Medicines, Volume 4, Issue 4 (December 2017) – 25 articles

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM. Full article

Background: In the pre-Hellenistic period, the concept of medicine was not well-defined. Usually, a disease was considered as a divine punishment and its treatment was devolved to the priests who asked for healing from the divinities. The only job that could be compared to medical practice was a kind of itinerant medicine, derived from the Egyptian therapeutic tradition based only on practical experience and performed by people that knew a number of remedies, mostly vegetable, but without any theoretical bases about the possible mechanisms of action. Opinions about the human nature (naturalistic thinking) and the origin of the illness and heal were the basis of Greek medicine practiced by ancient priests of Asclepius. However, with the evolution of the thought for the continuous research of “κόσμος” (world) knowledge, philosophy woulld become an integral part of medicine and its evolution. This close relationship between philosophy and medicine is confirmed by the Greek physician Galen in the era of the Roman Empire. Methods: Philosophical thought looked for world knowledge starting from mathematics, physics, astronomy, chemistry, medicine, psychology, metaphysics, sociology, and ethics. We must keep in mind that, according to the ancient people, the physicians could not heal the patients without the aid of a “divine God” until medicine, thanks to the Hippocratic practice, became more independent from the supernatural, and contemporary, ethical, and professional. Many physicians were philosophers, as confirmed by their views of life, such as Hippocrates of Cos, Aristotle (hailed as the father of comparative anatomy and physiology), Pythagoras of Samos, Alcmaeon of Croton, Empedocles, Praxagoras, Erasistratus, Galen, and others, including Asclepiades of Bithynia (atomists affinity). Asclepiades, a Greek physician born in Prusa, studied in Athens and Alexandria. His thought was influenced by Democritus’ theories, refusing extensively the Hippocratic ideas that diseases are a result of mood imbalance. Results: Differing from the current Hippocratic idea, only in extreme cases he prescribed medications and bloodletting, two of the most-used therapies of that time. He usually prescribed therapies based on the Epicurean thought, then consisting of walks and music, massages, and thermal baths. He anticipated the modern idea of the body consisting of atoms, and believed that between the atoms exist empty spaces called pores. As the founder of the so called Methodist School, he was the first to divide acute and chronic diseases, and thought that body weakness was dependent on the excessive width of the pores, while their excessive shrinkage determines fever. According to his student Caelius Aurelianus he was the first to adopt tracheotomy as an emergency therapy for diphtheria. Conclusions: Although it is very difficult to reconstruct the theories of Asclepiades of Bithynia because of the lack of original texts, this paper attempts to focus his role and his thought in affirming the Greek medical practice in ancient Rome and to highlight his modernity. Full article

Background: Paracetamol overdose/abuse as a result of self-medication is a common occurrence amongst people living in low/middle income countries. The present study was designed to investigate the hypolipidemic and cardioprotective potentials of Vernonia calvoana (VC) ethanol extract in acetaminophen (paracetamol)-treated rats. Methods: Thirty-five Wistar rats weighing 100–150 g were randomly assigned into five groups of seven rats each. Groups 2–5 received high doses of paracetamol to induce liver damage, while group 1 was used as normal control. Afterwards, they were allowed to receive varying doses of VC (group 3 and 4) or vitamin E (group 5), whilst groups 1 and 2 were left untreated. The treatment period lasted for twenty one days after which sera were harvested and assayed for serum lipid indices using standard methods. Results: Groups 3 to 5 treated animals indicated significant decrease (p < 0.001) in low density lipoprotein cholesterol (LDL-c), total cholesterol (TC) and triacylglycerol (TG) levels relative to the normal and acetaminophen-treated controls, the atherogenic index showed a significant decrease (p < 0.001) in all treated groups compared with normal and acetaminophen-treated controls. However, the VC- and vitamin E-treated groups showed significant (p < 0.001) increase in high density lipoprotein cholesterol (HDL-C) relative to the controls. Conclusions: Data from our study suggest that ethanol leaf extract of VC possesses probable hypolipidemic and cardioprotective effects. Full article

Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population. The pain management of the children with major burns challenges the skills of the personnel of every unit. Managing these wounds requires intensive therapeutic treatment for multi-organ dysfunction, and surgical treatment to prevent sepsis and other complications that further delay wound closure. Alternatives to the practice of donor site harvest and autografting for the treatment of severe burns and other complex skin defects are urgently needed for both adult and pediatric populations. This review article focuses on thermal burn pathophysiology and pain management and provides an overview of currently approved products used for the treatment of pediatric burn wounds. A new promising approach has been presented as a first-line therapy in the treatment of burns to reduce surgical autografting in pediatric patients. Full article

Background: Herbs have played a fundamental and essential role in the humans life since ancient times, especially those which are used as food and/or folk medicinedue to both their nutritive and curative properties.This study aimed to investigate new antilipase agents from tentraditional Palestinian edible and medicinal plants through inhibition of the absorption of dietary lipids. Methods: The anti-lipase activity for ten plants was evaluated and compared with the reference compound Orlistat by using the porcine pancreatic lipase inhibitory test which was conducted by using a UV-visible spectrophotometer. Results: The aqueous extracts of Vitis vinifera and Rhus coriaria had the highest antilipase effects with IC₅₀ values 14.13 and 19.95 mcg/mL, respectively. Meanwhile, the organic extract of Origanum dayi had an IC₅₀ value 18.62 mcg/mL. V. vinifera showed the highest porcine pancreatic lipase inhibitory effects when compared with Orlistat, which has an IC₅₀ value 12.38 mcg/mL. Conclusions: According to the obtained results, V. vinifera, R. coriaria, and O. dayi can be considered a natural inhibitors of the pancreatic lipase enzyme as well as new players in obesity treatment. In fact, these plants can be freely and safely consumed in a daily diet or can be prepared as nutraceutical formulations to treat or prevent of obesity. Full article

Background: The present study was conducted to investigate the antinociceptive activity of methanol extract of Macaranga denticulata (Met.MD) in an animal model, followed by molecular docking analysis. Methods: Antinociceptive activity was determined by acetic acid-induced writhing and formalin-induced licking test in mice. Then, molecular docking study was performed to identify compounds having maximum activity against the COX-1 enzyme using Schrödinger Maestro (version 10.1) to determine docking fitness. Results: A preliminary phytochemical analysis of Met.MD revealed that it contained alkaloids, carbohydrates, phenols, flavonoids, tannins, and terpenoids. Met.MD exhibited a dose-dependent and statistically significant antinociceptive activity in the acetic acid and formalin test at the doses of 200 and 400 mg/kg. In addition, our docking study showed that macarangin had the best fitness score of −5.81 with COX-1 enzyme among six major compounds of M. denticulata. Conclusions: Results of the present study confirmed the potential antinociceptive activity of M. denticulata leaf extract in both in vivo and in silico models. Full article

Mesenchymal stromal cells are a population of undifferentiated multipotent adult cells possessing extensive self-renewal properties and the potential to differentiate into a variety of mesenchymal lineage cells. They express broad anti-inflammatory and immunomodulatory activity on the immune system and after transplantation can interact with the surrounding microenvironment, promoting tissue healing and regeneration. For this reason, mesenchymal stromal cells have been widely used in regenerative medicine, both in preclinical and clinical settings. Another clinical application of mesenchymal stromal cells is the targeted delivery of chemotherapeutic agents to neoplastic cells, maximizing the cytotoxic activity against cancer cells and minimizing collateral damage to non-neoplastic tissues. Mesenchymal stem cells are home to the stroma of several primary and metastatic neoplasms and hence can be used as vectors for targeted delivery of antineoplastic drugs to the tumour microenvironment, thereby reducing systemic toxicity and maximizing antitumour effects. Paclitaxel and gemcitabine are the chemotherapeutic drugs best loaded by mesenchymal stromal cells and delivered to neoplastic cells, whereas other agents, like pemetrexed, are not internalized by mesenchymal stromal cells and therefore are not suitable for advanced antineoplastic therapy. This review focuses on the state of the art of advanced antineoplastic cell therapy and its future perspectives, emphasizing in vitro and in vivo preclinical results and future clinical applications. Full article

