Kozak L, Congdon S. Acupuncture Is Underutilized in Hospice and Palliative Medicine. Am J Hosp Palliat Care 2008; 25:298-308. [DOI: 10.1177/1049909108315916] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Acupuncture is a complementary and alternative medical modality. A considerable body of acupuncture research has accumulated since 1998. Acupuncture has been integrated into palliative care settings in the United Kingdom but is yet to be widely offered in the United States. The literature was searched to identify clinical trials involving acupuncture, palliative care, hospice, chronic obstructive pulmonary disease, bone marrow, and cancer. Twenty-seven randomized controlled clinical trials of acupuncture were found that reported on conditions common to the hospice and palliative care setting, including dyspnea, nausea and vomiting, pain, and xerostomia, and 23 reported statistically significant results favoring acupuncture use for the conditions investigated. Acupuncture is safe and clinically cost-effective for management of common symptoms in palliative care and hospice patients. Acupuncture has potential as adjunctive care in palliative and end-of-life care, and the evidence warrants its inclusion in reimbursed palliative and end-of-life care in the United States.
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111
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Acupuncture-associated Listeria monocytogenes arthritis in a patient with rheumatoid arthritis. Joint Bone Spine 2008; 75:502-3. [DOI: 10.1016/j.jbspin.2007.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2007] [Accepted: 08/09/2007] [Indexed: 12/17/2022]
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112
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Hori S, Mihaylov I, Vasconcelos JC, McCoubrie M. Patterns of complementary and alternative medicine use amongst outpatients in Tokyo, Japan. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2008; 8:14. [PMID: 18433476 PMCID: PMC2375857 DOI: 10.1186/1472-6882-8-14] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 04/23/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) has been increasing rapidly throughout the world during the past decade. The use of CAM in the general Japanese population has been previously reported to be as high as 76%. This study aims to investigate the patterns of CAM use, perceived effectiveness and disclosure of CAM use to orthodox medical practitioners amongst patients attending typical primary and secondary care clinics in a busy district general hospital in Tokyo, Japan. METHODS The authors analysed data collected during March 2002 on patients attending general outpatient clinics held at Shiseikai Daini Hospital in Tokyo, Japan. Data was collected by use of self-completed questionnaires distributed to patients in the outpatient clinics waiting area. Statistical analysis was performed using chi-square tests of independence. RESULTS 515 adults were approached to participate in this study and the overall response rate was 96% (n = 496). 50% of the patients were using or have used at least 1 CAM therapy within the last 12 months. The 5 most commonly used therapies were massage (n = 106, 43%), vitamins (n = 85, 35%), health foods including dietary supplements (n = 56, 23%), acupressure (n = 51, 21%) and kampo (n = 46, 19%). The majority of CAM users (75%, n = 145) found their CAM treatment to be effective (95% CI = 68-81%). Patients who were more likely to use CAM were females (p = 0.003) and those with a high number of medical conditions (p = < 0.0001). Only a small proportion of patients reported their CAM use to their physician (42%, n = 74). There was no significant difference in CAM use for the different age groups (p = 0.85), education level (p = 0.30) and financial status (p = 0.82). CONCLUSION Patterns of CAM usage in the sample surveyed was high (50%). Despite this high prevalence rate and presumed acceptance of CAM in Japan, the reporting of CAM use by patients to their physicians was low (42%). It is therefore important that physicians are aware of the possibility that their patients may be using CAM and also increase their knowledge and understanding of these treatments.
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113
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3052] [Impact Index Per Article: 190.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Abstract
The symptoms of patients presenting with non-allergic food-related reactions may partly mimic allergic responses. Therefore, correct delineation of food allergies is often difficult and various differential diagnoses have to be considered. We describe three cases of differential diagnoses to food-induced symptoms: A 14-month-old with lactose intolerance, an 8-month-old with severe diet-induced malnutrition and subsequent development of kwashiorkor and a 12-yr-old with chronic urticaria due to colouring agents. These cases represent common symptom constellations involving food-induced reactions. A proper and correct diagnosis of food-related symptoms is particularly important for children - not only in order to find the appropriate diet but also to avoid unnecessary exclusion diets, which may lead to severe impairments in growth and development.
