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.

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.

The neuroprotective effects of baobab and black seed on the rat hippocampus exposed to a 900-MHz electromagnetic field

This study investigated the potential effects on the hippocampus of electromagnetic fields (EMFs) disseminated by mobile phones and the roles of baobab (Adansonia digitata) (AD) and black seed (Nigella sativa) (BS) in mitigating these. Fifty-six male, 12-week-old Wistar albino rats were divided into eight groups of seven animals each. No EMF exposure was applied to the control, AD or BS groups, while the rats in the Sham group were placed in an EMF system with no exposure. A 900-MHz EMF was applied to the EMF+AD, EMF+BS, EMF+AD+BS and EMF groups for 1 hour a day for 28 days. Pyramidal neurons in the hippocampus were subsequently counted using the optical fractionator technique, one of the unbiased stereological methods. Tissue sections were also evaluated histopathologically under light and electron microscopy. The activities of the enzymes catalase (CAT) and superoxide dismutase (SOD) were also determined in blood serum samples. Analysis of the stereological data revealed no statistically significant differences between the EMF and control or sham groups in terms of pyramidal neuron numbers (p>0.05). However, stereological examination revealed a crucial difference in the entire hippocampus between the control group and the AD (p<0.01) and BS (p<0.05) groups. Moreover, exposure to 900-MHz EMF produced adverse changes in the structures of neurons at histopathological analysis. Qualitative examinations suggest that a combination of herbal products such as AD and BS exerts a protective effect against such EMF side-effects.

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.

Protective Effect of Nigella sativa Seed Extract and its Bioactive Compound Thymoquinone on Streptozotocin-induced Diabetic Rats

BACKGROUND

The lack of a substantial breakthrough in the treatment of diabetes, a global issue, has led to an ongoing quest for herbs that contain bioactive elements with hypoglycemic properties.

OBJECTIVE

To investigate the potential protective effect of Nigella sativa seeds ethanol extract and its active ingredient, thymoquinone, on streptozotocin-induced diabetic rats.

METHODS

To induce diabetes, the male Wistar rats were administered an intraperitoneal injection of STZ at a dosage of 90mg/kg body weight in 0.9 percent normal saline after being fasted for 16 hours and made diabetic Group 1; 7 rats non-diabetic control (saline-treated), Group 2; 7 untreated diabetic rats, Group 3; 7 diabetic rats treated orally with N. sativa extract at a dose of 100mg/kg body weight, Group 4; 7 diabetic rats treated orally with thymoquinone at a dose of 10mg/kg body weight and Group 5; 7 diabetic rats treated orally with Metformin at a dose of 5mg/kg body weight. After the treatment of 28 days, all groups were examined for body weight and biochemical alterations.

RESULTS

The results showed a significant decrease in blood glucose, urea, creatinine, uric acid, total protein, total cholesterol, low-density lipoprotein, and very low-density lipoprotein, while high-density lipoprotein was increased. Hepatic enzymes, alanine transaminase, aspartate aminotransferase, and alkaline phosphate were also normalized and significantly increased body weight.

CONCLUSION

These preliminary findings demonstrate that the ethanol extract of N. sativa seeds and its active ingredient, thymoquinone have a protective effect against streptozotocin-induced diabetic rats. The present study opens new vistas for the use of N. sativa and its bioactive compound, thymoquinone, regarding its clinical application as a new nontoxic antidiabetic agent for managing diabetes mellitus.

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.

Herbal Medications Used to Treat Fever

Fever is a natural body defense and a common symptom of disease. Herbs have been used for thousands of years to treat fever. Many herbs have anti-inflammatory properties. Some are useful in reducing the release of cytokines and mediators of inflammation, whereas others work as natural aspirins to inhibit cyclooxygenase. In addition, herbs have known antipathogenic properties and can be effective in the treatment of infection from numerous microorganisms. Last, in traditional Chinese medicine, herbs are used to restore imbalances between the nonpathogenic and the pathogenic clearing interior heat and treating heat patterns in a variety of ways.

Drug and herbal/dietary supplements-induced liver injury: A tertiary care center experience

BACKGROUND

Drug-induced liver injury (DILI) and herbal/dietary supplements (HDS) related liver injury present unique diagnostic challenges. Collaboration between the clinician and the pathologist is required for an accurate diagnosis and management.

AIM

To report our experience on the clinical-pathological findings of hepatic injury caused by drugs/HDS.

METHODS

A retrospective review of clinically proven cases of DILI/HDS who presented to our institution from January 1, 2013 to December 31, 2017 was performed. Slides were reviewed for histopathological patterns of injury and correlated with the causative agent. Out of 600 patients presenting with unexplained rise in liver enzymes undergoing biopsy, 107 were suspected to have DILI/HDS. Of these, 53 had a directly linked exposure to drug/herbal supplements. Fifteen patients were excluded for concurrent known liver disease. Thirty-eight patients with clinically proven DILI/HDS were finally included.