Background: The Ayurvedic medicinal system employs a holistic approach to health, utilising the synergistic properties of organic resources. Research into the Ayurvedic herb Bacopa monnieri (L.) Wettst. (B.monnieri) has reported improvements in cognitive outcomes in child and adult populations. The aim of current review is to systematically assess and critically summarize clinical trials investigating B.monnieri-dominant poly-herbal formulas and their effects on the cognition, memory, learning, and behaviour in children and adolescents. Methods: Key word searches were performed using PubMed, Scopus, Cochrane Library, DHARA, and CINAHL for publications meeting inclusion criteria up to November 2017. There were no restrictions in study design. Effect sizes were calculated for all significant findings to allow for direct comparisons, and each study was evaluated on design quality. Cognitive and behavioural outcomes were grouped into validated constructs for cross-study comparison. Results: Nine trials met inclusion criteria. Five studies reported sufficient data for effect size analysis with most improvements reported in behavioural outcomes. True cognitive abilities and behavioural constructs were reviewed in six studies, with visual perception, impulsivity, and attention demonstrating the greatest improvements. The veracity of the evidence for the formulations reviewed is weakened by inconsistent statistical design and under-reporting of safety and tolerability data (44%). Conclusions: The current review extends research supporting B.monnieri as a cognitive enhancer and provides modest evidence for the use of B.monnieri in poly-herbal preparations for improving cognitive and behavioural outcomes in child and adolescent populations. Greater emphasis on statistical vigour and the reporting of tolerability data are essential for future trials to adequately document poly-herbal treatment efficacy. Full article

Background: This study investigated the combination effects of the Danshen and Sanqi herb pair on angiogenesis in vitro. Methods: Nine combination ratios of Danshen-Sanqi extracts (DS-SQ) were screened for their angiogenic effects in the human vascular endothelial EAhy 926 cell line via cell proliferation, cell migration and tube formation activities against the damage to the cells exerted by DL-homocysteine (Hcy) and adenosine (Ado). The type of interaction (synergistic, antagonistic, additive) between Danshen and Sanqi was analyzed using combination index (CI) and isobologram models. The angiogenic activities of key bioactive compounds from Danshen and Sanqi were tested in the same models. Results: DS-SQ ratios of 2:8 and 3:7 (50–300 µg/mL) potentiated angiogenic synergistic effects (CI < 1) in all three assays. The observed wound healing effects of DS-SQ 2:8 was significantly attenuated by phosphatidylinositol-3 kinases (PI3K), mitogen-activated protein kinase (MEK) and extracellular signal-regulated kinases (ERK) inhibitors which inferred the potential mechanistic pathways. Out of all the tested compounds, Notoginsenoside R1 from Sanqi exhibited the most potent bioactivity in cell proliferation assay. Conclusions: This study provides scientific evidence to support the traditional use of the Danshen-Sanqi combination for vascular disease, in particular through their synergistic interactions on previously unexamined angiogenic pathways. Full article

Background: Croton membranaceus extract has apoptotic effects on BPH-1 cells. This study determined if the apoptotic effects were created through the ceramide pathway. Methods: The study was a follow-up to a previous observational study of 30 histologically confirmed patients with benign prostatic hyperplasia (BPH) who were on C. membranaceus ethanolic extract at 20 mg t.i.d orally for 3 mo. Thereafter, total and free prostate-specific antigen (PSA), lipid profile plus Apo lipoprotein A and B, ceramide/Sphingophospho-kinase 1 (SphK1) and 2 (SphK2), sphingosine lyase (SPL), the cytotoxic adducts of oxidative stress 4-hydroxy-2-nonenal (4HNE) and malondialdehyde (MDA), were determined. Results: Total and free PSA were significantly (p < 0.05) different after treatment. Apo lipoprotein A was significantly different (p = 0.024). The SphK1/SphK2 ratio reduced significantly (p = 0.049). Furthermore, SPL, ceramide, and MDA increased significantly after treatment (p = 0.05, p = 0.004, and p = 0.007, respectively). A weak positive correlation was found between high-density lipoprotein (HDL) cholesterol and SphK1, and HDL and ceramide before treatment (p = 0.036, r = 0.3826; p = 0.018, r = 0.4286, respectively. Conclusions: C. membranaceus uses the ceramide pathway by modulating the SphK1/SphK2 ratio and increasing SPL to generate oxidative stress and consequently apoptosis. Full article

