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1.
World J Gastroenterol ; 25(46): 6704-6712, 2019 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-31857773

RESUMO

Herbal and dietary supplements (HDS) are increasingly used worldwide for numerous, mainly unproven health benefits. The HDS industry is poorly regulated compared to prescription medicines and most products are easily obtainable. Drug induced liver injury (DILI) is a well-recognized entity associated with prescription and over the counter medications and many reports have emerged of potential HDS-related DILI. There is considerable geographic variability in the risk and severity of DILI associated with HDS but the presentation of severe liver injury is similar with a hepatocellular pattern accompanied by jaundice. This type of injury can lead to acute liver failure and the need for liver transplantation. Patients will often fail to mention their use of HDS, considering it natural and therefore harmless. Hence physicians should understand that these products can be associated with DILI and explicitly ask about HDS use in any patient with otherwise unexplained acute liver injury.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Suplementos Nutricionais/efeitos adversos , Transplante de Fígado , Preparações de Plantas/efeitos adversos , Ásia , Doença Hepática Induzida por Substâncias e Drogas/cirurgia , Europa (Continente) , Humanos , Estados Unidos
2.
Toxicol Mech Methods ; 29(9): 702-709, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31364917

RESUMO

Leukopenia is the early clinical manifestation of benzene poisoning. The aim of our research was to evaluate the preventive effects of three kinds of garlic preparations on benzene induced leukopenia. The mouse model of Leukopenia was established with benzene orally. At the same time, mice were administrated with garlic homogenate (GH), garlic oil (GO) or diallyl trisulfide (DATS) as preventional measures. The counts of white blood cells (WBC), the organ indexes, pathological examinations, blood biochemical parameters, weight gains, and food intakes were evaluated to observe the protective effect and potential adverse events. The results demonstrated that the counts of WBC increased by 144.04%, 140.07%, and 148.34%, respectively, after intervention by GH (400 mg/kg), GO (60 mg/kg) and DATS (30 mg/kg), compared with that in the model group. The spleen and thymus indexes in the benzene model group were 44.99% and 54.04% lower than those in the blank control group, the number of spleen nodules reduced and the thymus atrophy, which were restored by three garlic preparations at different degree. The results suggested that the three preparations all could prevent the leukopenia and protect the organ injuries induced by benzene. However, the spleen index and weight gains revealed that GH and GO brought more adverse events than DATS.


Assuntos
Compostos Alílicos/farmacologia , Benzeno/toxicidade , Alho/química , Leucopenia/prevenção & controle , Preparações de Plantas/farmacologia , Sulfetos/farmacologia , Compostos Alílicos/efeitos adversos , Animais , Modelos Animais de Doenças , Contagem de Leucócitos , Leucopenia/sangue , Leucopenia/induzido quimicamente , Masculino , Camundongos Endogâmicos , Preparações de Plantas/efeitos adversos , Baço/efeitos dos fármacos , Baço/patologia , Sulfetos/efeitos adversos , Timo/efeitos dos fármacos , Timo/patologia
4.
Medicine (Baltimore) ; 98(30): e16466, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348248

RESUMO

INTRODUCTION: In Korea, low back pain (LBP) which is occupation-related symptom is one of the major health issues owing to rapid industrialization. Even traditional Korean medicine has the long history in pain treatment, there still has been lack of supporting evidence on herbal prescription itself. Sogyeonghwalhyeol-tang, a Korean herbal medicine prescription, has been suggested as a medication for treating chronic LBP as well as work-related pains. OBJECTIVE: This study aims to evaluate the clinical efficacy and safety of herbal medicine, Sogyeonghwalhyeol-tang on work-related chronic LBP patients. METHOD: This trial is designed as a multicenter, randomized, controlled, clinical trial. Seventy-two participants who have chief complaint of LBP in Korean medicine rehabilitation center will be randomly assigned to ether Sogyeonghwalhyeol-tang group or placebo group with a ratio of 1:1. They will receive assigned drugs in 4 weeks and follow-up for 2 weeks. DISCUSSION: The result of this study will provide the valuable information for efficacy and safety of Sogyeonghwalhyeol-tang for patients with work-related chronic LBP.


