Longitudinal changes in adverse effects reporting in multiple dietary supplement classifications: The US military dietary supplement use study.

Over 70% of United States military service members (SMs) regularly use dietary supplements (DSs) and about 18% have reported adverse effects (AEs) associated with use. This investigation examined longitudinal changes in AEs reporting among DS users. On two separate occasions 1.3 ± 0.2 years apart (mean ± standard deviation), 5778 SMs completed identical questionnaires on DS use and associated AEs. Among SMs reporting DS use ≥1 time/week, ≥1 AE was reported by 19% and 15% in the baseline and follow-up phases, respectively. The risk of reporting DS use at follow-up was similar among those reporting and not reporting AEs at baseline for most DS categories including prohormones, proteins/amino acids, individual vitamins and minerals, multivitamin/multiminerals, herbals, fish oils, joint health products, and other DSs. An exception was combination products where those reporting AEs at baseline had an increased risk of use at follow-up (risk ratio = 1.13, 95% confidence interval = 1.06-1.09). Those reporting AEs at baseline and continuing DS use in the follow-up were more likely to report AEs at follow-up compared to those not reporting baseline AEs. In conclusion, AEs reported at baseline did not deter many participants from using DSs in the follow-up period, and many SMs reporting AEs at baseline continued reporting them at follow-up.

Comprehensive insights into rheumatoid arthritis: Pathophysiology, current therapies and herbal alternatives for effective disease management.

Rheumatoid arthritis is a chronic autoimmune inflammatory disease characterized by immune response overexpression, causing pain and swelling in the synovial joints. This condition is caused by auto-reactive antibodies that attack self-antigens due to their incapacity to distinguish between self and foreign molecules. Dysregulated activity within numerous signalling and immunological pathways supports the disease's development and progression, elevating its complexity. While current treatments provide some alleviation, their effectiveness is accompanied by a variety of adverse effects that are inherent in conventional medications. As a result, there is a deep-rooted necessity to investigate alternate therapeutic strategies capable of neutralizing these disadvantages. Medicinal herbs display a variety of potent bioactive phytochemicals that are effective in the complementary management of disease, thus generating an enormous potency for the researchers to delve deep into the development of novel phytomedicine against autoimmune diseases, although additional evidence and understanding are required in terms of their efficacy and pharmacodynamic mechanisms. This literature-based review highlights the dysregulation of immune tolerance in rheumatoid arthritis, analyses the pathophysiology, elucidates relevant signalling pathways involved, evaluates present and future therapy options and underscores the therapeutic attributes of a diverse array of medicinal herbs in addressing this severe disease.

Research progress on the toxicity of toxic Traditional Herbals from Thymelaeaceae.

ETHNOPHARMACOLOGICAL RELEVANCE: Plants from the Thymelaeaceae family are widely distributed in tropical and temperate regions, with approximately 113 species used as Traditional Herbals. There are numerous applications for them, such as treating leukemia, AIDS, and liver cancer. It should be noted that around 20% of these plants have shown harmful side effects when used in clinical applications, including solid irritations to the skin and mucous membranes, carcinogenic effects, organ damage, vomiting, and diarrhea. AIM OF THE STUDY: This paper aims to review the toxic side effects, toxic compounds, toxic mechanisms, and detoxification methods of Traditional Herbals in Thymelaeaceae, guiding their safe clinical uses. MATERIALS AND METHODS: This review employed the keywords "Thymelaeaceae," 48 different "genus," 966 "species," and the combination of "toxicity" to identify the medicinal value and toxicity of plants from Thymelaeaceae in scientific databases (Pubmed, SciFinder Scholar, Elsevier, Web of Science, and CNKI). Information relevant to the toxicity of Traditional Herbals from Thymelaeaceae up to June 2023 has been summarized. The plant names have been checked with "World Flora Online" (www.worldfloraonline.org). RESULTS: 28 toxic Traditional Herbals from 13 genera within the Thymelaeaceae family were categorized. Toxicities were summarized at the cellular, animal, and clinical levels. The toxic substances are primarily concentrated in the Daphne L. and Wikstroemia Endl. genera, with terpenes being the main toxic components. The toxicity mechanism is primarily associated with the mitochondrial pathways. Detoxification and enhanced efficacy can be achieved through processing methods such as vinegar-processing and sweat-soaking. CONCLUSIONS: Medicinal plants in the Thymelaeaceae exhibit significant pharmacological activities, such as anti-HIV and anti-tumor effects, indicating a broad potential for application. However, their clinical uses are hindered by their inherent toxicity. Researching the toxic components and mechanisms of these Traditional Herbals and exploring more effective detoxification methods can contribute to unveiling the latent value of these medicinal plants from Thymelaeaceae.

