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1.
Medicine (Baltimore) ; 99(47): e23197, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217831

RESUMO

BACKGROUND: Brucea javanica oil emulsion (BJOE), extracted from the Chinese herb Bruceae Fructus (Yadanzi), is a broad-spectrum anti-tumor drug and has been widely used for the treatment of liver cancer in China. The aim of this study is to systematically investigate the efficacy and safety of BJOE for the treatment of liver cancer. METHODS: Seven electronic databases including the Cochrane Library, PubMed, Excerpt Medica Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Scientific Journal Database, and Wanfang Database will be systematically retrieved for data extraction from their inceptions to September 2020. Cochrane Risk of Bias tool will be used to assess the risk of bias of included studies. The RevMan 5.4 and Stata 16.0 software will be applied for statistical analyses. Statistical heterogeneity will be computed by I tests. Sensitivity analysis will be conducted to evaluate the stability of the results. The publication bias will be evaluated by funnel plots and Egger test. The quality of evidence will be assessed by the GRADE system. RESULTS: The results of our research will be published in a peer-reviewed journal or presenting the findings at a relevant conference. CONCLUSION: The conclusion of this study will provide helpful evidence of the effect and safety of BJOE for the treatment of liver cancer in clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/UC8XQ.


Assuntos
Antineoplásicos/uso terapêutico , Brucea , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Fitoterapia , Óleos Vegetais/uso terapêutico , Antineoplásicos/efeitos adversos , Emulsões/uso terapêutico , Humanos , Metanálise como Assunto , Fitoterapia/efeitos adversos , Óleos Vegetais/efeitos adversos , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
2.
Cochrane Database Syst Rev ; 9: CD004448, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32977351

RESUMO

BACKGROUND: Sickle cell disease, a common recessively inherited haemoglobin disorder, affects people from sub-Saharan Africa, the Middle East, Mediterranean basin, Indian subcontinent, Caribbean and South America. It is associated with complications and a reduced life expectancy. Phytomedicines (medicine derived from plants in their original state) encompass many of the plant remedies from traditional healers which the populations most affected would encounter. Laboratory research and limited clinical trials have suggested positive effects of phytomedicines both in vivo and in vitro. However, there has been little systematic appraisal of their benefits. This is an updated version of a previously published Cochrane Review. OBJECTIVES: To assess the benefits and risks of phytomedicines in people with sickle cell disease of all types, of any age, in any setting. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, the International Standard Randomised Controlled Trial Number Register (ISRCTN), the Allied and Complimentary Medicine Database (AMED), ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). Dates of most recent searches: Cochrane Cystic Fibrosis and Genetic Disorders Haemoglobinopathies Trials Register: 17 March 2020; ISRCTN: 19 April 2020; AMED: 18 May 2020; ClinicalTrials.gov: 24 April 2020; and the WHO ICTRP: 27 July 2017. SELECTION CRITERIA: Randomised or quasi-randomised trials with participants of all ages with sickle cell disease, in all settings, comparing the administration of phytomedicines, by any mode to placebo or conventional treatment, including blood transfusion and hydroxyurea. DATA COLLECTION AND ANALYSIS: Both authors independently assessed trial quality and extracted data. MAIN RESULTS: Three trials (212 participants) of three phytomedicines: Niprisan® (also known as Nicosan®), Ciklavit® and a powdered extract of Pfaffia paniculata were included. The Phase IIB (pivotal) trial suggests that Niprisan® may be effective in reducing episodes of severe painful sickle cell disease crisis over a six-month period (low-quality evidence). It did not appear to affect the risk of severe complications or the level of anaemia (low-quality evidence). The single trial of Cajanus cajan (Ciklavit®) reported a possible benefit to individuals with painful crises, and a possible adverse effect (non-significant) on the level of anaemia (low-quality evidence). We are uncertain of the effect of Pfaffia paniculata on the laboratory parameters and symptoms of SCD (very low-quality of evidence). No adverse effects were reported with Niprisan® and Pfaffia paniculata (low- to very low-quality evidence). AUTHORS' CONCLUSIONS: While Niprisan® appeared to be safe and effective in reducing severe painful crises over a six-month follow-up period, further trials are required to assess its role in managing people with SCD and the results of its multicentre trials are awaited. Currently, no conclusions can be made regarding the efficacy of Ciklavit® and the powdered root extract of Pfaffia paniculata in managing SCD. Based on the published results for Niprisan® and in view of the limitations in data collection and analysis of the three trials, phytomedicines may have a potential beneficial effect in reducing painful crises in SCD. This needs to be further validated in future trials. More trials with improved study design and data collection are required on the safety and efficacy of phytomedicines used in managing SCD.