Assuntos
Dor Lombar/tratamento farmacológico , Medicina Tradicional Coreana/métodos , Doenças Profissionais/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Método Duplo-Cego , Humanos , Medição da Dor , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos , Qualidade de Vida , República da Coreia
5.
Int J Mol Sci ; 20(15)2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31349548

RESUMO

Currently, hundreds of herbal products with potential hepatotoxicity were available in the literature. A comprehensive summary and analysis focused on these potential hepatotoxic herbal products may assist in understanding herb-induced liver injury (HILI). In this work, we collected 335 hepatotoxic medicinal plants, 296 hepatotoxic ingredients, and 584 hepatoprotective ingredients through a systematic literature retrieval. Then we analyzed these data from the perspectives of phylogenetic relationship and structure-toxicity relationship. Phylogenetic analysis indicated that hepatotoxic medicinal plants tended to have a closer taxonomic relationship. By investigating the structures of the hepatotoxic ingredients, we found that alkaloids and terpenoids were the two major groups of hepatotoxicity. We also identified eight major skeletons of hepatotoxicity and reviewed their hepatotoxic mechanisms. Additionally, 15 structural alerts (SAs) for hepatotoxicity were identified based on SARpy software. These SAs will help to estimate the hepatotoxic risk of ingredients from herbs. Finally, a herb-ingredient network was constructed by integrating multiple datasets, which will assist to identify the hepatotoxic ingredients of herb/herb-formula quickly. In summary, a systemic analysis focused on HILI was conducted which will not only assist to identify the toxic molecular basis of hepatotoxic herbs but also contribute to decipher the mechanisms of HILI.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Preparações de Plantas/efeitos adversos , Preparações de Plantas/química , Plantas Medicinais/química , Animais , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Interações Medicamentosas , Humanos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Estrutura Molecular , Filogenia , Compostos Fitoquímicos/química , Compostos Fitoquímicos/farmacologia , Preparações de Plantas/análise , Plantas Medicinais/classificação , Plantas Medicinais/genética , Relação Estrutura-Atividade
6.
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
8.
Intern Med ; 58(17): 2459-2465, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31178508

RESUMO

Objective Kikyo-to (KKT) is a fixed combination of glycyrrhiza root and platycodon root extracts. It is an herbal medicine traditionally used in Japan for relieving sore throat associated with acute upper respiratory tract infection (URTI). No controlled studies have yet demonstrated its effect, however. We investigated the efficacy of KKT on sore throat associated with acute URTI. Methods Patients with sore throat who were diagnosed with URTI at the General Medicine Department Office, Akashi Medical Center Hospital, between December 2017 and May 2018 were enrolled. Participants were randomly assigned to two groups at a 1:1 ratio, with stratification by age and sore throat score on a Visual Analogue Scale (VAS), to receive 2.5 g of either KKT or a placebo. Participants and investigators were blinded to group allocation. The primary outcome was the change in sore throat score on VAS 10 minutes after KKT administration. Secondary outcomes were the impact of the sore throat on daily life (none, mild, moderate, and severe) at 10 minutes after administration. Results Thirty-five participants were assigned to each group (n=70, total). The difference in the mean change of sore throat score according to VAS within 10 minutes between the two groups was not statistically significant (KKT 14.40 vs. placebo 17.00; p=0.39). The proportion of patients with a moderate or greater impact of their sore throat on their daily life was also not significantly different between the groups (KKT 22.9% vs. placebo 40.0%; p=0.20). Patients reported no side effects. Conclusion KKT did not significantly relieve sore throat associated with acute URTI compared with placebo.


Assuntos
Medicina Tradicional do Leste Asiático/métodos , Faringite/tratamento farmacológico , Faringite/etiologia , Preparações de Plantas/uso terapêutico , Infecções Respiratórias/complicações , Adulto , Método Duplo-Cego , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Fitoterapia , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos , Fatores de Tempo
10.
Biomolecules ; 9(5)2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31035513

RESUMO

Chyawanprash (CP) is an Ayurvedic health supplement which is made up of a super-concentrated blend of nutrient-rich herbs and minerals. It is meant to restore drained reserves of life force (ojas) and to preserve strength, stamina, and vitality, while stalling the course of aging. Chyawanprash is formulated by processing around 50 medicinal herbs and their extracts, including the prime ingredient, Amla (Indian gooseberry), which is the world's richest source of vitamin C. Chyawanprash preparation involves preparing a decoction of herbs, followed by dried extract preparation, subsequent mixture with honey, and addition of aromatic herb powders (namely clove, cardamom, and cinnamon) as standard. The finished product has a fruit jam-like consistency, and a sweet, sour, and spicy flavor. Scientific exploration of CP is warranted to understand its therapeutic efficacy. Scattered information exploring the therapeutic potential of CP is available, and there is a need to assemble it. Thus, an effort was made to compile the scattered information from ancient Ayurvedic texts and treatises, along with ethnobotanical, ethnopharmacological, and scientifically validated literature, that highlight the role of CP in therapeutics. Citations relevant to the topic were screened.