A systematic methodology to assess the identity of plants in historical texts: A case study based on the Byzantine pharmacy text John the Physician's Therapeutics.

ETHNOPHARMACOLOGICAL RELEVANCE: In recent decades, the study of historical texts has attracted research interest, particularly in ethnopharmacology. All studies of the materia medica cited in ancient and medieval texts share a concern, however, as to the reliability of modern identifications of these substances. Previous studies of European or Mediterranean texts relied mostly on authoritative dictionaries or glossaries providing botanical identities for the historical plant names in question. Several identities they suggest, however, are questionable and real possibility of error exists. AIM OF THE STUDY: This study aims to develop and document a novel and interdisciplinary methodology providing more objective assessment of the identity of the plants (and minerals) described in these resources. MATERIALS AND METHODS: We developed an iterative experimental approach, using the 13th century Byzantine recipe text John the Physician's Therapeutics in its Commentary version (JC) as a case study. The methodology has six stages and relies on comparative analyses including statistical evaluation of botanical descriptions and information about medicinal uses drawn from both historical and modern sources. Stages 1-4 create the dataset, stage 5 derives the primary outcomes to be reviewed by experts in stage 6. RESULTS: Using Disocorides' De Materia Medica (DMM) (1st century CE) as the culturally related reference text for the botanical descriptions of the plants cited in JC, allowed us to link the 194 plants used medicinally in JC with 252 plants cited in DMM. Our test sample for subsequent analyses consisted of the 50 JC plant names (corresponding to 61 DMM plants) for which DMM holds rich morphological information, and the 130 candidate species which have been suggested in the literature as potential botanical identities of those 50 JC plant names. Statistical evaluation of the comparative analyses revealed that in the majority of the cases, our method detected the candidate species having a higher likelihood of being the correct attribution from among the pool of suggested candidates. Final assessment and revision provided a list of the challenges associated with applying our methodology more widely and recommendations on how to address these issues. CONCLUSIONS: We offer this multidisciplinary approach to more evidence-based assessment of the identity of plants in historical texts providing a measure of confidence for each suggested identity. Despite the experimental nature of our methodology and its limitations, its application allowed us to draw conclusions about the validity of suggested candidate plants as well as to distinguish between alternative candidates of the same historical plant name. Fully documenting the methodology facilitates its application to historical texts of any kind of cultural or linguistic background.

Erosive potential of vitamin waters, herbal drinks, carbonated soft drinks, and fruit juices on human teeth: An in vitro investigation.

Background: Dental erosion is the loss of dental hard tissues through the acid dissolution of tooth minerals. One of the major factors that cause erosion is the consumption of acidic food and drinks. This study investigated and compared the effect of vitamin waters, herbal beverages, carbonated soft drinks, and fruit juices on the loss of human dental hard tissue. Methods: Human tooth samples were immersed in various drinks: vitamin waters, herbal beverages, carbonated soft drinks, and fruit juices. The pH value of each drink was measured using a pH meter. The weight of each sample was determined before and after six days of immersion in the tested drink, and the weight loss percentage was calculated. The exposed tooth surfaces were also examined under a scanning electron microscope. Results: Most of the tested drinks were acidic and displayed pH values lower than the critical pH for enamel erosion. Significant weight loss of the tooth samples was found in all tested drink groups. Additionally, the samples immersed in fruit juices and herbal beverages exhibited significantly greater weight loss than those immersed in carbonated soft drinks. Scanning electron micrographs showed samples immersed in the tested drinks to demonstrate structural disintegration with occasional void spaces, except for samples immersed in Doi Kham® Lemongrass drink. Conclusion: Most of the tested drinks have the potential to cause dissolution and destruction of dental hard tissues. Consumers should be aware that prolonged exposure to these drinks could lead to permanent loss of tooth mineral and dental erosion.

Associations between clinically diagnosed medical conditions and dietary supplement use: the US military dietary supplement use study.