Assuntos
Anemia Falciforme/tratamento farmacológico , Antidrepanocíticos/uso terapêutico , Fitoterapia , Extratos Vegetais/uso terapêutico , Adolescente , Adulto , Amaranthaceae/química , Anemia/induzido quimicamente , Anemia Falciforme/sangue , Antidrepanocíticos/efeitos adversos , Criança , Pré-Escolar , Ensaios Clínicos Fase II como Assunto , Feminino , Humanos , Lactente , Masculino , Fitoterapia/efeitos adversos , Extratos Vegetais/efeitos adversos , Raízes de Plantas/química , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Clin Nephrol ; 94(3): 142-149, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32716290

RESUMO

AIMS: Medicinal plants contain many active constituents that can cause adverse effects on kidneys that are often unrecognized. The aim of our work was to study the association between the regular use of medicinal plants and the risk of chronic renal failure in hospitalized patients in four departments of Mohammed VI University Hospital. MATERIALS AND METHODS: A case-control study was performed from January 2018 to December 2018. The cases were patients with a first-time diagnosis of chronic renal failure and without family history of kidney diseases or pre-existing renal disease. One control was matched to each case for age, gender, date of entry, and history of hypertension or diabetes. RESULTS: 208 patients were recruited. Among 104 cases, 42 patients (40.4%) regularly used medicinal plants compared to 18.3% in the group of controls (OR: 1.3; 95% CI; p < 0.001). Multivariate analysis showed that the regular use of medicinal plants was significantly associated with the risk of chronic renal failure (OR: 3.05; 95% CI; p < 0,001). Also a total of 52 plant species representing 29 plant families were reported in our study. Dominant plant families were represented by the Lamiaceae followed by the Apiaceae. CONCLUSION: Regular use of medicinal plants increases the risk of chronic kidney failure. Therefore, we need active measures to regulate this sector.


Assuntos
Falência Renal Crônica/induzido quimicamente , Fitoterapia/efeitos adversos , Plantas Medicinais/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Cochrane Database Syst Rev ; 5: CD011505, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32421208