Assuntos
Suplementos Nutricionais , Preparações de Plantas/farmacologia , Alimento Funcional , Humanos , Marketing , Compostos Fitoquímicos/análise , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos
11.
Toxicol Lett ; 314: 10-17, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31082523

RESUMO

Botanical safety science continues to evolve as new tools for risk assessment become available alongside continual desire by consumers for "natural" botanical ingredients in consumer products. Focusing on botanical food/dietary supplements a recent international roundtable meeting brought together scientists to discuss the needs, available tools, and ongoing data gaps in the botanical safety risk assessment process. Participants discussed the key elements of botanical safety evaluations. They provided perspective on the use of a decision tree methodology to conduct a robust risk assessment and concluded with alignment on a series of consensus statements. This discussion highlighted the strengths and vulnerabilities in common assumptions, and the participants shared additional perspective to ensure that this end-to-end safety approach is sufficient, actionable and timely. Critical areas and data gaps were identified as opportunities for future focus. These include, better context on history of use, systematic assessment of weight of evidence, use of in silico approaches, inclusion of threshold of toxicological concern considerations, individual substances/matrix interactions of plant constituents, assessing botanical-drug interactions and adaptations needed to apply to in vitro and in vivo pharmacokinetic modelling of botanical constituents.


Assuntos
Árvores de Decisões , Suplementos Nutricionais/efeitos adversos , Preparações de Plantas/efeitos adversos , Toxicologia/métodos , Animais , Consenso , Qualidade de Produtos para o Consumidor , Relação Dose-Resposta a Droga , Humanos , Modelos Biológicos , Segurança do Paciente , Preparações de Plantas/farmacocinética , Medição de Risco , Fatores de Risco , Toxicocinética , Toxicologia/normas
12.
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
13.
Dermatol Ther ; 32(3): e12866, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30838736

RESUMO

The aim of this study is to review the efficacy of herbal and allopathic drugs used to manage and treat psoriasis. The review has been compiled using reference materials from major databases, Online Journals, Science Direct, Scopus, Open J Gate, Google Scholar and PubMed. Psoriasis is a common skin disease affecting 2-3% of the world's population. It is cosmetically debilitating and chronic disease, which occurs both in developing and developed countries. It can affect any part of the body, but the most common sites are the elbows, knees, and scalp. It is usually treated with synthetic medicine either given systematically or applied locally. The prescribed synthetic medicines used for the treatment of psoriasis are associated with severe side effects and complications, thus researchers around the world are trying to explore new, more effective, and safer drugs from natural resources. Medicinal plants are safe and efficacious, and most of the people all over the world rely on herbal medicine due to their easy availability, low cost, and efficacy for treating psoriasis. A number of medicinal plants having therapeutic potential with high efficacy are used in the treatment of psoriasis have been described. Moreover, studies should be conducted to isolate and investigate the mechanism of actions of phytochemicals responsible for anti-psoriasis potential.


Assuntos
Preparações de Plantas/administração & dosagem , Plantas Medicinais/química , Psoríase/tratamento farmacológico , Animais , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/isolamento & purificação , Humanos , Fitoterapia/métodos , Preparações de Plantas/efeitos adversos
14.
BMC Res Notes ; 12(1): 166, 2019 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-30909953

RESUMO

OBJECTIVE: In Africa, 80% of women ingest traditional medicine (TM) during pregnancy. Although widely used in Cameroon, no study in has either demonstrated its safety or effectiveness. Hence, we sought to determine the effects of TM ingestions during the peri-partum period on maternal and foetal outcomes. A cohort study was conducted from January to April 2016 in two referral maternity departments of Cameroon. We consecutively enrolled all consenting parturients with gestational age above 28 weeks. We divided them into two groups; exposed and unexposed. The exposure studied was ingestion of TM within 72 h prior to delivery. Variables studied were socio-demographic characteristics, type and frequency of TM ingested and details of labour. RESULTS: We enrolled a total of 603 parturients of whom 147 in the exposed group and 456 in the non-exposed group. The most frequently used TM were honey and Triumfetta pentandra A. Ingestion of TM in the peri-paritum period was associated with intra-partum vaginal bleeding, dystocic labour, tachysystole and uterine atony. No adverse neonatal outcome was observed. Overall, these findings could help guide the direction of future research into the safety and potential benefits of peri-partum TM use, as well as serving as a preliminary reference for counselling.


