Estratégias populares de saúde no vale do Rio Negro / Popular strategies of health at Rio Negro Valley

Concentra-se sobre o Rio Negro, na Amazônia brasileira, onde busca compreender a construçäo, pela populaçäo residente nas áreas rurais, dos conceitos de saúde e de doença, histórica e localmente determinados. Estas noçöes estäo fortemente relacionadas ao corpo e à capacidade de trabalho dos indivíduos. A partir de depoimentos coletados na regiäo em 1995 através das técnicas de história de vida e complementados com outros documentos textuais, estratégias de saúde desenvolvidas pela populaçäo local podem ser compreendidas e identificadas, tendo atençäo para a precariedade das políticas para a saúde popular formuladas pelo poder público. (AU)

Polyhydroxylated alkaloids isolated from mulberry trees (Morusalba L.) and silkworms (Bombyx mori L.).

New polyhydroxylated alkaloids, (2R,3R,4R)-2-hydroxymethyl-3,4-dihydroxypyrrolidine-N-propionamide from the root bark of Morus alba L., and 4-O-alpha-D-galactopyranosyl-calystegine B(2) and 3 beta,6 beta-dihydroxynortropane from the fruits, were isolated by column chromatography using a variety of ion-exchange resins. Fifteen other polyhydroxylated alkaloids were also isolated. 1-Deoxynojirimycin, a potent alpha-glucosidase inhibitor, was concentrated 2.7-fold by silkworms feeding on mulberry leaves. Some alkaloids contained in mulberry leaves were potent inhibitors of mammalian digestive glycosidases but not inhibitors of silkworm midgut glycosidases, suggesting that the silkworm has enzymes specially adapted to enable it to feed on mulberry leaves. The possibility of preventing the onset of diabetes and obesity using natural dietary supplements containing 1-deoxynojirimycin and other alpha-glucosidase inhibitors in high concentration is of great potential interest.

The use of alternative therapies by patients with Parkinson's disease.

OBJECTIVE: To determine the prevalence and spectrum of use of alternative therapy (AT) by patients with PD and to determine whether use of AT correlates with demographic, social, or disease-specific characteristics. METHODS: The authors administered a structured questionnaire, by interview, regarding the use of AT to 201 patients with PD. Demographic, social, and disease-specific characteristics were recorded for all patients. RESULTS: Eighty-one patients (40%) used at least one AT. Vitamins and herbs, massage, and acupuncture were most common. Users of AT were younger (p = 0.0021) and had a younger age at onset of PD (p = 0.0011) than nonusers of AT. There was no correlation with sex or race. Patients who used AT had a higher income (p = 0.038) and education level (p = 0.006) than did nonusers of AT. There was no association between the use of AT and the Hoehn and Yahr score, duration of PD, duration of treatment with levodopa, surgery for PD, and presence of fluctuations. CONCLUSIONS: The use of AT is common in patients with PD. The age at onset of PD is the most potent predictor of AT use. There is no association between the use of AT and the severity of PD. The widespread and largely unexamined use of AT for PD requires more attention. This should be directed at testing their safety and efficacy and improving physician and patient knowledge about the potential benefits, costs, limitations, and risks of AT.

[The safety of herbal medicines in the psychiatric practice].

The use of alternative medicines is increasing world-wide and in Israel. These drugs, considered by the Ministry of Health as food supplements, are to be obtained at pharmacies and health stores and are being sold freely, without any professional advice. Many of the herbs are used by patients to treat psychiatric disorders. These herbs have a pharmacological activity, adverse effects and interactions with conventional drugs, which can produce changes in mood, cognition, and behavior. We present the most commonly used herbal drugs, and discuss their safety and efficacy in psychiatric practice. Hypericum--used as an antidepressant and as an antiviral medicine, was reported in 23 randomized clinical trials reviewed from the MEDLINE. It was found to be significantly more effective than placebo and had a similar level of effectiveness as standard antidepressants. Recent studies almost clearly prove that this herb, like most of the conventional antidepressants, can induce mania. Valerian--is used as an anti-anxiety drug, and reported to have sedative as well as antidepressant properties. In contrast to the significant improvement in sleep that was found with the use of valerian, compared to placebo, there are several reports on the valerian root toxicity. This includes nephrotoxicity, headaches, chest tightness, mydriasis, abdominal pain, and tremor of the hands and feet. Ginseng--another plant that is widely used as an aphrodisiac and a stimulant. It has been associated with the occurrence of vaginal bleeding, mastalgia, mental status changes and Stevens-Johnson syndrome after it's chronic administration. It has interactions with digoxin, phenelzine and warfarin. Ginkgo--in clinical trials the ginkgo extract has shown a significant improvement in symptoms such as memory loss, difficulties in concentration, fatigue, anxiety, and depressed mood. Long-term use has been associated with increased bleeding time and spontaneous hemorrhage. Ginkgo should be used cautiously in patients receiving aspirin, NSAIDs, anticoagulants or other platelet inhibitors. Health care professionals can no longer ignore the widespread use of alternative medicines and cannot continue with the "don't ask, don't tell" policy. Clinicians should ask the patients about their use of herbs in a non-judgmental way, and should document the patient's use of these drugs. Finally, we must be more aware of the side effects and the potential drug interactions of these herbs, and advise our patients to avoid long term use of these drugs due to lack of information regarding the safety of these medicines.