RESUMO

BACKGROUND: Many women express concern about their ability to produce enough milk, and insufficient milk is frequently cited as the reason for supplementation and early termination of breastfeeding. When addressing this concern, it is important first to consider the influence of maternal and neonatal health, infant suck, proper latch, and feeding frequency on milk production, and that steps be taken to correct or compensate for any contributing issues. Oral galactagogues are substances that stimulate milk production. They may be pharmacological or non-pharmacological (natural). Natural galactagogues are usually botanical or other food agents. The choice between pharmacological or natural galactagogues is often influenced by familiarity and local customs. Evidence for the possible benefits and harms of galactagogues is important for making an informed decision on their use. OBJECTIVES: To assess the effect of oral galactagogues for increasing milk production in non-hospitalised breastfeeding mother-term infant pairs. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), Health Research and Development Network - Phillippines (HERDIN), Natural Products Alert (Napralert), the personal reference collection of author LM, and reference lists of retrieved studies (4 November 2019). SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs (including published abstracts) comparing oral galactagogues with placebo, no treatment, or another oral galactagogue in mothers breastfeeding healthy term infants. We also included cluster-randomised trials but excluded cross-over trials. DATA COLLECTION AND ANALYSIS: We used standard Cochrane Pregnancy and Childbirth methods for data collection and analysis. Two to four review authors independently selected the studies, assessed the risk of bias, extracted data for analysis and checked accuracy. Where necessary, we contacted the study authors for clarification. MAIN RESULTS: Forty-one RCTs involving 3005 mothers and 3006 infants from at least 17 countries met the inclusion criteria. Studies were conducted either in hospitals immediately postpartum or in the community. There was considerable variation in mothers, particularly in parity and whether or not they had lactation insufficiency. Infants' ages at commencement of the studies ranged from newborn to 6 months. The overall certainty of evidence was low to very low because of high risk of biases (mainly due to lack of blinding), substantial clinical and statistical heterogeneity, and imprecision of measurements. Pharmacological galactagogues Nine studies compared a pharmacological galactagogue (domperidone, metoclopramide, sulpiride, thyrotropin-releasing hormone) with placebo or no treatment. The primary outcome of proportion of mothers who continued breastfeeding at 3, 4 and 6 months was not reported. Only one study (metoclopramide) reported on the outcome of infant weight, finding little or no difference (mean difference (MD) 23.0 grams, 95% confidence interval (CI) -47.71 to 93.71; 1 study, 20 participants; low-certainty evidence). Three studies (metoclopramide, domperidone, sulpiride) reported on milk volume, finding pharmacological galactagogues may increase milk volume (MD 63.82 mL, 95% CI 25.91 to 101.72; I² = 34%; 3 studies, 151 participants; low-certainty evidence). Subgroup analysis indicates there may be increased milk volume with each drug, but with varying CIs. There was limited reporting of adverse effects, none of which could be meta-analysed. Where reported, they were limited to minor complaints, such as tiredness, nausea, headache and dry mouth (very low-certainty evidence). No adverse effects were reported for infants. Natural galactagogues Twenty-seven studies compared natural oral galactagogues (banana flower, fennel, fenugreek, ginger, ixbut, levant cotton, moringa, palm dates, pork knuckle, shatavari, silymarin, torbangun leaves or other natural mixtures) with placebo or no treatment. One study (Mother's Milk Tea) reported breastfeeding rates at six months with a concluding statement of "no significant difference" (no data and no measure of significance provided, 60 participants, very low-certainty evidence). Three studies (fennel, fenugreek, moringa, mixed botanical tea) reported infant weight but could not be meta-analysed due to substantial clinical and statistical heterogeneity (I2 = 60%, 275 participants, very low-certainty evidence). Subgroup analysis shows we are very uncertain whether fennel or fenugreek improves infant weight, whereas moringa and mixed botanical tea may increase infant weight compared to placebo. Thirteen studies (Bu Xue Sheng Ru, Chanbao, Cui Ru, banana flower, fenugreek, ginger, moringa, fenugreek, ginger and turmeric mix, ixbut, mixed botanical tea, Sheng Ru He Ji, silymarin, Xian Tong Ru, palm dates; 962 participants) reported on milk volume, but meta-analysis was not possible due to substantial heterogeneity (I2 = 99%). The subgroup analysis for each intervention suggested either benefit or little or no difference (very low-certainty evidence). There was limited reporting of adverse effects, none of which could be meta-analysed. Where reported, they were limited to minor complaints such as mothers with urine that smelled like maple syrup and urticaria in infants (very low-certainty evidence). Galactagogue versus galactagogue Eight studies (Chanbao; Bue Xue Sheng Ru, domperidone, moringa, fenugreek, palm dates, torbangun, moloco, Mu Er Wu You, Kun Yuan Tong Ru) compared one oral galactagogue with another. We were unable to perform meta-analysis because there was only one small study for each match-up, so we do not know if one galactagogue is better than another for any outcome. AUTHORS' CONCLUSIONS: Due to extremely limited, very low certainty evidence, we do not know whether galactagogues have any effect on proportion of mothers who continued breastfeeding at 3, 4 and 6 months. There is low-certainty evidence that pharmacological galactagogues may increase milk volume. There is some evidence from subgroup analyses that natural galactagogues may benefit infant weight and milk volume in mothers with healthy, term infants, but due to substantial heterogeneity of the studies, imprecision of measurements and incomplete reporting, we are very uncertain about the magnitude of the effect. We are also uncertain if one galactagogue performs better than another. With limited data on adverse effects, we are uncertain if there are any concerning adverse effects with any particular galactagogue; those reported were minor complaints. High-quality RCTs on the efficacy and safety of galactagogues are urgently needed. A set of core outcomes to standardise infant weight and milk volume measurement is also needed, as well as a strong basis for the dose and dosage form used.


Assuntos
Galactagogos/administração & dosagem , Lactação/efeitos dos fármacos , Leite Humano , Fitoterapia/métodos , Extratos Vegetais/administração & dosagem , Administração Oral , Peso Corporal/efeitos dos fármacos , Aleitamento Materno , Domperidona/administração & dosagem , Domperidona/efeitos adversos , Feminino , Galactagogos/efeitos adversos , Humanos , Lactente , Recém-Nascido , Metoclopramida/administração & dosagem , Metoclopramida/efeitos adversos , Leite Humano/efeitos dos fármacos , Mães , Fitoterapia/efeitos adversos , Extratos Vegetais/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Sulpirida/administração & dosagem , Sulpirida/efeitos adversos , Hormônio Liberador de Tireotropina/administração & dosagem , Hormônio Liberador de Tireotropina/efeitos adversos
5.
Plast Reconstr Surg ; 146(4): 474e-481e, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32345835

RESUMO

Dietary supplements are frequently used in surgical patients. Surgeons should be up to date with regard to the efficacies and potential complications related to these supplements. This article provides the most updated practices and evidence of commonly used supplements.