Assuntos
Doenças do Recém-Nascido/induzido quimicamente , Medicina Tradicional Africana/efeitos adversos , Complicações do Trabalho de Parto/induzido quimicamente , Preparações de Plantas/efeitos adversos , Resultado da Gravidez , Triumfetta/efeitos adversos , Adolescente , Adulto , Camarões , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Terceiro Trimestre da Gravidez , Adulto Jovem
15.
BMC Complement Altern Med ; 19(1): 65, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30876425

RESUMO

BACKGROUND: Herbal medicine has become the panacea for many rural pregnant women in Ghana despite the modern western antenatal care which has developed in most parts of the country. To our knowledge, previous studies investigating herbal medicine use have primarily reported general attitudes and perceptions of use, overlooking the standpoint of pregnant women and their attitudes, and utilisation of herbal medicine in Ghana. Knowledge of herbal medicine use among rural pregnant women and the potential side effects of many herbs in pregnancy are therefore limited in the country; this qualitative study attempts to address this gap by exploring the perceptions of herbal medicine usage among pregnant women in rural Ghana. METHODS: A sample of 30, conveniently selected pregnant women, were involved in this study from April 11 to June 22, 2017. Data from three different focus group discussions were thematically analysed and presented based on an a posteriori inductive reduction approach. RESULTS: The main findings were that pregnant women used herbal medicine, most commonly ginger, peppermint, thyme, chamomile, aniseeds, green tea, tealeaf, raspberry, and echinacea leaf consistently throughout the three trimesters of pregnancy. Cultural norms and health beliefs in the form of personal philosophies, desire to manage one's own health, illness perceptions, and a holistic healing approach were ascribed to the widespread use of herbs. CONCLUSION: We recommend public education and awareness on disclosure of herbal medicine use to medical practitioners among pregnant women.


Assuntos
Fitoterapia , Preparações de Plantas , Gravidez/etnologia , Adulto , Estudos de Coortes , Feminino , Gana/etnologia , Medicina Herbária , Saúde Holística , Humanos , Fitoterapia/efeitos adversos , Fitoterapia/métodos , Fitoterapia/estatística & dados numéricos , Preparações de Plantas/efeitos adversos , Preparações de Plantas/uso terapêutico , Pesquisa Qualitativa , Adulto Jovem
16.
Pak J Pharm Sci ; 32(1(Supplementary)): 339-343, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30829213

RESUMO

Cough is the common disease condition which affects patients of every age. Numerous OTC medications available in community pharmacies however no antiviral treatment and even antibiotics has been shown to be effective without pre-existing lung infection. The treatment approach of medicinal herbs has been recognized for many decades and even longer for the treatment and prevention of cough. The aim of this study was to evaluate the safety and efficacy of Mukalbion poly herbal chewable tablets for the treatment of cough with improved palatability against a marketed brand (Poly herbal). For the formulation development of test group, the herbs were supplied by the Procurement department of Herbion Pakistan Pvt. Ltd. Althea officinalis (roots), Hedera helix (leaves) and Sisymbrium irio (seeds) were used for the manufacturing of Mukalbion (poly herbal, test group) chewable tablet. The comparative control clinical trial was carried out during a time frame of 07 months with sample size of 70 patients as per epidemiological software for sample size and each group contained 35 (±5) patients. Chewable tablets were administered and evaluated for effectiveness after 15 days of treatment. The data were collected by the patients through clinical trial questionnaire. The validated quality of life questionnaire (LCQ) was also used for assessment. The results were analyzed by applying paired sample T test by using IBM SPSS version 20.00. The p value was <0.005 at 95% confidence interval for cough variables including cough bouts, viscosity of sputum, chest congestion, sore throat and shortness of breath. The LCQ cough scale score was higher in test group as compared to control group. The test group also showed well tolerated in term of palatability. None of the patient claimed any of the side effects and no compliance were observed against the marketed brand.