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Affiliation(s)
- Birgit Ahrens
- Department of Pediatric Pneumology and Immunology, Charité- Universitätsmedizin Berlin, Berlin, Germany
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115
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Pruthi RK, Schmidt KA, Slaby JA, Rodriguez V. Platelet dysfunction induced by herbal supplements in a patient with mild hemophilia A. J Thromb Haemost 2007; 5:2556-8. [PMID: 17877787 DOI: 10.1111/j.1538-7836.2007.02765.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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116
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Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, Bruffaerts R, de Girolamo G, de Graaf R, Gureje O, Haro JM, Karam EG, Kessler RC, Kovess V, Lane MC, Lee S, Levinson D, Ono Y, Petukhova M, Posada-Villa J, Seedat S, Wells JE. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 2007; 370:841-50. [PMID: 17826169 PMCID: PMC2847360 DOI: 10.1016/s0140-6736(07)61414-7] [Citation(s) in RCA: 957] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Mental disorders are major causes of disability worldwide, including in the low-income and middle-income countries least able to bear such burdens. We describe mental health care in 17 countries participating in the WHO world mental health (WMH) survey initiative and examine unmet needs for treatment. METHODS Face-to-face household surveys were undertaken with 84,850 community adult respondents in low-income or middle-income (Colombia, Lebanon, Mexico, Nigeria, China, South Africa, Ukraine) and high-income countries (Belgium, France, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Spain, USA). Prevalence and severity of mental disorders over 12 months, and mental health service use, were assessed with the WMH composite international diagnostic interview. Logistic regression analysis was used to study sociodemographic predictors of receiving any 12-month services. FINDINGS The number of respondents using any 12-month mental health services (57 [2%; Nigeria] to 1477 [18%; USA]) was generally lower in developing than in developed countries, and the proportion receiving services tended to correspond to countries' percentages of gross domestic product spent on health care. Although seriousness of disorder was related to service use, only five (11%; China) to 46 (61%; Belgium) of patients with severe disorders received any care in the previous year. General medical sectors were the largest sources of mental health services. For respondents initiating treatments, 152 (70%; Germany) to 129 (95%; Italy) received any follow-up care, and one (10%; Nigeria) to 113 (42%; France) received treatments meeting minimum standards for adequacy. Patients who were male, married, less-educated, and at the extremes of age or income were treated less. INTERPRETATION Unmet needs for mental health treatment are pervasive and especially concerning in less-developed countries. Alleviation of these unmet needs will require expansion and optimum allocation of treatment resources.
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Affiliation(s)
- Philip S Wang
- Division of Services and Intervention Research, National Institute of Mental Health, Rockville, MD, USA.
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117
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Noiesen E, Munk MD, Larsen K, Høyen M, Agner T. Use of complementary and alternative treatment for allergic contact dermatitis. Br J Dermatol 2007; 157:301-5. [PMID: 17573876 DOI: 10.1111/j.1365-2133.2007.08015.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies show that use of complementary and alternative medicine (CAM) is frequent among dermatological patients in general and that the use of CAM is linked to disease severity and duration. OBJECTIVES To investigate factors influencing the use of CAM and visits to alternative practitioners among patients with allergic contact dermatitis. METHODS The study was a postal questionnaire survey among 485 patients with allergic contact dermatitis to fragrances and preservatives in consumer products. The questionnaire included questions about use of conventional treatment, use of CAM and visits to alternative therapists. It also included questions about eczema severity and duration as well as social factors. The patients were recruited from one dermatological clinic in the capital city area and two clinics in smaller cities. RESULTS The response rate was 79%. Forty per cent of respondents were users of CAM, predominantly in combination with conventional treatment, and 29% had visited an alternative practitioner. Women were found to be significantly more frequent users of CAM and visitors to alternative practitioners than men, and patients from urban/rural districts reported more frequent use of CAM than patients from the capital city area. Frequent eczema eruptions, hand eczema, long duration of disease and work-related problems were positively associated with use of CAM and/or visits to alternative practitioners. CONCLUSIONS The typical CAM user is female, lives in a rural district or town (not the capital area), has long disease duration and often work-related problems. Overall, the use of CAM is not an alternative to conventional treatment, but is a supplement.
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Affiliation(s)
- E Noiesen
- National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, Niels Andersensvej 65, 2900 Hellerup, Denmark.
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Makino T, Mizuno F, Mizukami H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol Pharm Bull 2006; 29:2065-9. [PMID: 17015952 DOI: 10.1248/bpb.29.2065] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Herb-drug interaction has attracted attention as medicinal topics recently. However, the drug information is sometimes confusing. Previous in vitro studies revealed that schisandra fruit had strong inhibitory effect on CYP3A4 and claimed the possibilities of its herb-drug interaction. In the present study, we evaluated the inhibitory effects of schisandra fruit and shoseiryuto, an herbal formula in Japanese traditional kampo medicine containing eight herbal medicines including schisandra fruit, on rat CYP3A activity in vitro, and the effect of shoseiryuto on pharmacokinetics of nifedipine in rats, in comparison with those of grapefruit juice, a well-characterized natural CYP3A inhibitor. Shoseiryuto and its herbal constituents, schisandra fruit, ephedra herb and cinnamon bark exhibited in vitro inhibitory effect of CYP3A. Although shoseiryuto inhibited rat CYP3A activity in vitro with a degree comparable to grapefruit juice, shoseiryuto did not significantly affect a plasma concentration profile of nifedipine in rats as grapefruit juice did. These results indicate that in vivo experiments using the extract of herbal medicine prepared with the same dosage form as patients take are necessary to provide proper information about herb-drug interaction.