LongoVital and herpes labialis: a randomised, double-blind, placebo-controlled study.

OBJECTIVE: LongoVital (LV) (DK. Reg. No. 5178/75) is a herbal-based tablet enriched with the recommended daily doses of vitamins. The present study was undertaken to investigate possible prevention of recurrent herpes labialis (RHL) during 4 months' daily intake of LV. DESIGN: Placebo-controlled, double-blind, randomised, clinical trial. SUBJECTS: Fifty-two patients with a minimum of 4 yearly HL episodes. METHODS: The patients were given either LV or placebo for 4 months and followed-up for another 4 months. The number, duration and maximal size of lesions were assessed. RESULTS: Twenty-seven patients (Group A) received LV and 25 patients placebo (Group B). There were no statistically significant differences between Group A and Group B with respect to number, duration and size of lesions. Within Group A, however, there was a decrease in all three parameters after 2 months' intake of LV (P < 0.05). The decrease in the number of HL episodes in Group A lasted during the entire follow-up period (P < 0.05). At the end of the medication period, significantly more patients in Group A than in Group B assessed the number and duration of recurrences to be reduced compared with before the trial (P < 0.05). CONCLUSION: LV was not superior to placebo in the prevention of RHL although subjective assessment was in favour of LV, and the LV group had less episodes after 2 months on the tablets.

[Herbal remedies in veterinary phytotherapy]. / Pflanzliche Arzneimittel in der Veterinärphytotherapie.

Phytotherapy is based on the use of herbal remedies (phytopharmaceuticals) for therapy and prophylactic measures of illness in humans and animals. Animal owners as well as veterinarians (surgeons) are more and more interested in veterinary phytotherapy. The following review explains fundamentals of veterinary phytotherapy as well as the production, application and possible side-effects of veterinary herbal remedies (veterinary phytopharmaceuticals).

Biological activities of Curcuma longa L.

There are several data in the literature indicating a great variety of pharmacological activities of Curcuma longa L. (Zingiberaceae), which exhibit anti-inflammatory, anti-human immunodeficiency virus, anti-bacteria, antioxidant effects and nematocidal activities. Curcumin is a major component in Curcuma longa L., being responsible for its biological actions. Other extracts of this plant has been showing potency too. In vitro, curcumin exhibits anti-parasitic, antispasmodic, anti-inflammatory and gastrointestinal effects; and also inhibits carcinogenesis and cancer growth. In vivo, there are experiments showing the anti-parasitic, anti-inflammatory potency of curcumin and extracts of C. longa L. by parenteral and oral application in animal models. In this present work we make an overview of the pharmacological activities of C. longa L., showing its importance.

[The administration of St. John's wort (Hypericum perforatum) in the treatment of depression]. / Zastosowanie preparatów dziurawca w leczeniu depresji.

Over the last years St. John's wort (Hypericum perforatum) has been extensively studied for its potential antidepressant activity. In Poland, it has not been approved yet as an antidepressant drug by the State Committee of Pharmaceutical Agents and Medical Materials Registration. However, since this agent is widely and commonly used (on a parapharmaceutical base), and also taking into account that possible hazard of such treatment and the risk of interactions with other drugs (which have been reported)--it seems reasonable to review and summarise the collected up-to-date data concerning these issues.

Anti-HIV activity of medicinal plant extracts.

As part of our screening of anti-AIDS agents from natural sources, ethanolic and aqueous extracts of 15 medicinal plants widely used in the folk medicine of the Iberian Peninsula were evaluated in vitro. Most of the extracts tested were relatively nontoxic to human lymphocytic MT-2 cells, but only the extracts of Tuberaria lignosa and Sanguisorba minor magnolii exhibited anti-HIV activity in an in vitro MTT assay. The aqueous extracts of these plants showed inhibitory effects against HIV-1 induced infections in MT-2 cells at concentrations ranging from 12.5 to 50 microg/ml and 50 microg/ml, respectively. Both extracts showed no appreciable cytotoxicity at these concentrations.