Assuntos
Antitussígenos/farmacologia , Tosse/tratamento farmacológico , Preparações de Plantas/farmacologia , Adolescente , Adulto , Antitussígenos/efeitos adversos , Criança , Feminino , Humanos , Masculino , Mastigação , Pessoa de Meia-Idade , Preparações de Plantas/efeitos adversos , Comprimidos , Paladar , Resultado do Tratamento
17.
G Ital Dermatol Venereol ; 154(1): 6-13, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30616332

RESUMO

BACKGROUND: The oxidative stress, the UV radiations, the matrix metalloproteinases (MMPs) and the hyaluronidase enzyme play an extremly important role in skin aging processes, leading an increasing production of elastase, collagenase and hyaluronidase that brings to degradation of collagen, elastin and hyaluronic acid respectively. They are responsible to provide strength, elasticity and moisture to the skin. Innovative devices were developed based on the effective ingredients against hyaluronidase and MMP. The inhibition of the destructuring enzymes of the dermis is the main mechanism of action of Bioliftan treatment, and this process is mainly addressed to hyaluronidase and MMP inhibition. The aim of our study was to evaluate the efficacy, tolerability and skin changes induced by antiaging topical based on Sibanid SG®, plant stem cells and regenerative and biostimulating active ingredients. The products tested are Bioliftan Day cream and Bioliftan concentrate. METHODS: All parameters were evaluated before the beginning of treatment (T0), and 60 (T1) days later. The evaluation of the effectiveness of the products was performed by clinical examination, photographic and instrumental documentation by corneometry, X-rite, elastometry, Moisture Meter EpiD, Confocal microscopy. RESULTS: The products tested after 60 days have induced an increase of hydration of the external cutaneous layers (P<0.0001), skin hydration (P<0.0001), skin brightness (P<0.01), skin elasticity (P<0.0001). All results were statistically significant. All volunteers completed the study. No patients reported side-effects. All results were confirmed by confocal microscopy. CONCLUSIONS: Our study evaluated efficacy, tolerability and skin changes after 60 days of Bioliftan day cream and Bioliftan serum concentrate application on the skin aged. Our study has shown an excellent skin tollerance of the products tested.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Preparações de Plantas/administração & dosagem , Envelhecimento da Pele/efeitos dos fármacos , Pele/efeitos dos fármacos , Administração Cutânea , Adulto , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/farmacologia , Elasticidade/efeitos dos fármacos , Feminino , Humanos , Microscopia Confocal/métodos , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Células Vegetais , Preparações de Plantas/efeitos adversos , Preparações de Plantas/farmacologia , Regeneração/efeitos dos fármacos , Células-Tronco/citologia
18.
Phytomedicine ; 57: 49-56, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30668322

RESUMO

BACKGROUND AND OBJECTIVE: Prior small-scale clinical trials showed that Artemisia annua and Artemisia afra infusions, decoctions, capsules, or tablets were low cost, easy to use, and efficient in curing malaria infections. In a larger-scale trial in Kalima district, Democratic Republic of Congo, we aimed to show A. annua and/or A. afra infusions were superior or at least equivalent to artesunate-amodiaquine (ASAQ) against malaria. METHODS: A double blind, randomized clinical trial with 957 malaria-infected patients had two treatment arms: 472 patients for ASAQ and 471 for Artemisia (248 A. annua, 223 A. afra) remained at end of the trial. ASAQ-treated patients were treated per manufacturer posology, and Artemisia-treated patients received 1 l/d of dry leaf/twig infusions for 7 d; both arms had 28 d follow-up. Parasitemia and gametocytes were measured microscopically with results statistically compared among arms for age and gender. RESULTS: Artemisinin content of A. afra was negligible, but therapeutic responses of patients were similar to A. annua-treated patients; trophozoites cleared after 24  h, but took up to 14 d to clear in ASAQ-treated patients. D28 cure rates defined as absence of parasitemia were for pediatrics 82, 91, and 50% for A. afra, A. annua and ASAQ; while for adults cure rates were 91, 100, and 30%, respectively. Fever clearance took 48  h for ASAQ, but 24  h for Artemisia. From D14-28 no Artemisia-treated patients had microscopically detectable gametocytes, while 10 ASAQ-treated patients remained gametocyte carriers at D28. More females than males were gametocyte carriers in the ASAQ arm but were unaffected in the Artemisia arms. Hemoglobin remained constant at 11 g/dl for A. afra after D1, while for A. annua and ASAQ it decreased to 9-9.5  g/dl. Only 5.0% of Artemisia-treated patients reported adverse effects, vs. 42.8% for ASAQ. CONCLUSION: A. annua and A. afra infusions are polytherapies with better outcomes than ASAQ against malaria. In contrast to ASAQ, both Artemisias appeared to break the cycle of malaria by eliminating gametocytes. This study merits further investigation for possible inclusion of Artemisia tea infusions as an alternative for fighting and eradicating malaria.


