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02 PSNews 14 giugno 2010

Newsletter mensile di Materiali sulle Medicine non Convenzionali

A cura del centro di documentazione dell’Istituto Prosa - Spinea (VE)

Supplemento di Propulsione Salute

Registrazione del Tribunale di Venezia N°1243 del 06.11.96

Redazione: e.mail: istprosa@tin.it

Responsabile di redazione:

Sommario

Agopuntura

Omeopatia

Fitoterapia

Altre news

Agopuntura e rinite allergica

Brinkhausa B, Witt CM, Ortiza M et al.Acupuncture in Seasonal Allergic Rhinitis (ACUSAR) - Design and Protocol of a Randomised Controlled Multi-Centre Trial.Forsch Komplementmed 2010; Zhang CS, Yang AW, Zhang AL, et al.Ear-acupressure for allergic rhinitis: a systematic review.Clin Otolaryngol. 2010 Feb;35(1):6-12.

La rinite allergica stagionale colpisce una percentuale molto elevata della popolazione globale, con un impatto sostanziale sulla salute della comunità e sulla sanità pubblica. Qui di seguito due studi, uno tedesco e l'altro australiano, che approcciano il problema del trattamento della rinite allergica stagionale.

Il primo studio, di un gruppo di ricercatori tedeschi, tratta il disegno di un protocollo di studio multicentrico relativo all'utilizzo dell'agopuntura nella rinite allergica stagionale (ACUSAR) per valutarne l'efficacia rispetto alla sham-agopuntura e all'uso di farmaci sintomatici. Sono stati creati tre gruppi randomizzati e controllati, all'interno dello studio multicentrico, con un follow-up totale di 16 settimane per il primo anno e di 8 settimane per il secondo anno di studio, arruolando 41 medici agopuntori in 37 strutture specializzate in agopuntura sul territorio tedesco. Il numero di pazienti arruolati corrisponde a 400, tutti con sintomi clinici e test positivi (skin-prick test e/o IgE specifiche) a betulla e graminacee.I pazienti sono stati randomizzati con un fattore di 2:1:1 rispettivamente nel gruppo di semi-standardizzata agopuntura più trattamento farmacologico (cetirizina), sham agopuntura più trattamento farmacologico e solo trattamento farmacologico. per 8 settimane. I risultati sono stati misurati attraverso un questionario di qualità della vita e uno score sul trattamento farmacologico sintomatico tra la settimana 6 e 8 del primo anno di trattamento. I risultato saranno disponibili nel 2011 e potranno dare un consistente apporto sulla valutazione dell'efficacia dell'agopuntura nel trattamento della rinite allergica stagionale.

Il secondo studio, australiano, ha invece lo scopo di valutare l'efficacia e la sicurezza dell'agopuntura auricolare per il trattamento della rinite allergica, con una revisione sistematica della letteratura finora prodotta sull'argomento. Sono stati analizzati 21 database elettronici in inglese e cinese fino ad aprile 2008. La qualità metodologica è stata valutata in base alla Scala di Jadad. Dei 92 documenti così identificati, solo 7, relativi a 5 studi, sono stati inclusi nell'analisi. La randomizzazione era citata in tutti e cinque ma senza dettagli precisi su di essa. Nessuno degli studi ha previsto un sistema di cecità nè un'analisi intention-to-treat. I risultati dimostrano che l'auricolo agopuntura si è mostrata più efficace della fitoterapia, efficace quanto l'agopuntura tradizionale e gli antistaminici a livello degli effetti a breve termine, ma più efficace degli antistaminici per gli effetti a lungo termine. Gli autori concludono riferendo

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l'impossibilità di arrivare ad una valutazione certa dell'efficacia della tecnica, dovuta alla bassa qualità metodologica degli studi finora prodotti sull'argomento.

Agopuntura e lesioni del midollo spinale

Moldenhauer S,Burgauner M,Hellweg R,Lun A.Mobilization of CD1331CD342 Cells in Healthy Individuals Following Whole-Body Acupuncture for Spinal Cord Injuries.Journal of Neuroscience Research 88:1645-1650 (2010)

L'agopuntura può alleviare i sintomi delle lesioni a livello del midollo spiale (SCI): il meccanismo implicato è tuttavia sconosciuto. Gli autori di questo studio ipotizzano che le cellule staminali potrebbero essere "mobilizzate" dall'agopuntura. A questo scopo, hanno selezionato 14 soggetti sani e li hanno sottoposti ad agopuntura specifica per il trattamento delle SCI. SOno state determinati i livelli, prima e dopo agopuntura, di cellule CD133 e CD34 cells nel sangue periferico e la concentrazione sierica di (MMP)-9,BDNF,NGF e interleuchina-6, a intervalli di 1h, 24h e 48h. Dopo l'agopuntura le cellule CD1331342 risultavano raddoppiate al controllo delle 48 h, con una riduzione concomitante dei livelli di BDNF e MMP-9 levels. L'interleuchina-6 risultava sotto i livelli di rilevazioneInte. Gli autori concludono indicando che l'azione dell'agopuntura si esplica con la mobilizzazione delle cellule, e l'ipotesi che questo meccanismo sia alla base dei risultati positivi nella gestione delle lesioni del midollo spianle.

Agopuntura e dolore miofasciale

Dorsher PT.Myofascial Referred-Pain Data Provide Physiologic Evidence of Acupuncture Meridians. The Journal of Pain, Vol 10, No 7 (July), 2009: pp 723-731

Alcuni recenti studi pubblicati suggeriscono una sovrapposizione sostanziale a livello anatomico, clinico e fisiologico tra i trigger points miofasciali e i punti di agopuntura, soprattutto nel trattamento dei problemi relativi al dolore. Questo studio esamina la situazione sovraesposta con l'intento di scoprire se i dati ricavabili di trigger points, riferiti al dolore miofasciale, possono fornire un'evidenza fisiologica dei meridiani di agopuntura. I risultati dell'analisi fisiologica dimostrano, a detta degli autori, la corrispondenza esatta tra le regioni dei trigger points e le corrispondenze anatomiche dei punti di agopuntura con i 12 meridiani, garantendo così agli specialisti del trattamento del dolore una nuova prospettiva e nuovi approcci nella comprensione del dolore neurofisioligico.

Menopausa ed agopuntura

E B, S G, A W. Menopausal problems and acupuncture. Auton Neurosci. 2010 May 4.

Le vampate sono un problema comune nelle donne in post-menopausa. Il trattamento con estrogeni comporta significativi rischi clinici. L'ipotesi attuale relativa al loro funzionamento comprende una riduzione della zona termoneutrale che può essere combattuta con interventi che aumentino l'estrogeno, le endorfine o i livelli di serotonina, o diminuiscano i livelli di noroadrenalina. L'agopuntura presenta vari meccanismi con il potenziale di ridurre la frequenza delle vampate e la loro gravità. Lo studio ha quindi lo scopo di analizzare la letteratura finora prodotta sull'argomento. Sono stati inclusi 16 studi: analizzando i risultati dei vari studi, i ricercatori norvegesi concludono che l'agopuntura nel complesso si presenta efficace nel ridurre la frequenza e la gravità delle vampate. Ci sono però pochi dati che dimsotrino una specificità di punti per ottenere questo effetto. Ulteriori ricerche sono quindi necessarie per stabilire i vari punti oscuri, come l'esistenza di un effetto biologico della puntura nel trattamento delle vampate o meno, la superiorità dell'agopuntura personalizzata rispetto a quella standardizzata e così via.

Auricolo e infarto cerebrale

Li CF, Jia CS, Li XF, Shi J, Dou ZZ, Sun P. Section of Acu-moxibustion of the 3rd Hospital, Department of Acu-moxibustion, College of Chinese Medicine, China. [Effect of penetrative needling of otopoints combined with body acupuncture on limb myodynamia and neurofunction in patients with acute cerebral infarction] Zhen Ci Yan Jiu. 2010 Feb;35(1):56-60.

OBJECTIVE: To compare the therapeutic effects of different acupuncture methods in improving the myodynamia and neuronfunction of patients with acute cerebral infarction (ACI). METHODS: A total of 90 ACI patients were randomized into ear-acupuncture, scalp-acupuncture and body-acupuncture groups, with 30 cases in each. For patients of ear-acupuncture group, the main otopoints used for penetrative needling were Zhen(MA-AT)-Nie(MA-AT)-E(MA-AT) on the affected side in combination with Jian(MA-SF 4)-Suogu(MA-SF 5) and Zhou(MA-SF 3)-Wan(MA-SF 2)-Zhi(MA-SF 1) for upper-limb paralysis, and with Tun (MA-AH 5)-Zuogushenjing(MA-AH 6), Kuan(MA-AH 4)-Xi(MA-AH 3), and Xi(MA-AH 3)-Huai(MA-AH 2)-Zhi(MA-AH 1) for lower-limb paralysis, and body acupoints as Jianyu(LI 15), Hegu(LI 4),

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Huantiao(GB 30), Taixi(KI 3), etc. For patients of scalp-acupuncture group, scalp-points used were Dingnie Qianxiexian(MS 6) and Dingnie Houxiexian(MS 7) on the healthy side, and combined with body acupoints (the same as those mentioned above). For patients of body-acupuncture group, only body acupoints were used. The treatment was given once daily for 14 days. RESULTS: Comparison among 3 groups showed that the increased myodynamia of both upper and lower limbs in ear-acupuncture and scalp-acupuncture groups was significantly superior to that of body-acupuncture group (P < 0.01). The neurofunctional deficit scores of ear-acupuncture and scalp-acupuncture groups were significantly lower than that of body-acupuncture group (P < 0.01) after the treatment. In comparison with pre-acupuncture, the neurofunctional deficit scores of the 3 groups lessened considerably after the treatment (P < 0.01). Of the 30 cases in each of ear acupuncture, scalp-acupuncture and body-acupuncture groups, 0, 1 and 0 were cured basically, 21, 18 and 4 experienced marked improvement, 9, 11 and 20 were improved, 0, 0 and 6 failed, respectively. The therapeutic effects of ear-acupuncture and scalp-acupuncture were obviously superior to that of body-acupuncture group (P < 0.01). No significant differences were found between ear-acupuncture and scalp-acupuncture groups in myodynamia improvement, neurofunctional deficit scores and clinical curative effect (P > 0.05). CONCLUSION: Acupuncture can effectively improve ACI patients' clinical symptoms and the therapeutic effect of ear-acupuncture and scalp-acupuncture was superior to that of simple body acupuncture.

Agopuntura e depressione

Pilkington K. School of Life Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK. Anxiety, depression and acupuncture: A review of the clinical research. Auton Neurosci. 2010 May 5.

Depression and anxiety together constitute a significant contribution to the global burden of disease. Acupuncture is widely used for treatment of anxiety and depression and use is increasing. The theoretical basis for acupuncture diagnosis and treatment derives from traditional Chinese medicine theory. An alternative approach is used in medical acupuncture which relies more heavily on contemporary neurophysiology and conventional diagnosis. Trials in depression, anxiety disorders and short-term acute anxiety have been conducted but acupuncture interventions employed in trials vary as do the controls against which these are compared. Many trials also suffer from small sample sizes. Consequently, it has not proved possible to accurately assess the effectiveness of acupuncture for these conditions or the relative effectiveness of different treatment regimens. The results of studies showing similar effects of needling at specific and non-specific points have further complicated the interpretation of results. In addition to measuring clinical response, several clinical studies have assessed changes in levels of neurotransmitters and other biological response modifiers in an attempt to elucidate the specific biological actions of acupuncture. The findings offer some preliminary data requiring further investigation.

CAM in oncologia ginecologica

Supoken A, Chaisrisawatsuk T, Chumworathayi B. Department of Obstetrics and Gynecology, Khon Kaen University, Thailand. Proportion of gynecologic cancer patients using complementary and alternative medicine. Asian Pac J Cancer Prev. 2009;10(5):779-82.

BACKGROUND AND OBJECTIVES: Complementary and alternative medicine (CAM) for treatment of cancer and for supportive care of cancer patients must be clearly separated. There is encouraging evidence for CAM in the latter area, such as acupuncture and progressive muscle relaxation for chemotherapy-related nausea and vomiting, and aromatherapy for decreasing anxiety and increasing quality of life. However, there are limited data about CAM used by gynecologic cancer patients, especially in Thai women. Therefore, the authors aimed to investigate the proportion and types of CAM using in our gynecologic cancer patients. METHODS: This cross-sectional survey was conducted between October to December, 2008. Totals of 50 admitted and 50 walk-in gynecologic cancer patients 1 month after diagnosis, aged more than 20 years and able to give informed consent, were selected for one-by-one interview by random walking survey. RESULTS: Among the 100 interviewed patients, aged 21-69 (mean=50.12), there were 46 cases of cervical cancers, 35 of ovarian cancers, 18 of endometrial cancers (two of these also had ovarian cancers), 2 of malignant gestational trophoblastic diseases, 1 of vulvar cancer, and 1 liver cancer (in a patient with ovarian cancer). Some 67% (95% CI, 57.8-76.2%) of them used CAM. As diet modifications, 11 used Chinese vegetarian, 8 common vegetarian, 5 Cheewajit, and 1 macrobiotics. Five of them used dietary supplements while colonic detoxification was emplyed in three. As herbal medicines, 27 used Thai herbs, 4 Chinese herbs, and 1 a herbal sauna. Twelve were receiving Thai massage. As exercises, 23 used aerobics and 5 stretching. Interestingly, 62 of them used Buddhist praying while only 3 employed native magic. CONCLUSIONS: The three most common forms of CAM used by our gynecologic cancer patients were Buddhist praying (62/67, 92.5%), followed by herbal medicines (27/67, 40.3%) and exercises (25/67, 37.3%).

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Tutto in un guscio di noce

Bensky D, Clavey S, Stoger E. Materia Medica. Chinese Herbal medicine. 3RD edition.

Si narra che Dionisio, incontrando casualmente Caria, figlia di Dione re della Laconia, se ne innamorò, ricambiato, perdutamente. Sia la giovane sia le sue sorelle, Orfe e Lico, erano vincolate da un patto con Apollo che aveva donato loro poteri profetici a condizione che non si fossero mai mostrate curiose delle cose che non le riguardavano. Ma purtroppo l'amore della sorella per il dio accese in Orfe e Lico un'irrefrenabile curiosità che spinse Dionisio a punirle trasformandole in roccia. Caria, disperata, morì per il dolore. Il suo amato, per celebrarne la memoria, decise di trasformarla in un noce, albero non solo dai frutti fecondi, ma dal legno di eccezionale resistenza e durata. Di legno di noce infatti furono le prime statue erette a memoria della fanciulla dette, in suo onore, Cariatidi.(1) La regia è una delle 20 specie del genere Juglans, di cui un'altra molto impiegata in occidente è la nigra detta black walnut. In Occidente, la droga è costituita dalle foglie finemente frammentate, contenenti 1,4,5,-trihydroxynaphthalene-4-beta-D-glucoside (precursore dello juglone), juglone (fortemente instabile allo stato puro), tannini (ellagitannini), flavonoidi (3,4 %) di cui iperoside (0,2-0,6%) e acido ascorbico (0,85%-1,0%). Lo juglone è particolarmente concentrato nella buccia del mallo. A causa della presenza di tannini la droga è stata impiegata, nella tradizione, per uso topico, per il trattamento delle malattie cutanee (acne, eczemi e piodermiti); lo juglone possiede un potere antimicotico e antibatterico ed è usato, esternamente, come succo fresco della buccia; l'uso della droga è stata approvata dalla Commissione E per l'indicazione al trattamento dell'eccessiva traspirazione e infiammazione della pelle. Un prolungato uso esterno ha dimostrato un potere cancerogeno, verosimilmente in relazione al dimostrato potere mutageno, sull'animale dello juglone.(2)(3) Sconsigliato in gravidanza e durante l'allattamento.(4) In India è usato come vermifugo. In medicina cinese, la droga, detta he tao ren, è il gheriglio (seme), è compresa fra i tonici dello yang; agisce sul rene, il polmone e sul colon contro la stipsi.(5) In quanto tonico, le è stato anche attribuito un generico potere afrodisiaco, che però né la tradizione, in modo esplicito, né le evidenze scientifiche hanno mai dichiarato e tantomeno dimostrato. A questo proposito si segnala la scoperta di una recente sofisticazione di un prodotto a base di estratto di Juglans regia di cui erano stati verificati effetti "miracolosi" nel trattamento della disfunzione erettile; un'attenta analisi del prodotto, a seguito di una segnalazione sull'anomala efficacia dell'estratto, ha dimostrato la presenza di un inibitore della 5-fosfodiesterasi, non presente naturalmente negli estratti.