Herbal medicine in pregnancy and childbirth.

Pregnant women often use medicinal herbs in an effort to maintain good health and reduce the need for medical intervention. A survey of the scientific and popular literature identified a number of therapeutic herbs used in North America. Three categories are discussed: tonics, herbs for preventing miscarriage, and herbs for inducing labor. Some of these preparations may address women's needs in ways that biomedicine has failed to do. Purported merits and hazards of these medications are discussed.

Medicinal herbs: answers and advice, part 1.

Many herbal medicines have been used for centuries but have only recently been subjected to rigorous scientific scrutiny. Fever-few, milk thistle, tea tree oil, and valerian are considered safe for use by most patients. All four appear to provide some benefits in treating or preventing illness, but the supporting evidence is inconclusive in some cases.

Liver toxicity. Could this be a drug reaction?

BACKGROUND: Adverse reaction to prescription medications, over the counter medications and complementary medicines, are an important cause of liver toxicity. OBJECTIVE: To highlight the importance of drug induced liver toxicity in patients presenting with abnormal liver function tests. DISCUSSION: In patients who present with symptoms of liver dysfunction such as anorexia, itch or Jaundice and in whom liver function tests are abnormal, the possibility of an adverse reaction to medications should be considered. A detailed history of all medications taken in the past few months, including complementary medicines, should be obtained. After exclusion of other causes of liver disease such a viral hepatitis or gallstones, the cessation of the offending medication and the normalisation of liver tests is usually sufficient to establish a diagnosis. Occasionally, referral to a specialist and liver biopsy may be required.

[Physicians and medicine in 16th century New Spain]. / Médicos y medicina en la nueva España del siglo XVI.

The more prominent physicians and surgeons, European, native and creole, who practiced their art in New Spain during the XVI century, are remembered. There were improvised surgeons among the Spanish soldiers, who faced the American natives in the name of universal empire and church. There were also native physicians, organized around an important cultural center: the Franciscan college of Holy Cross in Tlatelolco. They perpetuated the ancestral medical traditions. In the dawning of New Spain, arrived here some physicians and surgeons prepared in important medical centers, such Sevilla, Salamanca, and Alcalá de Henares. Soon after a noteworthy exchange of medicinal plants and, generally, of therapeutic products between the old and new world took place. Likewise arrived here medical books printed in Europe and, in the second half of such century, appeared Newspanish medical books. When the first chair of medicine was established in the Royal University of México (1578), the number of medical publications increased until, in 1598, appeared the first medical thesis printed in America.

Complexation of Ginkgo biloba extract with phosphatidylcholine improves cardioprotective activity and increases the plasma antioxidant capacity in the rat.

The aim of this work was to compare in the rat the cardioprotective efficacy and the total plasma antioxidant activity of a standardised Ginkgo biloba L. extract (GB) as such (300 mg/kg/day) or complexed with phosphatidylcholine (GB-PC; 1:2 w/w), after a 5 days oral administration. At the end of the treatment, the total plasma antioxidant defence was determined by the TRAP and FRAP assays, and the hearts from all groups of animals subjected to moderate ischemia (flow reduction to 1 ml/min for 20 min) and reperfusion (15 ml/min for 30 min). The recovery of left ventricular developed pressure (LVDP) at the end of reperfusion was 35-40% of the preischemic values in both control and vehicle rats, 50.2% in the GB group and 72.5% in the GB-PC pre-treated animals. Creatine kinase (CK) outflow in the perfusate from the hearts of GB and GB-PC treated animals were restrained to a different extent vs. controls (by 71% GB-PC; by 22% GB); the rate of prostacyclin (6-keto-PGF1 alpha) release was far greater in GB-PC than in GB hearts. In parallel, the GB extract significantly increased the total antioxidant plasma capacity (by 24.5% TRAP; 27.9% FRAP) only when complexed with phospholipids. This indicates an increased bioavailability of phenolic antioxidants when suitably embedded within a lipophilic carrier. The results of this study demonstrate that complexation of Ginkgo biloba with phospholipids induces in the rat, even after a short treatment a greater resistance of the heart to ischemia/reperfusion damage in respect to the native extract, due to an increased plasma antioxidant activity.