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Affiliation(s)
- Toshiaki Makino
- Department of Pharmacognosy, Graduate School of Nagoya City University, Tanabe-Dori, Nagoya, Japan.
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119
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Kiesser M, McFadden J, Belliard JC. An interdisciplinary view of medical pluralism among Mexican-Americans. J Interprof Care 2006; 20:223-34. [PMID: 16777790 DOI: 10.1080/13561820600718055] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This article highlights the relationship between traditional, complementary, and alternative medicine (TCAM) and biomedicine, and the challenges this relationship poses to patients. Medical professionals tend to represent these systems dualistically - as mutually exclusive and in competition with one another. Patients, on the other hand, tend to make truly pluralistic health care decisions - moving freely between TCAM and biomedicine based on what they can access, what they can relate to, and what they believe works. Using their experience with Mexican immigrant and Mexican-American populations in Southwestern United States, the authors discuss strengths and weaknesses in both healthcare systems, and how medical dualism can be a significant barrier to effective healthcare. Recent literature on medical pluralism is discussed from the public health (i.e., community) and medical (i.e., provider) perspectives. These two disciplines are brought together in an attempt to deconstruct the notion that TCAM and biomedicine are diametrically opposed healthcare systems. Biomedically trained health care providers must understand, appreciate, and integrate into their practice how their patients make use of other healing practices and beliefs. Such integration is particularly essential when serving immigrant or minority populations as these groups are more likely to use a pluralistic approach in meeting their health needs.
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Affiliation(s)
- Manfred Kiesser
- Loma Linda University School of Public Health, Loma Linda University School of Medicine, Loma Linda, California 92350, USA
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Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J. ARIA update: I--Systematic review of complementary and alternative medicine for rhinitis and asthma. J Allergy Clin Immunol 2006; 117:1054-62. [PMID: 16675332 DOI: 10.1016/j.jaci.2005.12.1308] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Revised: 12/12/2005] [Accepted: 12/12/2005] [Indexed: 12/26/2022]
Abstract
Complementary-alternative medicines are extensively used in the treatment of allergic rhinitis and asthma, but evidence-based recommendations are lacking. To provide evidence-based recommendations, the literature was searched by using MedLine and the Cochrane Library to March 2005 (Key words: Asthma [OR] Rhinitis, [AND] Complementary [OR] Alternative Medicine, [OR] Herbal, [OR] Acupuncture, [OR] Homeopathy, [OR] Alternative Treatment). Randomized trials, preferably double-blind and published in English, were selected. The articles were evaluated by a panel of experts. Quality of reporting was assessed by using the scale validated by Jadad. The methodology of clinical trials with complementary-alternative medicine was frequently inadequate. Meta-analyses provided no clear evidence for the efficacy of acupuncture in rhinitis and asthma. Some positive results were described with homeopathy in good-quality trials in rhinitis, but a number of negative studies were also found. Therefore it is not possible to provide evidence-based recommendations for homeopathy in the treatment of allergic rhinitis, and further trials are needed. A limited number of studies of herbal remedies showed some efficacy in rhinitis and asthma, but the studies were too few to make recommendations. There are also unresolved safety concerns. Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.