Glaucoma

Huang P, Xu Y, Wei R et al. J Glaucoma 2010 Apr; 30.

In questo interessante studio sperimentale, la somministrazione per via topica di tetrandrina è divisa in due fasi: pre-valutazione dell'effetto anche in ratti sani e, quindi, con dosaggi diversi di soluzioni di tetrandrina in ratti malati. La sperimentazione è stata eseguita in un modello sperimentale di glaucoma del ratto e a nostro avviso è particolarmente stimolante perché dimostra che la tetrandrina non ha azione ipotensiva nell'occhio sano e contemporaneamente è comparata al ben noto farmaco timololo. In questo studio sperimentale, controllato e randomizzato la somministrazione di una soluzione intraoculare di tetrandrina allo 0,3% aveva la medesima azione ipotensiva di una soluzione allo 0,5% di timololo. Inoltre, l'alcaloide tetrandrina estratto dalla Stephania tetrandrae S. Moore è ben nota anche per l'attività antinfiammatoria, antifibrotica e di inibizione della proliferazione vasolare, ha in più un buon profilo di sicurezza nonostante contenga sostanze alcaoidee.

L'Ibisco nel trattamento della sindrome metabolica

Gurrola-Díaz CM, García-López PM, Sánchez-Enríquez S et al. Phytomedicine 2010;17(7):500-5.

Questo studio clinico con controllo eseguito sia in pazienti sani sia affetti da sindrome metabolica dimostra l'efficacia di un estratto secco etanolico titolato > 18% in sambubiosidi di infiorescenze di Hibiscus sabdariffa nel modificare tutti i parametri che sono alterati in modo caratteristico nella sindrome metabolica: riduzione dei livelli di colesterolo totale, colesterolo LDL e VLDL, trigliceridi, glicemia e aumento del livello medio di colesterolo HDL. Inoltre, è stata confermata l'attività ipotensiva anche se lieve. A nostro giudizio questo studio è molto interessante perché questo estratto sembra normalizzare tutti i parametri che sono tipicamente alterati nei pazienti affetti dalla sindrome metabolica.

Panax ginseng

Bilgi N, Bell K, Ananthakrishnan AN et al. Ann Pharmacother 2010;44(5):926-8.

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Come noto il Panax ginseng e i suoi estratti non hanno nessuna dimostrata tossicità sul fegato, tuttavia i ginsenosidi possono inibire il citocromo 3A4 e questo report ne dimostra i possibili gravi effetti in una giovane paziente affetta da leucemia cronica in terapia con imatinib. Questa paziente di 24 anni aveva assunto 400 mg al giorno di imatinib per 7 anni senza alcuna reazione tossica quando ha iniziato ad assumere di propria iniziativa una bevanda energizzante a base di ginseng per 3 mesi. Si è quindi sviluppata una grave reazione epatotossica che l'ha costretta al ricovero e a sospendere ogni terapia. La paziente successivamente ha di nuovo inziato ad assumere imatinib al solito dosaggio senza nessun effetto epatotossico. L'imatinib è una ben nota sostanza epatotossica, ma in questo caso, dopo l'episodio tossico, è stato di nuovo assunto dalla paziente che lo ha ben tollerato. Questo report enfatizza ancora una volta l'importanza dell'educazione alla conoscenza dei rischi delle erbe medicinali soprattutto nei pazienti più delicati in quanto affetti da malattie gravi o in terapia con uno o più farmaci potenzialmente tossici perché a basso indice terapeutico.

Piante a caffeina: limiti e indicazioni per lo sportivo

La caffeina chimicamente è una xantina, un alcaloide ampiamente distribuito nel mondo vegetale: coffea arabica, thea chinensis, guaranà, noci di cola, cacao ecc. da cui si ricavano bevande popolari. Nella società odierna la caffeina è contenuta in molti prodotti commerciali consumati soprattutto come bevande di tendenza (smart drink, energy drink ecc.). Normalmente, la caffeina produce i suoi effetti sul sistema nervoso centrale a partire da dosi intorno agli 85-300 mg; a tali dosi, esercita un'azione stimolante centrale che si manifesta con l'aumento della veglia, dell'attenzione e del ritmo respiratorio, in più c'è un'attivazione cardio-vascolare con un aumento dell'irrorazione sanguigna dei muscoli scheletrici e quindi del lavoro muscolare. I suoi effetti non si limitano solamente all'azione di stimolazione sul sistema nervoso centrale ma essa favorisce anche l'utilizzazione degli acidi grassi, il combustibile preferito dai muscoli negli sforzi di lunga durata, facendo risparmiare le riserve muscolari di glicogeno e quindi rallentando l'insorgere della fatica. C'è in definitiva un incremento della performance fisico-psichica, che è alla base dell'abuso di caffeina anche nello sportivo. Infatti, gli effetti maggiormente ricercati dallo sportivo attraverso l'assunzione di caffeina sono: ottenere una migliore reattività, combattere la fatica, ridurre il peso. La caffeina esercita i suoi effetti inibendo la fosfodiesterasi, promuovendo l'accumulo intracellulare di Amp ciclico e inibendo la captazione del Ca2+ nel reticolo sarcoplasmatico. L'azione farmacologica più accreditata delle metilxantine è quella responsabile dell'interazione con i recettori dell'adenosina. Recenti studi hanno verificato la presenza di eteromeri tra recettori adenosinici di tipo A2a e recettori dopaminergici di tipo D2 a livello del corpo striato, la caffeina blocca l'azione dell'adenosina su dimeri eteromeri tra recettori A2a e D2, aumentandone l'affinità per la dopamina. Questo meccanismo a livello striatale si traduce in una maggiore stimolazione della corteccia motoria da parte dei circuiti motori diretto e indiretto (Ferrè et al. 2008). Le piante a caffeina oltre alla caffeina stessa, contengono una varietà di composti biologici quali gli antiossidanti ad azione protettiva, alimenti ricchi di flavonoidi quali il cioccolato fondente o il cacao migliorano la dilatazione flusso mediata e sono anche in grado di ridurre la pressione arteriosa. Bere tè verde fa ridurre il colesterolo, in più ha un effetto protettivo sull'incidenza di ictus, sia ischemico sia emorragico. La letteratura epidemiologica sulla caffeina è vastissima e controversa, quella più recente e autorevole ha sconfessato decisamente e in modo documentato certe credenze del passato ancora dure a morire in merito all'uso e all'abuso del caffè, per esempio che il caffè si renderebbe responsabile di patologie come l'infarto del miocardio, il cancro del rene, della vescica e del pancreas, la malattia fibrocistica della mammella, l'iperlipidmia. Al contrario, il bere abitualmente caffè è stato associato a un ridotto rischio di mortalità per malattie croniche, compreso il cancro (André Nkondjock 2008). Infine i dati della letteratura scientifica indicano che il regolare consumo di caffè non è associato a un aumento di rischio di disturbi cardiovascolari e di mortalità e potrebbe ridurre il rischio di ictus. Il rapporto tra caffeina e sport è stato in passato molto dibattuto, fino al 2003, infatti, la caffeina figurava tra le sostanze soggette a limitazione d'uso all'interno dell'elenco delle sostanze dopanti del Comitato olimpionico internazionale (CIO) e dell'Agenzia mondiale antidoping (WADA), oggi la caffeina non è più considerata sostanza dopante. Si ricorda, che dosi superiori ai 300 mg possono causare cefalea, nervosismo e ansia, dosi più elevate sono considerate tossiche e causano dolori muscolari agitazione degli arti, effetti psichici. La dose letale nell'adulto è di 5-10 g. La caffeina è una sostanza che appare spesso anche in prodotti come le bibite energetiche e gli integratori dietetici. Questi ultimi contengono alcaloidi dell'efedra che associati a caffeina pongono a serio rischio la salute di coloro che li utilizzano. Contrariamente, la caffeina inserita nel regime alimentare degli sportivi, in quantità moderata (300 mg di caffeina/giorno), oltre a essere un utile complemento al miglioramento della performance può avere anche effetti salutistici generali.

Fiori di Sambuco, PPARs e diabete

Christensen KB et al. Identification of bioactive compounds from flowers of Black Elder (Sambucus nigra L.) that activate the human peroxisome proliferator-activated receptor γ. Phytother Res. 2010 Mar;11.

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I PPARs (peroxisome proliferator-activated receptors) sono fattori di trascrizione nucleari ligando-dipendenti, coinvolti nella regolazione dell'espressione di numerosi geni relativi a fattori biologici e metabolici quali divisione, differenziamento e sviluppo cellulare, metabolismo di carboidrati e lipidi, dinamiche infiammatorie. Ligandi endogeni di PPARs sono acidi grassi liberi, acido α-linolenico e linoleico, prostaglandina PGJ2; una volta attivata la proteina PPAR eterodimenizza si lega a una sequenza consenso nei promotori di specifici geni, la cui espressione viene condizionata in maniera dipendente sia dal tipo di ligando sia dalla presenza di coattivatori e corepressori. Conosciamo oggi tre forme di PPARs: alfa, beta (o delta) e gamma; in particolare quest'ultima, presente ubiquitariamente nell'uomo e in special modo nel tessuto adiposo, se attivata riduce i livelli sierici di acidi grassi liberi, promuove la redistribuzione del tessuto adiposo da viscerale a sottocutaneo e aumenta il rilascio di adiponectina, producendo nel complesso una migliorata sensibilità all'insulina. È noto, infatti, come alcune mutazioni del gene PPAR-γ o disfunzioni dello splicing alternativo del costrutto primario possano originare proteine malfunzionanti, legate a lipodistrofie proaterogene, obesità e insulinoresistenza. Non a caso queste tre condizioni cliniche sono tutte coinvolte nel definire la sindrome metabolica, affezione che secondo la WHO colpisce il 20-30% della popolazione adulta mondiale; proprio per queste implicazioni metaboliche PPRA-γ è il target di farmaci agonisti incentivanti la sensibilità tissutale all'insulina, come il tiazolidinedione (TZD). Recentemente(1) in tal senso si è dimostrato attivo anche un aglicone presente nell'estratto metanolico di fiori di sambuco (Sambucus nigra L.), pianta nota per le sue proprietà diaforetiche, antinfiammatorie e antinfluenzali: si tratta della naringenina, flavanone in grado di attivare PPAR-γ aumentando la sensibilità all'insulina senza stimolare la differenziazione adipocitaria: la naringenina sarebbe quindi un agonista selettivo della forma -γ, al contrario del TZD che invece attiva tutte le isoforme della proteina, dando origine a sgraditi effetti avversi. Ulteriori studi sono necessari ora per comprendere appieno i fenomeni osservati, dal momento che i fiori di sambuco sono ricchi anche in acido α-linolenico e linoleico; i dati forniti da questi studi preliminari ex vivo aprono comunque buoni scenari.

Fitogalenica: gli olii essenziali

1. Curr Pharm Des 2006;12:287-311; 2. Indian J Pharm Sci 2008;70(4):445-9

Gli olii essenziali (o.e.) sono presenti in numerose specie vegetali e si ottengono per distillazione o tramite corrente di vapore a partire dalla droga fresca. A fronte di un elevata potenzialità terapeutica per lo più di natura antibatterica e/o antimicotica, spasmolitica e mucolitica, il loro uso in pratica è limitato da un basso indice terapeutico, e per questo devono essere assunti sotto controllo medico. È possibile utilizzarli per via topica, veicolati in gel, creme o unguenti ad una conc. max del 5%; per aereosol utilizzando come surfattante il Tween 20 e a una conc. non superiore al 2% o per via orale, somministrati in capsule previo adsorbimento su supporto inerte. A questo scopo vengono preferite le polveri di origine vegetale come l'Altea officinalis, la Glycyrrhiza glabra, l'Equisetum arvense o la Ceratonia siliqua (Carruba) dove al potere adsorbente si associa anche un potenziale terapeutico. Con 100 g di polvere si possono veicolare fino a un massimo di 15-20 ml di o.e. L'adsorbimento avviene in mortaio mediante ripetuta frantumazione della polvere umettata con l'olio aggiunto poco per volta. Si ottiene un composto umido che deve essere trattato con un eccipiente, per lo più maltodestrine, per renderlo lavorabile. Gli o.e., una volta ingeriti, vengono eliminati per via renale (nella forma metabolizzata) o per via polmonare esplicando la loro azione terapeutica. Quando si vuole sfruttare il loro potere spasmolitico sulla muscolatura liscia intestinale, è il caso per esempio degli o.e. di Mentha piperita e del Foeniculum vulgaris, è indispensabile utilizzare le capsule gastroresistenti. Studi recenti hanno confermato per alcuni componenti degli o.e. (fenoli e terpeni) la potenzialità di aumentare la biodisponibilità dei p.a. co-somministrati in quanto capaci di inibire in vitro la pompa P-gp a conc. inferiori al microg/ml.(1) Un esempio riguarda la curcumina, p.a. poco biodisponibile, che somministrato in presenza dell'o.e. di curcuma, ricco in sesquiterpeni, viene assorbito circa 7 volte di più.(2)

Fitoterapia e ipertensione

Cesarone MR, Belcaro G, Stuard S, et al. Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants—a controlled study. Cardiovasc Pharmacol Ther. Mar 2010;15(1): 41-46.

Pycnogenol® is a French maritime pine bark (Pinus pinaster) extract with vasodilatory, antiplatelet aggregation, anti-inflammatory, antioxidant, and hypoglycemic effects.1 Its cardiovascular effects are the most studied, and clinical studies have shown that Pycnogenol improves endothelial function, venous insufficiency, blood circulation, blood pressure, and platelet function.1 Preliminary research indicates that it may have beneficial effects on kidney function, including cortical flow.2 This clinical trial was designed to study the protective effects of Pycnogenol on kidney function when used with an angiotensin-converting enzyme (ACE) inhibitor.

The researchers enrolled hypertensive patients with altered kidney function and cardiovascular disease symptoms, including prior episodes of myocardial infarction or strokes associated with metabolic syndrome. The patients were

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advised to avoid salt, exercise moderately, and manage risk factors like weight, though all had a body mass index < 26. All patients were taking 5 mg of the ACE inhibitor ramipril twice a day. For 6 months, the control group (n=26) continued taking ramipril, and the Pycnogenol group (n=29) took 50 mg Pycnogenol (GEFA; Chateaugiron, France) 3 times daily in addition to ramipril in this unblinded study. Fasting blood samples and 24-hour urine samples were taken, along with the patients' blood pressures. Color Doppler/duplex ultrasound was used to measure renal cortical flow.