Background: Extensive surveys of several population settlements in different parts of India—covering plains, mountains, valleys, river banks and deeper areas of forests at different altitudes—between 1968 and 2016 demonstrated that the basic vital need of hunger is being fulfilled since antiquity by plants in the wild. Methods: Based on collections, consultations with local population personnel and literature searches, this paper presents many plants that are commonly used as food and focuses on their products, which are rich in alkaloids, polysaccharides, steroids, terpenoids, flavonoids, aminoacids, fatty acids and antibiotics etc. These complex organic compounds are suitable for the production of drugs for many ailments/diseases, including the prevention of cancers. Results: There are more than 100 families including several hundred plant taxa from various plant groups like angiosperms, bryophytes, pteridophytes, gymnosperms and even fleshy fungi, which have offered essential food items to ever-growing human populations since antiquity. Phytochemicals functioning as antioxidants are exceedingly beneficial to the human body but excess consumption of these compounds, adding higher levels of antioxidants, may even be responsible for chronic diseases including aging, cancer, cardiovascular diseases, rheumatoid arthritis, atherosclerosis, etc. These medicines can obviously be taken in small and prescribed quantities but can never be consumed as “food items.” Full article

Background: Acorus calamus (Sweet flag) is a known herbal drug commonly used in traditional medicine. Our aim was to perform seasonal and altitudinal phytochemical screening to assess the antioxidant activity of the essential oils in the rhizome and leaves of A. calamus from three different altitudes. Methods: Phytochemical screening was performed using GC/MS analysis and in vitro antioxidant assay was done by different methods. Results: The essential oils mainly contained α-asarone, β-asarone (35.3–90.6%), and Z-isoelemicin (1.7–7.3%) as the major constituents, besides linalool, Z-methyl isoeugenol, shyobunone, kessane, etc. All the oils exhibited vast molecular diversity in terms of quantitative ingredients. All essential oils were studied for their antioxidant activity by different methods, including their effect on the DPPH radical-scavenging activity, reducing power, and chelating properties of Fe²⁺. The oils isolated in all the different seasons exhibited antioxidant activity as a function of concentration, with IC₅₀ values ranging from 475.48 ± 0.08 to 11.72 ± 0.03 compared to standards. Conclusion : From the results obtained it can be inferred that the herb may be a good source of bioactive compounds and can work as an antioxidant to prevent oxidative deterioration in food. The data provide a basis for its in-situ investigation for judicious exploitation. Full article

Background: Phosphodiesterases (PDEs) play a major role in the regulation of cyclic adenosine monophosphate (cAMP)- and cyclic guanosine monophosphate (cGMP)-mediated pathways. Their inhibitors exhibit anti-inflammatory, vasodilatory and antithrombotic effects. Therefore, consumption of foods with PDE-inhibiting potential may possess beneficial influence on the risk of cardiovascular diseases. Methods: Four plant extracts (Arbutus unedo, Camellia sinensis, Cynara scolymus, Zingiber officinale) with promising ingredient profiles and physiological effects were tested for their ability to inhibit cAMP-specific PDE in vitro in a radioactive assay. Results: Strawberry tree fruit (Arbutus unedo) and tea (Camellia sinensis) extracts did not inhibit PDE markedly. Alternatively, artichoke (Cynara scolymus) extract had a significant inhibitory influence on PDE activity (IC₅₀ = 0.9 ± 0.1 mg/mL) as well as its flavone luteolin (IC₅₀ = 41 ± 10 μM) and 3,4-dicaffeoylquinic acid (IC₅₀ > 1.0 mM). Additionally, the ginger (Zingiber officinale) extract and one of its constituents, [6]-gingerol, significantly inhibited PDE (IC₅₀ = 1.7 ± 0.2 mg/mL and IC₅₀ > 1.7 mM, respectively). Crude fractionation of ginger extract showed that substances responsible for PDE inhibition were in the lipoid fraction (IC₅₀ = 455 ± 19 μg/mL). Conclusions: A PDE-inhibitory effect was shown for artichoke and ginger extract. Whether PDE inhibition in vivo can be achieved through ingestion of artichoke or ginger extracts leading to physiological effects concerning cardiovascular health should be addressed in future research. Full article

