Effect of CIMicifuga racemosa on metaBOLIC parameters in women with menopausal symptoms: a retrospective observational study (CIMBOLIC).

PURPOSE: To compare the influence of Cimicifuga racemosa extract (CR, Ze 450) and menopausal hormone therapy (MHT) on metabolic parameters and body weight in symptomatic menopausal women. METHODS: In this monocentric retrospective cohort study, women over 40 years old with a first consultation between 2009 and 2016 were screened. Included in the final analysis were women treated with either MHT or CR and having at least one follow-up consultation. Metabolic serum parameters (lipids, glucose, insulin, and HOMA-IR), body weight, and menopausal symptoms [Menopause Rating Scale (MRS)-II] were the main outcome measures. Statistical analysis by uni- and multi-variable linear mixed-effects regression models assuming a linear effect of time. RESULTS: 174 women were included in the final analysis (CR n = 32, MHT n = 142). There was no difference between the groups regarding baseline characteristics (age, BMI, serum metabolic parameters, hormones, and blood pressure) and total MRS-II score, while reproductive stage differed significantly with more postmenopausal women treated with CR (83%) than MHT (55%) (p = 0.038). Median follow-up time was 12 months. In both groups, metabolic serum parameters and body weight did not change over the follow-up period, while total and MRS-II subscores improved. CONCLUSION: Menopausal symptoms improved significantly in both groups (MHT and CR), while serum metabolic parameters and body weight did not change in MHT- or CR-treated women.

Perceptions and attitudes of Bhutanese people on Sowa Rigpa, traditional Bhutanese medicine: a preliminary study from Thimphu.

BACKGROUND: Many claims are made that the use of traditional medicine is a substantial and growing part of healthcare behavior around the world. In Bhutan traditional medical practice is one of the country's tangible heritages. The country hosts two forms of traditional medicines: local healing practices and the official traditional medical system known as sowa rigpa, meaning "the science of healing". This paper explores the attitudes on sowa rigpa among Bhutanese living in Thimphu, the capital of Bhutan. METHODS: This study was conducted from May to September 2009. In total, 155 people coming from diverse social backgrounds were randomly selected for the study. The study made use of qualitative as well as quantitative approaches, involving the administration of questionnaires and conducting in-depth interviews. RESULTS: From the 155 respondents 99% have heard about sowa rigpa, mainly from their friends or relatives. The study showed that sowa rigpa is popular among the respondents since more than half (51%) have said that they have been treated by sowa rigpa doctors. The data revealed that the majority (83%) of the respondents are satisfied with the treatment received. CONCLUSION: The Bhutanese healthcare system that integrates sowa rigpa and modern medicine offers an opportunity for active healthcare decision-making by the patients. The improved understanding of the knowledge, attitudes and treatment seeking practices of the participants in the study provides useful information for health practitioners and policy makers to plan health activities. The present preliminary study represents only people living in the capital city of Bhutan. Therefore, a further nationwide study is planned to better understand the role sowa rigpa plays also in rural Bhutan.

Petasol butenoate complex (Ze 339) relieves allergic rhinitis-induced nasal obstruction more effectively than desloratadine.

BACKGROUND: Allergic rhinitis symptoms of itching, sneezing, rhinorrhea, and nasal obstruction significantly decrease patients' quality of life. Compared with histamine and leukotriene receptor antagonists, the petasol butenoate complex Ze 339 displays pharmacologically distinct properties. In vitro it inhibits the biosynthesis of leukotrienes and mediator release from activated eosinophils. OBJECTIVE: This study aimed to assess the efficacy and mode of action of Ze 339, desloratadine, and placebo on allergic rhinitis symptoms, nasal airflow, and local mediator levels after unilateral nasal allergen provocation. METHODS: In this double-blind, randomized, crossover study 18 subjects with allergic rhinitis to grass pollen received Ze 339, desloratadine, and placebo for 5 days before nasal allergen challenge with grass pollen extract. Rhinomanometry, symptom assessment, and local inflammatory mediator measurement were performed during the 24 hours after allergen challenge. RESULTS: With Ze 339, the patient's time to recovery (5.4 ± 1.6 hours) from nasal obstruction after allergen challenge (time for return to 90% of baseline value ± SEM) was significantly shorter than with placebo (9.1 ± 2.3 hours, P = .035) and desloratadine (10.7 ± 2.5 hours, P = .022). Likewise, Ze 339's standardized symptom assessment for nasal obstruction (3.2 ± 1.3 hours) showed significantly faster relief (time for return to baseline value ± SEM compared with placebo, 8.3 ± 2.4 hours; P = .027) and desloratadine (4.5 ± 1.2 hours, P = .030). One interesting finding was that Ze 339 significantly reduced IL-8 and leukotriene B(4) levels in nasal secretions before challenge. CONCLUSION: When compared with desloratadine and placebo, Ze 339 shows better efficacy in relieving nasal obstruction symptoms and inhibiting critical components of the chemokine network and as such represents a novel symptomatic and possible prophylactic treatment for allergic rhinitis.