There were 5 drop-outs in the control group and 6 drop-outs in the Pycnogenol group "due to an altered schedule in management or failure to follow the described regimen." The authors observed "no serious side effects or tolerability problems," but do not specify adverse event reports. Both groups experienced reductions in diastolic and systolic blood pressure, but the Pycnogenol group experienced a greater reduction in diastolic blood pressure compared to the control group (P<0.05). Both groups showed heart rate decreases, but the Pycnogenol group experienced a greater decrease than the control group (P<0.05). Serum creatinine decreased in both groups, and the decrease was greater in the Pycnogenol group compared to the control group (P<0.05). Increased serum creatinine levels indicate kidney damage. The Pycnogenol group also experienced greater decreases in white blood cell count and C-reactive protein (CRP) levels (P<0.05 for both). There were no significant changes in total cholesterol and high density lipoprotein (HDL) cholesterol levels. Both groups experienced decreases from baseline to 6 months in the 24-hour urinary excretion of albumin (P<0.05), a protein whose presence in urine indicates possible kidney damage. The decrease was greater in the Pycnogenol group than in the control group (57.1% vs. 26%, P=0.0021). Diastolic and systolic kidney cortical flow velocities and the diastolic component increased in both groups compared to baseline after 6 months of treatment (P<0.05 for all). The Pycnogenol group experienced greater increases in diastolic and systolic kidney cortical flow velocities compared to the control group (P<0.05 for both). After 6 months of treatment, the Pycnogenol group had a significantly higher diastolic component, an indicator of improved kidney perfusion, than the control group (P<0.05). In summary, this study shows that the addition of Pycnogenol to ramipril treatment improves kidney function and kidney cortical flow and perfusion more so than ramipril alone in advanced hypertensive patients with histories of cardiovascular events. The results of this study are in alignment with prior studies indicating that Pycnogenol decreases blood pressure.1 The improvements in renal cortical blood flow could be related to improvements in endothelial function, but more research is needed. It is not clear how long the duration of ramipril use occurred prior to baseline measurements for this study, a factor that may have influenced the outcomes if there were significant differences in treatment times between the nonrandomized groups. The authors write that further research is needed to confirm these results, including clinical studies with larger patient samples and longer study periods.

Ricetta con rabarbaro

Malia Kirby, L.Ac. Strawberry-Rhubarb Crisp. BluePoppyNews 14May2010

Rhubarb – it’s not just for colon blow anymore! It’s also quite efficient at making you swoon when you’re jonesing for that first fruit crop of the year. This is the recipe we reach for when we’re elbow-deep in strawberries and swimming in those glorious crimson-red stalks. If you’re lucky enough to live in an area where strawberries grow wild, then use those bad boys if you can harvest enough of them for the dessert. Since they’re usually more flavorful than those that are commercially grown, you won’t need the full two quarts I’ve listed here. One quart will usually get the job done, but don’t let me stop you from using the full two quarts if you’re looking for outright decadence. Also, harvest your rhubarb when the stalks are still relatively small, about the size of a celery stalk. They’ll be tender and less fibrous than the larger stalks. Strawberry-Rhubarb Crisp (Serves 6-8): 2 c rhubarb stalks, cut into 1” pieces, 2 qt strawberries, hulled and halved, zest and juice from 1 lemon, ½ c granulated sugar, 2 ¼ c flour, 1 t baking powder, ¾ c dark brown sugar, 4 oz butter (1 stick), melted. Preheat oven to 375ºF and line a baking sheet with foil. Filling: Toss the rhubarb and strawberries with the lemon juice and zest, then add the granulated sugar and 1 c flour. Place filling in a 9 x 9 baking pan. Topping: Sift the remaining flour (1 ¼ c) in a mixing bowl with the baking powder and the brown sugar. Add the melted butter and mix until small, pea-sized clumps form. Cover the filling with the topping. Place the baking pan in the oven on the foil-lined baking sheet and bake for 45 minutes or until the rhubarb mixture is bubbling and the topping is golden-brown.

Colesterolo e noci

Joan Sabaté, MD, DrPH; Keiji Oda, MA, MPH; Emilio Ros, MD, PhD. Nut Consumption and Blood Lipid Levels. A Pooled Analysis of 25 Intervention Trials. Arch Intern Med. 2010;170(9):821-827.

Background: Epidemiological studies have consistently associated nut consumption with reduced risk for coronary heart disease. Subsequently, many dietary intervention trials investigated the effects of nut consumption on blood

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lipid levels. The objectives of this study were to estimate the effects of nut consumption on blood lipid levels and to examine whether different factors modify the effects. Methods We pooled individual primary data from 25 nut consumption trials conducted in 7 countries among 583 men and women with normolipidemia and hypercholesterolemia who were not taking lipid-lowering medications. In a pooled analysis, we used mixed linear models to assess the effects of nut consumption and the potential interactions. Results With a mean daily consumption of 67 g of nuts, the following estimated mean reductions were achieved: total cholesterol concentration (10.9 mg/dL [5.1% change]), low-density lipoprotein cholesterol concentration (LDL-C) (10.2 mg/dL [7.4% change]), ratio of LDL-C to high-density lipoprotein cholesterol concentration (HDL-C) (0.22 [8.3% change]), and ratio of total cholesterol concentration to HDL-C (0.24 [5.6% change]) (P < .001 for all) (to convert all cholesterol concentrations to millimoles per liter, multiply by 0.0259). Triglyceride levels were reduced by 20.6 mg/dL (10.2%) in subjects with blood triglyceride levels of at least 150 mg/dL (P < .05) but not in those with lower levels (to convert triglyceride level to millimoles per liter, multiply by 0.0113). The effects of nut consumption were dose related, and different types of nuts had similar effects on blood lipid levels. The effects of nut consumption were significantly modified by LDL-C, body mass index, and diet type: the lipid-lowering effects of nut consumption were greatest among subjects with high baseline LDL-C and with low body mass index and among those consuming Western diets. Conclusion Nut consumption improves blood lipid levels in a dose-related manner, particularly among subjects with higher LDL-C or with lower BMI.

Da commenti stampa: Levels of blood cholesterol can be improved by eating nuts according to a study of 25 trials. The data from 25 past trials was pooled and examined by researchers who discovered that by eating 67 grams of nuts daily, the volunteers in the studies were able to reduce their low-density lipoprotein or "bad" cholesterol level by 7.4%. Study leader from Loma Linda University, California, Joan Sabaté, M.D., gathered together the data derived from nut consumption trials from 7 countries. In total 583 men and women participated who had both normal and high cholesterol levels. A control group was involved in all of the 25 trials. As a foundation to their study the researchers wrote in the report that "Dietary interventions to lower blood cholesterol concentrations and to modify blood lipoprotein levels are the cornerstone of prevention and treatment plans for coronary heart disease." Nuts have long been associated with healthy eating primarily due to their plant protein, mineral, vitamin and fibre content. They also contain high levels of phytoesterols and antioxidants as well as unsaturated fatty acids. One of the authors summed up their dietary usefulness saying, "Recently, consumption of nuts has been the focus of intense research because of their potential to reduce coronary heart disease risk and to lower blood lipid [fat and cholesterol] levels based on their unique nutritional attributes." The researchers recommended that nuts should be part of a therapeutic diet in order to get blood cholesterol levels under control. They said: "Nuts are a whole food that has been consumed by humans throughout history. Increasing the consumption of nuts as part of an otherwise prudent diet can be expected to favourably affect blood lipid levels (at least in the short term) and have the potential to lower coronary heart disease risk."

Going nuts in your diet can be good for your health, according to a study published Monday, which showed that eating nuts helps to lower blood cholesterol levels. People who ate an average of 67 grams (2.4 ounces) of nuts a day saw a 5.1 percent fall in total cholesterol concentration and a 7.4 percent drop in low density lipoprotein cholesterol (LDL-C) - sometimes referred to as bad cholesterol - concentration compared to no-nut eaters, the study showed. People with high triglyceride levels who ate nuts saw a 10.2 percent fall in those blood lipid levels, said the study, which analyzed data from 25 trials conducted in seven countries, involving 583 men and women aged 19-86 with high or normal cholesterol levels. All the trial data that were analyzed for the study compared nut-eaters to a control group that did not eat nuts. None of the participants were taking medication to lower their blood lipids. Researchers led by Dr Joan Sabate of Loma Linda University in California found in the study published Monday in the American Medical Association's Archives of Internal Medicine that the benefits to health were the same no matter what nut is eaten. A person's weight and baseline LDL cholesterol levels did, however, influence whatever benefits might be derived from eating nuts. The higher the starting LDL-C, the greater the cholesterol-lowering effects of nuts, the study found. And the lower a patient's body mass index - in other words, if the patient was not overweight or obese - the greater the effects of nuts on lowering cholesterol levels, the study found, urging more research to determine why nuts are less effective in lowering the blood cholesterol levels of obese people. A person's diet also played a role in the effect nuts have on blood cholesterol levels. Consumers of Western diets, which are high in saturated fat, got more benefits from nut-eating than those who already ate a healthy diet, high in monounsaturated olive oil, fish and fresh fruit and vegetables, the study found. And there's more good news: the data analyzed for the study showed that the benefits of eating nuts remain with us for a long time; that nut consumption appears to reduce the risk of developing type 2 diabetes; and, in spite of their high fat content, nuts don't necessarily make us fat. "Research has shown that frequent nut consumption does not lead to weight gain," said the study. "Increasing the consumption of nuts as part of an otherwise prudent diet can be expected to favorably affect blood lipid levels... and have the potential to lower coronary heart disease risk," it concluded.

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Agopuntura e depressione

Manber R, Schnyer RN, Lyell D, et al. Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol 2010 Mar;115(3):511-20.

Acupuncture Can Alleviate Depression During Pregnancy. Depression with pregnancy is more common than you might think. One study estimates that about 13 percent of pregnant women will experience depression during their second trimester. This is made even more difficult because pregnant women cannot take any antidepressants. Now, a study in the March issue of Obstetrics and Gynecology may provide a way to help these women. A group of researchers at Stanford University provided one of three treatments to 150 pregnant women with major depression. The women received either acupuncture specific to depression, general acupuncture or massage therapy for 12 sessions over eight weeks. At the end of the treatments, they found that the women who received depression-specific acupuncture treatment had a 63 percent response rate, compared to either of the other two control treatments (44 percent). Based on these findings, the researchers concluded that depression-specific acupuncture could be considered a "viable treatment option."

Magnolia

AAVV. Magnolia Bark (hou po). Acupuncturetoday newsletter 19.05.10

Herbal medicine is an integral component of traditional Chinese medicine (TCM). It is also one of the oldest (and most popular) forms of health care. Studies have shown that as much as 40% of all American adults use herbal products, with the amount of money spent on herbal remedies in this country each year in the tens of billions. The use of herbal medicine is even higher overseas, with some countries reporting a usage rate of 75% or greater. The term "herbal medicine" refers to the use of a plant's seed, berries, roots, leaves, bark or flowers for medicinal purposes. While the scientific study of herbs in the United States began just over two centuries ago, herbs and botanicals have been used to treat a wide range of health problems in Asia for thousands of years. When used to facilitate healing in chronic, ongoing problems, herbal medicine has a great deal to offer. Studies have shown that herbal products can treat a variety of conditions, including colds, digestive disorders, insomnia, headaches, arthritis, skin disorders, asthma, and a host of other problems usually treated with pharmaceuticals and prescription medications. Magnolia bark comes from the magnolia tree, a deciduous arbor that grows in the Sichuan, Hubei and Zhejiang provinces of China. The tree is often used as a type of ornamental for gardens, and is an important source of timber, with green leaves and fragrant flowers that vary in color from white to purple. The bark is harvested first by being peeled from the tree, then dried, boiled (until the internal surface of the bark turns a dark red or brownish gray), steamed until soft, and rolled into cylindrical pieces. At that point, the bark is again dried and prepared with ginger juice for later use. In traditional Chinese medicine, magnolia bark has bitter, pungent and warm properties, and is associated with the Liver, Lung, Spleen and Stomach meridians. Traditionally, it has been used to treat asthma, coughs and abdominal problems. It is often used with other herbs, such as atractylodes, tangerine peel, and apricot kernels. The typical dosage of magnolia bark is between 3 and 10 grams, boiled in water for oral use as a decoction. Dried, rolled magnolia bark can be found at many herbal shops and specialty stores. However, magnolia bark does not last long in storage, so stocks of the bark need to be replenished rather often. Magnolia bark is also incorporated into larger herbal formulas. Extracts of magnolia bark are available in capsule and tincture form. Magnolia bark has been given a class 2B rating by the American Herbal Products Association, which means that it should not be used by women who are pregnant. In addition, magnolia bark contains a compound called magnocurarine, which has a sedative effect; large amounts can reduce blood pressure. As of this writing, there are no known drug interactions associated with magnolia bark. As always, make sure to consult with a licensed health care provider before taking magnolia bark or any other herbal remedy or dietary supplement.

Agopuntura e autismo

Virginia Chun-Nei Wong, Jie-Guang Sun. Randomized Controlled Trial of Acupuncture Versus Sham Acupuncture in Autism Spectrum Disorder. The Journal of Alternative and Complementary Medicine. May 2010, 16(5): 545-553. doi:10.1089/acm.2007.0768.

Objective: We aim to study the efficacy of acupuncture versus sham acupuncture in children with autism spectrum disorder. Methods: A single-blind randomized control trial was conducted in 50 children. These children were randomly assigned to the treatment group with tongue acupuncture (40 sessions over 8 weeks) or the control group (sham tongue acupuncture to nonacupoints in the tongue). Results: There was improvement in both the treatment and control groups in all assessed measures but more so in the treatment than in the control group: (1) eye–hand

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coordination, performance, and practical reasoning of Griffiths Mental Developmental Scale; (2) sensory-motor, social, affectual, language, and total score of Ritvo-Freeman Real Life Scale; (3) Comprehension Language age in the Reynell Language Developmental Scale; and (4) Total Score and Mental Age in Symbolic Play Test. The only statistically significant improvement in the treatment as compared to the control group was seen in self-care and cognition domains of the Functional Independence Measure for children. Conclusions: We had demonstrated that a short course of acupuncture had efficacy in improving various developmental and behavioral aspects of children with autism. The long-term efficacy in functional gain needs to be further explored.

Agopuntura e infertilità

Hilda Cavalla. Acupuncture and Electroauriculotherapy Treatment for Infertility. Medical Acupuncture. March 2010, 22(1): 49-52. doi:10.1089/acu.2009.0715.

Background: Acupuncture and electroauriculotherapy treatments may enhance the success rate of the embryo implantation stage of in vitro fertilization (IVF) in the treatment of infertility due to hormonal imbalances. Objective: To examine the integrated approach of acupuncture and electroauriculotherapy as an adjunct to fertility medication and IVF. Design, Setting, and Patient: A case report of a 33-year-old woman who was in the beginning of her third IVF cycle, who presented to a private clinic and received a total of 8 treatments over a 1-month period. Intervention: Acupuncture, electroauriculotherapy, and nutritional supplements. Main Outcome Measure: Embryo implantation and pregnancy outcomes. Results: The patient achieved successful embryo implantation and full-term pregnancy. She did not need follow-up care after the treatment period. No complications occurred during pregnancy or at childbirth. No side effects were reported from acupuncture, electroauriculotherapy treatments, or supplements. Conclusions: Electroauriculotherapy and acupuncture appeared to be useful for this patient as an adjunctive therapy with IVF treatments and fertility medications.