The biopsychosocial model is a modern humanistic and holistic view of the human being in health sciences. Currently, many researchers think the biopsychosocial model should be expanded to include the spiritual dimension as well. However, “spiritual” is an open and fluid concept, and it can refer to many different things. This paper intends to explore the spiritual dimension in all its meanings: the spirituality-and-health relationship; spiritual–religious coping; the spirituality of the physician affecting his/her practice; spiritual support for inpatients; spiritual complementary therapies; and spiritual anomalous phenomena. In order to ascertain whether physicians would be willing to embrace them all in practice, each phrase from the Physician’s Pledge on the Declaration of Geneva (World Medical Association) was “translated” in this paper to its spiritual equivalent. Medical practice involves a continuous process of revisions of applied concepts, but a true paradigm shift will occur only when the human spiritual dimension is fully understood and incorporated into health care. Then, one will be able to cut stereotypes and use the term “biopsychosocial–spiritual model” correctly. A sincere and profound application of this new view of the human being would bring remarkable transformations to the concepts of health, disease, treatments, and cure. Full article

Background: It has been postulated that during liver and kidney damage there is a decreased in the antioxidant status associated with a simultaneous increase in the reactive oxygen species and lipid peroxidation. In consonant with this, Capecitabine, an oral chemotherapy and inactive non-cytotoxic fluoropyrimidine considered for the treatment of advance colorectal cancer, has also been shown to induce oxidative stress in liver tissues. Caffeic acid, a typical hydroxycinnamic, has been claimed to be effective against oxidative stress. Therefore, this present work studied the protective effect of caffeic acid on oxidative stress-induced liver and kidney damage by the administration of capecitabine. Methods: Twenty-four male Wistar strain rats were randomly divided into four treatment groups: A. control, B. capecitabine (CPTB)-treated group (30 mg/kg b.w. CPTB), C. caffeic acid (CFA)-treated group (100 mg/kg b.w. CFA) and D. co-treated group with CFA (100 mg/kg b.w.) and CPTB (30 mg/kg b.w.). Results: Caffeic acid administration significantly ameliorated the elevated plasma biomarkers of hepatic and renal tissue damage induced by the capecitabine and improved enzymatic and non-enzymatic antioxidant levels in liver organ. Conclusions: The protective effect of caffeic acid could be attributed to its ability to boost the antioxidant defence system and reduce lipid peroxidation. Full article

Background: Musa acuminata fruit peels are used in the northern part of Nigeria for the treatment of hypertension and other cardiovascular related diseases. The effects of aqueous extracts of ripped fruit peel of three cultivars of Musa acuminata (Saro, Ominni and Oranta) on the hepatic and renal parameters of normal rats were examined. Methods: Fruit peel aqueous extracts (FPAE) of the 3 cultivars of Bananas (100 mg/kg b.w.) were administered by oral intubation (that is through esophageal cannula) to normal rats (140–180 g) for a period of 28 days. Blood samples were collected for determination of plasma aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase ALK-P), total protein, albumin, creatinine as well as urea. Results: From the results obtained, there were no significant (p < 0.05) changes in the ALK-P, AST, ALT, total protein and albumin among the experimental rats administered FPAE of the 3 cultivars of Musa acuminata when compared with the normal control group. There was a significant (p < 0.05) increase in the level of serum creatinine (in mg/dL) (1.53 ± 0.23) when compared to the normal control (0.72 ± 0.15), Ominni (0.92 ± 0.39) and Oranta (0.74 ± 0.22). Similarly, there was a significant (p < 0.05) increase in the level of serum urea (in mg/dL) of Saro (41.56 ± 4.68) when compared to the normal control (26.05 ± 0.73), Ommini (28.44 ± 2.43) and Oranta (26.10 ± 2.94). Conclusion: The findings reveal the Saro cultivar of Musa acuminata to be nephrotoxic and not a good potential drug candidate among the cultivars studied hence should be discouraged in the treatment of hypertension and other cardiovascular related diseases. Full article