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121
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Koenig K, Roehr CC. Does treatment with Echinacea purpurea effectively shorten the course of upper respiratory tract infections in children? Arch Dis Child 2006; 91:535-7. [PMID: 16714733 PMCID: PMC2082762 DOI: 10.1136/adc.2005.093468] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- K Koenig
- Children's Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
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122
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Lohse B, Stotts JL, Priebe JR. Survey of Herbal Use by Kansas and Wisconsin WIC Participants Reveals Moderate, Appropriate Use and Identifies Herbal Education Needs. ACTA ACUST UNITED AC 2006; 106:227-37. [PMID: 16442871 DOI: 10.1016/j.jada.2005.10.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2004] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine herbal use by a sample of low-income, nutritionally vulnerable children. DESIGN Caregivers completed a survey of child and caregiver herbal usage practices. SUBJECTS/SETTING A convenience sample of 2,562 caregivers to children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Kansas and Wisconsin who were attending a WIC clinic was selected. WIC project selection was random, with stratification for geographic and ethnic representation. STATISTICAL ANALYSES PERFORMED Herbal usage profiles were described with measures of central tendency. Groups were compared with a two-tailed independent t test and chi2 for continuous and categorical variables, respectively. RESULTS Child herbal use was reported on 917 surveys, representing 1,363 children ranging in age from 1 week to 17.5 years; 820 were younger than age 5 years. Herb use was greater among Latino children (48.4% vs 31.4%) and caregivers (43.4% vs 37.2%). Caregivers had a mean age of 27.8+/-8.32 years and 38.8% (n=994) denoted using herbs. Herbs most commonly used by children were aloe vera, chamomile, garlic, peppermint, lavender, cranberry, ginger, echinacea, and lemon. Reasons for herbal use paralleled recommendations. Family (78.9%) and friends (32.9%) were predominant information sources. Herbs with safety issues, such as St John's wort, dong quai, and kava were used. Herbal use characteristics did not differ between states, but were unique for Latino clients. CONCLUSIONS Herbal use by WIC children is mostly congruent with known indications; however, practices with potential to harm urge herbal education in WIC clinics, especially for Latinos.
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Affiliation(s)
- Barbara Lohse
- Department of Nutritional Sciences, Pennsylvania State University, University Park 16802, USA.
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123
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Hyman SL, Levy SE. Introduction: novel therapies in developmental disabilities--hope, reason, and evidence. ACTA ACUST UNITED AC 2005; 11:107-9. [PMID: 15977317 DOI: 10.1002/mrdd.20060] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Complementary and alternative medicine (CAM) is used both alongside (complementary) and as a substitute for (alternative) conventional therapies. Although CAM use is reported to be high among children with typical development, reported rates for CAM use to address symptoms of children with developmental disabilities may be higher. Increased use in this population may relate to hope for amelioration of symptoms, concerns regarding side effects of conventional treatments, and a need on the part of families to participate in decision making regarding their child's care. Primary health care providers may find that the child's needs are best served when they maintain a dialogue with families to evaluate the evidence supporting novel therapies. Interventions need to be assessed in an evidence based fashion whether or not they are initially preceived as CAM. This issue of Mental Retardation and Developmental Disabilities Research Reviews contains reviews of CAM used to treat several developmental disabilities as well as some broader discussions related to the determinants of CAM use, current efforts to evaluate novel therapies, and how to consider the possibility of placebo effects.
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Affiliation(s)
- Susan L Hyman
- Strong Center for Developmental Disabilities, Golisano Children's Hospital at Strong, University of Rochester School of Medicine, New York 14642, USA.
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124
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Wheaton AG, Blanck HM, Gizlice Z, Reyes M. Medicinal Herb Use in a Population-Based Survey of Adults: Prevalence and Frequency of Use, Reasons for Use, and Use Among Their Children. Ann Epidemiol 2005; 15:678-85. [PMID: 16157255 DOI: 10.1016/j.annepidem.2004.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2004] [Accepted: 09/01/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE There is sparse population-based data on health factors related to medicinal herb use and use of medicinal herbs in children. For a sample of American adults, we estimated the prevalence and frequency of medicinal herb use, factors related to use, reasons for use, patient-physician discussion, and the proportion of respondents who gave herbs to their children. METHODS The data used in this study was from the 2001 North Carolina Behavioral Risk Factor Surveillance System, a population-based telephone survey of English-speaking adults (n = 2982). RESULTS Approximately 20% of respondents reported using medicinal herbs in the past year. Of these, 34% reported discussion of herb use with a physician; 69% reported taking herbs to maintain health, 20% to prevent illness, and 11% to treat illness. Of the total sample, 7% reported using herbs everyday and 5% of the respondents reported giving their children herbal medicines in the past year. CONCLUSIONS Medicinal herb use is common in this population sample. The lack of discussion between users and their physicians highlights the importance of patient-physician communication to avoid possible herb-drug interactions and surgical complications. Herb use appears to be a popular strategy for maintaining health. Children may be vulnerable to herbal toxicity and therefore clinicians need to know about their medicinal herb use and counsel appropriately.