Rullano di nuovo i tamburi dell'Inquisizione...

di Simonetta Bernardini. Omeopatia 33, maggio

Tom Dolphin, novello Torquemada? Sembrerebbe di si. E' suo infatti il paragone dell'omeopatia alla stregoneria. Il vicepresidente della British Medical Association ha così serrato le fila, arruolando nelle truppe a difesa dell'intoccabile pensiero dominante della medicina gli ignari giovani medici durante la loro conferenza annuale. Già, i giovani medici, quelli formati nelle facoltà di medicina dove non si insegna filosofia, psicologia, sociologia, bioetica. Dove si insegna a curare gli organi, la macchina uomo, e non l'uomo. Dove si magnifica, senza critica, il potere della medicina accademica. Nessun cenno ai tanti insuccessi, non occorre elencarli, non è utile. Che restino ancora un po', i giovani medici, a crogiolarsi nel suadente delirio di onnipotenza. Ne usciranno piano piano, molti di loro da soli. Basterà che comincino a curare sul serio le persone e il mito dell'infallibilità del metodo lascerà piano piano il posto ad un più ragionevole possibilismo. "E' un'autentica vergogna che in Inghilterra si impegni denaro pubblico per rimborsare (parzialmente, ndr) i medicinali omeopatici, e finanche per finanziare un ospedale nel centro di Londra!" - tuona il saggio vicepresidente. Non solo, che sia impedito ai giovani medici di fare tirocinio al Royal London Homeopathic Hospital. Potrebbero trovarci, aggiungiamo noi, centinaia di cittadini contenti di essere curati con l'omeopatia, chissà perché. Potrebbero ascoltare quelle storie che i medici un tempo giovani impareranno piano piano nella loro esperienza professionale e che narrano non solo dei successi ma anche degli insuccessi del già infallibile medicinale convenzionale. "Sarebbe meglio che i servizi sanitari si concentrassero sui trattamenti che portano dei benefici reali piuttosto che dispensare medicinali inutili e privi di evidenze scientifiche", continua Dolphin. Non sorprende l'ennesima sciocchezza; sorprende, tuttavia, la risonanza che i media internazionali hanno dato ad affermazioni prive di senso e di buon senso. Qualche dato ci vuole. Lo prendiamo, per esempio, da un BMJ del 2004: solo il 36% dei trattamenti "ortodossi" è efficace o potenzialmente efficace. Su 2500 interventi di uso clinico corrente: 13% vantaggiosi, 23% potenzialmente vantaggiosi, 8% incerti, 6% difficilmente vantaggiosi, 4% probabilmente inefficaci o pericolosi mentre la percentuale di interventi di efficacia non nota è del 46%. Ma che dire dell'indagine commissionata nel 2005 dall'IBM e riportata sul Il Sole 24 Ore in cui si evidenziava la sconsolante efficacia dei cento farmaci più usati: 40% efficaci senza effetti collaterali, 20% efficaci ma con effetti collaterali non sopportabili, 30% solo effetti collaterali e nessuna efficacia e 10% di pazienti "non responder" ne' all'azione terapeutica, ne' agli effetti collaterali? E cosa dire dello studio effettuato proprio dai medici di famiglia del SSN britannico che evidenzia non solo l'efficacia dell'omeopatia ma anche il risparmio della spesa sanitaria? Sul refrain, poi, che l'omeopatia non abbia evidenze di efficacia lasciamo parlare Omeopatia33 e il sito SIOMI. In tutto il mondo si pubblicano nelle riviste di medicina lavori che invitano all'integrazione terapeutica, all'alleanza tra risorse di cura. Come afferma Ivan Cavicchi: "La medicina dovrà farsi medicina di medicine". Se la medicina integrata si va sempre più affermando in tutto il mondo il motivo è sin troppo semplice: il buon senso è ancora di casa in medicina. Avviare una ricerca indipendente in Omeopatia su

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obiettivi condivisi. Questo uno dei punti del protocollo d'intesa firmato nel mese di aprile tra il Presidente dei medici per l'ambiente, ISDE Italia, Roberto Romizi e il presidente della SIOMI, Simonetta Bernardini. L'Associazione Italiana Medici per l'Ambiente (ISDE) è nata per stimolare l'impegno dei medici per la salvaguardia dell'ambiente sia in quanto medici che abitanti della terra. Un impegno sottoscritto anche con la federazione nazionale degli Ordini dei medici. La salvaguardia dell'ambiente e la prevenzione da danni ambientali alla salute è tema cui sono molto sensibili anche i medici della SIOMI, la maggioranza dei quali sono oltre che omeopati, medici del servizio sanitario nazionale. La SIOMI nel suo progetto finalizzato a promuovere la medicina integrata pone da sempre attenzione anche ai temi dell'ecologia anche attraverso la ricerca dell'integrazione delle cure con i medicinali omeopatici che sono privi di effetti tossici sia per la salute dell'uomo che per quella degli animali e dell'ambiente. Non è un caso, dunque, che le due Società abbiano trovato intese ed obiettivi naturalmente condivisibili. Per questo SIOMI ritiene utile sostenere i medici per l'ambiente con il versamento del 5 per mille dell'IRPEF. Il 5 per mille non sostituisce il versamento dell'8 per mille e non rappresenta un ulteriore aggravio per il contribuente: infatti si tratta di una piccola parte del denaro che sarebbe versato obbligatoriamente come IRPEF, ma che il contribuente destina ad altro uso. In questo caso il contributo sarà destinato alla promozione della ricerca scientifica in omeopatia in Italia con la garanzia e l'impegno delle due Associazioni.

L'ormesi nel Phaseolus vulgaris

Mariana Moreira Lensi, Tatiana Jurgensen Siqueira, Gustavo Henrique Silva. A Pilot Study of the Influence of Natrum muriaticum at 6CH and 30CH Potency in a Standardized Culture of Phaseolus vulgaris. Int J High Dil Res, 2010, 9, (30), 43

The use of highly diluted and dynamized solutions is widespread. Its use extends to all living beings, including vegetables, acting effectively in primary and secondary metabolism. The aim of the present pilot study was to confirm the action of Natrum muriaticum at 6 CH and 30 CH dilutions in comparison to the action of a 5.0% NaCl solution, when administered separately in population of Phaseolus vulgaris (common bean). An evaluation was performed by determining the Relative Growth Rate (RGR) of bean population treated for six weeks and subdivided into 4 groups (with 5 vases each): P1, the control group, which was treated with a 30% alcohol solution only; P2, treated with an aqueous 5.0% NaCl solution; P3, treated with Natrum muriaticun at 6 CH dilution; P4, treated with Natrum muriaticum at 30 CH dilution. The results obtained showed that an increase in soil salinity caused inhibition of the development of bean population (P2). In addition, the use of the Natrum muriaticum dilution promoted a significant increase in vegetable growth, chiefly related to the 6 CH (P3), causing a significant increase in the RGR of the bean population. The use of this high dilutions provided evidence that method is efficient in vegetables.

E' profondo, intrigante preciso e fornisce informazioni al limite del fastidioso per chi non vuole essere informato. Ci riferiamo al filone di ricerca che studia gli effetti delle alte diluizioni sul metabolismo delle piante: aiuta a vederci più chiaro in modo documentario e non "patetico". Così abbiamo letto con gusto lo studio, pubblicato su un numero recente di Int J High Dilution Res, di Mariana Moreira Lensi che ha verificato l'azione di Natrum muriaticum 6CH e 30CH sulla crescita di una popolazione di Phaseolus vulgaris, utilizzando una misura ben nota tra gli agronomi, il RGR (Relative Growth Rate), ossia il rapporto tra il logaritmo naturale del totale della massa secca ottenuta da due successive campionature e l'intervallo di tempo trascorso tra i due prelievi. Lensi ha studiato il RGR di quattro gruppi di fagioli (ognuno rappresentato da cinque vasi), trattati per sei settimane con soluzione alcoolica al 30% (gruppo 1), soluzione acquosa di cloruro di sodio al 5% (gruppo 2), Natrum muriaticum 6CH (gruppo 3) e 30CH (gruppo 4). Dopo sei settimane Lensi ha registrato un aumento della salinità del terreno con un conseguente ritardo della crescita nelle piante del gruppo 2. Al contrario il gruppo 3, che aveva ricevuto Natrum muriaticum 6CH, mostrava un evidente sviluppo della massa verde e conservava la pigmentazione per un tempo maggiore rispetto agli altri gruppi. L'analisi del RGR confermava l'impressione soggettiva evidenziando una differenza statisticamente significativa tra il gruppo P3 (Natrum muriaticum 6CH) e tutti gli altri vasi; Lensi ipotizza che il mancato effetto della diluizione 30CH di Natrum muriaticum sia la conseguenza di un aggravamento patogenetico. A noi pare che questi risultati siano un manufatto perfetto, un incastro a coda di rondine, per mostrare le proprietà ormetiche che Natrum muriaticum in questo esperimento evidenzia. L'ormesi non è una nozione vecchia e superflua. Ripensarla è un atto salutare che invita tutti a rinunciare alle pigre e rassicuranti certezze e a mettere in discussione tutto quello che viene presentato come pacifico e scontato.

Protezione isopatica da cadmio omeopatico

Roberta Ghilosso Bortolini, Leoni Villano Bonamin, Carla Holandino. Putative protective effect of Cadmium chloride highdiluted solution on LLC-PK1 cell intoxicated by high concentration of this same metal: an isopathic in vitro assay. Int J High Dil Res, 2010, 9, (30), 16

Cadmium is an important toxic environmental heavy metal. Several studies have demonstrated that a major site of cadmium toxicity in humans and in other animals is the proximal tubule of the kidney. A well established model for nefrotoxicity is the use of

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in vitro technique with proximal tubule epithelial cell lines, as LLC-PK1. Herein, we have the intention to study the possible protective effect of highdiluted CdCl2 solutions. In a blinding way, LLC-PK1 cells were pre-treated with highdiluted cadmium chloride in the potencies 10 cH, 15 cH and 20cH. After 4 days, these cells have received CdCl2 in a pre-determined toxic concentration. The cell viability was assessed by MTT assay. We have identified a protective effect of two CdCl2 highdiluted solutions, 10 cH and 20 cH, when cells were intoxicated by sublethal CdCl2 concentration. The results indicate that probably the highdilutions have an expressive action on cells in sublethal intoxication.

Il cadmio è un importante e tossico metallo pesante ambientale comunemente reperibile nelle produzioni industriali metallurgiche e manifatturiere delle batterie di nichel-cadmio, nei coloranti e nelle plastiche, oltre che nel fumo di sigarette, nei cibi, nell'acqua, nell'aria; la sua tossicità è stata associata al cancro della prostata, del polmone e del testicolo. A livello cellulare colpisce la proliferazione, la differenziazione e causa apoptosi. Non a caso è stato classificato agente cancerogeno dalla IARC (International Agency for Research of Cancer). Per il suo particolare tropismo per l'epitelio del tubulo renale prossimale la sua accidentale inalazione o ingestione può causare da una iniziale disfunzione minima tubulare ad un severo coinvolgimento dei tubuli e dei glomeruli. E' nota l'intrinseca capacità delle cellule dell'epitelio renale di riparare danni dovuti ad esposizione sub letale di tossici a cui sono peraltro esposte, dato l'elevato flusso ematico e la presenza di un sistema di trasporto cellulare che facilita la concentrazione all'interno delle cellule stesse. Quando avviene un insulto chimico, il tessuto reagisce dinamicamente cercando di riparare velocemente il danno. Questo potere diminuisce quando le cellule ricevono un insulto costante. Riguardo al danno cellulare è noto il meccanismo di difesa per cui l'esposizione ad una sostanza nefrotossica, come il cadmio, induce la sintesi di proteine disintossicanti, come la metallotionina (MT) e altre proteine dello shock termico (HSP). Queste proteine dello stress hanno un ruolo contro il danno ossidativo del DNA e la loro induzione è considerata una risposta adattativa che le cellule mettono in atto per la sopravvivenza tanto che l'espressione di HPS70 si è dimostra un marker precoce di esposizione a tossici. L'esposizione a 25 M di CdCl2 causa un danno al citoscheletro cellulare che si aggrava, quando la concentrazione sale a 50 M, con la depolimerizzazione dell'actina, che indica la frammentazione del DNA. Allo scopo di studiare una cura si è cercato di sviluppare in vitro modelli tossicologici di questo specifico tessuto sulle cui cellule effettuare le sperimentazioni farmacologiche. Una varietà di linee cellulari "immortali" derivate da varie specie animali sono state impiegate: LLC-PK1 (suino), NRK-52E (ratto), OK (opossum), HK-2 (umane). Sulle cellule LLC-PK1 nel 1993, Delbancut e altri pubblicarono su Cahiers de Biothérapie, l'esperimento degli effetti protettivi delle alte diluizioni di cadmio per contrastare concentrazioni citotossiche dello stesso metallo. Per dar seguito a questo studio sono state trattate LLC-PK1 con cloruro di cadmio (CdCl2) a 10-15-20CH e si è visto che, messe a contatto con concentrazioni tossiche di questo metallo presentavano una più alta vitalità in confronto a cellule di controllo che non avevano ricevuto il trattamento.

Con metodi di indagine differenziati si è potuto stabilire che l'azione protettiva delle alte diluizioni 10CH e 20CH di cloruro di cadmio è probabilmente legata alla induzione della sintesi delle proteine disintossicanti (MT e HSP) che contrastano l'effetto tossicologico dell'esposizione a dosi sub letali di Cadmio (25 M) stimolando la sintesi di proteine anti-stress (azione preventiva?) mentre non hanno potere nel contrastare l'intossicazione di dosi massive (50 M) dello stesso metallo.

Omeopatia o medicina tradizionale? Dibattito al Corriere della Sera

Milano, 25 Maggio 2010

Intervengono Christian Boiron, presidente dei Laboratoires Boiron, leader mondiale nella produzione di farmaci omeopatici, e Silvio Garattini, direttore e fondatore dell'Istituto di Ricerche Farmacologiche «Mario Negri»; coordina Luigi Ripamonti. Nell'ambito degli incontri organizzati dalla Fondazione del Corriere della Sera e dedicati al tema: "La salute fra responsabilità e ideologia", segnaliamo questo evento che si terrà il 25 maggio prossimo a Milano dalle 18 alle 20. Nella seconda parte dell'incontro ci sarà anche la possibilità di intervenire da parte del pubblico. Senza avere come obiettivo quello di convincere Garattini, si tratta di una ottima opportunità per parlare agli osservatori, professionisti della salute e pubblico, giornalisti e politici, reclamando un'equità di trattamento tra omeopatia e medicina convenzionale, sia sul piano normativo che economico, universitario e ospedaliero: stessi doveri, ma anche stessi diritti. L'evento si terrà nella "Sala Buzzati" del Corriere della Sera (Via Balzan 3, angolo via San Marco 21, Milano). L'ingresso è gratuito. La prenotazione è necessaria a causa dei posti limitati. Per prenotare si può telefonare allo 02.87387707 oppure mandare una e-mail a rsvp@fondazionecorriere.it. Per i più lontani da Milano, si può anche assistere all'evento che sarà in diretta sul sito internet del Corriere della sera.