'Local Food-Nutraceuticals': bridging the gap between local knowledge and global needs.

Food use is changing very fast all over the world. This and other changes (e.g. reduced physical activity, increased longevity) result in novel health risks for the populations in European countries and beyond. Also, in recent decades the convenience food market has grown dramatically and offers novel opportunities for small and large industries alike. Simultaneously, there is a dramatic and irrevocable loss of the local knowledge which forms the basis of many cultural traditions (traditional food knowledge--TFK). The Mediterranean region is well known for a dietary tradition commonly called 'Mediterranean diet(s)', which is renowned for health benefits based among others on widely consumed foods and beverages. While the focus of research has mostly been on the more widely used elements of the Mediterranean diets (especially olive oil and red wine), in this review the focus is on 'local food'. These are ingredients, which are gathered, grown or produced locally and prepared into dishes, which often represent local specialities. Such food is derived from animals, fungi and plants, but in this paper the main subject is food of botanical origin. Particularly important among these local foods are vegetables and salads derived from wild greens (gathered food plants--GFPs) and local cultivars of fruit trees and shrubs. In this review we discuss the theoretical basis (including the concept of traditional knowledge systems) and general approach of an EU-funded multidisciplinary ethnobotanicalpharmacological project focusing on the use of such local resources in several regions of the Mediterranean including the ethnobotanical documentation of food products of selected communities in southern Italy, Spain, Greece (mostly Crete), the identification of extracts/pure compounds (leads for new health food supplements) with potent activity on a series of in vitro targets, especially ones relevant to assess for antioxidant activity, the more detailed in vivo study of some lead extracts and lastly the dissemination of such TFK in local/national languages.

Disseminating knowledge about 'Local Food Plants' and 'Local Plant Foods'.

Ethnobotanical approaches to the study of Mediterranean food plants offer novel ways for analyzing and preserving traditional knowledge and agrobiodiversity in the Mediterranean area. This article highlights our strategy to increase the awareness within traditional knowledge systems and encourage the continuous evolution of it, avoiding the loss of substantial parts of the local cultural and biological diversity. The strategy is part of a broader stream of thought, which does attempt to disseminate information locally in a multitude of ways, e.g. through a range of publications in rural or urban zones, to people with or without formal education, to children or the elderly. This article is a very personal account of the experience of the authors, but there is an urgent need to assess the impact of such activities on a broader level, and, also, to reassess the impact researchers have on the communities. Our clear impression in all field sites has been that the simple fact that such traditional knowledge systems are the focus of scientific investigation are an essential element of giving renewed sociocultural value to such knowledge and that activities like the ones described here are of great interest to the communities we worked in.

Ta chòrta: wild edible greens used in the Graecanic area in Calabria, Southern Italy.

Dietary patterns change rapidly all over the world. The body of available local food knowledge, which forms the basis of many local traditions, is decreasing dramatically. At the same time, consumers demand novel types of tasty food, which is easy to prepare. In the Mediterranean, vegetables and salads made from wild greens have been particularly important as local (traditional) foods since ancient times. This double interest in local plant use and diets led to an ethnobotanical and socio-nutritional survey carried out in 2002 and 2003 among the inhabitants of the Graecanic area in Southern Calabria, Italy. The Graecanic area is part of the cultural and linguistic heritage of the Magna Graecia and the later Byzantine Empire. The villagers in the area have retained many aspects of this cultural heritage, including their own language Grecanico, in which wild edible greens are called ta chòrta. The inhabitants of the Graecanic area regularly gather more than 40 wild food species. The present study demonstrates how the consumption of wild food plant species is strongly embedded in the local culture, and that they contribute to a healthy and balanced diet.

Knowledge and use of complementary and alternative medicine among British undergraduate pharmacy students.