RESULTS

Thirty-eight cases of DILI/HDS with a male:female of 1:1.5 and mean age of 51 ± 3 years were identified. DILI was identified in 84.2% cases while HDS injury in 15.8%. Acute hepatitis (42.1%) was the most common pattern of injury while granulomatous hepatitis (2.6%) was the least common. We found one case of acute-cholestasis due to rivaroxaban and two cases of cholestatic-hepatitis due to rizatriptan and trimethobenzamide-hydrochloride that, to the best of our knowledge, have not been previously reported. One case of steatohepatitis due to trimethoprim-sulfamethoxazole and three unusual cases of cholestatic-hepatitis with bile duct injury and steatosis due to dronedarone, C4-Extreme and hydroxycut, were also seen. Of our cohort, 81.6% of the patients fared well with discontinuation of drug and 18.4% underwent transplant; of which 42.9% were deceased.

CONCLUSION

We describe the clinical findings, histopathological patterns of injury and clinical outcomes caused by drugs. In particular, we report a few previously unreported/ rarely observed clinical and histopathological patterns of hepatic injury.

Complementary and Alternative Medicine-related Drug-induced Liver Injury in Asia

The use of complementary and alternative medicines (CAMs) for treatment of acute and chronic diseases is on the rise world over, especially in Asian countries, and mostly in China and India. Drug-induced liver injury (DILI) due to CAM is increasingly reported in the literature from multiple centers all around the world and with large-number patient series published from the West, mostly based on nation-wide DILI networks and multicenter collaboration. Comprehensive DILI networks are lacking among major Asian countries with high incidence of CAM practices. Chinese medical societies dealing with drug toxicity, CAM practice and hepatobiliary disease have adopted an integrated approach to establishing identification, diagnosis and treatment of CAM-related DILI, representing a systematic approach that could be iterated by other countries for improving patient outcomes. In this exhaustive review, we provide published data on CAM-related DILI in Asia, with detail on incidences along with analysis of patient population and their clinical outcomes. Concise and clear discussion on commonly implicated CAM agents in major Asian countries and associated chemical and toxicology analyses as well as descriptions of liver biopsy findings are discussed with future directions.

Ethnopharmacology in the Upper Guadiana River area (Castile-La Mancha, Spain)

ETHNOPHARMACOLOGICAL RELEVANCE

Determining traditional remedies for human pathologies is relevant, when compared with the standard materia medica of the pharmacopoeias and dietary supplement databases, because we can assess the species and uses that have been previously studied and target understudied species for further pharmacological investigation.

BACKGROUND

The aim of this study was to systematically record and analyze medicinal uses of natural resources (Plantae, Animalia, Fungi and minerals), mostly local, in the territories adjoining the upper Guadiana River and its tributaries. We were particularly interested in recording resources and pathologies linked to wetland areas, especially in the National Parks Las Tablas de Daimiel and Cabañeros. Wetlands are interesting because they present a double face in relation with human health: Wetlands furnish hydration, safe water, nutrition, and medicinal resources; are places from which people derive their livelihood. However wetlands are also sites of exposure to pollution or toxicants, and infectious diseases; and sites of physical hazards. We wanted to identify procedures for preparation of medicinal formulae and routes of administration. We also intended to detect whether a geographical pattern exists or not in our records in relation to the use of local resources.

METHODS

We used semi-structured interviews with one-to-one informants or groups, from 1998 to 2018. Raw data were introduced in a Firebird database and analyzed. To identify ingredients and pathologies we consulted local floras and epidemiological literature. Finally, we compared documented pathologies, remedies and ingredients in the historical context of medicinal uses of natural resources in Castile-La Mancha and especially in Ciudad Real.

RESULTS

126 pathologies and 220 species furnishing ingredients have been recorded from the interviews. In total, 188 are plants and 20 animals. The most commonly used species include Malva sylvestris, Phlomis lychnitis, Genista tridentata and Thymus mastichina. Most records refer to flowers, or fruits, of locally available plant species, classified as Mediterranean, European or widespread that belong to the Lamiaceae, Compositae or Leguminosae. Ingredients which are collected in open shrublands, known as "garrigue", and dry grasslands furnish a relevant proportion of records while the imported ingredients remain marginal. The contribution of wetlands, riverine habitats and irrigated fields and gardens as a source of medicinal resources is 36% of the records. It is relatively high considering its limited presence in terms of total extension within the study area. The most frequently reported diseases are respiratory, gastrointestinal, dermatological and infectious or parasitic.

CONCLUSIONS

Along the Guadiana River in the Ciudad Real province exists a wide and deep knowledge of traditional remedies for the treatment of common pathologies, based fundamentally on the use of local flora, fauna and mineral resources. The uses and ingredients documented are useful for further pharmacological investigation to improve health care for a wide range of pathologies.

How do pharmacists use and recommend vitamins, minerals, herbals and other dietary supplements?

Background

Use of complementary and alternative medicine (CAM), including vitamins, minerals, herbals, and other dietary supplements, is widespread in the United States (ranging from 24% in Hispanics to 50% in American Indians). Pharmacists are an accessible source for healthcare information, but little is known about their use of CAM products and to whom they would recommend these products.

Methods

A cross-sectional survey was sent via email to pharmacists licensed in one state in the United States in 2015. The survey included items about their use of 10 vitamins and minerals, and 21 herbal or other dietary supplements, as well as reasons for use, conditions used to treat, if they would recommend the product to patients, family, or friends, their perception of CAM safety and effectiveness, and four demographic questions. Descriptive statistics were used to summarize the data, and a chi-square test was used to determine differences between pharmacists’ use of vitamins/minerals and herbals/other dietary supplements. The a priori alpha level was 0.05.