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Affiliation(s)
- Anne G Wheaton
- Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA
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125
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Woodward KN. The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products. Hum Exp Toxicol 2005; 24:219-33. [PMID: 16004184 DOI: 10.1191/0960327105ht529oa] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this paper is to explore the possibility that adverse reactions and drug interactions arising from the use of homeopathic and herbal medicines could lead to confusion when adverse reactions to conventional medicines are reported. An extensive literature review was conducted on the occurrence of adverse reactions and drug interactions following the use of homeopathic or herbal remedies, and the potential for these to confound adverse event reporting to conventional medicines considered. The survey demonstrates the potential for herbal remedies and homeopathic products, to produce adverse drug reactions or drug interactions, and shows the scope for potential for confusion with those arising from conventional medicines. There is a need for greater awareness that adverse reactions apparently due to a conventional medicine, might in reality be due to a herbal medicine or a drug interaction between a herbal medicine and a conventional drug, particularly when a health professional is unaware of the extent of a patient's self-medication with alternative therapies.
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Affiliation(s)
- K N Woodward
- Department of Life Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.
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126
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Mullins RJ, Heddle RJ, Smith P. Non‐conventional approaches to allergy testing: reconciling patient autonomy with medical practitioners’ concerns. Med J Aust 2005; 183:173-4. [PMID: 16097911 DOI: 10.5694/j.1326-5377.2005.tb06986.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 07/12/2005] [Indexed: 11/17/2022]
Abstract
It may be difficult for patients to distinguish current concepts of immune function from other, non-conventional explanations of illness.
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127
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Menon-Miyake MA, Saldiva PHN, Lorenzi-Filho G, Ferreira MA, Butugan O, Oliveira RCD. Luffa operculata effects on the epithelium of frog palate: histological features. Braz J Otorhinolaryngol 2005; 71:132-8. [PMID: 16446907 PMCID: PMC9450526 DOI: 10.1016/s1808-8694(15)31300-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Luffa operculata is the botanical name of buchinha-do-norte or cabacinha, which is a medicinal plant widely used for the treatment of rhinitis and rhinosinusitis. In Europe and USA, it is available in homeopathic medicines. In Brazil, Luffa operculata dry fruit infusion is inhaled or instilled into the nose releasing profuse mucous secretion, thus relieving nasal symptoms. Nevertheless, this often may cause irritation, epistaxis or anosmia. Study design Experimental. Material and Method The effects of Luffa operculata were evaluated in different concentration infusions, in isolated frog palate preparation, testing 46 palates after immersion. Four groups (n = 10) were tested with the infusion prepared with frog Ringer (isotonic): control; 60 mg/L; 600 mg/L; and 1200 mg/L. An additional group was tested using the infusion with water (600 mg/L H2O, n = 6). Epithelial samples were harvested to be studied under light microscopy and electron transmission microscopy. Results In treated palates, light microscopy findings were dose-dependent standard toxic changes. Electron transmission microscopy showed enlargement of intercellular spaces and tight junctions disruption, pointing to ion-fluid transport abnormalities. Conclusions: Luffa operculata infusion in currently used doses can promote significant structural and ultrastructural changes in the epithelium of this ex vivo model of respiratory mucosa.
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128
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Abstract
Acupuncture as a complex therapeutic system has been used to treat a variety of diseases and pathological conditions. Although the exact mechanism(s) of acupuncture remains unknown, some evidence suggests a mechanism initially involving signal transduction through connective tissue, with secondary involvement of other systems including the nervous system. Acupuncture has become increasingly popular in the Western countries as a therapy for pain and several chronic disorders difficult to manage with conventional treatments. Acupuncture and acupuncture-like somatic nerve stimulation have been used in different kidney diseases and several complications related to them. The effect of acupuncture techniques in some kidney diseases is reviewed on the basis of clinical reports as well as mechanisms that may possibly explain the beneficial effects mediated by acupressure/acupuncture. The potential effect of acupressure techniques in renal inflammation and whether these effects could be mediated through the newly identified cholinergic anti-inflammatory pathway are discussed.
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Affiliation(s)
- Gabriela E Garcia
- Section of Nephrology, Baylor College of Medicine, Houston, TX 77030, USA
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129
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Menon-Miyake MA, Saldiva PHN, Lorenzi-Filho G, Ferreira MA, Butugan O, Oliveira RCD. Efeitos da Luffa operculata sobre o epitélio do palato de rã: aspectos histológicos. ACTA ACUST UNITED AC 2005. [DOI: 10.1590/s0034-72992005000200003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Luffa operculata é o nome botânico da buchinha-do-norte ou cabacinha, uma planta medicinal usada popularmente no tratamento das rinites e rinossinusites. Na Europa e nos EUA, está em medicamentos homeopáticos. No Brasil, a infusão (chá) do fruto seco de Luffa operculata é utilizada para inalação ou instilação nasal, resultando em liberação profusa de muco que alivia os sintomas nasossinusais, mas há relatos freqüentes de irritação nasal, epistaxe e anosmia. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Avaliamos os efeitos da infusão de Luffa operculata em diferentes concentrações, no modelo experimental do palato isolado de rã, examinando 46 palatos após imersão. Quatro grupos (n=10) foram testados com infusão feita em Ringer-rã (solução isotônica): controle; 60mg/l; 600mg/l e 1200mg/l. Um grupo foi testado em água (600mg/l H2O, n=6). Coletamos amostras do epitélio para estudo histológico à microscopia-de-luz e microscopia eletrônica de transmissão. RESULTADOS: Nos palatos tratados, os achados à microscopia-de-luz mostram lesões epiteliais de padrão tóxico, dose-dependentes. Na microscopia eletrônica, aumento dos espaços intercelulares e ruptura de tight junctions apontam para anormalidade no transporte iônico e de fluidos. CONCLUSÕES: A infusão de Luffa operculata, nas concentrações utilizadas popularmente, promove alterações significantes na estrutura e ultraestrutura epitelial deste modelo ex vivo de mucosa respiratória.