Assuntos
Suplementos Nutricionais , Fitoterapia , Procedimentos Cirúrgicos Operatórios , Vitaminas/uso terapêutico , Suplementos Nutricionais/efeitos adversos , Humanos , Fitoterapia/efeitos adversos , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/prevenção & controle , Vitaminas/efeitos adversos
6.
BMC Vet Res ; 16(1): 29, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005244

RESUMO

BACKGROUND: Phytotherapy is becoming a more and more common practice, not only for personal care but also for pet care. Nevertheless, we often have to deal with substances on which, in most cases, very little literature is available, even more so if the species of interest are the exotic ones. In particular, the essential oil from the Melaleuca leaves, because of its antinflammatory and antibacterial properties, is widely used and very little is known about its potential toxicity on pet birds. The present paper describes the first case of Tea tree oil intoxication in a pet bird. CASE PRESENTATION: A one-year-old, 80 g male cockatiel (Nymphicus hollandicus) was presented for clinical examination due to a serious despondency episode after the application of 3 drops of tea tree oil (Melaleuca alternifoglia) directly on the cutis of its right wing. The subject was urgently hospitalized and blood tests were performed.Serum biochemical values showed severe liver damage and slight renal involvement, complete blood count (CBC) parameters indicated a moderate neutrophilia a moderate neutropenia. Warm subcutaneous fluids and vitamin (VIT) B12 were administered, and after 8 h of fluid therapy the clinical condition of the patient improved. The subject was discharged after 48 h of hospitalization, in stable conditions. CONCLUSIONS: Toxicosis are relatively common in bird pets and a number of cases are reported in literature, concerning heavy metals intoxications and toxic plants ingestion. However, in literature there are no described cases regarding Melaleuca oil intoxication in pet birds, but it has been reported in humans (mainly by ingestion) as well as in dogs, cats and rats. We hope that this first case report can be an initial aid in the knowledge of this potential toxicosis and therefore in the clinical veterinary practice of pet birds.


Assuntos
Doenças das Aves/induzido quimicamente , Cacatuas , Óleo de Melaleuca/envenenamento , Administração Cutânea , Animais , Doença Hepática Induzida por Substâncias e Drogas/veterinária , Masculino , Fitoterapia/efeitos adversos , Fitoterapia/veterinária
7.
BMC Pregnancy Childbirth ; 20(1): 122, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32085731

RESUMO

BACKGROUND: Despite research suggesting an association between certain herb use during pregnancy and delivery and postnatal complications, herbs are still commonly used among pregnant women in sub-Sahara Africa (SSA). This study examines the factors and characteristics of women using local herbs during pregnancy and/or labor, and the associations between local herb use and postnatal complications in Kigoma, Tanzania. METHODS: We analyzed data from the 2016 Kigoma Tanzania Reproductive Health Survey (RHS), a regionally representative, population-based survey of reproductive age women (15-49 years). We included information on each woman's most recent pregnancy resulting in a live birth during January 2014-September 2016. We calculated weighted prevalence estimates and used multivariable logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for factors associated with use of local herbs during pregnancy and/or labor, as well as factors associated with postnatal complications. RESULTS: Of 3530 women, 10.9% (CI: 9.0-13.1) used local herbs during their last pregnancy and/or labor resulting in live birth. The most common reasons for taking local herbs included stomach pain (42.9%) and for the health of the child (25.5%). Adjusted odds of local herb use was higher for women reporting a home versus facility-based delivery (aOR: 1.6, CI: 1.1-2.2), having one versus three or more prior live births (aOR: 1.8, CI: 1.4-2.4), and having a household income in the lowest versus the highest wealth tercile (aOR: 1.4, CI: 1.1-1.9). Adjusted odds of postnatal complications were higher among women who used local herbs versus those who did not (aOR: 1.5, CI: 1.2-1.9), had four or more antenatal care visits versus fewer (aOR: 1.4, CI: 1.2-1.2), and were aged 25-34 (aOR: 1.1, CI: 1.0-1.3) and 35-49 (aOR: 1.3, CI: 1.0-1.6) versus < 25 years. CONCLUSIONS: About one in ten women in Kigoma used local herbs during their most recent pregnancy and/or labor and had a high risk of postnatal complications. Health providers may consider screening pregnant women for herb use during antenatal and delivery care as well as provide information about any known risks of complications from herb use.


Assuntos
Medicina Herbária/estatística & dados numéricos , Fitoterapia/efeitos adversos , Complicações na Gravidez/tratamento farmacológico , Gravidez/efeitos dos fármacos , Adolescente , Adulto , Estudos Transversais , Parto Obstétrico/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Serviços de Saúde Materna/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , População Rural/estatística & dados numéricos , Tanzânia , Adulto Jovem
8.
BMC Gastroenterol ; 19(1): 199, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775657