OBJECTIVE: This study examined associations between multiple dietary supplement (DS) categories and medical conditions diagnosed by health professionals. DESIGN: Cross-sectional. SETTING: Volunteers completed an online questionnaire on DS use and demographic/lifestyle factors. Medical diagnoses were obtained from a comprehensive military electronic medical surveillance system and grouped into twenty-four clinically diagnosed medical conditions (CDMC). PARTICIPANTS: A stratified random sample of US service members (SM) from all military services (n 26 680). RESULTS: After adjustment for demographic/lifestyle factors (logistic regression), higher risk was found for 92 % (22/24) of CDMC among individual vitamins/minerals users, 58 % (14/24) of CDMC among herbal users, 50 % (12/24) of CDMC among any DS users and 46 % (11/24) of CDMC among multivitamins/multiminerals (MVM) users. Among protein/amino acid (AA) users, risk was lower in 25 % (6/24) of CDMC. For combination products, risk was higher in 13 % (3/24) of CDMC and lower in 8 % (2/24). The greater the number of CDMC, the higher the prevalence of DS use in most DS categories except proteins/AA where prevalence decreased. CONCLUSIONS: Users in many DS categories had a greater number of CDMC, but protein/AA users had fewer CDMC; results for combination products were mixed. These data indicate those with certain CDMC were also users in some DS categories, especially individual vitamins/minerals, herbals and MVM. Data are consistent with the perception that use of DS enhances health, especially in those with CDMC. Protein/AA and combination product users were more likely to be younger, more physically active men, factors that likely reduced CDMC.

The rise and fall of mandrake in medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: Mandrake (Mandragora sp.) is one of the most famous medicinal plants. It has been in continuous medical use throughout written history and is still in use today in popular medicine. AIM OF THE STUDY: Mandrake derived drugs once played an important role in medicine and in magical practices. Today, the role of mandrake in popular medicine is marginal. However, natural products present in mandrake such as atropine and scopolamine, as well as their semi synthetic derivatives continue to hold and important role in medicine. Here we aim to trace the development of historical rationales and scientific events that led to the abandonment of mandrake as a medicine. MATERIALS AND METHODS: We review the medicinal uses of mandrake drugs since antiquity in an attempt to pinpoint use patterns that were popular in certain periods of time and others that are more general. We compare the uses from the native territories to those from regions where the plant got introduced and use literature reporting mandrake's chemistry and pharmacology in order to explain the diachronic changes of use patterns. RESULTS AND CONCLUSION: We found information about 88 different medicinal uses for mandrake, grouped into 39 conditions. According to the number of different medicinal uses, the most versatile period was the medieval (37), followed by the Renaissance (31), the classical (27), and the modern period (21). Considering the higher number of textual sources and use-records collected for the Renaissance period, the decrease of versatility in comparison to the medieval period appears robust. This seems to indicate a more consolidated use pattern, that might be conditioned by the reproduction of classic textual sources as well as by a less experimental approach and reduced popularity of mandrake in medicine. The introduction of the volatile anaesthetics with more reliable narcotic effects set the seal on using mandrake in surgery but opened the way for atropine being used as a prophylactic and antidote during surgical interventions.

Herbal-Based Dressings in Wound Management.

Wound management is one of the major global challenges in recent times, and woundassociated infection has a significant impact on the healthcare economy worldwide. Wounds can be acute or chronic type, also diabetic, trauma, accidental, burn wounds and minor cuts, bruises, and rashes, etc. One of the primary treatment options available in these conditions are the use of suitable dressing materials to cover the wound and accelerate the healing process. Since ancient times, according to archaeological theories, medicinal plants and oils have been employed for the treatment of wounds. Today researchers across the globe are focusing their efforts on fabrication of novel dressing materials that can provide the most effective treatment, easy exchange of nutrients, and absorb exudate from the wounds. Very lately, various research groups are also concentrating on the design and development of herb-loaded wound dressings, as herbal preparations contain numerous phytoconstituents with a broad spectrum of pharmacological properties when compared to synthetic drugs and also due to the perceived notion that herbal products are generally safe, even when administered over prolonged periods. They contain numerous bioactive that can act on the various phases of the wound healing process, providing an ideal environment for the healing process. The present review discusses the numerous approaches that are employed for the preparation of dressing materials incorporated with plant-derived phytoconstituents/extracts. This review also provides an insight into the healing process and wound healing agents derived from medicinal plants and oils. The review can serve as a database for researchers working in this field and can help them to select the most appropriate dressing material for the effective delivery of herbal preparations in the management of wounds.