Results

A total of 639 pharmacists completed the survey. Female pharmacists used vitamins/minerals (p = 0.031) and herbals/others (p = 0.039) more than male pharmacists. Older pharmacists used herbals/others more than younger pharmacists (p < 0.001). Fifty-nine percent thought the dietary supplements in the survey were safe while 32% reported they were effective. Seventy-eight percent of respondents reported use of any vitamin or mineral product versus 42% who reported use of any herbal or other dietary supplement. Commonly used products included: multivitamins (91%), vitamin C (71%), fish oil (65%), probiotics (53%), and fiber (53%). The most commonly reported reason for use was general health and wellness (17–90%). Pharmacists most commonly recommend fiber/psyllium (94%) and calcium (90%) to patients, family, and friends.

Conclusions

Pharmacists in this survey selectively used vitamins, minerals, herbals and other dietary supplements, and recommended some of the more commonly used products to patients, family and friends. This is valuable information given that pharmacists are frontline healthcare professionals who may be asked to provide advice about these products.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2637-y) contains supplementary material, which is available to authorized users.

Employing barcoding markers to authenticate selected endangered medicinal plants traded in Indian markets

The high demand of medicinal plants and their unrestricted collection have rendered many of these as rare or endangered. The restrictions imposed on their collection and trade are difficult to implement because of the inability to identify them in fragmented form. The rarity of these plants in nature and lack of their cultivation raise doubt about the authenticity of the herbals sold in markets. Therefore, in the present investigation, ITS/ITS2, matK, rbcL and rpoC1 sequences of fourteen species of important medicinal plants, some of which are endangered, were generated and checked for their species-specificity (sequences having maximum similarity only with their own) by BLAST1 and/or BOLD identifications. ITS sequences of 12 species were species-specific. However, ITS2 of only 10 of these 12 species were species-specific. As for the chloroplast loci, rbcL and rpoC1 sequences of all 14 species could be obtained, while matK sequences of only 10 of these could be generated. Of the retrieved sequences, rbcL, rpoC1 and matK sequences of 7, 11 and 7 species, respectively, were species-specific. The sequences of the targeted loci from the herbal samples of these species were difficult to retrieve because of failure in the amplification or sequencing. Nevertheless, based on ITS2 and/or one or more of the chloroplast loci targeted, the botanical identities of 22 herbal market samples were checked by phylogenetic tree, BLAST1 and BOLD identification methods. Of these 22 samples, only one of each of Rauvolfia serpentina and Picrorhiza kurroa were found to be authentic.

Ethnopharmacological study of Sephardic remedies in the 19th century: The "Livro de Milizinas"

ETHNOPHARMACOLOGICAL RELEVANCE

The Sephardic or Judeo-Spanish communities kept a cultural heritage extremely relevant which is recognizable through the peculiar form of their language and practices. Medicine was one of the main professional activities among Jews of Spain before their expulsion in 1492. We expected to find ingredients and recipes in the Sephardic traditional medicine related to classical medicine and to modern ethnopharmacology of Spain, but also influenced by the host countries. Recipes for specific diseases could be compared with modern ethnopharmacology. Although the basic language of the recipes is Judeo-Spanish, it presents local variants and names which are not only dialectal Spanish, but also Turkish, Hebrew or Bosnian.

METHODS

The main source of information for Sephardic folk medicine are the specimens of the "Livro de Milizinas" printed in Thessaloniki and Smyrna (Izmir) during the 19th century. Others are some documents on pharmacy conserved in Bosnia associated to the Papo family of Sephardic Aktars or Attars (Ottoman herbalists) and the oral tradition in the Sephardic communities of Asia, Europe and the Americas. In order to analyze these formularies, we have studied the recipes in eleven different sources systematized in an Excel^® 2010 book. We focused on formulas that are not merely rituals instead contain specific ingredients and pathologies. Specific dictionaries were generated in Excel^® 2010, to standardize names of ingredients and pathologies.

RESULTS

In the 502 complete recipes and variants studied, 107 pathologies and 154 different ingredients appear. Among ingredients, 93 are plants, 38 animals and 23 mineral substances. The most common pathologies in the recipes correspond to infectious diseases, headache, epistaxis, parasites and the "espanto". These ingredients received 397 different vernacular names, being prevalent those in Spanish (303) followed by those in Turkish. Preparations recorded are simple, easily made at home, not requiring special tools or hardware. In studies dated 1845 in Bulgaria the forms of preparation and administration are similar. Topic preparations externally applied are prevalent in numbers doubling the oral administration on the contrary of modern ethnopharmacology studies in Thessaloniki where dominate internal uses over external ones. The books of medicines of Smyrna and Thessaloniki are very similar, if not almost identical. The "Livro de Milizinas" constitute a peculiar Sephardic text within the Ottoman style of medicine. The proximity in the analyses with Ottoman sources (Ottoman pharmacopoeias, Turkish Aktar shops and Medieval Cairo Jewish pharmacopoeia) is due to the high proportion of ingredients in common. After excluding animal and mineral ingredients of the analyses, modern ethnobotanical records from Greece and Turkey appear closer to the Sephardic main sources. The rest of Sephardic sources with notably smaller lists of ingredients represent fragments of mostly oral transmitted tradition and treat pathologies such as evil eye or "espanto". The recipes of the Sephardic of Bosnia comprise pathologies such as plague, cholera, typhus or gastroenteritis. Ingredients, largely of plant origin, to 93, are still in use in phytotherapy and/or local medical-pharmaceutical ethnobotany in Turkey or Greece.