Terra Futura: agopuntura, omeopatia, fitoterapia e discipline bio-naturali

di Mariella Di Stefano

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Qualità della vita in Toscana significa anche farsi curare in ambulatori pubblici con le medicine complementari (ormai oltre 100) o migliorare il proprio benessere con il Qigong o una seduta di shiatsu di qualità. Per questo, e per il settimo anno consecutivo, medicine complementari e discipline bio-naturali sono presenti (28-30 maggio) alla Fortezza da Basso di Firenze per la mostra-convegno internazionale Terra Futura con un ampio programma di convegni e incontri per operatori e di dimostrazioni pratiche per il pubblico. Venerdì 28 alle 16.30, nel Padiglione Spadolini, saranno presentati due interessanti documenti che testimoniano l'intensa e innovativa attività regionale nel settore: il volume su sicurezza del paziente e rischio clinico in medicina complementare e il documento sulle MC della Commissione regionale di bioetica. L'utilizzo delle MC in età pediatrica sarà al centro del convegno "Approccio naturale alla salute del bambino" sabato 29 presso la Sala della Polveriera. E' previsto un intervento del nuovo Assessore alla salute, Daniela Scaramuccia. Verranno inoltre illustrati i dati dell'indagine 2009 sull'uso di terapie complementari e discipline bio-naturali in Toscana. La mattina del 30 maggio si parlerà di cure complementari per contrastare l'infertilità, mentre nel pomeriggio si terrà un incontro con gli operatori sulle pratiche complementari per il sostegno al parto naturale. Sabato 29 dimostrazioni pratiche sulle discipline bio-naturali a cura delle associazioni toscane del settore.

Garattini, poca ricerca clinica in Italia

di Marco Malagutti

«La ricerca clinica è molto trascurata. Per verificarlo basta valutare il gap esistente nella spesa tra la ricerca di base, che pure è molto utile, e quella clinica Eppure quest'ultima è quella che determina il reale progresso, dando il riscontro di ciò che è utile e ciò che è dannoso nella pratica clinica, e avendo come punto di arrivo il paziente». Lo sottolinea in occasione della Giornata Internazionale della Ricerca Clinica, Silvio Garattini, direttore dell'Istituto Mario Negri, in apertura di un convegno sul tema, svoltosi presso l'Istituto di Ricerche milanese. Molti i temi in discussione, tra i quali, proprio nell'intervento introduttivo di Garattini, l'evoluzione dei concetti di salute e malattia. «I cittadini - ha sottolineato il direttore del Mario Negri - vogliono la salute ma spesso fanno il contrario, come conferma l'aumento dei fumatori. Eppure basterebbe una seria prevenzione, una parola attorno alla quale si fa poca ricerca, per ottenere ottimi risultati sul piano della salute». Il problema? «La prevenzione non vende nulla» sottolinea Garattini «Ed è perciò poco popolare andando contro il sistema che genera ricchezza». Molto più remunerativo, secondo il direttore del Negri il cosiddetto "disease mongering", disturbi enfatizzati, ingigantiti, che nell'immaginario collettivo e sui mass media assumono il ruolo di vere e proprie malattie. Ma come difendersi? Fondamentale l'empowerment del paziente, aspetto al centro del libro "Quale salute per chi: la dimensione sociale della salute" edito da Franco Angeli e in uscita a fine giugno di cui si è parlato nel corso del convegno. Gli autori sono convinti che una adeguata comprensione del ruolo del paziente possa essere utile per una migliore definizione delle strategie di realizzazione della condizione di salute. In chiusura Alessandro Liberati del Centro Cochrane Italiano che riprendendo le premesse di Garattini, ha ribadito come in Italia si faccia poca ricerca clinica a scapito di quella di base. Anzi dice Liberati «quella clinica non è considerata neanche ricerca ma attività amministrativa, In compenso pullulano le ricerche su argomenti totalmente irrilevanti per il consumatore (paziente/medico pratico)». Le ragioni? Buona parte della responsabilità «è dell'industria farmaceutica e del suo ruolo sempre più pervasivo. In più non è da sottovalutare come la ricerca di base in qualche modo vagheggi l'immortalità». Indubbiamente un ottimo strumento di marketing.

Omeopatia in Africa

Rachael Mutinda. Village Mobile Clinics and Mass Treatment with Homeopathy. Hpathy Ezine, April, 2010

Rachael Mutinda DHom (ALCNM), ND, DRefl, AcuTech, KSoH - Rachael has been a homeopath for 7 years, and is a graduate of Abha Light College of Natural Medicine. She is an instructor and supervises intern students from ALCNM. Her clinic at Kibera slum, in Nairobi.

How do you treat 200 patients in one day at a rural mobile clinic? The author describes the approach and the challenges. No doubt the beauty of Homeopathy lies in its individuality of treatment. But if Homeopathy is to move into the popular mind it has to be flexible and able enough to treat en masse. It’s exciting to go onto a successful village mobile clinic. Generally these are run with ALCMN homeopaths, student interns and volunteers. A well advertised clinic may attract anywhere from 30 to 200 patients. We are committed to attending to all of them. This may mean that we are working straight into the evening. Most patients are in acute disease states and coming to our low-cost mobile clinics looking for a quick answer. To that, we are confident that at least 75% of our patients get some satisfaction from treatment. Hopefully they are inspired to return to our permanent base clinics for further treatment. To treat quickly, we use several approaches. When there’s a line of patients waiting for you, you need to do a lot of thinking “on-your-feet” so to speak. Instead of an hour long patient-led consultation where you let the patient ramble as long as they like, you need to quickly get to the core issues, and learn to ask pointed questions that will complete the CLAMS for the case. Some of you may remember this mnemonic, that summarizes a complete symptom picture: concomitant, location, aetiology, modality , sensation. When this is combined with familiarity of KEYNOTES, you can

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usually get to a suitable remedy in the few minutes you have with the patient. We also make great use of complex remedies and epidemic-style treatment. Also, nosodes are very useful to “kick” an acute case, which we then follow with a symptomatically correct remedy. Sometimes, when there are a large number of patients, or it’s the first time at a school or orphanage, we separate the patients and treat whole groups together. “All kids with ringworm – over here!” “All malaria cases, please line up here”, and so on. Then we can simply move down the line with the selected epidemic remedy, and get on with it quickly. Visiting volunteers from abroad are sometimes freaked out at the thought of mass treatment with homeopathy. They’ve never imagined that homeopathy could be used in such a way. I can remember one clinic which had been advertised on the radio. Over 300 people showed up. Our young homeopath-volunteers were in a state of shock and found it impossible to help. In fact, they wanted to return to Nairobi. There were only two of us plus the two shocked volunteers. We had to call in a few more of our own Abha Light practitioners to rush in, support the team and finish the job. Most volunteers ultimately find it an experience to remember and grow by. They come away with a new respect for the versatility of homeopathy. Abha Light students cut their teeth on mobile clinics. It is a way to quickly learn how to capture a case and learn the remedies. It builds confidence, because in the follow-up clinic, you find that these simple cures actually worked. Most patients get cured and spread the word to others. That’s another benefit to doing these clinics. It’s a way to make homeopathy known and popular to the public. The mobile clinics are relatively cheap to run, so we can get into a community to see if they like us. Later, a graduating student may be able to open his or her permanent clinic in that place.

Omeopatia e depressione

Didi Ananda Ruchira. Hepar Sulph in Depression. Hpathy Ezine, April, 2010

My experience in Africa is that, if I may put it in this way, many cases are solved because the symptoms “lie on the surface” so to speak. The culture and environment of Kenya and Africa is very much oriented to physical survival. On one hand, deep psychic traumas are certainly there, yet that also shows on a very physical level. The trauma of childhood rape and incest can scar for life. Kezia (name changed) had been repeatedly abused as a child by her brother and a cousin. As an adult Kezia is severely depressed, unable to make decisions or hold a job, anger bursts out of her uncontrolled and unpredictably, and she has strong suicidal tendencies. When she came to me for help, I realized I was not able to help her alone and I referred her to Carole, a psychologist specializing in trauma therapy, who donates her time at Abha Light. She has been seeing Kezia for nearly two years with the progress understandably slow, though steady. A few months ago, Carole and I had a discussion about the possibility of using remedies with psychiatric patients. After two years of therapy, Kezia was able to intellectually define her problems, but there remained a disconnect between her intellectual understanding and the emotional healing that still needed to take place. That’s when she returned to me. To be frank, I was totally baffled. While I was having heady discussions with Carole, I could toss around the names of remedies that related to psychic trauma – you know – Nat. Mur., Ignatia, Anacardium, Aurum, Staphysagria. Well, I thought, that’s about my limit. My experience in dealing with suicidal behaviour, chronic depression and other psychoses are limited indeed. I thought I was only taking a “mentals” case, and so ended up with a rather feeble list of symptoms. Kezia was able to recite her list of problems rather blandly, after all she’d been through it with her therapist over and over again:

•she feels shame & guilt (of the incest forced on her in childhood)

•she has low self-esteem

•she feels she’d be better off dead

•the depression is worse in night

That’s not very definitive homeopathically, but she thought she had said it all and closed up after that. I was intimidated about asking much more. Indeed she’d been in therapy for so long and had probably recited her problems again and again. I started Kezia off on Aurum 200c, and later tried Ignatia. Nothing changed, so Carole sent her back to me. This time Kezia was coughing. I asked her about it and this is what I got:

•She has a lifetime of “allergies” and coughing with “bronchitis” several times a year.

•Sneezing, coughing with expectoration

•Pain in the lower lungs, lower sides of the chest

•Pain with pressure

•< cold; she covers her face with a blanket every night

•< sudden drops in temperature; <perfumes; strong odours

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•Other observations: her voice is not clear – that is, slightly hoarse. She talks speedily with a low voice. Her anger and irritability can just flare up at the slightest cause

The “covering of the face at night” tipped me off. I then confirmed Hepar sulph:

•She loves sour and vinegary tastes and eats some vinegar every day (it’s an unusual food choice in Kenyan diet)

•She likes the rain, which makes her calm (again unusual in that in Nairobi weather, “rain” and “cold” go hand in hand)

For those unfamiliar with Hepar sulph’s relevant symptoms (from Murphy’s Lotus Materia Medica)

•Generals - Great sensitiveness to all impressions. Sweating patient pulls blanket around him. Chilliness, hypersensitiveness. Craving for sour and strong things are very characteristic. Feeling as if wind were blowing on some part.

•Lungs - Bronchitis of old, exhausted people. Loses voice and coughs when exposed to dry, cold wind. Dry, hoarse cough. Cough excited whenever any part of the body gets cold, or is uncovered, or from eating anything cold.

•Nose – Hay fever. Sinusitis after coryza.

•Temperature – Chilly in open air or from slightest draught.

•Food – Longing for acids, wine and strong-tasting food.

•Modalities – Better in damp weather. Better from wrapping head up and from warmth. Worse inhaling air, cold air, dry winds, slightest draught, open air. Worse in the night, on awakening, when blowing the nose. Worse from single parts of the body getting cold.

Now the mentals of Hepar sulph:

•MIND – Dejected and sad. Depression, sure of death and desires it. Forgetful. Anguish in the evening and night with thoughts of suicide. The slightest cause irritates him. Ferocious. Hasty speech.

Can Hepar sulph be a remedy for suicidal tendency and depression? Who would have thought it?

I gave her Hepar sulph 200c for the first week. In the next therapy session with Carole (who shared her progress with me ), Kezia finally had the emotional breakthrough in therapy that Carole was waiting for. She also had a few days where she felt more “up” than “down”. The next week, Kezia made a leap in therapy by finally following her therapist’s assignment to keep a diary, through which she started to have certain realizations about herself. Two weeks later I followed up homeopathically. Kezia wasn’t coughing but also didn’t report clearly on whether her physical symptoms had changed much. I gave Hepar sulph 1M. Kezia now continues to make progress in her therapy. Her therapist has asked her to assert herself in looking for a job. Many of us look on Hepar sulph as a respiratory remedy and generally only as an acute. Yet we can see in this example that when a person is resonating to a remedy, they resonate it through and through. In a truly core-remedy case, the physicals reflect the mentals as much as the mentals reflect the physicals; either way you’ll reach the remedy. In severe depression, the mental symptoms are very much dominated by the “symptoms of the disease”. It could take hours and repeated visits for a homeopath, untrained in psychology, to unearth a relevant symptom that would uncover the case. In this example, even with an extended case-taking, Hepar sulph would have been easily lost as a minor remedy to affect change, and may never have been found by a psychological case-taking.

Omeopatia dal dentista

Robert Medhurst. Homeopathy in Dentistry. Hpathy, may 2010

Homeopathy has a broad range of uses and there are some areas in particular where the results from its use can be spectacular. In the area of dentistry and oral health in general, the judicious use of the appropriate homeopathic medicine can provide rapid relief from a number of conditions for which there is little that conventional medicine can offer, or where the cure may at times be worse than the disease. Following are some of the more common conditions that may be seen here and some solutions that have been found in routine practice to alleviate them. Unless specified, the medicines mentioned should not be repeated any more than 3 times without the advice of a competent and qualified practitioner.

Abrasions: From instrumentation or manipulation- apply Hypericum and Calendula tinctures to the area 3 times daily.

Abscesses: Initially, with throbbing, and mild, Belladonna 30C, every 30 mins. With halitosis and excessive salivation use Merc sol 6C every hour. With obvious pus, to hasten it’s expulsion, use Hepar sulph 6C every 2 hours. Where the

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abscess is swollen and accompanied by numbness in the area, use Myristica 6X every hour. Once pus has started to drain, to hasten it’s removal use Silica 6C twice daily.

Apthous ulcers: In nervous patients use Borax 30C every 4 hours. Where they occur with foul breath, and the tongue is large and retains the imprints of the teeth, use Merc sol 30C every 4 hours. Ulcers with yellow or yellow-green bases, with a swollen uvula, use Kali bich 30C every 4 hours. Ulcers with bleeding bases, use Nit ac 30C every 4 hours.

Anaesthetic, general, to detoxify: Use a mixture of Leptandra 6C, Nux vomica 6C, Lycopodium 6C and Urtica urens 6C, three times daily.

Apprehension (about surgery): Trepidation with lethargy – use Gelsemium 30C on the morning and evening prior to the procedure and then one hour prior. Trepidation with hyperactivity – use Arg nit 30C on the morning and evening prior to the procedure and then one hour prior.

Bleeding: Initially, Arnica 200C every 15 minutes. For persistent bleeding of bright red blood use Phosphorus 30C every 15 inutes. For persistent bleeding of dark blood use Lachesis 30C every hour.

Bruxism: While sleeping, use Cina 30C, one hour before sleep. While awake, use Nux vomica 30C twice daily.

Dental Trauma: Injuries resulting in bruising or fractures- use Arnica 30C three times daily for chronic problems, or every hour for acute injury for up to 6 doses. Injuries resulting in nerve damage should be treated with Hypericum 30C every hour for acute injury. Injuries resulting from puncture wounds, such as injections, use Ledum 30C every hour. Injuries resulting from incisional wounds, use Staphysagria 15C every hour. For tired sore jaws following prolonged surgical procedures that are improved by warmth, use Mag phos 30C every hour. For tired sore jaws following surgical procedures that are not improved by warmth, use Arnica 30C every hour.

Dry socket: With throbbing pain use Belladonna 30C every hour. With unbearable pain, use Coffea 30C, every 15 minutes. To promote healing use Hepar sulph 6C every 4 hours.

Eruption of teeth, delayed: Use Calc carb 30C, twice a week.

Gingivitis (acute): With heavily coated tongue, use Merc sol 30C three times daily. With clean tongue, use Nit ac 30C three times daily. With excessive destruction of tissue, use Kali chlor 30C three times daily.

Halitosis: Use a mixture of Carbo veg 30C and Merc sol 30C twice daily.

Pain: Chamomilla 200C, one hour prior to surgery, and repeated very 15 minutes as necessary for no more than 6 doses.