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130
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Roehr CC, Edenharter G, Reimann S, Ehlers I, Worm M, Zuberbier T, Niggemann B. Food allergy and non-allergic food hypersensitivity in children and adolescents. Clin Exp Allergy 2005; 34:1534-41. [PMID: 15479267 DOI: 10.1111/j.1365-2222.2004.02080.x] [Citation(s) in RCA: 183] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Previous studies have shown a 10-fold discrepancy of self-reported food-induced symptoms and physician-diagnosed food hypersensitivity. Little information is available on the prevalence of food hypersensitivity in unselected paediatric populations. No data were available for German children. OBJECTIVE To study the perception of food-induced symptoms in the paediatric population, to investigate the allergens accused, to objectify patients' reports, and to identify subgroups at risk of having food-induced allergy (FA) or non-allergic food hypersensitivity (NAFH) reactions. METHODS This paper presents the data of the paediatric group (0-17 years) of a representative, randomly sampled, cross-sectional population-based survey studying 13 300 inhabitants of the German capital city Berlin regarding food-related symptoms. Instruments included mailed questionnaires, structured telephone interviews, physical examination, skin-prick tests, specific serum IgE and standardized, controlled and blinded oral food challenges. RESULTS Two thousand three hundred and fifty-four individuals were contacted by mailed questionnaire, 739 (31.4%) responses could be fully evaluated. Four hundred and fifty-five (61.5%) participants reported symptoms related to food ingestion, 284 (38.4%) affirmed reproducible symptoms in the standardized telephone interview. One hundred and eighty-four (24.8%) individuals were fully examined. Reproducible symptoms to food were found in 31 (4.2%) children and adolescents: 26 (3.5%) showed symptoms of FA and five (0.7%) of NAFH. The oral allergy syndrome was most often observed. Foods most commonly identified by oral challenges were apple, hazelnut, soy, kiwi, carrot and wheat. CONCLUSION The perception of food-related symptoms is common among children and adolescents from the general population. Self-reports could be confirmed in around one out of 10 individuals, still resulting in 4.2% of proven clinical symptoms. However, most reactions were mild and mainly because of pollen-associated FA, while NAFH reactions were less common. Severe IgE-mediated FA was observed in individuals with pre-existing atopic disease, who should be fully investigated for clinically relevant FA.
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Affiliation(s)
- C C Roehr
- Department of Pediatric Pneumology and Immunology, University Hospital Charité, Humboldt University, Berlin, Germany
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131
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Molassiotis A, Fernández-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AMA, Platin N, Kearney N, Patiraki E. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005; 16:655-63. [PMID: 15699021 DOI: 10.1093/annonc/mdi110] [Citation(s) in RCA: 692] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients across a number of European countries. METHODS A descriptive survey design was developed. Fourteen countries participated in the study and data was collected through a descriptive questionnaire from 956 patients. RESULTS Data suggest that CAM is popular among cancer patients with 35.9% using some form of CAM (range among countries 14.8% to 73.1%). A heterogeneous group of 58 therapies were identified as being used. Herbal medicines and remedies were the most commonly used CAM therapies, together with homeopathy, vitamins/minerals, medicinal teas, spiritual therapies and relaxation techniques. Herbal medicine use tripled from use before diagnosis to use since diagnosis with cancer. Multivariate analysis suggested that the profile of the CAM user was that of younger people, female and with higher educational level. The source of information was mainly from friends/family and the media, while physicians and nurses played a small part in providing CAM-related information. The majority used CAM to increase the body's ability to fight cancer or improve physical and emotional well-being, and many seemed to have benefited from using CAM (even though the benefits were not necessarily related to the initial reason for using CAM). Some 4.4% of patients, however, reported side-effects, mostly transient. CONCLUSIONS It is imperative that health professionals explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
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Affiliation(s)
- A Molassiotis
- School of Nursing, University of Manchester, Manchester, UK.