CONCLUSIONS

The Sephardic materia medica presented in the "Livro de Milizinas" is eclectic, adapted to an urban environment and to the prevalent pathologies of the second half of the 19th century, within the main cultural framework of the Ottoman Empire but with peculiarities characteristic of Sephardic Culture. These can be traced back to the period immediately after the expulsion of Sephardic from Spain. Their relationships with other modern sources are scarce, even in terms of pathologies.

Dietary Supplement Use in a Large, Representative Sample of the US Armed Forces

BACKGROUND

Dietary supplement (DS) use is prevalent among the US Armed Forces personnel, but representative cross-service comparisons and characteristics of personnel using DSs are limited.

OBJECTIVE

Examine DS use and characteristics associated with use in a representative sample of US Armed Forces personnel (Army, Navy, Air Force, Marine Corps, and Coast Guard) using data from the 2011 Department of Defense Survey of Health-Related Behaviors.

DESIGN AND PARTICIPANTS

A stratified random sample of service members (SMs) was contacted and asked to complete a questionnaire assessing personal characteristics and DS use.

RESULTS

Overall, 69% of the 39,877 SMs reported using DSs ≥1 time per week. The most commonly used DSs were multivitamin or multiminerals (50%), antioxidants (34%), individual vitamins or minerals (33%), bodybuilding supplements (27%), fish oils (26%), herbals (16%), and weight-loss supplements (16%). Multiple logistic regression indicated overall DS use was higher among women, those with higher educational levels, Marine Corps SMs, officers, those with higher body mass index, those engaged in greater physical activity and weight training, and people in weight control programs. DS use was lower when peer groups or leadership discouraged substance abuse.

CONCLUSIONS

DS use was considerably higher in the US Armed Forces compared with civilian populations, although many demographic and lifestyle factors associated with use were similar. Some categories of DSs extensively used by SMs such as bodybuilding supplements have been associated with adverse events. Discouraging substance abuse through peer groups and leadership actions may reduce use of unnecessary or dangerous DSs.

Integrative Dermatology - The Use of Herbals and Nutritional Supplements to Treat Dermatological Conditions

From humble beginnings at the dawn of time to it's advanced and successful status today, this essay traces the history of natural medicine and the development of integrated dermatology to what it is today. Some of the most well-known natural (international and Australian) products with an application in dermatology are discussed. The history and functions of the Psoriasis Eczema Clinic and the products developed by its founder, Prof. Michael Tirant, are explained.

Ethnopharmacological survey of home remedies used for treatment of hair and scalp and their methods of preparation in the West Bank-Palestine

Background

Natural products have many uses and purposes, including those linked to pharmaceutics and cosmetics. The aim of this study was to investigate the use of natural remedies for the treatment of hair and scalp disorders in the West Bank, Palestine.

Methods

An ethnopharmacological survey of herbal remedies and other natural products used in cosmetics and cosmeceuticals was carried out in the West Bank, Palestine. A questionnaire was distributed to 267 herbalists, traditional healers, hairdressers and rural dwellers. Collected information included: the names of plants and other natural products, the parts used, hair conditions, diseases and problems for which these products were used and also their methods of preparation. To identify the most important species used, the factor of informant’s consensus (F_ic), fidelity level (Fl) and the use-value (UV) were calculated.

Results

Collected data showed that 41 plants are utilized for the treatment of hair and scalp disorders, belonging to 27 families; among them Lamiaceae and Rosaceae, which were the most commonly used. Plant oils and their fruits are the most commonly used parts. Hair loss, dandruff, split hair endings and lice treatment, are reported as the most treated disorders. The number of plant species used consisted of 19, 14, 13, and again 13 with a factor of informant’s consensus (Fic) for these disorders corresponding to 0.93, 0.94, 0.95 and 0.92, respectively. Fl was 100% for many plants; the highest UV value (0.84) was registered for Lawsonia inermis, which belongs to the Lythraceae family.

Conclusions

This study showed that many natural remedies are still used in Palestine for the treatment of scalp and hair disorders as well as for cosmeceutical purposes. This study is of great importance as it allows us to have a greater perspective on our folkloric use of these natural products. A combined scientific effort between informants and the scientific community, working in this field, may help in the discovery of new cosmetics, cosmeceutical and nutraceutical products.

Use of lipid-lowering medicinal herbs during pregnancy: A systematic review on safety and dosage

BACKGROUND

Hyperlipidemia is one of the important diseases in pregnancy that causes fetal abnormalities during pregnancy and after the birth. Unfortunately, the usual anti-fat drugs are associated with high morbidity in fetus and due to people's inclination towards taking herbs, it is required to identify side effects of medicinal herbs in pregnancy. The aim of this study was to present hypolipidemic herbs that would not any complications for mother and fetus.