Periodontitis (Chronic pyorrhoea): With bleeding gums, foul breath and a large tongue the retains the imprint of the teeth use Merc sol 6C once daily. For bleeding gums with substantial loss of periodontal bone, use Phosphorus 15C once daily.

Scar tissue, to reduce formation of: Use a mixture of Thiosinaminum 6C, Silica 6C, Arnica 6C, Anagalis 6C and Benzoic acid 6C, three times daily for 5 days after surgery.

Scaling, for sore gums following: Use Arnica 30C every 2 hours.

Thrush (oral): Borax 30C three times daily.

Vischio e cancro

Gunver Sophia Kienle, MD and Helmut Kiene. Influence of Viscum Album L (European Mistletoe) Extracts on Quality of Life in Cancer Patients: A Systematic Review of Controlled Clinical Studies Integrative Cancer Therapies OnlineFirst Alert, 18 may 2010

Objective. To evaluate controlled clinical studies on the efficacy and effectiveness of Viscum album for quality of life (QoL) in cancer. Materials and methods. The authors conducted a search of 7 electronic databases and reference lists and had extensive consultations with experts. They carried out a criteria-based assessment of methodological study quality. Results. The authors identified 26 randomized controlled trials (RCTs) and 10 non-RCTs that investigated the influence of V album extracts (VAEs) on QoL in malignant diseases; 26 studies assessed patient-reported QoL. Questionnaires were mostly well established and validated. Half of the studies investigated VAEs concomitant with chemotherapy, radiotherapy, or surgery. Some studies were well designed, whereas others had minor or major methodological weaknesses. Among the 26 RCTs, 22 reported a QoL benefit, 3 indicated no difference, and 1 did not report any result. All the non-RCTs reported a QoL benefit. Of the studies with higher methodological quality, most reported a benefit, whereas 1 found no difference. Improvements were mainly in regard to coping, fatigue, sleep, exhaustion, energy, nausea, vomiting, appetite, depression, anxiety, ability to work, and emotional and functional

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well-being in general and, less consistently, in regard to pain, diarrhea, general performance, and side effects of conventional treatments. VAEs were well tolerated. Conclusions. VAEs seem to have an impact on QoL and reduction of side effects of conventional therapies (chemotherapy, radiation) in experimental trials as well as in routine daily application. The influence on fatigue especially should be investigated further.

Agopuntura e dolore nel cancro

Elizabeth Dean-Clower et al. Acupuncture as Palliative Therapy for Physical Symptoms and Quality of Life for Advanced Cancer Patients Integrative Cancer Therapies 2010, doi:10.1177/1534735409360666 First published on May 18, 2010

Background. Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL). Methods. This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session. A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points. Results. Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety, fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression (P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002), pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks. Conclusions. This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.

Agopuntura e gastrite

Ren R, Zhuang LX. [Effect of acupuncture and moxibustion of Shu- and Mu-acupoints on the quality of life in patients chronic superficial gastritis] Zhen Ci Yan Jiu. 2009 Aug;34(4):262-6.

OBJECTIVE: To observe the therapeutic effect of electroacupuncture plus moxibustion (EA-Moxi) of combined Shu- and Mu-acupoints on the symptoms and quality of daily life in chronic superficial gastritis (CSG) patients. METHODS: Sixty cases were randomly divided into EA-Moxi group (n = 30) and medication group (n = 30). For patients of the former group, EA (50 Hz, 3 mA) was applied to Zhongwan (CV 12), bilateral Weishu (BL 21), bilateral Zusanli (ST 36), in combination with bilateral Ganshu (BL 18) and Qimen (LR 14) for patients with liver-stomach disharmony syndrome, and with moxibustion of Zhongwan (CV 12), bilateral Weishu (BL 21), bilateral Zusanli (ST 36), Pishu (BL 20) and Zhangmen (LR 13) for those with spleen-stomach deficiency syndrome. The treatment was administrated once a day, five days a week for 4 weeks. The patients of medication group were treated with Omeperazole (20 mg, qd.) capsules. The total course of treatment was 4 weeks. Clinical therapeutic effects were evaluated according to some related standards, and the quality of life was assessed by SF-36 questionnaire. RESULTS: After the treatment, of the 30 cases in EA-Moxi and medication groups, 6 (20.0%) and 3 (10.0%) were cured, 16 (53.3%) and 8 (26.7%) experienced marked improvement, 5 (16.7%) and 9 (30.0%) were effective, and 3 (10.0%) and 10 (33.3%) failed, with the effective rates being 90.0% and 66.7% respectively. The difference of the effective rates between two groups was significant (P < 0.05). Self-comparison showed a marked improvement in the quality of life including physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role emotion (RE) and mental health (MH) in both groups after the treatment. The scores of health utility (HU), RP and RE in EA-Moxi group were evidently higher than those of medication group (P < 0.05, P < 0.01). CONCLUSION: EA-Moxi of combined Shu- and Mu-acupoints can effectively relieve CSG patients' clinical symptoms and their quality of life.

MnC e fibromialgia

Porter NS, et al. Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. J Altern Complement Med. 2010 Mar;16(3):235-49.

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BACKGROUND: There have been several systematic reviews attempting to evaluate the efficacy of possible treatments for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM). However, information regarding the efficacy of complementary and alternative medicine (CAM) has not been comprehensively or systematically covered in these reviews, despite its frequent use in the patient community. PURPOSE: The purpose of this study was to systematically review and evaluate the current literature related to alternative and complementary treatments for ME/CFS and FM. It should be stressed that the treatments evaluated in this review do not reflect the clinical approach used by most practitioners to treat these illnesses, which include a mix of natural and unconventionally used medications and natural hormones tailored to each individual case. However, nearly all clinical research has focused on the utility of single CAM interventions, and thus is the primary focus of this review. METHODS: Several databases (e.g., PubMed, MEDLINE,((R)) PsychInfo) were systematically searched for randomized and nonrandomized controlled trials of alternative treatments and nonpharmacological supplements. Included studies were checked for references and several experts were contacted for referred articles. Two leading subspecialty journals were also searched by hand. Data were then extracted from included studies and quality assessments were conducted using the Jadad scale. RESULTS: Upon completion of the literature search and the exclusion of studies not meeting criterion, a total of 70 controlled clinical trials were included in the review. Sixty (60) of the 70 studies found at least one positive effect of the intervention (86%), and 52 studies also found improvement in an illness-specific symptom (74%). The methodological quality of reporting was generally poor. CONCLUSIONS: Several types of alternative medicine have some potential for future clinical research. However, due to methodological inconsistencies across studies and the small body of evidence, no firm conclusions can be made at this time. Regarding alternative treatments, acupuncture and several types of meditative practice show the most promise for future scientific investigation. Likewise, magnesium, l-carnitine, and S-adenosylmethionine are nonpharmacological supplements with the most potential for further research. Individualized treatment plans that involve several pharmacological agents and natural remedies appear promising as well.

MTC a Singapore

Loh CH. Use of traditional Chinese medicine in Singapore children: perceptions of parents and paediatricians. Singapore Med J. 2009 Dec;50(12):1162-8.

INTRODUCTION: In a country dominated by western healthcare, interest in traditional Chinese medicine (TCM) is growing. The increasing popularity of TCM, occasionally used with conventional medicine, needs to be assessed, especially in a vulnerable paediatric population. This paper sought to evaluate the use of TCM in children, mainly to determine the common conditions they seek TCM, the pattern of acupuncture or herbal usage for various age groups, the extent of concurrent usage of TCM and conventional medicine, and the reasons for TCM use. Paediatricians' perceptions of TCM will allow us to gauge the acceptability of TCM by those who practise conventional medicine. These are assessed in another arm of this study, with a set of predictive characteristics for their personal TCM use, their perceptions of herb/acupuncture safety, and their own referral to TCM eventually determined. METHODS: An anonymous questionnaire was administered on 300 parents awaiting consultation at a large TCM clinic. Next, a separate qualitative questionnaire survey form was posted to 100 paediatricians. RESULTS: Herb usage in children is very common (84.3 percent) and 80 percent of parents admitted concurrent usage of TCM and conventional medicine for their children. Drug-herb interactions was an issue of concern for paediatricians. Paediatricians with a higher level of self-reported TCM knowledge were more likely to refer for a cure. CONCLUSION: This was the first study to determine the characteristics of children attending a large TCM clinic in a country which is dominated by western healthcare. It also provided insight into the perceptions of TCM among paediatricians in Singapore. Specifically, it gave us an idea of the predictor traits that determine their referral patterns to TCM and their perceptions of herb and acupuncture safety.

Biologia molecolare e agopuntura

Wang SJ, Tan LH, Yang YS. [Application of molecular biological techniques to the study on acupuncture and moxibustion] Zhen Ci Yan Jiu. 2009 Aug;34(4):283-8.

In the present paper, the authors introduce recent progress of application of molecular biological techniques in the studies on the underlying mechanism of acupuncture therapy for 1) resisting inflammation and relieving pain, 2) resisting tumors, 3) improving ischemic cerebral and myocardial injury, and 4) delaying aging from gene transcription and expression (synthesis of mRNA); and for relieving sciatic nerve injury, spinal traumatic injury, and cerebral ischemia from protein expression or phosphorylation. In addition, the authors also make a preliminary analysis on the extant problems of the application of techniques of both genomics and proteomics in acupuncture research at the present and predict their applicable prospect.

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Omeopatia e cancro

Frenkel M. Homeopathy in cancer care. Altern Ther Health Med. 2010 May-Jun;16(3):12-6.

Homeopathy is a controversial system of care that is practiced extensively in Europe, Asia, and South America primarily for functional and minor ailments. In this review, published studies on homeopathic remedies and cancer were examined. Data were obtained from multiple research disciplines, ranging from basic science to scientifically valid animal and clinical studies. The data from a few laboratory experiments in cancer models show some beneficial effect of homeopathic remedies on selected cancer cell lines. However, in the clinical arena, this effect is not clear. Several published outcome studies and some randomized controlled trials have shown that there may be a role for homeopathy in symptom relief and improving quality of life in patients touched by cancer. Such effects have not been demonstrated unequivocally, and specific antitumor effects have not been shown in any controlled clinical research to date, which raises the need for further clinical trials to investigate the use of homeopathy in cancer care.

MTC e arteriosclerosi

Su W, Sun A, Xu D, Zhang H, Yang L, Yuan L, Jia J, Zou Y, Wu Y, Wang K, Ge J. Tongxinluo Inhibits Oxidized-LDL Induced Maturation of Human Dendritic Cells via Activating PPAR Gamma Pathway. J Cardiovasc Pharmacol. 2010 May 14.

TongXinLuo (TXL) is a traditional Chinese herbal medicine with multiple vasoprotective activities. Dendritic cells (DCs) play an active role in the immunological processes related to atherosclerosis. The purpose of this study was to determine the effect and possible mechanisms of TXL on oxidized-LDL induced maturation and immune function of DCs. Human monocyte-derived DC were incubated with TXL or ciglitazone, and were subsequently stimulated with oxidized-LDL to induce maturation. Similar to ciglitazone, a PPARgamma agonist, TXL could significantly reduce the maturation-associated markers induced by ox-LDL, such as CD40, CD86,CD1a,HLA-DR, improved the endocytosic function and decreased secretions of cytokine IL-12, TNFalpha. These inhibitory effects of TXL could be partly reversed by silencing the expression of PPAR gamma in DCs. In conclusion, TXL could inhibit oxidized-LDL induced maturation of DCs through activating PPAR gamma pathway.

MTC ed evidenze

Xue CC, Zhang AL, Greenwood KM, Lin V, Story DF. World Health Organization (WHO) Collaborating Centre for Traditional Medicine, Discipline of Chinese Medicine, School of Health Sciences, RMIT University, Bundoora, Victoria, Australia. Traditional chinese medicine: an update on clinical evidence. J Altern Complement Med. 2010 Mar;16(3):301-12.

BACKGROUND: As an alternative medical system, Traditional Chinese Medicine (TCM) has been increasingly used over the last several decades. Such a consumer-driven development has resulted in introduction of education programs for practitioner training, development of product and practitioner regulation systems, and generation of an increasing interest in research. Significant efforts have been made in validating the quality, effectiveness, and safety of TCM interventions evidenced by a growing number of published trials and systematic reviews. Commonly, the results of these studies were inconclusive due to the lack of quality and quantity of the trials to answer specific and answerable clinical questions. OBJECTIVES: The methodology of a randomized clinical trial (RCT) is not free from bias, and the unique features of TCM (such as individualization and holism) further complicate effective execution of RCTs in TCM therapies. Thus, data from limited RCTs and systematic reviews need to be interpreted with great caution. Nevertheless, until new and specific methodology is developed that can adequately address these methodology challenges for RCTs in TCM, evidence from quality RCTs and systematic reviews still holds the credibility of TCM in the scientific community. CONCLUSIONS: This article summarizes studies on TCM utilization, and regulatory and educational development with a focus on updating the TCM clinical evidence from RCTs and systematic reviews over the last decade. The key issues and challenges associated with evidence-based TCM developments are also explored.

MnC e disordini bipolari

Jarman CN, Perron BE, Kilbourne AM, Teh CF. Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder. J Altern Complement Med. 2010 Mar;16(3):251-5.

OBJECTIVES: Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested

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whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. DESIGN: Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. RESULTS: Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. CONCLUSIONS: Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known, providers should conduct routine assessments of CAM use.

Fitoterapia potenzialità

Cravotto G, Boffa L, Genzini L, Garella D. Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Turin, Italy. giancarlo.cravotto@unito.it Phytotherapeutics: an evaluation of the potential of 1000 plants. J Clin Pharm Ther. 2010 Feb;35(1):11-48.

OBJECTIVE: The aim of this review is to evaluate and summarize the available scientific information on the commonest plant extracts marketed in Western countries. In view of the intense, ongoing search for new plant extracts with powerful anti-inflammatory activity, we paid particular attention to this topic. The aim is to provide broad coverage of as many potentially useful plants as possible and then to focus on those with the greatest therapeutic potential. METHODS: Our bibliographic sources were the SciFinder databases: CAPLUS, MEDLINE, REGISTRY, CASREACT, CHEMLIST, CHEMCATS (update to October 2007). In order to assess the value of clinical trials, we focused a specific search on clinical investigations concerning nine plants with the most trial data, viz., Althaea officinalis, Calendula officinalis, Centella asiatica, Echinacea purpurea, Passiflora incarnata, Punica granatum, Vaccinium macrocarpon, Vaccinium myrtillus, Valeriana officinalis. This was carried out in several databases (update to June 2008): ISI Web of Knowledge(SM) (ISI WoK), SciFinder (CAPLUS, MEDLINE, REGISTRY, CASREACT, CHEMLIST, CHEMCATS) and PubMed (indexed for MEDLINE). RESULTS: Our survey covers roughly a 1000 plants, although clinical trials have been published only for 156 plants supporting specific pharmacological activities and therapeutic applications. However, for about half of the plants, in vitro and in vivo studies provide some support for therapeutic use. For one-fifth of the plants included in our search, only phytochemical studies were found. Their properties and indications were often attributed to the presence of certain compounds, but no evidence concerning the activities of the whole extracts was presented. We found that for about 12% of the plants, currently available on the Western market, no substantial studies on their properties had been published, while there was strong evidence that 1 in 200 were toxic or allergenic, so that their use ought to be discouraged or forbidden. Nine plants had considerable evidence of therapeutic effect, viz., A. officinalis, Calendula officinalis, Centella asiatica, E. purpurea, Passiflora incarnata, Punica granatum, Vaccinium macrocarpon, Vaccinium myrtillus, Valeriana officinalis. CONCLUSION: The present review provides a baseline on the level of evidence available on many herbal preparations and should be of help to those intending to research further on these topics.