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132
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Bousquet J, Warner JO. Allergy and Pediatric Allergy and Immunology are the official organs of the European Academy of Allergology and Clinical Immunology. Allergy 2004; 59:1333-8. [PMID: 15507103 DOI: 10.1111/j.1398-9995.2004.00766.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Warner JO, Bousquet J. Allergy and Pediatric Allergy and Immunology are the official organs of the European Academy of Allergology and Clinical Immunology. Pediatr Allergy Immunol 2004; 15:479-84. [PMID: 15610359 DOI: 10.1111/j.1399-3038.2004.00235.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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134
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Theoharides TC, Bielory L. Mast cells and mast cell mediators as targets of dietary supplements. Ann Allergy Asthma Immunol 2004; 93:S24-34. [PMID: 15330009 DOI: 10.1016/s1081-1206(10)61484-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the increasing amount of data that support or dispel the use of dietary supplements in the treatment of inflammatory conditions that involve mast cells, such as allergies, arthritis, and chronic pelvic pain syndrome. DATA SOURCES A search was conducted in MEDLINE for natural substances, dietary supplements, flavonoids, and proteoglycans for their in vitro or in vivo effects on allergic and inflammatory conditions. STUDY SELECTION Studies were selected for inclusion because of the impact factor of the journal, the definitive nature of the findings, the soundness of the study design, and the expert opinion of the authors. RESULTS Dietary supplements include a large group of products, such as vitamins, minerals, plant, or animal extracts, as well as herbal preparations that are often called medicinal herbs. Many of the available dietary supplements contain a multitude of ingredients, the source and/or purity of which is seldom disclosed; some of these may have biologic effects of their own or may interact with other supplements or drugs, often leading to adverse effects. The most well-documented evidence published to date is on the inhibitory action of natural compounds, especially flavonoids, on mast cells and allergic symptoms. Some flavonoids have weak inhibitory activity, whereas others may have no benefit or may be detrimental. Sulfated proteoglycans could provide synergistic action but require formulations with increased absorption. CONCLUSIONS Combining the most active flavonoids with proteoglycans could be helpful in atopic and inflammatory conditions. However, a complete list of active ingredients and their source, purity, and exact concentration should be a requirement for nutraceuticals to standardize, compare, and promote their safe use.
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Affiliation(s)
- Theoharis C Theoharides
- Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine and Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
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135
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Brinkhaus B, Hummelsberger J, Kohnen R, Seufert J, Hempen CH, Leonhardy H, Nögel R, Joos S, Hahn E, Schuppan D. Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy 2004; 59:953-60. [PMID: 15291903 DOI: 10.1111/j.1398-9995.2004.00540.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with allergic rhinitis (AR) increasingly use complementary medicine. The aim of this study was to determine whether traditional Chinese therapy is efficacious in patients suffering from seasonal AR. METHODS Fifty-two patients between the ages of 20 and 58 who had typical symptoms of seasonal AR were assigned randomly and in a blinded fashion to (i) an active treatment group which received a semi-standardized treatment of acupuncture and Chinese herbal medicine, and (ii) a control group which received acupuncture applied to non-acupuncture points in addition to a non-specific Chinese herbal formula. All patients received acupuncture treatment once per week and the respective Chinese herbal formula as a decoction three times daily for a total of 6 weeks. Assessments were performed before, during, and 1 week after treatment. The change in severity of hay fever symptoms was the primary outcome measured on a visual analogue scale (VAS). RESULTS Compared with patients in the control group, patients in the active treatment group showed a significant after-treatment improvement on the VAS (P = 0.006) and Rhinitis Quality of Life Questionnaire (P = 0.015). Improvement on the Global Assessment of Change Scale was noted in 85% of active treatment group participants vs 40% in the control group (P = 0.048). No differences between the two groups could be detected with the Allergic Rhinitis Symptom Questionnaire. Both treatments were well-tolerated. CONCLUSIONS The results of this study suggest that traditional Chinese therapy may be an efficacious and safe treatment option for patients with seasonal AR.