Diverse in Local, Overlapping in Official Medical Botany: Critical Analysis of Medicinal Plant Records from the Historic Regions of Livonia and Courland in Northeast Europe, 1829-1895.

Works on historical ethnobotany can help shed light on past plant uses and humankind's relationships with the environment. We analyzed medicinal plant uses from the historical regions of Livonia and Courland in Northeast Europe based on three studies published within the 19th century by medical doctors researching local ethnomedicine. The sources were manually searched, and information extracted and entered into a database. In total, there were 603 detailed reports of medicinal plant use, which refer to 219 taxa belonging to 69 families and one unidentified local taxon. Dominant families were Asteraceae (14%), Solanaceae (7%), Rosaceae (6%), and Apiaceae (5%). The majority of use reports were attributed to the treatment of four disease categories: digestive (24%), skin (22%), respiratory (11%), and general (11%). The small overlapping portion (14 taxa mentioned by all three authors and another 27 taxa named by two authors) contained a high proportion of taxa (46%) mentioned in Dioscorides, which were widespread during that period in scholarly practice. Despite the shared flora, geographical vicinity, and culturally similar backgrounds, the medicinal use of plants in historical Courland and Livonia showed high biocultural diversity and reliance on wild taxa. We encourage researchers to study and re-evaluate the historical ethnobotanical literature and provide some suggestions on how to do this effectively.

A review: traditional herbs and remedies impacting pathogenesis of Parkinson's disease.

Parkinson's disease (PD) is characterized by progressive degeneration of dopaminergic neurons, leading to misbalance and loss of coordination. Current therapies are claimed only for symptomatic relief, on long-term use, which causes alteration in basal ganglia, and give rise to various adverse effects like dyskinesia and extra pyramidal side effects, which is reversed and proved to be attenuated with the help of various herbal approaches. Therefore, in order to attenuate the dopaminergic complications, focus of current research has been shifted from dopaminergic to non-dopaminergic strategies. Herbs and herbal remedies seems to be a better option to overcome the complications associated with current dopaminergic therapies. In recent years, various herbs and herbal remedies based on Ayurveda, traditional Chinese and Korean remedies, have become the target of various researches. These herbs and their bioactive compound are being extensively used to treat PD in India, China, Japan, and Korea. The major focus of this current review is to analyze preclinical studies with reference to various herbs, bioactive compounds, and traditional remedies for the management of Parkinson disorder, which will give an insight towards clinical trials.

Herbals and Plants in the Treatment of Pancreatic Cancer: A Systematic Review of Experimental and Clinical Studies.

BACKGROUND: Pancreatic cancer represents the most lethal malignancy among all digestive cancers. Despite the therapeutic advances achieved during recent years, the prognosis of this neoplasm remains disappointing. An enormous amount of experimental (mainly) and clinical research has recently emerged referring to the effectiveness of various plants administered either alone or in combination with chemotherapeutic agents. Apart from Asian countries, the use of these plants and herbals in the treatment of digestive cancer is also increasing in a number of Western countries as well. The aim of this study is to review the available literature regarding the efficacy of plants and herbals in pancreatic cancer. METHODS: The authors have reviewed all the experimental and clinical studies published in Medline and Embase, up to June 2021. RESULTS: More than 100 plants and herbals were thoroughly investigated. Favorable effects concerning the inhibition of cancer cell lines in the experimental studies and a favorable clinical outcome after combining various plants with established chemotherapeutic agents were observed. These herbals and plants exerted their activity against pancreatic cancer via a number of mechanisms. The number and severity of side-effects are generally of a mild degree. CONCLUSION: A quite high number of clinical and experimental studies confirmed the beneficial effect of many plants and herbals in pancreatic cancer. More large, double-blind clinical studies assessing these natural products, either alone or in combination with chemotherapeutic agents should be conducted.

San-Wu-Huang-Qin decoction attenuates tumorigenesis and mucosal barrier impairment in the AOM/DSS model by targeting gut microbiome.