METHODS

In this review article, the major electronic databases such as EBSCO, Central Register of Controlled Trials (CENTRAL), China Network Knowledge Infrastructure (CNKI), Cochrane, Google scholar, MEDLINE, SciVerse, Scopus, and Web of Science were searched using the key words "herbal" and "hyperlipidemia", "herbal" and "pregnancy" matched by MeSH from their respective inceptions till September, 2016. Total of 1723 publications (145 review articles, 855 original research articles, and 723 abstracts) about the effect of herbals on hyperlipidemia and 682 publications (200 abstracts, 423 original research articles, and 59 review articles) about the effect of herbals in pregnancy were retrieved. At the end, a list of medicinal plants effective on hyperlipidemia alongside their effects on pregnancy was developed. Finally, the plants effective on hyperlipidemia and safe during pregnancy were determined and their dosage, complications, mechanism of action, and side effects were reported.

RESULTS

A total of 110 effective herbs on hyperlipidemia were identified and complications of 95 plants in pregnancy were studied. At last, among the 55 selected plants effective on hyperlipidemia and examined for pregnancy, we reported 12 herbs with their dosage and special considerations that can be used to treat hyperlipidemia during pregnancy.

CONCLUSION

Some medicinal plants can be used to treat hyperlipidemia during pregnancy without any significant side effects both on mother or fetus.

Potential role of nutraceutical compounds in inflammatory bowel disease

Conventional therapies for inflammatory bowel diseases (IBD) involve combinations of pharmacologic agents such as aminosalicylates, azathioprine, and corticosteroids. Recently, the therapeutic scenario has been heavily increased by the introduction of agents including monoclonal antibodies targeted to specific proinflammatory cytokines, to adhesion molecules, and the induction of anti-inflammatory cytokines and T-cell activation. However, the use of these drugs is accompanied by a certain number of side effects, with some of them being quite severe, rising concerns about the safety profile. Furthermore, the cost of these emerging therapeutic strategies is significant , considering the increasing incidence and the chronic trend of IBD. Nutraceuticals is a broad term used to describe any product derived from food sources claiming extra health benefits beyond the intrinsic nutritional value found in foods. The beneficial effects of nutraceutical compounds in human health have been emerging in the last decades. Although few clinical trials have been performed in IBD patients, nutraceuticals, such as herbal products or vitamins, are generally accepted as safer alternative/supplementation to conventional therapy. In vitro and IBD-animal models studies have shown their involvement in several biological processes, including antioxidant defenses, cell proliferation, gene expression, which could account for a role in the maintenance of the mucosal barrier integrity, the control of the inflammatory pathways and the modulation of the immune response. These data suggest a wide spectrum of positive effects exerted by nutraceuticals, with a high potential for a therapeutic use in humans. In the present review, the beneficial effects of the most investigated nutraceutical compounds in the setting of human IBD are discussed.

Herbal and Dietary Supplement-Induced Liver Injury

The increase in the use of herbal and dietary supplements (HDSs) over the last decades has been accompanied by an increase in the reports of HDS-associated hepatotoxicity. The spectrum of HDS-induced liver injury is diverse and the outcome may vary from transient liver test increases to fulminant hepatic failure resulting in death or requiring liver transplant. There are no validated standardized tools to establish the diagnosis, but some HDS products have a typical clinical signature that may help to identify HDS-induced liver injury.

Is there nothing new under the sun? The influence of herbals and pharmacopoeias on ethnobotanical traditions in Albacete (Spain)

ETHNOPHARMACOLOGICAL RELEVANCE

This paper has two overarching aims: (1) presenting the results of studying the Albacete tariff of medicines of 1526 and (2) broadly analyzing the origin and influences of medicinal traditional knowledge in the region of Albacete, Spain. We use historical and modern literature that may have influenced this knowledge. Our primary goal was to determine the ingredients used in the pharmacy in the 16th century CE in Albacete through the analysis of the tariff, and our secondary goal was to investigate until when ingredients and uses present in pharmacy and herbals persisted in later periods.

METHODS

The identity of medicines and ingredients was determined by analyzing contemporary pharmacopoeias and classical pharmaceutical references. We analyzed further 21 sources (manuscripts, herbals, and books of medicines, pharmacopoeias, pharmacy inventories, and modern ethnobotanical records) for the presence/absence of ingredients and complex formulations of the tariff. Using factorial and cluster analysis and Bayesian inference applied to evolution models (reversible-jump Markov chain Monte Carlo), we compared textual sources. Finally, we analyzed the medicinal uses of the top 10 species in terms of frequency of citation to assess the dependence of modern ethnobotanical records on Renaissance pharmacy and herbals, and, ultimately, on Dioscorides.