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Affiliation(s)
- B Brinkhaus
- Department of Medicine I, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen Germany
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136
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Heine G, Schnuch A, Uter W, Worm M. Frequency of contact allergy in German children and adolescents patch tested between 1995 and 2002: results from the Information Network of Departments of Dermatology and the German Contact Dermatitis Research Group. Contact Dermatitis 2004; 51:111-7. [PMID: 15479199 DOI: 10.1111/j.0105-1873.2004.00411.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Allergic contact dermatitis (ACD) affects approximately 7% of the general population. To evaluate the frequency of ACD in children, we analysed patch test results collected by the Information Network of Departments of Dermatology between 1995 and 2002. Data of 285 children (6-12 year) and 2175 adolescent patients (13-18 year) were analysed to determine the frequency of sensitization to the 30 most common contact allergens, adjusting for age and sex. As control group, we defined adult patients (60-66 year, n = 7904). The top allergens in children were thimerosal, gentamicin sulphate, nickel-II-sulphate, ammoniated mercury, cobalt-II-chloride, fragrance mix, bufexamac, Compositae mix, propylene glycol and turpentine. The overall proportion of sensitized patients according to the patch test results was 52.6% in the children group compared to 49.7% in the adolescent group. These findings were similar in the adult group at 52.2%. The detailed analysis regarding sex, occupation, atopy, site of eczema and age showed distinct patterns in each group indicating age-specific exposures. Atopy-related diseases were more common in children compared to adults. On the basis of the data of this study, the relationship between atopy and the risk of development of ACD, at least in children, needs further investigation.
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Affiliation(s)
- Guido Heine
- Klinik für Dermatologie, Venerologie und Allergologie, Campus Charité-Mitte, Universitätsmedizin, Berlin, Germany
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137
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Ye F, Wang H, Jiang S, Wu J, Shao J, Cheng X, Tu Y, Zhang DY. Quality Evaluation of Commercial Extracts of Scutellaria baicalensis. Nutr Cancer 2004; 49:217-22. [PMID: 15489215 DOI: 10.1207/s15327914nc4902_14] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Botanical products have been widely used for various illnesses and general well-being. However, quality control of botanical products is often not performed due to lack of standardization, resulting in inconsistent efficacies and sometimes serious toxicity. The goals of this study were to determine the correlation between chemical composition and biological activities and to establish a method to measure authenticity, chemical consistency, and biological potency of botanical products. A high-performance liquid chromatography method was used to analyze the authenticity and chemical composition of 10 different commercial extracts. The cell viability assay and prostaglandin E2 (PGE2) enzyme immunoassay were used to analyze biological potency and consistency. Our results showed all extracts contained marker components (baicalein and/or baicalin), confirming their authenticity. However, significant product-to-product and batch-to-batch variation of these marker components was observed with 4 products containing no baicalin at all and baicalein concentration ranging from 0 to 52.3 g/mg. The 50% growth inhibition concentration of the extracts ranged from 0.18 to 2.0 mg/ml, more than an 11-fold variation. PGE2 levels varied from 19.5 to 111.1 pg/106 cells, more than a 5.7-fold difference. These results demonstrated significant variation in chemical composition and biological activities of the commercial extracts and that the amount of marker components may not reflect biological activity levels. Therefore, chemical analysis alone is inadequate for quality control, and biological assays must be included for botanical products to ensure chemical authenticity as well as pharmacological/biological potency and consistency.
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Affiliation(s)
- Fei Ye
- Department of Pathology, Mount Sinai School of Medicine, New York University, New York, USA
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138
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Abstract
PURPOSE OF REVIEW Adverse reactions to food resulting in gastrointestinal symptoms are common in the general population. Although only a minority of individuals complaining of such symptoms have immune-mediated reactions to food (food allergy), gastrointestinal food allergies do exist in both children and adults. This review provides an update on the pathogenesis and clinical management of food allergy manifesting in the gut, emphasizing recent developments in the field. RECENT FINDINGS Recent studies have broadened our understanding of the innate gastrointestinal defense systems and the role of the gut flora for protection against allergy. These findings support the hygiene theory in which microbial challenge in early life is thought to protect against the development of allergic disease. New insights into the regulation of mast cells and eosinophils, their homing to the intestine, and their interaction with the specific immune system and the enteric nervous system have been given. In parallel, the molecular structure of major food allergens is being unraveled, and new therapies that focus largely on modulating the immune response to food antigens have been developed. SUMMARY These new findings have important implications for the diagnosis and management of food allergies. The availability of recombinant allergens will improve methods to diagnose and treat food allergy, and genetic engineering will allow future therapies such as vaccination against food allergy. Emerging knowledge of the role of the gut flora in mucosal immunity will enhance strategies to prevent and treat food allergy using probiotics such as Lactobacillus GG. Such new approaches will extend existing options for managing food allergy and preventing anaphylaxis.
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Affiliation(s)
- Stephan Bischoff
- Department of Gastroenterology, Hepatology, and Endocrinology, University Medical School of Hannover, Hannover, Germany
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