BACKGROUND: A classic herbal formula San-Wu-Huang-Qin (SWHQ) decoction has been widely used in clinical practices to prevent and treat colorectal cancer (CRC) for years, but its anti-tumorigenic properties and the underlying mechanisms remain undetermined. PURPOSE: The present study used a CRC mouse model to clarify whether and how SWHQ suppresses tumorigenesis. METHODS: Different doses of SWHQ were gavaged to the AOM/DSS model mice to examine its anti-tumor efficacy in comparison with the positive control drug Aspirin. The underlying microbiota-driven anti-tumor action of SWHQ was proven with bacterial manipulations by fecal microbial transplantation (FMT) in vivo and anaerobic culturing in vitro. RESULTS: SWHQ decoction dose-dependently reduced colonic tumor numbers/loads of AOM/DSS models and suppressed their disease activity index scores. SWHQ also recovered epithelial MUC2 secretion and colonic tight junction protein (ZO-1 and claudin1) expression in the mouse model. Such inhibitory impact on tumorigenesis and mucosal barrier impairment was found to be associated with modulation of gut dysbiosis, particularly for suppressing lipopolysaccharide (LPS) producers. The FMT experiment confirmed the substantial contribution of SWHQ-reshaped microbiota to anti-tumor function and mucosal barrier protection. Moreover, LPS-activated TLR4/NF-κB signaling and its downstream pro-inflammatory factors were significantly suppressed in the colon of SWHQ-treated models and SWHQ-reshaped microbiota recipients. CONCLUSIONS: We demonstrated that the SWHQ effectively inhibited tumorigenesis and protect mucosal barrier in CRC at least partially by targeting gut microbiota. This study provides scientific basis for the clinical usage of SWHQ in CRC intervention and prevention.

Bioactive-Based Cosmeceuticals: An Update on Emerging Trends.

Cosmetic-containing herbals are a cosmetic that has or is claimed to have medicinal properties, with bioactive ingredients purported to have medical benefits. There are no legal requirements to prove that these products live up to their claims. The name is a combination of "cosmetics" and "pharmaceuticals". "Nutricosmetics" are related dietary supplements or food or beverage products with additives that are marketed as having medical benefits that affect appearance. Cosmetic-containing herbals are topical cosmetic-pharmaceutical hybrids intended to enhance the health and beauty of the skin. Cosmetic-containing herbals improve appearance by delivering essential nutrients to the skin. Several herbal products, such as cosmetic-containing herbals, are available. The present review highlights the use of natural products in cosmetic-containing herbals, as natural products have many curative effects as well as healing effects on skin and hair growth with minimal to no side effects. A brief description is given on such plants, their used parts, active ingredients, and the therapeutic properties associated with them. Mainly, the utilization of phytoconstituents as cosmetic-containing herbals in the care of skin and hair, such as dryness of skin, acne, eczema, inflammation of the skin, aging, hair growth, and dandruff, along with natural ingredients, such as for hair colorant, are explained in detail in the present review.

Coronavirus management and control: Nutrition and alternative medicines.

Background: In late December 2019, the outbreak of COVID-19 caused by the coronavirus severe acute respiratory syndrome-CoV-2, originated in Wuhan Province, the People's Republic of China (PRC). The rapid and highly infectious virus quickly spread around the country and has become a global pandemic. Thousands of people have been infected, and have died. Scientists around the world are working on the vaccine; however, an effective cure is yet to be developed. Aims: Search to be made on some alternative antiviral components from the rich sources of traditional herbal medicine in India as well as in the PRC. Here we discuss them with references. Methods: The knowledge gained from the literature search of antiviral known herbal products or Ayurvedic medicines that used to be applied against any viral or bacterial infections in the past, may be considered for deployment against COVID-19, and may be rewarded. Results: Many medicinal compounds are extracted from plants and have led to drug discovery. Similarly, plant products and their analogues have been employed as an early line of defense against COVID-19. Conclusion: Research into ethnobotany, phytochemistry, plant physiology and ecology may be important in protecting the global population from current and future pandemics.

Local ecological knowledge and folk medicine in historical Estonia, Livonia, Courland and Galicia in Northeastern Europe, 1805-1905.

Background: Historical ethnobotanical data can provide valuable information about past human-nature relationships as well as serve as a basis for diachronic analysis. This data note aims to present a dataset which documented medicinal plant uses, mentioned in a selection of German-language sources from the 19 th century covering the historical regions of Estonia, Livonia, Courland, and Galicia. Methods: Data was mainly entered by systematic manual search in various ethnobotanical historical German-language works focused on the medicinal use of plants. Data about plant and non-plant constituents, their usage, the mode of administration, used plant parts, and their German and local names was extracted and collected into a database in the form of Use Reports.