RESULTS

In Albacete 1526, we determined 101 medicines (29 simple drugs and 72 compound medicines) comprising 187 ingredients (85% botanical, 7.5% mineral, and 7.5% zoological substances). All composed medicines appear standardized in the pharmacopoeias, notably in the pharmacopoeia of Florence from 1498. However, most were no longer in use by 1750 in the pharmacy, and were completely absent in popular herbal medicine in Albacete 1995 as well as in Alta Valle del Reno (Italy) in 2014. Among the ingredients present in different formulation are the flowers of Rosa gallica, honey (Apis mellifera), the roots of Nardostachys jatamansi, and Convolvulus scammonia, pistils of Crocus sativus, grapes and raisins (Vitis vinifera), rhizomes of Zingiber officinale, bark of Cinnamomum verum, leaves and fruits of Olea europaea, mastic generally of Pistacia lentiscus, and wood of Santalum album. The statistical analysis of sources produces four well-separated clusters (Renaissance Herbals and Pharmacopoeias, Ethnobotany and Folk Medicine, Old phytotherapy, and Modern phytotherapy including Naturopathy) confirming our a priori classification. The clade of Renaissance Herbals and Pharmacopoeias appears separated from the rest in 97% of bootstrapped trees. Bayesian inference produces a tree determined by an initial set of two well-distinct core groups of ingredients: 64, locally used in Mediterranean Europe during centuries; and 45, imported, used in pharmacy during centuries. Complexity reached its maximum in Albacete 1526 and contemporary pharmacopoeias, gradually decreasing over time. The analysis of medicinal uses of the top 10 ingredients showed low coincidence between Dioscorides and different Renaissance herbals or medical treatises and of all of them with ethnobotany in Albacete.

CONCLUSIONS

Regarding our question: is there something new under the sun? In some aspects, the answer is "No". The contrast between expensive drugs, highly valued medicines, and unappreciated local wild medicinal plants persists since the Salerno's school of medicine. Old medicine in Mediterranean Europe, as reflected by Albacete 1526 tariff of medicines, involved strict formulations and preferences for certain ingredients despite other ingredients locally available but underappreciated. This confirms the fact that any system of medicine does not get to use all available resources. Ethnobiological records of materia medica, in rural areas of Albacete, describe systems with a high degree of stability and resilience, where the use of local resources, largely wild but also cultivated, is predominant in contrast with the weight of imported exotic products in pharmacy.

Anti-Inflammatory and Antimicrobial Effects of a Novel Herbal Formulation (WSY-1075) in a Chronic Bacterial Prostatitis Rat Model

PURPOSE

The aim of this study was to investigate the anti-inflammatory and anti-oxidative effects of a multi-herbal formula known as WSY-1075 in the treatment of chronic bacterial prostatitis in a rat model.

MATERIALS AND METHODS

Experimental chronic bacterial prostatitis was induced in 32 Wistar rats by instillation of a bacterial suspension (Escherichia coli, 10⁸ colony-forming units [CFU]/mL) into the prostatic urethra. After the induction of prostatitis, the rats were randomly divided into one of 4 treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (400 mg/kg) (n=8), and WSY-1075 (400 mg/kg)+ciprofloxacin (n=8). After 4 weeks of treatment, microbiological data from prostate tissue cultures, level of prostatic pro-inflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin [IL]-6, and IL-8), anti-oxidant effects (superoxide dismutase [SOD]), and histological findings were noted.

RESULTS

The WSY-1075, ciprofloxacin, and WSY-1075+ciprofloxacin groups showed fewer CFUs in prostate tissue cultures than the control group. The WSY-1075, ciprofloxacin and WSY-1075+ciprofloxacin groups showed statistically significantly lower levels of the pro-inflammatory cytokines TNF-α, IL-6, and IL-8 than the control group. SOD levels in the WSY-1075, ciprofloxacin and WSY-1075+ciprofloxacin groups were significantly higher than in the control group.

CONCLUSIONS

This study found that WSY-1075 had anti-microbial effects, anti-inflammatory effects, and anti-oxidative effects in a chronic bacterial prostatitis rat model. We expect the WSY-1075 may be useful for the clinical treatment of chronic bacterial prostatitis.

Spirits and liqueurs in European traditional medicine: Their history and ethnobotany in Tuscany and Bologna (Italy)

ETHNOPHARMACOLOGICAL RELEVANCE AND BACKGROUND

Fermented drinks, often alcoholic, are relevant in many nutritional, medicinal, social, ritual and religious aspects of numerous traditional societies. The use of alcoholic drinks of herbal extracts is documented in classical pharmacy since the 1st century CE and it is often recorded in ethnobotanical studies in Europe, particularly in Italy, where are used for a wide range of medicinal purposes. Formulations and uses represent a singular tradition which responds to a wide range of environmental and cultural factors.

AIMS

This research has two overarching aims To determine how long ancient uses, recipes and formulas for medicinal liqueurs from the pharmacopoeias and herbals of the 18th century persisted in later periods and their role in present ethnobotanical knowledge in areas of Tuscany and Emilia-Romagna (Italy). To trace other possible relationships among ancient and recent recipes of alcoholic beverages, from both popular and 'classic' (learned) sources in N-C Italy and neighboring areas.

METHODS

The review of herbals and classical pharmacopoeias, and ethnobotanical field work in Alta Valle del Reno (Tuscany and Emilia Romagna, Italy) were followed of a systematic study of ingredients and medicinal uses with multivariate analysis techniques.