RESUMO

BACKGROUND: Drug induced liver injury (DILI) is an important cause of acute liver injury and accounts for approximately 10% of all cases of acute hepatitis. Both prescription and natural health products (NHPs) have been implicated in DILI. There is a dearth of studies on NHPs induced liver injury. CASE PRESENTATION: A previously healthy 37-year-old female presented with subacute hepatitis, in the context of a previous admission to a separate institution, months prior for undiagnosed acute hepatitis. Importantly, she had disclosed taking complex regiments of natural health products (NHPs) for months. Her only other medication was rivaroxaban for her homozygous Factor V Leiden deficiency. She had an extensive work up for causes of acute and unresolving hepatitis. She discontinued several but not all of her NHPs after her initial presentation for acute hepatitis at the first institution and continued taking NHPs until shortly after admission to our institution. The predominant pathological features were that of drug induced liver injury, although an abnormal amount of copper was noted in the core liver biopsies. However, Wilson's disease was ruled out with normal serum ceruloplasmin and 24-urine copper. After 2 months of stopping all the NHPs, our patient improved significantly since discharge, although there is evidence of fibrosis on ultrasound at last available follow up. CONCLUSION: NHPs are a well-established but poorly understood etiology of DILI. The situation is exacerbated by the unregulated and unpredictable nature of many of the potential hepatotoxic effects of these agents, especially in cases of multiple potential toxic agents. This highlights the importance of acquiring a clear history of all medications regardless of prescription status.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Suplementos Nutricionais/efeitos adversos , Fitoterapia/efeitos adversos , Adulto , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Diagnóstico Diferencial , Feminino , Degeneração Hepatolenticular/diagnóstico , Humanos
9.
Medicine (Baltimore) ; 98(37): e17005, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517818

RESUMO

BACKGROUND: Overactive bladder (OAB) is a common disease in the urinary system. The morbidity is increasing annually. Herbal medicines have been pervasively used in the therapy of OAB. However, systematic review or meta-analysis has not been found to assess the effects and safety of herbal medicines in curing OAB at present. Hence, the systematic review is conducted to scientifically and methodically evaluate the value of its effectiveness and safety of herbal medicines on OAB. METHODS: We will collect all randomized controlled trials (RCTs) to assess the effectiveness and safety of herbal medicines on OAB. The RCTs will be searched from the electronic databases, including 7 English databases, consisting of PubMed, Excerpta Medica Database (EMBASE), MEDLINE, Web of Science, Cochrane Library, SpringerLink, and WHO International Clinical Trials Registry Platform (ICTRP), and 4 Chinese databases, namely Wanfang Chinese database, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP), others valid search strategy will be adopted. All the RCTs will be assessed from the databases establishment to July 2019. We will perform the meta-analysis of RCTs when the dissertation is appropriate. We will conduct an assessment including data synthesis, bias risk, and subgroup analysis by means of Review Manager software (RevMan) V.5.3.5 software while the setting condition is met. RESULTS: This systematic view and meta-analysis will generate a summary based on the current relevant research to calculate the effects and safety of herbal medicines in promoting the therapy of OAB. Furthermore, it will provide a high-quality synthesis for participants who use herbal medicine to cure OAB. CONCLUSION: The summary of our systematic view will verify whether herbal medicines intervention could be an effective and safety approach in curing OAB.


Assuntos
Metanálise como Assunto , Fitoterapia , Revisões Sistemáticas como Assunto , Bexiga Urinária Hiperativa/tratamento farmacológico , Humanos , Fitoterapia/efeitos adversos , Plantas Medicinais , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Medicina (Kaunas) ; 55(9)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466381

RESUMO

The menopausal transition, or perimenopause, is characterized by menstrual irregularities, vasomotor symptoms, sleep disturbances, mood symptoms, and urogenital tract atrophy. These changes can also affect the quality of life and one's self-esteem. Hormone replacement therapy (HRT) is considered the best option to achieve therapeutic relief of different menopausal symptoms but is usually restricted to moderate or severe symptoms. Moreover, many women refuse HRT for a variety of reasons concerning the fear of cancer and other adverse effects. According to these considerations, new topics are emerging: Dissatisfaction with drug costs and conventional healthcare, desire for personalized medicines, and the public perception that "natural is good". In this context, nonhormonal therapies are mostly evolving, and it is not unusual that women often request a "natural" approach for their symptoms. The aim of this study is to investigate nonhormonal therapies that have been identified to reduce the menopausal symptoms.


Assuntos
Suplementos Nutricionais , Menopausa , Fitoterapia , Contraindicações de Medicamentos , Terapia de Reposição Hormonal , Fogachos/tratamento farmacológico , Humanos , Osteoporose Pós-Menopausa/prevenção & controle , Fitoestrógenos/efeitos adversos , Fitoestrógenos/uso terapêutico , Fitoterapia/efeitos adversos , Transtornos do Sono-Vigília/tratamento farmacológico , Vitaminas/uso terapêutico
11.
Medicine (Baltimore) ; 98(26): e16231, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261581

RESUMO

BACKGROUND: Crohn disease (CD) is associated with substantial healthcare related costs and impairment of quality of life. Tripterygium wilfordii Hook F (TwHF) is proved to be effective for CD in animal and human. However, there is no systemic review and meta-analysis regarding the clinical efficacy and safety of TwHF preparation for the treatment of CD. METHODS: Six electronic databases (Medline, EMBASE, Cochrane database, Chinese National Knowledge Infrastructure, Wanfang Database and Chongqing VIP Database) will be searched for eligibility studies. Data from the included studies will be extracted and the quality of studies will be assessed. Data synthesis will be performed using Review Manager software. Sensitivity analysis and publication bias assessment will also be carried out. RESULTS: This systemic review and meta-analysis will provide synthesized result of clinical efficacy and safety of TwHF preparation for the treatment of CD. CONCLUSION: This research will determine the clinical efficacy and safety of TwHF preparation for the treatment of CD.Registration: PROSPERO CRD42019127893.