Herbal plants as immunity modulators against COVID-19: A primary preventive measure during home quarantine.

The novel coronavirus or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a deadly virus which has spread globally and claimed millions of lives. This novel virus transmits mainly through droplets and close human contact. It's impact in different countries varies depending on geographical location, climatic conditions, food habits, and cultural activities. Several precautionary measures, as well as many medicines, are applied in different combinations to limit the spread of infection. This results in a preliminary relief of people infected in the first stage of infection. An alternative approach has been introduced which proposes natural herbs, which have minimal or no side effects, and improve overall immunity. Some essential herbs with their immunomodulatory effects are mentioned in this article along with suggestions for improved immunity and protection.

Exploration of Predictive Modeling of Defense Health Agency & Department of Veterans Affairs Beneficiaries Dietary Supplements Use.

PURPOSE: The purpose of this study was to predict dietary supplements (DS) use among Defense Health Agency (DHA) and Veterans Affairs (VA) beneficiaries who were scheduled for surgical procedures. DESIGN: This was a predictive descriptive multicenter study with a convenience sample of 2,623 adult subjects. After institutional review board exemption, data collection occurred preoperatively via electronic survey. Participation was voluntary and data unidentifiable. METHODS: Data were collected in preoperative anesthesia clinics during preanesthetic evaluations, or in surgery holding areas immediately prior to surgery, using a validated data collection tool. The total convenience sample size was 2,623 subjects from 6 medical centers. Data were voluntarily, anonymously, and verbally obtained from subjects using electronic survey methodology. Collected data included: gender, age, rank, beneficiary status, race, body mass index, tobacco use, marital status, and knowledge of DS side effects and drug interactions. For predictive modeling of DS use, multiple logistic regression was performed for binary outcomes via SPSS. FINDINGS: For binary logistic regression the predictors were significant for the following outcomes: taking DS (education, sex, age, and race; P < .05), knowledge of side effects (age, race, and rank; P < .05), and believe they are having side effects (age; P < .05). CONCLUSIONS: Understanding DS use is central to predict and anticipate potential negative sequelae in patient outcomes in anesthesia. College education, females, Caucasians, and increasing age are indicators for greater DS use. These results provide opportunities for perianesthesia nurses to improve preoperative assessments, design patient specific perianesthesia care, and enhance patient education. Further research is recommended.

Computational Analysis of Naturally Occurring Aristolochic Acid Analogues and Their Biological Sources.

Aristolochic acids are known for nephrotoxicity, and implicated in multiple cancer types such as hepatocellular carcinomas demonstrated by recent studies. Natural products that are analogues to aristolochic acids have been constantly isolated from organisms; a larger chemical space of these compounds and a wider coverage of biological sources should be determined in consideration of the potential hazard of aristolochic acid analogues and the wide distribution of their biological sources in the nature. Therefore, we carried out an in silico research of naturally occurring aristolochic acid analogues and their biological sources, as a supplement to existing studies. The result shows a chemical space of 238 naturally occurring aristolochic acid analogues that are present in 175 species of biological sources including 44 traditional medicines. With the computational estimation for toxicity and the implication in hazard assessment of a biological source with the presence of aristolochic acid analogues, we propose that additional awareness should be raised to the public for avoidance of toxic species, especially those that are used as herbal medicines and easily accessible.

[Interactions between herbals medicines and drugs in chronic patients with complexity in primary care.] / Interacciones entre plantas medicinales y medicamentos en pacientes crónicos complejos en atención primaria.

OBJECTIVE: Taking medicinal herbs (MH) is frequent in patients and can cause interactions with others medications. Consumption of MH could be high in chronic patients with complexity (CPC) and produce interactions with drugs and knowledge about these drugs in primary health care (PC) professionals about these interactions is low. The aim was to measure the prevalence of potencial interactions between HM and drugs in CPC and evaluate the degree of knowledge of PC professionals. METHODS: Descriptive observational study in a population of CPC assigned to two PC teams. We investigated MH consumption through interviews and review potential drug interactions. We evaluated the degree of professionals knowledge through a survey designed for the study. A descriptive analysis was carried out. The Student-t test for paired data was used to compare the means.The statistical significance was established at p<0.05. RESULTS: The survey was distributed among 179 patients, mean age 76.9 years old (DE 9.7), 54.6% women. 62.57% (112) take MH. We detected 88 potentially relevant interactions in 51 patients (45.54%). Of the 219 professionals interviewed 51.1% consider that their knowledge about MH were low and 64,4% thought that was important to know the mH consumption of their patients. CONCLUSIONS: We detected a high prevalence of MH consumption in CPC and interactions between herbs medicinal and drugs. Lack of knowledge of PC health professionals is important. It's necessary to record this consumption in the medical history and improve the knowledge of professionals about MH to detect possible interactions, reduce the associated risk and improve the quality of care.