AIM: Attitudes and practice concerning complementary and alternative medicine (CAM) are currently an area of considerable importance. However, little is known about the overall importance of CAM in groups of health care professionals. Therefore, the primary objective was to analyse the knowledge about and use of CAM in an ethnically diverse student population at the London School of Pharmacy. METHODS: A questionnaire was administered to students (264 completed questionnaires, response rate: 59.1%) and in-depth interviews were carried out with a sample of seven students. RESULTS: Forty-three percent reported using at least one type of CAM during the last 12 months. The types of CAM used that were most frequently mentioned include aromatherapy, Traditional Chinese Medicine (TCM) and medicinal herbalism. TCM was reported by students of Chinese origin and by students from other ethnic backgrounds. However, Ayurvedic (Indian) medicine and medicine from Africa were only used in cultures from which the users originated. The study shows that a large number of herbal medical products were commonly reported by students of pharmacy. CONCLUSION: The knowledge about and use of CAM is widespread among this group of future health care professionals and the students also expressed a strong interest in the topic. In-depth studies on the knowledge and use of CAM among other health care professionals and among ethnic minorities are urgently needed and may help to better manage the treatment of minor disorders as well as chronic diseases.

Food for two seasons: culinary uses of non-cultivated local vegetables and mushrooms in a south Italian village.

The use of non-cultivated plants in a daily diet based on local cuisines is potentially of considerable interest to nutritional scientists, because of the plants' role as local products and their potential as sources of novel nutraceuticals. In many Mediterranean regions these traditions are at risk of disappearing, hence the urgent need to study such knowledge systems. Accordingly, an ethnobotanical survey was carried out among the 850 inhabitants of the village of Castelmezzano, in central Lucania, which is located in the inland southern Italy. Seventy-five taxa of non-cultivated and semi-cultivated local food plants and mushrooms were documented, and uncommon food uses of a few species were reported for the first time. These include Bellavalia romana, Lepista nebularis and Onopordum illyricum. Most of the recorded non-cultivated food plants and mushrooms are cooked in oil or fat. Very few are consumed raw. This article discusses in detail the traditional culinary uses of these plants, their seasonality, ethnoecology, and their economic and nutritional potentials. The article also demonstrates how food agro-biodiversity is inextricably connected with cultural heritage.

Questionnaire surveys: methodological and epistemological problems for field-based ethnopharmacologists.

The classical scientific approach is empirical. One of the favoured means of gathering quantitative data in the health and social sciences, including ethnopharmacology and medical ethnobotany, is by use of questionnaires. However, while there are numerous published articles discussing the importance of questionnaire content, the fact that questionnaires themselves may be inappropriate in a number of cultural contexts, even where literacy is not a factor, is usually ignored. In this paper, the authors will address the main issues posed by the use of questionnaire surveys, using case studies based on their own personal experiences as ethnopharmacologists 'in the field'. The pros and cons of qualitative and quantitative research and the use of alternative means to elicit quantitative data will be discussed.

Ethnopharmacy of the ethnic Albanians (Arbëreshë) of northern Basilicata, Italy.

Intercultural studies about the methods of use and perceptions of traditional remedies in Europe are strategically important in understanding how pharmaceutical means in our multicultural modern societies are differently accepted by diverse ethnic groups. In this survey, we analysed the biological means traditionally used in the ethnomedicine of three Arbëreshë (ethnic Albanians) communities in the Vulture area (northern Lucania, southern Italy). The majority of remedies are represented by plants belonging to 54 botanical taxa. A few of the recorded species have a traditional therapeutic use that has never previously been reported in southern Italy. Other means-especially used in the past-are comprised of mineral, animal and industrial derived materials. In specific cases, some of these materials and even plants are neither applied externally or internally, but are instead utilised as symbolic ritual objects in spiritual healing ceremonies. Ethnopharmacological and anthropological considerations about these usages are discussed.

Ethnopharmacology of liakra: traditional weedy vegetables of the Arbëreshë of the Vulture area in southern Italy.

An ethnobiological field study on food plants and medicinal foods traditionally consumed in three Arbëresh (ethnic Albanian) communities in northern Lucania (southern Italy) document approximately 120 botanical taxa used for these purposes. Non-domesticated food vegetables (liakra), mostly gathered during the spring season, play a central role as traditional functional food. Quantitative ethnobotanical, ethnotaxonomical, ethnoecological, ethnogastronomical, and ethnopharmacological aspects related to gathering, processing, cooking and consumption of liakra are discussed. Unusual food species, such as Lycium europeaum, Centaurea calcitrapa, and a few spontaneous weedy Asteraceae and Brassicaceae species are locally used in the kitchen. Most of these are very poorly known phytochemically and phytopharmacologically. Moreover, an analysis of taste perception of the most commonly used botanical foods was conducted in the village of Ginestra. Arbëresh taste classification and indigenous criteria related to the perception of bitter taste in considering non-cultivated plants as food or medicine are discussed as well.