Assuntos
Doença de Crohn/tratamento farmacológico , Metanálise como Assunto , Fitoterapia , Extratos Vegetais/uso terapêutico , Revisões Sistemáticas como Assunto , Tripterygium , Humanos , Fitoterapia/efeitos adversos , Extratos Vegetais/efeitos adversos , Projetos de Pesquisa , Resultado do Tratamento
12.
Nutrients ; 11(7)2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31261861

RESUMO

Prostate cancer is a heterogeneous disease, the second deadliest malignancy in men and the most commonly diagnosed cancer among men. Traditional plants have been applied to handle various diseases and to develop new drugs. Medicinal plants are potential sources of natural bioactive compounds that include alkaloids, phenolic compounds, terpenes, and steroids. Many of these naturally-occurring bioactive constituents possess promising chemopreventive properties. In this sense, the aim of the present review is to provide a detailed overview of the role of plant-derived phytochemicals in prostate cancers, including the contribution of plant extracts and its corresponding isolated compounds.


Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Compostos Fitoquímicos/uso terapêutico , Fitoterapia , Neoplasias da Próstata/tratamento farmacológico , Adulto , Idoso , Animais , Antineoplásicos Fitogênicos/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Fitoquímicos/efeitos adversos , Fitoterapia/efeitos adversos , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Fatores de Risco , Resultado do Tratamento
13.
Investig Clin Urol ; 60(4): 275-284, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31294137

RESUMO

Purpose: To investigate the efficacy and safety of KBMSI-2, an herbal formula consisting of Ginseng Radix Rubra, Dioscorea tenuipes, Cornus officinalis Sieb. et Zucc., Lycium chinense Mill, and Curcuma longa Linn, for the treatment of erectile dysfunction (ED). Materials and Methods: Patients were instructed to take placebo or 6 g of KBMSI-2 twice per day for 8 weeks, at least 1 hour after food intake. The primary outcome was a change from baseline in erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire. Secondary outcome included changes from baseline in all domain scores of the IIEF, scores on the Aging Males' Symptoms scale, and serum total testosterone levels, as well as changes in questions 2 and 3 of the Sexual Encounter Profile, responses to the Global Assessment Question, and changes in the number of 'yes' responses on the Androgen Deficiency in Aging Males questionnaire. Results: Patients receiving KBMSI-2 had a statistically significant improvement in baseline IIEF-EF domain scores at 8 weeks compared to the placebo group. Intercourse satisfaction domain and the total IIEF scores also increased in the KBMSI-2 group. However, we could not find any significant differences in other efficacy variables between the groups. Only one patient had an adverse event, which was mild in severity. Conclusions: This preliminary clinical study of KBMSI-2 shows significant improvements in EF and intercourse satisfaction, as measured by the IIEF in patients with ED. Further studies using a larger number of patients in the long term should follow.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Disfunção Erétil/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Adulto , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Masculino , Fitoterapia/efeitos adversos , Resultado do Tratamento
15.
Health Hum Rights ; 21(1): 239-252, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31239630

RESUMO

In January 2007, former president of The Gambia Yahya Jammeh created the Presidential Alternative Treatment Program (PATP), which introduced a fraudulent "HIV cure." PATP and the fraudulent HIV herbal cure (PATP cure) were widely advertised in state media through patient testimonials and specially produced broadcasts of Jammeh administering treatment, enticing people living with HIV to join the program. Jammeh faced little to no opposition from within The Gambia. Due to the great power and influence he wielded, PATP was nothing short of a health dictatorship. This paper argues that PATP and the PATP cure violated the human rights of people living with HIV in The Gambia and compromised HIV health service delivery. In addition, during PATP's 10-year operation, the global health community was derelict in its duty to stop Jammeh's promotion and use of the PATP cure and to protect people living with HIV.


Assuntos
Decepção , Infecções por HIV/terapia , Fitoterapia/efeitos adversos , Gâmbia , Direitos Humanos , Humanos , Meios de Comunicação de Massa , Política
16.
Dermatol Ther ; 32(4): e12995, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31197923

RESUMO

Miliaria crystallina is a skin disorder that often erupts in the process of febrile diseases or under hot and humid climatic conditions. Toxic epidermal necrolysis (TEN) is a rare, acute, and life-threatening mucocutaneous disease with a mortality rate of 25-35%. There has been no inevitable connection between the two diseases among previously reported cases, but we observed a case of secondary miliaria crystallina a woman with herbal remedies-induced TEN during the therapeutic process.