MTC e ischemia miocardica

Huang X, Zhang XY, Qin F, Wang XY, Ren P, Liu ZQ, Zhou HH. Pretreatment with a traditional Chinese formula, guanxin II, reduces cardiac apoptosis via the Akt survival pathway in rats with myocardial ischemia. Tohoku J Exp Med. 2010;220(2):157-63.

Guanxin II (GXII) is a traditional Chinese formula to treat coronary heart disease in China. Previous studies indicate cardioprotection of GXII are related to cardiomyocyte apoptosis. Akt is necessary and sufficient for inhibition of apoptosis in cardiomyocytes. Our aim was to examine whether or not the antiapoptotic mechanisms of GXII are related to the Akt pathway. Male Sprague-Dawley rats were randomly assigned to four groups: GXII administered at 2.5 or 0.5 g raw materials/kg, the vehicle control and sham-operated oral 0.9% NaCl. They were pretreated once a day for 15 consecutive days by gavage. Thirty min after the last administration, the left anterior descending coronary

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artery was occluded to induce myocardial ischemia except for the sham-operated rats. Compared with rats receiving vehicle, those rats pretreated with GXII at 2.5 g/kg significantly reduced infarct size and decrease apoptosis. Furthermore, GXII (2.5 g/kg) significantly activated Akt kinase, increased the Bcl-2/Bax ratio, inhibited cytochrome c release, reduced caspase-9 activation, and attenuated subsequent caspase-3 activation. GXII at 0.5 g/kg have no noticeable effect on these parameters. Meanwhile, GXII at 2.5 g/kg did not change myocardial blood flow of ischemic zone, indicating a direct action on cardiomyocytes. These results suggest GXII at 2.5 g/kg ensures the survival of myocardium by enhancing the Akt-mediated antiapoptosis pathway. The findings provide new evidence of the effective and safe therapy with GXII for patients with chronic coronary heart disease.

MTC e cancro

Wu SB, Pang F, Wen Y, Zhang HF, Zhao Z, Hu JF. Antiproliferative and apoptotic activities of linear furocoumarins from Notopterygium incisum on cancer cell lines. Planta Med. 2010 Jan;76(1):82-5. Epub 2009 Aug 3.

Bioassay-guided fractionation of the antiproliferative chloroform extract of the traditional Chinese medicine Qiang-Huo (Notopterygium incisum) led to the isolation of nine linear furocoumarins (1- 9). All the isolates were tested against two human cancer cell lines (HepG-2 and MCF-7) and a rat cancer cell line (C6) using the MTT assay method. Among them, notopol (1), notopterol (2), 5-[(2 E,5 Z)-7-hydroxy-3,7-dimethyl-2,5-octadienoxy]psoralene (3), and 5-[(2,5)-epoxy-3-hydroxy-3,7-dimethyl-6-octenoxy]psoralene (4) showed significant antiproliferative activity against the HepG-2 and C6 cancer cell lines, with IC(50) values of 7.7-24.8 microg/mL (5-FU: ca. 5 microg/mL). Compounds 1- 3 also showed moderate cytotoxicity against the MCF-7 cancer cell line, with IC(50) values of 39.4-61.3 microg/mL (5-FU: 17.3 microg/mL). The cell cycle-specific inhibition and apoptosis induced by compounds 1 and 2 were determined using flow cytometry. The structure-activity relationship (SAR) is briefly discussed herein. It was found that the presence of a free hydroxy at the lipophilic side chain linked to C-5 of the linear furocoumarins was essential for their in vitro antiproliferative activity.

Sesamo e danno ischemico

Jamarkattel-Pandit N, Pandit NR, Kim MY, Park SH, Kim KS, Choi H, Kim H, Bu Y. Department of Herbal Pharmacology, College of Oriental Medicine, Kyung Hee University, Seoul, Korea. Neuroprotective effect of defatted sesame seeds extract against in vitro and in vivo ischemic neuronal damage. Planta Med. 2010 Jan;76(1):20-6. Epub 2009 Jul 13.

Sesame (Sesamum indicum L.) is an important oilseed crop that possesses a wide spectrum of pharmacological activities. Many studies have been conducted to investigate its health-promoting effects. Compared to other plant oils, sesame seed oil is highly stable to oxidation and has been demonstrated to have protective effects against ischemia-reperfusion injury in the rat brain. However; the effects of defatted sesame seeds extract (DSE) have not been studied yet. The purpose of this study was to evaluate the protective effect of DSE against ischemia models. For in vitro ischemia, oxygen-glucose deprivation followed by reoxygenation (OGD-R, 4 h OGD followed by 24 h reoxygenation) in HT22 cells was used to investigate the protective effects on cell death and the inhibitory effects on lipid peroxidation. For in vivo ischemia, the middle cerebral artery occlusion (MCAo, 2 h of MCAo followed by 22 h of reperfusion) rat model was used. Twenty-two h after occlusion the rats were assessed for neurobehavioral deficit and infarct volume. DSE (0.1-10 microg/mL) significantly reduced the cell death and inhibited lipid peroxidation induced by OGD-R. DSE (30, 100 and 300 mg/kg, p.o.) given twice at 0 h and 2 h after onset of ischemia reduced brain infarct volume dose-dependently and improved sensory-motor function. The therapeutic time window of DSE (300 mg/kg, p.o.) was 2 h after MCAo in rats. In conclusion, our results show that DSE may be effective in ischemia models by an antioxidative mechanism.

MTC e diabete

Grant SJ, Bensoussan A, Chang D, Kiat H, Klupp NL, Liu JP, Li X. Chinese herbal medicines for people with impaired glucose tolerance or impaired fasting blood glucose. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006690. DOI: 10.1002/14651858.CD006690.pub2.

Background. Around 308 million people worldwide are estimated to have impaired glucose tolerance (IGT); 25% to 75% of these will develop diabetes within a decade of initial diagnosis. At diagnosis, half will have tissue-related damage and all have an increased risk for coronary heart disease. Objectives. The objective of this review was to assess the effects and safety of Chinese herbal medicines for the treatment of people with impaired glucose tolerance or impaired fasting glucose (IFG). Search strategy. We searched the following databases: The Cochrane Library, PubMed, EMBASE, AMED, a range of Chinese language databases, SIGLE and databases of ongoing trials. Selection criteria. Randomised clinical trials comparing Chinese herbal medicines with placebo, no treatment, pharmacological or non-pharmacological interventions in people with IGT or IFG were considered. Data

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collection and analysis. Two authors independently extracted data. Trials were assessed for risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, outcome assessors and intervention providers, incomplete outcome data, selective outcome reporting and other sources of bias. Main results. This review examined 16 trials lasting four weeks to two years involving 1391 participants receiving 15 different Chinese herbal medicines in eight different comparisons. No trial reported on mortality, morbidity or costs. No serious adverse events like severe hypoglycaemia were observed. Meta-analysis of eight trials showed that those receiving Chinese herbal medicines combined with lifestyle modification were more than twice as likely to have their fasting plasma glucose levels return to normal levels (i.e. fasting plasma glucose <7.8 mmol/L and 2hr blood glucose <11.1 mmol/L) compared to lifestyle modification alone (RR 2.07; 95% confidence intervall (CI) 1.52 to 2.82). Those receiving Chinese herbs were less likely to progress to diabetes over the duration of the trial (RR 0.33; 95% CI 0.19 to 0.58). However, all trials had a considerable risk of bias and none of the specific herbal medicines comparison data was available from more than one study. Moreover, results could have been confounded by rates of natural reversion to normal glucose levels. Authors' conclusions. The positive evidence in favour of Chinese herbal medicines for the treatment of IGT or IFG is constrained by the following factors: lack of trials that tested the same herbal medicine, lack of details on co-interventions, unclear methods of randomisation, poor reporting and other risks of bias. Chinese herbal medicines for people with impaired glucose tolerance or impaired fasting blood glucose. Around 308 million people worldwide are reported to have 'impaired glucose tolerance'. These individuals show higher than normal blood sugar (glucose) levels, but do not meet diagnostic criteria for having type 1 or type 2 diabetes. This may provide a window in which to prevent or delay the onset of diabetes and its complications like cardiovascular disease. Within a decade of the initial diagnosis 'impared glucose tolerance' 25% to 75% are estimated to progress to diabetes. This review examined 16 randomised controlled trials of 15 different Chinese herbal medicines. The trials lasted from four weeks to two years (average nine months) and involved altogether 1391 participants. Death from any cause, diabetic complications and economic outcomes were not investigated. No serious adverse events were reported. The available evidence suggests that Chinese herbal medicines are able to lower and normalise high blood glucose. Due to considerable distortions (bias) in the trials, further high-quality and rigorously evaluated studies are required before any conclusions can confidently be reached about the effects of Chinese herbal medicines for the treatment of impaired glucose tolerance and the delay of diabetes onset.

Diverse sotanze tradizionali della medicina cinese possono aiutare a controllare i livelli di zucchero nel sangue nelle persone con un elevato rischio di sviluppare il diabete, secondo una ricerca australiana. L'equipe della dottoressa Suzanne J. Grant, del Centre for Complementary Medicine Research della University of Western Sydney, ha passato in rassegna 16 trial clinici condotti su 15 diversi composti di piante medicinali cinesi e ha scoperto che nel complesso le erbe hanno aiutato ad abbassare il glucosio nelle persone con pre-diabete, ovvero un ridotto controllo degli zuccheri nel sangue che può portare al diabete vero e proprio. Unendo l'uso di queste erbe a un cambiamento dello stile di vita (alimentazione corretta, attività fisica, etc.), i partecipanti agli studi raddoppiavano le probabilità di riportare i loro livelli di glucosio entro la norma. Inoltre, le persone che usavano le erbe cinesi avevano meno probabilità degli altri di sviluppare il vero e proprio diabete, come si legge sulla Cochrane Library, rivista della Cochrane Collaboration. Si tratta di risultati "promettenti", secondo la Grant. Gli studi esaminati dalla sua equipe hanno incluso in tutto 1.391 uomini e donne con intolleranza al glucosio o glucosio a digiuno fuori norma - problemi nel controllo degli zuccheri nel sangue che portano a una glicemia alta, ma non sono ancora considerati diabete. Gli studi hanno testato diversi mix di erbe cinesi usati per il controllo della glicemia: Jiangtang Bushen, Xiaoke Huaya, Tang Kang Yin. Nella maggior parte dei trial, i prodotti sono stati combinati con modifiche dello stile di vita. Non sono stati rilevati effetti collaterali. La dottoressa Grant tuttavia avverte: è presto per raccomandare la Medicina Cinese in caso di pre-diabete e questo perchè i trail finora condotti non sempre sono stati rigorosi e obiettivi. Inoltre, nella Medicina Cinese non c'è una formula che vale per tutti: il medico valuta caso per caso e prescrive il mix giusto di erbe per ciascun paziente e, pertanto, nella prescrizione occorre servirsi di medici esperti sia in medicina scientifica che in Medicina Cinese.

Omeopatia per il gatto

S. Palmerini Sintesi dalla tesi di laurea: Omeopatia e patologie delle vie urinarie del gatto: uno studio sperimentale. presentata alla Scuola Superiore Internazionale di Medicina Omeopatica Veterinaria "R. Zanchi" (Cortona, Arezzo), Anno Accademico 2007-2008

Lo studio si occupa di due casi di patologie delle basse vie urinarie nel gatto (FLUTD, Feline Lower Urinary Tract Disease), trattate con la medicina omeopatica. La FLUTD è molto frequente nella specie felina e la sua eziologia multifattoriale determina spesso delle risposte insoddisfacenti con terapie convenzionali. Si distingue in FLUTD ostruttiva che compare a seguito di ostruzione uretrale ed è frequente nel gatto maschio e in FLUTD non ostruttiva, associabile soprattutto a cistite idiopatica (64%), urolitiasi (15%) e difetti anatomici (11%). Il primo caso è quello di una gatta incrocio siamese di circa due anni, sterilizzata all'età di 10 mesi. L'animale presenta cistite, con fastidio alla minzione ed emissione di urina rossastra a gocce; inoltre all'esame delle urine nel sedimento sono presenti eritrociti, cristalli di struvite e cellule di sfaldamento. Dopo i primi accertamenti clinici il soggetto è stato dimesso con la sola terapia alimentare (mangime specifico per urolitiasi), posticipando ad una successiva visita la repertorizzazione e la valutazione della prognosi energetica; quindi è stato prescritto Agaricus 200CH per tre giorni in plus e contemporaneamente è stata sospesa la terapia alimentare specifica. Dopo 14 giorni dalla somministrazione del rimedio, si osserva un sensibile miglioramento della sintomatologia e dei parametri di laboratorio alterati. Il secondo

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caso clinico riguarda gatta europea di cinque anni, sterilizzata all'età di cinque mesi. Dopo avere diagnosticato una cistite con presenza di ematuria, stranguria, presenza nelle urine di numerosi cristalli di struvite e pH fortemente alcalino, l'animale viene sottoposto a regime dietetico specifico. Dopo circa due anni, a seguito della somministrazione errata di un alimento, si ripresenta la sintomatologia clinica della cistite (stranguria ed ematuria), confermata da un peggioramento dei paramentri di laboratorio. A questo punto si decide di procedere con la terapia omeopatica e si somministra Natrum carbonicum 200CH, per 5 giorni in plus, sospendendo contemporaneamente l'alimentazione dietetica. Le successive visite di controllo hanno evidenziato la scomparsa della sintomatologia clinica ed un netto miglioramento dei parametri urinari. In entrambi i casi il follow-up positivo del soggetto ha permesso un sensibile miglioramento della vita domestica e di relazione

La Società Italiana di Pediatria apre alle Medicine Complementari

È ufficiale la nascita della Commissione/Osservatorio per le Medicine Complementari (omeopatia, fitoterapia, agopuntura) all'interno della SIP, Società Italiana di Pediatria, storica Società Medico Scientifica della Pediatria Italiana.

L. Zanino

La commissione nasce dalla collaborazione tra SIP e SIOMI, oltre che dall'attenzione per il tema delle Medicine Complementari da parte del Prof. Gian Paolo Salvioli, Direttore del Dipartimento di Scienze Ginecologiche, Ostetriche e Pediatriche dell'Università di Bologna. Oltre al Prof. Salvioli, coordinatore della Commissione e al Prof. Gianfranco Temporin, Presidente della Commissione ECM in SIP, i componenti della commissione sono: la Presidente SIOMI Simonetta Bernardini, il vicepresidente SIOMI Francesco Macrì (segretario della commissione), il consigliere nazionale SIOMI Luisella Zanino e il già vicepresidente SIOMI Gianfranco Trapani.

Con l'istituzione della commissione si getta dunque un ponte per il confronto e lo scambio culturale fra la pediatria istituzionale, rappresentata dalla SIP, e la pediatria, rappresentata dalla SIOMI, che attraverso la conoscenza e l'applicazione delle medicine complementari, promuove l'integrazione dei saperi in medicina. I progetti della commissione sono ambiziosi: quantificare l'impiego delle Medicine Complementari in pediatria sul territorio nazionale, promuovere studi clinici di verifica sull'efficacia delle medicine complementari, valutare la congruità delle MC nel campo della tutela della salute del bambino, fornire al SSN dati sui costi delle MC, allestire un registro su scala nazionale per la segnalazione di eventuali effetti avversi. Il progetto prevede di far giungere ai pediatri SIP una corretta informazione riguardo le MC in ambito scientifico, attraverso convegni, seminari o altre modalità di approfondimento, favorendo anche l'inserimento a livello Universitario di Corsi di Formazione in Medicine Complementari per il pediatra; la Commissione sarà aperta ai soci SIP interessati e potrebbe diventare un gruppo di studio se il numero dei soci dovesse essere congruo e i risultati ottenuti lo indicassero opportuno. La SIOMI, accogliendo tra i propri iscritti un numero cospicuo di pediatri esperti in MC e iscritti alla SIP, rappresenta sicuramente una importante compagine iniziale di supporto alle iniziative che saranno intraprese.