RESULTS

The multivariate analysis clearly shows six different styles of preparing medicinal alcoholic beverages: 1. The medicinal wine formulae by Dioscorides (1st century CE). 2. The pharmacopoeias of Florence and Bologna in the 18th century CE. 3. The formularies of Santa Maria Novella and Castiglione (19th and early 20th centuries CE). 4. The ethnobotanical data from Appennino Tosco-Emiliano; home-made formulations based almost exclusively on the use of local resources. 5. Traditional recipes from NE Italy and Austria. 6. Traditional recipes from NW Italy, Emilia, and Provence (France). A total of 54 ingredients (29 fruits) from 48 species are used in different combinations and proportions in Alta Valle del Reno (Italy) to produce fermented beverages, liqueurs, distilled spirits and aromatized wines. Among these, 37 ingredients (33 species) are used as medicinal remedies. 15 ingredients (14 species) are also used to prepare specific medicinal liqueurs. Most are addressed to the treatment of diseases of the digestive system, dyspepsia in particular, followed by diseases of the respiratory system symptoms, not elsewhere classified and diseases of the skin and subcutaneous tissue, fundamentally of allergic origin.

CONCLUSIONS

Although medicinal wines, liqueurs and spirits are recorded in numerous classical herbals and pharmacopoeias in Italy and other countries of Europe these show in terms of formulations and ingredients little influence in the ethnobotanical formulations recorded in Alta Valle del Reno (Italy), they apparently play no role in present ethnobotanical knowledge in Appennino Tosco-Emiliano and similarly in other areas of Italy, France and Austria. No (or very poor) persistence was found of ancient uses, recipes and formulas for medicinal liqueurs from pharmacopoeias and herbals of the 16th century CE in later periods in the formulas in use in the pharmacies of Tuscany. Popular recipes are strongly dependent on the availability of local wild and cultivated plants. Overall, Alta Valle del Reno ethnobotanical formulations of medicinal wines and spirits are extremely simple involving from one single ingredient to a few, which are locally produced or collected and selected among relevant medicinal resources used for a wide range of diseases in form of non-alcoholic aqueous extracts. Fruits gathered in the forests are the main ingredients which in this aspect show similarities with those from Tyrol (Austria). Medicinal liqueurs and wines are in analyzed ethnobotanical data mainly employed as digestives.

Risk assessment on the use of herbal medicinal products containing pyrrolizidine alkaloids

Pyrrolizidine alkaloids (PA) are common plantal toxins directed against insect herbivores. Unsaturated PAs are known to be hepatotoxic. Many of the PAs are in addition mutagenic and some may possibly be carcinogenic for humans. The risk of an exposure to PAs associated with their occurrence in herbal medicinal products and in foodstuff is under current discussion. The present risk assessment for herbal medicinal products containing PAs is based on a margin of safety derivation for foodstuff indicating that a life-long exposure to maximally 0.007 μg/kg bw/day is not expected to be associated with safety concerns. This approach offers a possibility to estimate the potential risk of PA-containing herbal medicinal products irrespective of the route of administration. It assumes PA levels in the final herbal medicinal product below 0.01 ppm and considers for dermal administration a 100% skin penetration of the PAs reflecting a worst-case scenario. As a result, the calculated margins of safety show a potential exposure using herbal medicinal products 70-, 45.5-, and 19.3-fold lower on a one-day base and 608-, 396-, and 168- fold lower on a one-year base for adults, children aged 12 years, and children aged 4 years, respectively, than the thresholds considered acceptable for foodstuff.

Cissus verticillata (L.) Nicolson and C.E. Jarvis (Vitaceae): Its identification and usage in the sources from 16th to 19th century

ETHNOPHARMACOLOGICAL RELEVANCE

Cissus verticillata (L.) Nicolson and C.E. Jarvis is best known for its hypoglycaemic and anti-lipemic action. In Brazilian ethnopharmacy it is called "plant-insulin" and used mostly against diabetes, as well as in abscesses, haemorrhage and epilepsy. In the present paper we study the past significance of this plant recorded between 1571 and 1829 both in ethnic (Mexico, Haiti) and official (European) pharmacies.

AIM OF THE STUDY

(1) We are able to identify Carolus Sanctus and Lupulus Mechiocanus from Renaissance and later sources as Cissus verticillata. The specific identity of its historical herbal stock has not been proposed yet. (2) The identification we propose enables us to extract a number of historical ethnopharmacological usages from historical texts, not mentioned so far. (3) We try to find links between historical and present popular usages of C. verticillata.

MATERIAL AND METHODS

The identity of Carolo Sancto and Lupulus Mechiocanus as Cissus verticillata has been proposed on the grounds of: (1) analysis of pre-Linnaean synonymic polynomials, (2) critical evaluation of old illustrations in botanical and pharmaceutical works, compared to living plants, (3) comparison of morphological, anatomical and histochemical characters of C. verticillata with old pharmacognostical descriptions of the plant and the herbal stock which it delivered.

RESULTS

We have recognised the specific identity on the basis of: (1) subsequent botanical works published between 1574 and 1763; (2) Hans Sloane׳s herbarium specimen No. BM589925; (3) morphology and organoleptic characteristics of the bark and roots published in the 16th and 17th century which are confirmable in living plants. Cissus verticillata was discovered by Nicolás Monardes in Mexico in 1571 and first published in Europe under the name Carolo Sancto in 1574. In European pharmacy the plant was also called Lupulus Mechiocanus. In official European pharmacy the root (Radix Caroli Sancti=Rad. Indica, later its sole bark) was appreciated for its action to teeth and gums when chewed. Internal usages (ascribed initially to this medicament) were gradually discarded in the late 1700s. Roots were met in the European trade until 1795.

