Origins and insights into the historic Judean date palm based on genetic analysis of germinated ancient seeds and morphometric studies

Germination of 2000-year-old seeds of Phoenix dactylifera from Judean desert archaeological sites provides a unique opportunity to study the Judean date palm, described in antiquity for the quality, size, and medicinal properties of its fruit, but lost for centuries. Microsatellite genotyping of germinated seeds indicates that exchanges of genetic material occurred between the Middle East (eastern) and North Africa (western) date palm gene pools, with older seeds exhibiting a more eastern nuclear genome on a gradient from east to west of genetic contributions. Ancient seeds were significantly longer and wider than modern varieties, supporting historical records of the large size of the Judean date. These findings, in accord with the region's location between east and west date palm gene pools, suggest that sophisticated agricultural practices may have contributed to the Judean date's historical reputation. Given its exceptional storage potentialities, the date palm is a remarkable model for seed longevity research.

Caring for the Caregivers: Results of an Extended, Five-component Stress-reduction Intervention for Hospital Staff

The health-related consequences of stress in hospital workers and associated costs of absenteeism and high turnover have increased the need for programs targeting stress in this population. "Caring for the Caregivers," a multimodal approach to stress-reduction designed to address the multidimensional nature of stress in hospital staff, integrates five components: cognitive, somatic, dynamic, emotive and hands-on, in a flexible eight-month format. Significant improvements were demonstrated for 97 participants compared to 67 controls in pre-post scores for the Maslach Burnout Inventory, Job-Related Tension Index, Perceived Stress Scale, Productivity Scale, General Health Questionnaire, Positive and Negative Affect Schedule, and Visual Analogue Scales of 12 stress-associated symptoms. Together with significant reduction in upper respiratory infections and family doctor visits, these results suggest that providing hospital staff with multiple techniques addressing commonly encountered work stressors impacts positively on health and well-being and significantly reduces stress and burnout in this population.

Is mercury in Tibetan Medicine toxic? Clinical, neurocognitive and biochemical results of an initial cross-sectional study

Mercury an important therapeutic substance in Tibetan Medicine undergoes complex "detoxification" prior to inclusion in multi-ingredient formulas. In an initial cross-sectional study, patients taking Tibetan Medicine for various conditions were evaluated for mercury toxicity. Two groups were identified: Group 1, patients taking " Tsothel" the most important detoxified mercury preparation and Group 2, patients taking other mercury preparations or mercury free Tibetan Medicine. Atomic fluorescence spectrometry of Tibetan Medicine showed mercury consumption 130 µg/kg/day (Group 1) and 30 µg/kg/day (Group 2) ( P ≤ 0.001), levels above EPA (RfDs) suggested threshold (0.3 µg/kg /day) for oral chronic exposure. Mean duration of Tibetan Medicine treatment was 9 ± 17 months (range 3-116) (Group 1) and 5 ± 1.96 months (range 1-114) (Group 2) (NS) with cumulative days of mercury containing Tibetan Medicine, 764 days ± 1214 (range 135-7330) vs. 103 days ± 111 (range 0-426), respectively ( P ≤ 0.001). Comparison of treatment groups with healthy referents (Group 3) not taking Tibetan Medicine showed no significant differences in prevalence of 23 non-specific symptoms of mercury toxicity, abnormal neurological, cardiovascular and dental findings and no correlation with mercury exposure variables; consumption, cumulative treatment days, blood/ urine Hg. Liver and renal function tests in treatment groups were not significantly increased compared to referents, with mean urine Beta₂ Microglobulin within the normal range and not significantly associated with Hg exposure variables after correcting for confounding variables. Neurocognitive testing showed no significant intergroup differences for Wechsler Memory Scale, Grooved Pegboard, Visual Retention, but Group1 scores were better for Mini-Mental, Brief Word Learning, Verbal Fluency after correcting for confounding variables. These results suggest mercury containing Tibetan Medicine does not have appreciable adverse effects and may exert a possible beneficial effect on neurocognitive function. Since evidence of mercury as a toxic heavy metal, however, is well known, further analysis of literature on mercury use in other Asian traditional systems is highly suggested prior to further studies.

PADMA-28, a traditional tibetan herbal preparation inhibits the respiratory burst in human neutrophils, the killing of epithelial cells by mixtures of oxidants and pro-inflammatory agonists and peroxidation of lipids

Both aqueous and methanolic fractions derived from the Tibetan preparation PADMA-28 (a mixture of 22 plants) used as an anti-atherosclerotic agent, and which is non-cytolytic to a variety of mammalian cells, were found to strongly inhibit (1) the killing of epithelial cells in culture induced by 'cocktails' comprising oxidants, membrane perforating agents and proteinases; (2) the generation of luminol-dependent chemiluminescence in human neutrophils stimulated by opsonized bacteria; (3) the peroxidation of intralipid (a preparation rich in phopholipids) induced in the presence of copper; and (4) the activity of neutrophil elastase. It is proposed that PADMA-28 might prove beneficial for the prevention of cell damage induced by synergism among pro-inflammatory agonists which is central in the initiation of tissue destruction in inflammatory and infectious conditions.