Assuntos
Amodiaquina/uso terapêutico , Antimaláricos/uso terapêutico , Artemisia , Artemisininas/uso terapêutico , Malária Falciparum/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Adolescente , Adulto , Amodiaquina/efeitos adversos , Artemisia annua , Artemisininas/efeitos adversos , Criança , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Febre/tratamento farmacológico , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Parasitemia/tratamento farmacológico , Preparações de Plantas/efeitos adversos , Plantas Medicinais , Resultado do Tratamento
19.
J Ethnopharmacol ; 233: 190-196, 2019 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-30639232

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited. AIM OF THE STUDY: This study aims to determine the clinical features of herb induced liver injury (HILI) including its constituent ratio among liver injury case cohorts that included both HILI and drug induced liver injury (DILI). MATERIALS AND METHODS: A systematic review was conducted using a literature search for DILI/HILI in seven electric databases including PubMed, Cochrane and Embase. We analyzed the DILI/HILI cases and clinical characteristics in terms of herbs, conventional drugs, concomitant, or others. RESULTS: Thirty-one studies met the necessary criteria and included 9 prospective and 22 retrospective studies. Among total number of overall DILI/HILI cases (7511, male 2819, female 3669 and unknown 1023), 25.0% (1874 cases) were implicated in herbs. HILI was relatively higher in females (69.8% vs. 30.2% male), compared to conventional drugs (57.3% female vs. 42.7% male, p < 0.01), while it was prone to induce hepatocellular injury (hepatocellular 78.8%, cholestatic 8.9%, mixed type 12.3%), contrary to conventional drugs (hepatocellular 56.7% vs. cholestatic 22.1% vs. mixed 21.2%), respectively (p < 0.01). The main herbs causing HILI included Polygonum multiflorum, Psoralea corylifolia, Corydalis yanhusuo, and Rheum officinale. CONCLUSIONS: This review created the comparative and comprehensive feature of hepatotoxicity by herbal products, which provides reference data for the clinical applications and establishing pharmacovigilance system of herbs.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Preparações de Plantas/efeitos adversos , Humanos
20.
Fundam Clin Pharmacol ; 33(2): 216-222, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30289178

RESUMO

The principal outcome was to identify which hypnotics substances, medicated (benzodiazepines, antihistamine, antidepressant…) or not medicated (herbal medicine, homeopathy, melatonin…), were consumed by community pharmacy patients who reported taking something for sleep disorder, and which factors can influence the consumption of medicated substance rather than nonmedicated substance. Data were collected via a network of 73 partner pharmacies around Nantes, France. Patients who reported taking a substance to sleep completed a questionnaire that collected data relative to the different substances consumed by that person for sleep, and the desired effect. Substances were classified in Hypnotic Drug Substances and nonmedicated hypnotic substances. A logistical regression was done in order to highlight the factors associated with the consumption of Hypnotic Drug Substance rather than nonmedicated hypnotic substances. Six hundred and forty-seven patients were included, with an average age of 58 years and 74% female. The principal strategy employed to combat sleep disorder was the consumption of Hypnotic Drug Substance (54%), followed by herbal medicine (32%) and homeopathy (19%). The factors positively associated with the consumption of a Hypnotic Drug Substance are age, living alone, being out of work, or in the process of looking for a job and being a parent. In our survey, the use of Hypnotic Drug Substance to help patients with sleep is far from systematic. On the other hand, among patients who consume HDS, misuse is still significant, particularly in terms of the duration of consumption.


Assuntos
Serviços Comunitários de Farmácia , Uso Indevido de Medicamentos , Hipnóticos e Sedativos/uso terapêutico , Medicamentos sem Prescrição/uso terapêutico , Preparações de Plantas/uso terapêutico , Medicamentos sob Prescrição/uso terapêutico , Transtornos do Sono-Vigília/tratamento farmacológico , Sono/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Uso Indevido de Medicamentos/efeitos adversos , Feminino , França/epidemiologia , Humanos , Hipnóticos e Sedativos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Medicamentos sem Prescrição/efeitos adversos , Preparações de Plantas/efeitos adversos , Uso Indevido de Medicamentos sob Prescrição/efeitos adversos , Medicamentos sob Prescrição/efeitos adversos , Medição de Risco , Fatores de Risco , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/fisiopatologia , Adulto Jovem
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