Assuntos
Miliária/etiologia , Preparações de Plantas/efeitos adversos , Síndrome de Stevens-Johnson/etiologia , Adulto , Feminino , Humanos , Miliária/patologia , Fitoterapia/efeitos adversos , Preparações de Plantas/administração & dosagem , Síndrome de Stevens-Johnson/patologia
17.
Biol Pharm Bull ; 42(5): 671-679, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31061309

RESUMO

Nicotiana glauca is a cosmopolitan shrub, used in medicine to treat swellings, wounds, sores and cancer. However, its users lack of knowledge of the adverse effects. We seek to evaluate the effects of lipid extracts from N. glauca on myoblasts, identifying the compounds which cause undesirable effects. Myoblasts are important in muscle homeostasis, thus a high death rate of them cause myopathies. We performed an ethanolic extraction from leaves of N. glauca and the extract was successively partitioned with hexane, chloroform and ethyl acetate. The effects of extracts in C2C12 cells were analysed by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL), Mitotracker and 4',6-diamidino-2-phenylindole (DAPI) staining, Western blotting, real-time PCR and immunofluorescence assays. Caspase activity was studied. The fraction with the highest apoptotic effects was analysed by chromatography, NMR and GC-MS spectrometry were used to identify the apoptotic agent, after which its biological activity was evaluated. The extracts from N. glauca induced apoptosis in C2C12 cells involving caspase-3/7. We found that the extracts trigger a defence response in muscle through Akt and heat shock protein 27 (HSP27). We identified an apoptotic agent as palmitic acid. These data suggest that the use of N. glauca in hormone replacement therapy, or in other therapies affects skeletal muscle homeostasis, worsening the negative effects of the menopause. Thus, the relevance of this work lies in the fact that it is the first time that a report about the molecular mechanism responsible for the side effects of medicinal use of N. glauca, has been shown. Moreover the compound responsible for these effects has been identified.


Assuntos
Mioblastos Esqueléticos/efeitos dos fármacos , Ácido Palmítico/efeitos adversos , Fitoterapia/efeitos adversos , Extratos Vegetais/efeitos adversos , Tabaco , Animais , Apoptose/efeitos dos fármacos , Linhagem Celular , Proteínas de Choque Térmico HSP27/metabolismo , Camundongos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Mioblastos Esqueléticos/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/genética
18.
Am J Chin Med ; 47(4): 751-767, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31094214

RESUMO

To systematically evaluate the efficacy and safety of berberine for the treatment of hyperlipidemia, six electronic literature databases including SinoMed, CNKI, WanFang Data, PubMed, Embase and The Cochrane Library were searched to collect clinical randomized controlled trials (RCTs) of berberine alone or combined with statins for the treatment of hyperlipidemia from the inception to 8 March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included RCTs. Then, meta-analysis was performed by using RevMan 5.3 software. A total of 11 RCTs involving 1386 patients were finally included. The results of meta-analysis showed that compared with the placebo group, berberine could significantly reduce the total cholesterol and low-density lipoprotein levels and elevate the high density lipoprotein level ( P<0.05 ). Compared with the simvastatin group, berberine was effective only in reducing the level of triglyceride ( MD=-0.37 , 95% CI: - 0.66, - 0.07, P=0.02 ). There, however, was no statistical significance between the BBR group and simvastatin group in the low density lipoprotein and high density lipoprotein levels. Compared with the simvastatin group, berberine plus simvastatin was more effective in reducing the level of triglyceride ( MD=-0.33 , 95% CI: - 0.46, - 0.20, P<0.00001 ) and total cholesterol ( MD=-0.36 , 95% CI: - 0.60, - 0.12, P=0.003 ). In terms of adverse reactions, the incidence of adverse reactions including transaminase elevation and muscle aches was lower in the berberine alone or combined with simvastatin group than that in the control group, while the instance of constipation was higher. This study suggests that berberine is effective for hyperlipidemia. The quality and quantity of included studies, however, were dissatisfactory, which might decrease the reliability of the results. Higher quality studies are needed to provide more high quality evidence.