Germination, genetics, and growth of an ancient date seed

An ancient date seed (Phoenix dactylifera L.) excavated from Masada and radiocarbon-dated to the first century Common Era was germinated. Climatic conditions at the Dead Sea may have contributed to the longevity of this oldest, directly dated, viable seed. Growth and development of the seedling over 26 months was compatible with normal date seedlings propagated from modern seeds. Preliminary molecular characterization demonstrated high levels of genetic variation in comparison to modern, elite date cultivars currently growing in Israel. As a representative of an extinct date palm population, this seedling can provide insights into the historic date culture of the Dead Sea region. It also has importance for seed banking and conservation and may be of relevance to modern date palm cultivation.

Mercury in traditional Tibetan medicine - panacea or problem?

Symptoms of mercury toxicity, biochemical changes, and blood/urine mercury levels were evaluated in a small group of patients. Six patients attending Delek Hospital, Dharamsala, India, taking mercury-containing traditional Tibetan medicine (TTM) (Group I), were compared with three patients taking non-mercury containing TTM (Group II) and healthy volunteers(Group II). Quantitative estimation of mercury ingestion based on chemical analysis was compared with US regulatory standards.

RESULTS

Group I were significantly older (mean 55 years+/-SE 6.4) range 26-69 years, than Group II (26.7 years+/-SE 5) range 17-34 years and Group III (32.5 years +/-SE 0.5) range 33-34 years (P =0.05). Group I took TTM on average for 51 months and had a mean of 2.5 non-specific, mercury-related symptoms. Group I had higher mean diastolic pressures (85 mmHg) than Group II (73 mmHg) (P=0.06) and more loose teeth. Mean daily mercury intake for Group I was 674 microg, estimated as 10 microg/kg per day. (Established reference dose for chronic oral exposure: 0.3 microg/kg per day.) Blood mercury levels were non-detectable, but mean urinary mercury levels for Group I were 67 microg/L (EPA levels <20 microg/L). Renal and liver function tests were not significantly different between groups and within normal clinical range.

CONCLUSIONS

Prolonged ingestion of mercury containing TTM is associated with absent blood levels, but relatively high urinary levels. Further studies are needed to evaluate toxicity and therapeutic potential.

A novel treatment for constipation-predominant irritable bowel syndrome using Padma Lax, a Tibetan herbal formula

BACKGROUND AND AIMS

Padma Lax, a complex Tibetan herbal formula for constipation was evaluated for safety and effectiveness in treating constipation-predominant irritable bowel syndrome in a 3-month double-blind randomised pilot study.

METHODS

Patients were recruited from Hadassah Hospital's Gastroenterology clinic, using the Rome I Criteria for irritable bowel syndrome, and the international consensus criteria for constipation. Symptom severity was evaluated monthly by patients and gastroenterologist, using categorical and numerical rating scales. A patient diary recorded daily stool habit and trial medication.

RESULTS

In 61 patients, (34 Padma Lax, 27 placebo), significant improvement was demonstrated after 3 months in the Padma Lax group compared to placebo in constipation, severity of abdominal pain, and its effect on daily activities, incomplete evacuation, abdominal distension and flatus/flatulence. A global assessment indicated that significantly more Padma Lax patients, compared to placebo, rated the current treatment superior to previous therapies tried for irritable bowel. Laboratory parameters displayed no clinically significant changes. Side effects, primarily loose stools in 7 Padma Lax patients responded well to lowering treatment dosage from 2 to 1 capsule/day.

CONCLUSIONS

Padma Lax is a safe and effective treatment for constipation-predominant irritable bowel syndrome and may offer an alternative to the current multi drug approach.

[Attitudes and exposuer of Israeli medical students to complementary medicine--a survey]

The use of alternative medicine is increasing rapidly and currently includes more than a third of the adult population in the US. Hence, two-thirds of US medical schools are presently including courses in complementary or alternative medicine as part of their curriculum. We addressed the deans of the four medical schools in Israel in order to determine the exposure of Israeli medical students to theoretical and practical aspects of complementary therapies within the curriculum, as well as future plans to include such programs. We also surveyed 154 medical students attending the Hebrew University medical school in order to ascertain interest and knowledge regarding complementary medicine, as well as their views on the introduction of these topics as part of their educational program. Most of the medical students were interested in learning about complementary therapies. Ninety-three percent stated that they would like to include an elective course in complementary medicine as part of the medical school program. Fifty four percent of the students surveyed had prior theoretical knowledge of complementary therapies through personal reading or had practical experience through treatments or courses. The present curriculum of Israeli medical schools, excluding Ben Gurion University, does not meet the students' growing interests in complementary medicine. However, all schools are considering the possibility of including these topics in future educational programs.