OBJETIVO: El consumo de plantas medicinales (PM) es frecuente en pacientes y puede causar interacciones con otros medicamentos. El consumo de PM puede ser alto en pacientes crónicos complejos (PCC) y producir interacciones con su medicación y el conocimiento sobre estos fármacos en profesionales sanitarios de Atención Primaria (AP) es bajo. El objetivo del estudio fue medir prevalencia de interacciones potenciales entre PM y medicamentos en PCC y evaluar grado de conocimiento de los profesionales de AP. METODOS: Estudio observacional descriptivo en una población de PCC asignados a dos equipos de AP. Se evaluaron el consumo de PM mediante entrevistas y se revisaron las interacciones potenciales con su medicación. Se evaluó el grado de conocimiento de los profesionales mediante una encuesta diseñada para el estudio. Se realizó un análisis descriptivo, La comparación de medias se realizó con la prueba t de Student. La significación estadística se estableció en p<0,05. RESULTADOS: La encuesta se distribuyó entre 179 pacientes, con una edad media de 76,9 años (DE 9,7), 54,6% mujeres. El 62,57% (112) consumieron PM. Detectamos 88 interacciones potencialmente relevantes en 51 pacientes (45,54%). De los 219 profesionales entrevistados el 51,1% consideraron que sus conocimientos sobre PM eran bajos y 64,4% pensaron que era importante conocer el consumo de PM de sus pacientes. CONCLUSIONES: Detectamos una alta prevalencia del consumo de PM en PCC y de interacciones entre PM y medicamentos. La falta de conocimientos de los profesionales sanitarios es importante. Es necesario registrar en la historia clínica este consumo y mejorar el conocimiento de los profesionales de AP sobre PM para detectar posibles interacciones, disminuir el riesgo asociado y mejorar la calidad asistencial.

An Overview of Pharmaceutical Production in Thai Hospitals.

Purpose: The purpose of this research was to provide an overview of pharmaceutical production in Thai hospitals. Methods: A cross-sectional survey was developed to study pharmaceutical production in the 1347 Thai hospitals. A representative sample was chosen using multistep selection arriving at a final total of 750 hospitals. Five experts in hospital pharmacy production were recruited to evaluate the content validity. The questionnaire consisted of 2 parts: (1) general details of the hospitals and (2) the type of pharmaceutical products. The latter classification were further divided into 6 types: (1) nonsterile products, (2) extemporaneous preparations, (3) total parenteral nutrition, (4) intravenous admixtures, (5) cytotoxic preparations, and (6) herbal medicine products. All data were analyzed via descriptive statistics. Results: From the 750 questionnaires sent out, 395 hospitals (52.67%) responded to the questionnaires. Regarding the 395 respondent sample group, approximately 60% of the hospitals were involved in pharmaceutical production. The top 3 pharmaceutical products were as follows: (1) cytotoxic preparations (315 items); (2) liquid nonsterile preparations (60 items), and (3) liquid extemporaneous preparations (52 items). The most frequently mentioned reasons for the production of each dosage form were as follows: (1) no commercially available product in appropriate dosage form or strength needed and (2) product was prepared following the hospital's policy. The support needs in hospital pharmacy production were revealed as follows: (1) master formula, (2) quality assurance and quality control processes, (3) equipment, (4) standard references, (5) buildings, (6) personnel, (7) budget, (8) raw material suppliers, and (9) the coordination between the faculties of pharmaceutical sciences and hospitals. Conclusions: Approximately 60% of the respondents had pharmaceutical production in their hospitals. The greatest need for support was for a master formula to inform hospital-based pharmaceutical production. These findings provide essential information, especially for stakeholders, to understand the professional challenges and likely pharmaceutically related health service changes in the future.