CONCLUSIONS

Cissus verticillata is common in Americas and could have been imported to Europe since the 16th century. Complete plants were not seen knowingly in European pharmacy; taxonomical investigation of this species developed independently. Ethnopharmacological usages described between 1582 and 1829 were not adopted in Europe with the exception of two recommendations: "weakness of the stomach" and fevers. Gastroprotective and anti-inflammatory actions were re-discovered in the 2000s. Two other historical usages: antiepileptic and styptic, are observed in today׳s ethnomedicine of Brazil.

The use of the local flora in Switzerland: a comparison of past and recent medicinal plant knowledge

ETHNOPHARMACOLOGICAL RELEVANCE

This analysis of documented medicinal plants of the Swiss Flora over the last two millennia provides a rich source of knowledge on earlier uses of plants and use patterns of the local flora. We ask which local plant species were used during different time periods of the last 2000 years and how the numbers of species and the use intensity of specific plant families, growth forms and habitats changed over time.

MATERIALS AND METHODS

Totally 25 herbals from the antiquity, monastic medicine, Renaissance, early modern era and the contemporary time as well as five recent ethnobotanical studies were considered. Use patterns were analysed with the Bayesian approach.

RESULTS

A total of 768 species, i.e. 32% of the vascular plants of the Swiss Flora have been documented as medicinal plants. Numbers increase until the monastic period (366 spp.) and the Renaissance (476) and remain relatively stable since then (modern and contemporary era: 477). But, 465 formerly documented species do not occur in the ethnobotanical studies and thus seem not to be used any more. Overall, 104 species are documented through all time periods. Archeophytes, trees and forest plants are generally overrepresented in herbals from all time periods while plants from above the timberline are generally underrepresented. Most widely used are the Lamiaceae and Apiaceae.

CONCLUSION

A constant body of medicinal plant knowledge in Switzerland exists since ancient time. This knowledge was always influenced by knowledge from neighboring countries and no "typical Swiss specialties" seem to exist. Medicinal plants are not randomly chosen from the available flora. Certain species are deliberately introduced others are neglected. This process, which is still ongoing, can be traced back with the help of herbals to the antiquity.

Women: medicine, their kidneys, and nephrology

As an act of compassion, the art of caring for the sick has always depended on women. As a practical tradition of healing skills, the "wise" and "old" women of antiquity were the original founders of what would ultimately become medicine. Throughout the subsequent millennia that it took for the gradual transformation of the healing skills from a craft to a profession, women continued to contribute to its progress and development. Unfortunately, recorded history has marginalized much of their fundamental contributions because most extant and investigated medical texts of the past were authored by men. As medicine began to embrace the basic sciences and became a university-based and regulated profession, rules excluding women from entry into the profession were made stricter and more rigorously enforced. It is only in the latter half of the 19th century that, in the footsteps of the growing feminine movement, women were admitted to medical schools, and in the 20th century that they began to contribute in earnest to the science of medicine. This article recounts this progress and highlights how it affected our knowledge of kidney disease in women and the enlarging role of women in the relatively new discipline of nephrology.

The Anti-Inflammatory Effects of a New Herbal Formula (WSY-1075) in a Nonbacterial Prostatitis Rat Model

PURPOSE

The aim of this study was to investigate the anti-inflammatory effects of a new herbal formula (WSY-1075) in a nonbacterial prostatitis rat model.

MATERIALS AND METHODS

Prostatitis was induced in male Wistar rats (n=32) by treatment with 17 beta-estradiol and dihydrotestosterone for 4 weeks. After the induction of prostatitis, the rats were randomly divided into one of four treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (100 mg/kg) (n=8), and WSY-1075 (400 mg/kg) (n=8). After 4 weeks of treatment, the prostatic proinflammatory cytokine (tumor necrosis factor-α, interleukin [IL]-6, and IL-8) levels and histological findings were noted.

RESULTS

The ciprofloxacin and WSY-1075 treatment groups showed significantly decreased proinflammatory cytokine levels compared with the control group. Histologically, treatment with ciprofloxacin and WSY-1075 significantly suppressed the severity of prostatitis lesions compared with those in the control group. No differences in the proinflammatory cytokine levels or histologic findings were observed with the dose dependent treatment of WSY-1075.

CONCLUSIONS

The new herbal formula, WSY-1075, showed effective anti-inflammatory activities in the prostate and may be useful for the clinical treatment of nonbacterial prostatitis. Our findings suggest that WSY-1075 has a beneficial effect on the prevention and treatment of nonbacterial prostatitis.

Dietary supplements and herbal medicine toxicities-when to anticipate them and how to manage them

BACKGROUND

Dietary supplements and herbal medicines are gaining popularity in many developed countries.

AIMS

Although most can be used without any problem, serious toxicities do occur.

METHODS

Problems can be anticipated when they are used for non-traditional indications, at excessive dose, for prolonged duration, or by patients who are also on multiple modern pharmaceuticals. Problems should also be anticipated when these products claim to be able to relieve symptoms rapidly or when herbs with pronounced pharmacological effects or toxic components are used.

RESULTS

Resuscitation, symptomatic and supportive care are the most important aspects of management of toxicities from these products.

CONCLUSION

This article reviews when problems with these products can be anticipated and outlines a practical approach to management.