Assuntos
Berberina/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hiperlipidemias/tratamento farmacológico , Fitoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Sinvastatina/uso terapêutico , Berberina/efeitos adversos , Colesterol/sangue , Bases de Dados Bibliográficas , Quimioterapia Combinada , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hiperlipidemias/sangue , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Fitoterapia/efeitos adversos , Sinvastatina/efeitos adversos , Resultado do Tratamento , Triglicerídeos/sangue
19.
BMJ Open ; 9(5): e024932, 2019 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-31076468

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of removing blood stasis (RBS) herbal medicine for the treatment of acute intracerebral haemorrhage (AICH) within a 6-hour time window. STUDY DESIGN: A randomised, multicentre, double-blind, placebo-controlled study performed in 14 hospitals in China. PARTICIPANTS AND INTERVENTIONS: Patients with AICH were randomly assigned to receive a placebo, the ICH-1 (Intracerebral Haemorrhage) formula (eight herbs, including the RBS herbs hirudo and tabanus) or the ICH-2 formula (six herbs without the RBS herbs hirudo and tabanus) within 6 hours of ICH onset. OUTCOMES: The primary safety outcome was the incidence of haematoma enlargement at 24 hours and at 10 days after treatment. The secondary outcome was the incidence of poor prognosis (mortality or modified Rankin Scale score ≥5) assessed at 90 days after symptom onset. RESULTS: A total of 324 subjects were randomised between October 2013 and May 2016: 105 patients received placebo; 108 patients received the ICH-1 formula; and 111 patients received the ICH-2 formula. The incidence of haematoma enlargement at 24 hours was 7.8% in the placebo group, 12.3% in the ICH-1 group and 7.5% in the ICH-2 group; the incidence of haematoma enlargement on day 10 was 1.1% in the placebo group, 1.1% in the ICH-1 group, and 3.1% in the ICH-2 group, with no significant differences among the groups (P>0.05). The mortality rates were 3.8% in the placebo group, 2.8% in the ICH-1 group, and 0.9% in the ICH-2 group; the incidences of poor prognosis were 7.1% in the placebo group, 6.0% in the ICH-1 group and 4.8% in the ICH-2 group at 3 months, with no significant differences among the groups (p>0.05). However, the overall frequency of treatment-emergent adverse events in the ICH-1 group (12.1%) was higher among the three groups (5.8% and 2.8%, respectively, p<0.05). All three cases of serious adverse events were in the ICH-1 group. CONCLUSIONS: Ultra-early administration of ICH-1 formula for AICH patients did not exert significant beneficial effects on clinical outcomes but increased the risk of bleeding, which probably resulted from the inclusion of RBS herbal medicines in ICH-1. TRIALREGISTRATION NUMBER: NCT01918722.


Assuntos
Coagulação Sanguínea/efeitos dos fármacos , Hemorragia Cerebral , Medicamentos de Ervas Chinesas , Hematoma , Hemorragia , Fitoterapia , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/tratamento farmacológico , Hemorragia Cerebral/mortalidade , China , Método Duplo-Cego , Monitoramento de Medicamentos/métodos , Monitoramento de Medicamentos/estatística & dados numéricos , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/classificação , Feminino , Hematoma/diagnóstico , Hematoma/etiologia , Hematoma/prevenção & controle , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mortalidade , Fitoterapia/efeitos adversos , Fitoterapia/métodos , Tempo para o Tratamento , Resultado do Tratamento
20.
Med Oncol ; 36(5): 45, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30993543

RESUMO

Cancer is becoming more prevalent in elderly patient. Due to polypharmacy, older adults with cancer are predisposed to drug-drug interactions. There is also an increasing interest in the use of complementary and alternative medicine (CAM). Thirty to seventy percent of patients with cancer have used CAM. Through pharmaceutical counseling sessions, we can provide advices on herb-drug interactions (HDI). All the patients seen in pharmaceutical counseling sessions were prospectively included. Information was collected during these sessions: prescribed medication (oral anticancer agents (OAA) and other drugs), CAM (phytotherapy especially), and use of over-the-counter (OTC) drugs. If pharmacist considered an interaction or an intervention clinically relevant, the oncologist was notified. Then, a literature review was realized to identify the potential HDI (no interactions, precautions for use, contraindication). Among 201 pharmacist counseling sessions, it resulted in 104 interventions related to 46 HDI, 28 drug-drug interactions and 30 others (wrong dosage, omission…). To determine HDI, we review 73 medicinal plants which are used by our patients with cancer and 31 OAA. A total of 1829 recommendations were formulated about 59 (75%) medical plants and their interaction with an OAA. Herb-drug interactions should not be ignored by healthcare providers in their management of cancer patients in daily practice.


Assuntos
Antineoplásicos/efeitos adversos , Interações Ervas-Drogas , Neoplasias/tratamento farmacológico , Fitoterapia/efeitos adversos , Polimedicação , Idoso , Antineoplásicos/administração & dosagem , Humanos , Pessoa de Meia-Idade , Medicamentos sem Prescrição/administração & dosagem , Medicamentos sem Prescrição/efeitos adversos , Farmacêuticos , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos , Estudos Prospectivos
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