Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement.

OBJECTIVE: The increasing interest in Western countries regarding phytotherapy use to treat menopause-related symptoms has led the Spanish Menopause Society (AEEM) to update its position statement performed in 2009 on the role of black cohosh (Cimicifuga racemosa) for the treatment of menopausal symptoms. MATERIAL AND METHODS: A panel of experts from both clinical and research backgrounds were assembled to investigate the best available evidence. Selected studies were obtained by an electronic search, including the Internet search engines MEDLINE-Pubmed (1997-December 2021) and the Cochrane Controlled Trials Register. RESULTS: Most of the well-designed studies published in recent years have been conducted with the isopropanolic extract of black cohosh/C. racemosa. The most common dose is 40 mg/day capable of achieving a significant reduction in hot flushes (particularly in women with intense hot flushes) and an improvement in mood. Used at the recommended doses, C. racemose produces no significant adverse reactions. CONCLUSION: Black cohosh is an effective and safe treatment option for the relieving of vasomotor symptoms. Finally, further clinical trials with sufficient patient enrollment and longer study follow-up are needed.

Quantitative Quadrupolar NMR (qQNMR) via nitrogen-14 for the accurate control of L-carnitine in food supplements.

A qQNMR methodology using nitrogen-14 as the quadrupolar nucleus of choice has been introduced for the first time as a robust and validated method to determine and quantify L-carnitine in food supplements. The quantification has been carried out by the alternative use of a calibration curve or by addition of ammonium chloride as internal standard. The method was validated at seven concentration levels in the range of 5.58-99.26 mM, affording intra- and inter day accuracies lower than 6.84% (expressed in CV), robustness towards temperature and recycle delay, limit of detection (LOD) of 2.48 mM, limit of quantification (LOQ) of 5.58 mM and remarkably with absence of matrix effect.

Posicionamiento de la Asociación Española para el Estudio de la Menopausia sobre el uso clínico de la Cimicífuga racemosa en el climaterio / Position statement of the Spanish Menopause Society on the Clinical Use of Cimicifuga racemosa during menopause

Objetivo: Dado el creciente interés en los países occidentales acerca de la utilización de ciertas plantas para el tratamiento de los síntomas relacionados con la menopausia, la AsociaciónEspañola para el Estudio de la Menopausia (AEEM)ha evaluado el papel de la Cimicífuga racemosa en el tratamiento de los síntomas climatéricos sobre la base de las mejores evidencias disponibles. Material y métodos. Se reunió un panel de expertos, clínicos e investigadores, en el campo dela fitoterapia. Los estudios seleccionados se obtuvieron mediante una búsqueda electrónica que incluyó buscadores de Internet, MEDLINE (1985-mayo 2008) y el Registro de Ensayos Clínicos Controlados Cochrane. Resultados: La mayoría de los estudios publicados en los últimos años están realizados con el extractoisopropanólico de Cimicífuga racemosa. La dosis más estudiada ha sido 40 mg/día y ha demostrado obtener una reducción moderada de las sofocaciones, sobre todo en las mujeres con sofocos más intensos, y una mejoría del estado de ánimo. Utilizada a las dosis recomendadas, no hay riesgo relevante desde el punto de vista hepático. Los datos disponibles sobre su efecto en la enfermedad cardiovascular, el hueso, la función cognitiva y la piel son muy escasos o inexistentes. Conclusiones: La Cimic ífuga racemosa es un tratamiento eficaz en el alivio de los síntomas vasomotores, al menos en una población adecuada de mujeres peri y posmenopáusicas, si bien se precisan mejores ensayos clínicos con suficiente número de pacientes incluidas y mayor duración del estudio (AU)

Objective: Due to an increasing interest in the symptoms related to menopause in western countries, the Spanish Menopause Society (SMS)has assessed the role of cimicifuga racemosa in relieving those symptoms based on the mostreliable evidence available. Material and methods: A meeting was held with a panel of experts, health scientists and researchers specialised in the field of phytotherapy. The studies selected were obtained through electronic search which included INTERNET, MEDLINE (1985-May 2008), and the Cochrane Controlled Clinical Trials Register. Results: Most studies published in recent years have been carried out using an isopropanol extract of cimicifuga racemosa. The dose most commonly studied was 40mg/day and was shown to result ina moderate decrease in hot flushes, particularly in those women with the most intense hot flushes, and an improvement in their mood. When recommended doses are used there is no significant risk to the hepatic system. Available data on the effect of cimicifuga racemosa on cardiovascular disease, bones, cognitive function or skin are scarce or non-existent. Conclusions: Cimicifuga racemosa is an effective treatment for relief of vasomotor symptoms, at least within a suitable population of peri- and postmenopausal women. Nevertheless, more accurate clinical trials which include sufficient numbers of patients and a longer follow-up are required (AU)

Acute renal hemodynamic effects of dimanganese decacarbonyl and cobalt protoporphyrin.

BACKGROUND: Heme oxygenase (HO) products have a protective role in acute renal failure (ARF) that may be hemodynamically mediated because the HO-derived carbon monoxide (CO) is an important control system of arteriolar tone. The vascular effects of HO may be caused directly through changes in CO synthesis, and indirectly by alterations in nitric oxide (NO) release. The present study evaluated in vivo the renal effects of a heme oxygenase inhibitor, Co(III)Protoporphyrin (CoPP) alone or in combination with the CO donor dimanganese decacarbonyl (Mn2(CO)10). METHODS: All drugs were administered into the renal artery of anesthetized rats. Changes in renal cortical nitric oxide concentration were measured in vivo electrochemically. RESULTS: The intrarenal administration of the CO donor Mn2(CO)10 increased blood carboxyhemoglobin levels (+74%), renal blood flow (+54%), glomerular filtration (+38%), and urinary cGMP excretion (+128%). On the other hand, the inhibition of renal HO with CoPP progressively induced an ARF characterized by a drop in renal blood flow (-77%), glomerular filtration (-93%), and urinary cGMP excretion (-93%). These deleterious effects of HO inhibition on renal function were nearly abolished by supplementing CO with the coadministration of Mn2(CO)10+ CoPP, indicating that they may be caused by inhibition of CO synthesis and the resulting hemodynamic changes. In addition, CoPP lowered the renal cortical NO concentration (-21%) and also decreased the urinary excretion of nitrates/nitrites, while Mn2(CO)10 increased renal NO levels (+20%) and raised the excretion of nitrates/nitrites, suggesting that changes in NO release may contribute to the renal effects of the HO-CO system. CONCLUSION: These results indicate that heme oxygenase-derived CO plays a cardinal role in the control of renal hemodynamics and glomerular filtration.