The ethnomedicinal values of plants form the basis of the herbal drug industry. India has contributed its knowledge of traditional system medicines (Ayurveda and Siddha) to develop herbal medicines with negligible side effects. The World Health Organization has also recognized the benefits of drugs developed from natural products. Abutilon indicum, Hibiscus sabdariffa, Sida acuta and Sida rhombifolia are ethnomedicinal plants of Malvaceae, commonly used in Indian traditional system of medicines. Traditionally these plants were used in the form of extracts/powder/paste by tribal populations of India for treating common ailments like cough and cold, fever, stomach, kidney and liver disorders, pains, inflammations, wounds, etc. The present review is an overview of phytochemistry and ethnopharmacological studies that support many of the traditional ethnomedicinal uses of these plants. Many phytoconstituents have been isolated from the four ethnomedicinal plants and some of them have shown pharmacological activities that have been demonstrated by in vivo and/or in vitro experiments. Ethnomedicinal uses, supported by scientific evidences is essential for ensuring safe and effective utilization of herbal medicines. Full article

The present investigation was carried out to review and highlight the potential phytochemicals and medicinal phenomena of the critically endangered medicinal plant, Gentiana kurroo Royle of the western and north-western Himalayas. The medicinal plant is heavily exploited for root and rhizome. Due to its endemic nature and the high rate of exploitation from its natural habitat, this species had become critically endangered. The phytochemical screening of the plant revealed that the plant contains some vital phyto-constituents (iridoids, xanthones, C-glucoxanthone mangiferin, and C-glucoflavones) that have a medicinal value for various acute and chronic diseases. Several researchers have carried out experimental work to validate the folkloric use of the medicinal plant for different ailments like antibacterial, antioxidant, anti-arthritic, anti-inflammatory, analgesic activities and anti-diabetic activity. However, it is yet to be confirmed the antifungal activity of the same plant. Because of endemic nature and high rate of exploitation there is need for alternative method called bio-prospecting of Endophytes from the plant, to carry out the production and characterization of bioactive metabolites for pharmacological uses and can become a conservative tool for the medicinal plant. Full article

Background: Ocimum gratissimum (OG) is used in the traditional management of diabetes in Nigeria. This study investigated the anti-diabetic potential of OG leaf fractions (OGLF) in a rat model of Type-2 diabetes (T2D). Method: Methanol crude extract of OG leaf was fractionated with solvents of increasing order of polarity (n-hexane, chloroform, ethyl-acetate, n-butanol and water). The anti-diabetic potential of the fractions was evaluated in vivo. T2D was induced in Albino Wistar rats and treated with OGLF. Result: The T2D rats showed significant elevation in serum levels of fasting blood glucose (FBG), liver and kidney function biomarkers. At 4-weeks of intervention with OGLF, the untreated diabetic control group maintained severe hyperglycaemia in the presence of 61.7% serum insulin, 17.3% pancreatic β-cell function (HOMA-β) and 51.5% Insulin sensitivity. The glucose tolerance ability was enhanced in the n-butanol-fraction (OGb) treated group. With 74.8% available serum insulin and 38.6% improvement in insulin sensitivity, the OGb treated group had a 63.5% reduction in FBG and it was found to be most effective as it ameliorates a majority of the changes caused in the studied parameters in diabetic rats. Conclusions: The data from this study suggest that OGb fraction is a potential candidate for the development of an effective drug for the management of T2D. Full article