The effect of Padma-28, a traditional Tibetan herbal preparation, on human neutrophil function

Human neutrophils were studied in vitro in the presence of the herbal preparation Padma-28. At concentrations higher than 0.3 mg/ml, the Padma-28 induced O2- production in unstimulated neutrophils. At lower concentrations, O2- production was inhibited in phorbol myristate acetate (PMA) stimulated cells. Lysozyme release by PMA and opsonized zymosan-stimulated cells was inhibited by Padma-28 at a concentration dependent manner. On the other hand, random and directed migration and adhesion to nylon fibers were not affected. These results suggest that Padma-28 may have anti-inflammatory activity whose mechanism remains to be elucidated.

Diarrhoeal disease in children in Gaza

A 1-year prospective study in Gaza of diarrhoeal disease in children aged < 5 years demonstrated that Salmonella spp. (18.5% of cases), Cryptosporidium (14.6%), Campylobacter spp. (8.3%) and rotavirus (6.8%) were the major pathogens. However, when compared with non-diarrhoeic controls, only Cryptosporidium and rotavirus were significantly associated with diarrhoea. Cryptosporidiosis was found only in children aged < 2 years and significantly more children with cryptosporidiosis were malnourished. This malnutrition may have been due to the infection, since children with cryptosporidiosis tended to have had diarrhoea for relatively long periods prior to admission. It was not possible to distinguish between the different enteropathogens on clinical grounds. However, more children with rotavirus infection vomited and cryptosporidial diarrhoea lasted significantly longer (14.9 days) than rotavirus diarrhoea (5.9 days). Overcrowding was linked with an increased risk of cryptosporidiosis and breast feeding was associated with some protection. Twenty-one of the 29 children who died during the study died with diarrhoea and Cryptosporidium was detected in eight (38%) of these 21 children.

"Early" vs. "late" diagnosis of celiac disease in two ethnic groups living in the same geographic area

Despite studies documenting existence of celiac disease worldwide, its prevalence in many parts of the world is underestimated and cases remain unrecognized. In Israel, celiac disease is relatively common among the Jewish population but considered to be rarer among the Arab population. We compared the manifestations of celiac disease in children of both ethnic groups and questioned whether differences in presentation relate to degree of awareness for celiac disease in each group. Age at presentation, time interval between onset of symptoms and diagnosis, prevalence of gastrointestinal symptoms, presence of signs of malabsorption and degree of growth retardation varied markedly between both groups. In populations in which there is a low index of suspicion for celiac disease, symptoms may be wrongly attributed to the post-gastroenteritis syndromes or protein-calorie malnutrition, thus resulting in a detrimental delay in diagnosis. Undiagnosed cases may in later childhood manifest predominantly as short stature.

Cryptosporidiosis in children in Gaza

A prospective survey of children admitted with gastro-enteritis to the Nasser Children's Hospital, Gaza revealed that 19% were excreting cryptosporidium, a significantly (p less than 0.001) greater percentage than that (7%) observed in children admitted for other reasons. Detection of cryptosporidium decreased when the change from hot dry to colder wetter weather occurred. Although Salmonella spp were isolated more frequently than cryptosporidium in children with diarrhoea (20% of cases), there was no statistically significant association between excretion of Salmonella spp and gastro-enteritis. A follow-up study of a cohort of the children with cryptosporidiosis indicated that over three-quarters were dehydrated and all were below their expected weight-for-age. There was a statistically significant association between cryptosporidium gastro-enteritis and evidence of respiratory tract infection.

Cryptosporidium, malnutrition, and chronic diarrhea in children

Cryptosporidium was found in the stools of 13.5% of 221 children hospitalized with diarrhea. It was the single most prevalent pathogen isolated. Children with Cryptosporidium-positive stools were significantly more malnourished than children in whom Cryptosporidium was not detected. Children with more severe malnutrition (ie, less than 50% of their expected weight) and with Cryptosporidium in their stools had a significantly longer duration of diarrhea than similarly malnourished children without Cryptosporidium (63 vs 32 days, respectively). In 77 better-nourished outpatients with diarrhea, Cryptosporidium was found in only 5.2% of cases and was associated with less-severe illness. Our findings are consistent with the hypothesis that in less-developed areas, Cryptosporidium is a major pathogen, not only in acute but also in chronic childhood diarrhea, and may play an important role in the interaction between diarrhea and malnutrition.