Background: Tai chi (TC) has been reported as being beneficial for improving balance post stroke, yet its utility in upper limb rehabilitation remains unknown. Methods: Twelve chronic stroke survivors with persistent paresis of an upper limb underwent 60 minutes of adapted TC twice a week for eight weeks, with a 4-week follow up. A 10-min TC home program was recommended for the days without sessions. TC level of performance, attendance to the sessions, duration of self-practice at home, and adapted TC movements used were recorded. Results: Eleven participants completed the study. A clinical reasoning algorithm underlying the adaptation of TC was elaborated throughout the trial. Participants with varying profiles including a severely impaired upper limb, poor balance, shoulder pain, and severe spasticity were not only capable of practicing the adapted TC, but attended all 16 sessions and practiced TC at home for a total of 16.51 ± 9.21 h. The degree of self-practice for subgroups with low upper limb function, shoulder pain, or moderate-to-severe spasticity was similar to that of subgroups with greater upper limb function, no shoulder pain, and minimal-to-no spasticity. Conclusion: Adapted TC seems feasible for upper limb rehabilitation post stroke. Although the study was based on a small sample size and requires confirmation, low upper limb function, insufficient balance, spasticity, and shoulder pain do not appear to hinder the practice of TC. Full article

Background: Arthritis is a chronic condition resulting in considerable disability, particularly in later life. Aims: The first aim of this review was to summarize and synthesize the research base concerning the use of Qigong exercises as a possible adjunctive strategy for promoting well-being among adults with arthritis. A second was to provide related intervention directives for health professionals working or who are likely to work with this population in the future. Methods: Material specifically focusing on examining the nature of Qigong for minimizing arthritis disability, pain and dependence and for improving life quality was sought. Results: Collectively, despite almost no attention to this topic, available data reveal that while more research is indicated, Qigong exercises—practiced widely in China for many centuries as an exercise form, mind-body and relaxation technique—may be very useful as an intervention strategy for adults with different forms of painful disabling arthritis. Conclusion: Health professionals working with people who have chronic arthritis can safely recommend these exercises to most adults with this condition with the expectation they will heighten the life quality of the individual, while reducing pain and depression in adults with this condition. Full article

Background: Protium species (Burseraceae) have been used in the treatment of various diseases and conditions such as ulcers and wounds. Methods: The essential oil from the oleoresin of Protium amazonicum was obtained by hydrodistillation and analyzed by GC-MS, GC-FID, and chiral GC-MS. P. amazonicum oleoresin oil was screened for antifungal activity against Candida albicans, Aspergillus niger, and Cryptococcus neoformans. Results: A total of 54 components representing 99.6% of the composition were identified in the oil. The essential oil was dominated by δ-3-carene (47.9%) with lesser quantities of other monoterpenoids α-pinene (4.0%), p-cymene (4.1%), limonene (5.1%), α-terpineol (5.5%) and p-cymen-8-ol (4.8%). Chiral GC-MS revealed most of the monoterpenoids to have a majority of levo enantiomers present with the exceptions of limonene and α-terpineol, which showed a dextro majority. P. amazonicum oleoresin oil showed promising activity against Cryptococcus neoformans, with MIC = 156 μg/mL. Conclusions: This account is the first reporting of both the chemical composition and enantiomeric distribution of the oleoresin essential oil of P. amazonicum from Ecuador. The oil was dominated by (−)-δ-3-carene, and this compound, along with other monoterpenoids, likely accounts for the observed antifungal activity of the oil. Full article

Abstract: Qigong is the meditative movement and therapeutic exercise of Eastern medicine. A growing body of evidence is validating its health benefits leading to mechanistic questions of how it works. The purpose of this article is to explore mechanisms of action related to Qigong, with the intent of unifying Eastern and Western exercise theory and to present a model for Qigong exercise analysis. Three exercises from a standardized Qigong form: ‘Plucking the Stars’, ‘Lotus Leaves Rustle in the Wind’, and ‘Pacing Forwards and Backwards’ were selected for meditative, energetic, and physical analyses. Meditative aspects include relaxation response, interoception and exteroception. Energetic aspects include stimulation of meridians through mental intent, acupressure, and self-massage. Physical aspects include flexibility, strength, articular stimulation, neuro-integration, respiratory effect, fascial stretch, visceral massage, balance challenge CranioSacral pump, lymphatic and venous return and glandular stimulation, and physiologic response to relaxation. Knowledge of mechanisms of action for specific Qigong exercises can guide operational definition of Qigong, selection of outcomes assessment in future research, inform prescriptive practice addressing clinical health issues, and advance adoption of Qigong practice within integrative health care. The model of analysis demonstrated in this discussion may assist in these endeavors. Full article