CAM in Pediatria, analisi di un bisogno

A. Bondi

La letteratura scientifica sull'impiego delle CAM in pediatria non è avara di risposte, come ha illustrato la dottoressa Simonetta Bernardini nel convegno dedicato alle medicine complementari in pediatria svoltosi ieri a Firenze in collaborazione con l'ospedale pediatrico "Anna Meyer" nell'ambito della manifestazione Terra Futura. A fronte di un importante ricorso alle CAM, manca tutt'ora da parte dei pediatri di famiglia una consapevolezza del reale ricorso alle MC da parte dei loro pazienti: la Bernardini ha infatti illustrato i risultati ottenuti tramite la distribuzione di un questionario ai pediatri di famiglia e ai medici omeopati effettuato nell'anno 2005 come frutto di una collaborazione tra SIOMI e FIMP, in occasione del convegno SIOMI: "Omeopatia, pediatria e medicina di famiglia, un dialogo possibile?". I risultati dell'indagine evidenziarono che la percezione di ricorso all'omeopatia secondo i pediatri di famiglia era del 2-3% dei loro pazienti, mentre la recente indagine ISTAT riporta percentuali di ricorso alle CAM che arrivano oltre l'11%. Ne risulta che i bambini in cura con l'omeopatia e più in generale con le medicine complementari sono ancora divisi tra due medici, piuttosto che condivisi. Questo espone a rischi clinici di gestione e fragilizza anche l'immagine professionale dei medici cui è devoluta la loro assistenza sanitaria. Per questo la relatrice ha proposto con forza all'ospedale pediatrico l'avvio di una concreta collaborazione con i medici toscani esperti nelle medicine complementari. Le ha risposto il prof. Arico del servizio di oncologia pediatrica del Meyer, che ha convenuto sulla necessità di avviare percorsi di integrazione in oncologia pediatrica dichiarando la disponibilità del suo team ad accogliere una collaborazione in tal senso. Venendo alle cifre di ricorso alle CAM, la relatrice ha riportato i risultati di alcuni studi epidemiologici svolti sia in Europa che in America. In Europa, il 65% dei bambini Svizzeri ha una polizza

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aggiuntiva per il rimborso di prestazioni di CAM da parte delle assicurazioni per le malattie. In America il 60% dei bambini diabetici si avvale anche delle CAM e il ricorso alla medicina integrata è tanto maggiore quanto più sono gli anni di durata della malattia e quanto più il diabete si accompagna a comorbidità. In Israele le ragioni principali mediche di ricorso alle CAM sono le allergie (30%), infezioni recidivanti (22%) e i disturbi da deficit di attenzione (14%). In America Pediatrics riporta un importante ricorso alle CAM, in primis l'omeopatia, nelle malattie gastrointestinali croniche. Una ulteriore motivazione forte appare essere il dolore non ben controllato (particolarmente nel caso dell'artrite reumatoide giovanile) e la perdita di giorni di scuola. Le ragioni non mediche che spingono i genitori a ricorrere alle CAM sono uguali in tutto il mondo e comprendono: insoddisfazione per i risultati ottenuti con la sola medicina convenzionale; desiderio di una terapia nel contempo efficace e priva di effetti collaterali; esperienza nell'uso di CAM da parte dei genitori e parenti. Negli USA, infine, i dati raccolti in più ambulatori pediatrici registrano percentuali molto variabili di ricorso alle CAM dal 12% di Seattle al 70% di Detroit. La spesa media annua per CAM in pediatria nell'anno 2004 negli USA è stata di 127 milioni di dollari per l'acquisto di medicinali e di 23 milioni di dollari per le visite mediche.

Terra Futura 2010, Scaramuccia sulle Medicine Complementari

D. Vicarelli

Terra Futura, la mostra convegno internazionale delle buone pratiche di sostenibilità è una consuetudine annuale nel mese di maggio in Toscana. Altrettanto consueto il convegno dedicato alle Medicine Complementari che quest'anno ha visto protagonista la pediatria grazie anche alla partecipazione dell'Ospedale pediatrico "Meyer". I medici dei servizi toscani di medicina complementare e gli esperti delle discipline bionaturali sanno che è ricorrenza abituale l'intervento dell'assessore alla salute alla fine della mattinata dei lavori. Così è stato anche quest'anno e il Convegno è stato dunque anche l'occasione per incontrare il nuovo assessore alla salute della regione Toscana, l'ingegner Daniela Scaramuccia che vanta una lunga esperienza di lavoro nel campo della sanità nazionale. L'assessore non ha deluso la platea di specialisti dimostrando di avere piena dimensione del fenomeno medicine complementari. Nel corso del suo intervento ha dedicato particolare attenzione alla terminologia sottolineando con convinzione la validità della scelta della regione Toscana di abbandonare termini inadatti come medicina alternativa o non convenzionale per adottare il termine medicine complementari e medicina integrata. L'assessore, nel sostenere il valore primario dell'empowerment del cittadino, oramai più consapevole di un tempo verso i temi della salute, ha ribadito che la medicina deve avvalersi anche delle risorse di cura delle medicine complementari. Ha elogiato l'attività dei centri toscani di riferimento per l'omeopatia, l'agopuntura e la fitoterapia, ha evidenziato come oramai in Toscana siano attivi più di cento ambulatori di MC nel servizio pubblico e ha richiamato l'attenzione sul progetto innovativo dell'Ospedale di Pitigliano cui la regione destina un importante finanziamento nei prossimi due anni. Nel sottolineare come la regione si aspetti dall'Ospedale concreti risultati ha anche sottolineato che è proprio l'ospedale il livello più alto dell'integrazione in medicina.

Boiron-Garattini, due monologhi in diretta

S. Bernardini

Nella scorsa settimana la TV del Corriere della Sera.it ha organizzato un dibattito che è stato molto seguito in Italia tra il professore emerito dell'Istituto Mario Negri e Christian Boiron, Presidente mondiale dell'omonima azienda omeopatica. Tra noi addetti ai lavori l'impressione prevalente era che avrebbe potuto trattarsi di un dialogo piuttosto improbabile. Così è stato. Il professore del Mario Negri ha speso i suoi abituali contenuti: non ci sono evidenze scientifiche, nei medicinali c'è solo acqua, il danno più grosso che può fare l'omeopatia è curare con il nulla. Nulla di nuovo dunque, il professore si riconferma campione di pregiudizi, esponente della pura farmacologia riduzionista. Da parte sua Boiron, che abbiamo imparato a conoscere come filosofo oltre che come manager di un'industria, ha offerto alla platea e agli spettatori di internet molte riflessioni aprendo da un lato un'ampia finestra sulla complessità, non più eludibile, del concetto di salute e di malattia, ma anche sulle prove di efficacia dell'omeopatia. Il tutto senza derogare al suo abituale pragmatismo, che lo qualifica da sempre un sostenitore consapevole di entrambe le medicine, allopatica e omeopatica. Alla fine abbiamo assistito a due monologhi e non poteva essere altrimenti. Il giudizio globale è a favore dell'iniziativa del Corriere e ammiriamo lo sforzo del moderatore Ripamonti, che ha condotto il confronto con la sua classe abituale, intrisa di delicata attenzione sia per il tema che per entrambi i relatori. Certo, c'è bisogno anche di questo, di creare opinioni, di dibattere davanti a grandi platee il tema dell'integrazione delle cure, che sta segnando il consolidamento dell'omeopatia nella medicina della nostra epoca storica. Ma riteniamo che oramai a livello culturale la medicina integrata sia un movimento di pensiero saldamente proiettato in avanti grazie al lavoro equilibrato di altri accademici, filosofi, medici, farmacologi, scienziati che, a differenza di Garattini, si sono messi in gioco nel ripensare altrimenti il ruolo della medicina e della cura secondo concetti di alleanza terapeutica. E' grazie a

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questo esercizio interdisciplinare che si diffonde negli ospedali, nei servizi pubblici di medicina complementare, nelle aule universitarie che il pensiero dominante della medicina ritrova vitalità. Gli abbagli dei farmacologi convenzionali d'altronde sono proverbiali. Come non ricordare Clark, ad esempio, "grazie" al quale il fenomeno dell'ormesi, chiave di lettura della farmacologia delle microdosi, rimase al palo fino al giorno della sua morte avvenuta alla fine degli anni quaranta del secolo scorso. Convincere Garattini non è possibile. Questo era e resta palese. La riflessione che traiamo da questo ulteriore confronto ci convince ancora di più che la via dell'integrazione deve seguire la strada maestra del dibattito e della collaborazione tra uomini privi di pregiudizio. Per questo pensiamo sia giunta l'ora di rivolgere altrove i riflettori.

Fitoterapia e bronchite

Matthys H, Lizogub VG, Malek FA, Kieser M. Efficacy and tolerability of EPs 7630 tablets in patients with acute bronchitis: a randomised, double-blind, placebo-controlled dose-finding study with a herbal drug preparation from Pelargonium sidoides. Curr Med Res Opin. 2010 Jun;26(6): 1413-1422.

Up to 95% of acute bronchitis cases may be viral, yet antibiotics remain the conventional therapy. Clinical trials have demonstrated that the extract of Pelargonium sidoides EPs 7630 which is contained in Umckaloabo® (ISO Arzneimittel; Ettlingen, Germany) is effective in treating acute bronchitis in adults, infants, and children.1,2 In vitro studies have demonstrated moderate direct antibacterial activity, enhanced phagocytosis, improved ciliary beating, and immunomodulatory effects for the extract and/or its constituents. Prior clinical trials have used liquid EPs 7630 formulations. The purpose of this prospective, double-blind and placebo-controlled dose-finding clinical trial "was to investigate the efficacy and tolerability of EPs 7630 administered as tablets in the treatment of adults suffering from acute bronchitis." This double-blind clinical trial was conducted at 16 study centers in the Ukraine between February and April 2006. EPs 7630 extract consisted of a dried 11% w/w ethanolic root extract (1:8-10). Following a screening visit, the patients took their assigned treatment 30 minutes before meals 3 times daily for 8 days. The patients were randomized using a computer-generated randomization list to a placebo group or 1 of 3 treatment groups: 30, 60, or 90 mg EPs 7630/day. The primary efficacy measure was the change in the total bronchitis-specific symptoms (BSS) score from day 0 to day 7 as rated by an investigator. The BSS total score consists of 5 bronchitis symptoms rated on a scale of 0 (not present) to 4 (very severe): coughing, sputum, pulmonary rales at auscultation, chest pain while coughing, and dyspnoea. Patients and investigators completed the Integrative Medicine Outcomes Scale (IMOS), which rates the treatment outcome on a scale from 1 (complete recovery) to 5 (deterioration). The SF-12 Health Survey and EQ-5D were used to assess health-related quality of life. The Integrative Medicine Patient Satisfaction Scales (IMPSS) were used to assess the patients’ satisfaction with treatment from 1 (very satisfied) to 5 (very dissatisfied). The researchers assessed further parameters, including laboratory safety parameters, adverse events, acetaminophen use, inability to work, and change of general symptoms. The patients were over 18 and had been suffering from acute bronchitis starting 48 hours or less prior to inclusion into the study. They were allowed to take no more than 1,500 mg acetaminophen per day. Out of 406 patients who were randomized, 405 were included in the full analysis set (FAS) because 1 emergency envelope containing a patient’s treatment allocation was accidentally opened. The per protocol set (PPS) included 404 patients because 1 patient in the 30 mg EPs 7630 group took a forbidden concomitant medication. The FAS included 102 patients in the placebo group, 102 patients in the 30 mg EPs 7630 group, 101 patients in the 60 mg EPs 7630 group, and 100 patients in the 90 mg EPs 7630 group. There was 1 withdrawal in the placebo group (lack of efficacy), 2 withdrawals in the 30 mg group (other reason, forbidden concomitant medication), and 1 withdrawal in the 90 mg group (adverse event). The total BSS score decreased from day 0 to day 7 by 2.7 ± 2.3 (mean ± standard deviation) in the placebo group, 4.3 ± 1.9 in the 30 mg group, 6.1 ± 2.1 mg in the 60 mg group, and 6.3 ± 2.0 in the 90 mg group (P<0.0001 placebo vs. 30 mg, 60 mg, and 90 mg EPs 7630 groups). The BSS total score was also significantly lower in the 30, 60, and 90 mg EPs 7630 groups compared to the placebo group at days 3-5, and the difference increased in a dose-dependent manner through day 7 (P<0.0001 for all active treatment groups compared to placebo). The authors write that the decrease in the total BSS score was significantly greater in the 60 mg group compared to the 30 mg group (P value not given). At day 7, the BSS total score was below 3 points for 5.9% of the placebo group patients and for 24.5% of the 30 mg group, 57.4% of the 60 mg group, and 55.0% of the 90 mg group (P=0.0002 placebo vs. 30 mg, P<0.0001 for placebo vs. 60 and 90 mg groups). The BSS total score decreased by at least 7 points from day 0 to day 7 for 6.9% of the placebo group patients and 14.7%, 43.6%, and 46.0% of the patients in the 30, 60, and 90 mg EPs 7630 groups, respectively (P<0.0001 for placebo vs. 60 and 90 mg EPs 7630 groups). The reduction in the intensity of the individual BSS symptoms increased with increasing EPs 7630 dose (P<0.0001 for all). The reductions in coughing and pulmonary rales from day 0 to day 7 were significantly greater in each of the EPs 7630 groups compared to the placebo group (P<0.0001 for all). The reductions in sputum, chest pain while coughing, and dyspnoea were greater in the 60 and 90 mg groups compared to the placebo group (P<0.0001). Patients in the EPs 7630 groups experienced dose-dependent decreases from day 0 to day 7 in hoarseness, headache, limb pain, and fatigue/exhaustion (P=0.0006, P=0.0001, P=0.032, and P=0.0001,

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respectively). Both the patients' and investigators' IMOS ratings were better in all 3 EPs 7630 groups compared to the placebo group (P<0.0001 for all). In the placebo group, 10.8% of patients had completely recovered or major improvement ratings, while 39.2%, 69.3%, and 77.0% of the 30, 60, and 90 mg EPs 7630 groups, respectively, had completely recovered or major improvement ratings. The patients in all 3 EPs 7630 groups experienced earlier onsets of treatment effect compared to the placebo group (P<0.0001 for all). The median duration of inability to work was 8 days in the placebo group and 6 days in all 3 of the EPs 7630 groups (P<0.0001 for all). The EPs 7630 groups experienced shorter durations of activity limitation during the treatment period than the placebo group (P<0.0001 for all). The physical component score of the SF-12 improved to a greater degree in the EPs 7630 groups compared to the placebo group (P<0.0001 for all). The overall SF-12 score improved to a greater degree in all 3 EPs 7630 groups compared to the placebo group (P<0.0001 for all). The IMPSS scores showed that the EPs 7630 groups were more satisfied with the treatment than the placebo group patients (P<0.0001 for all). There were no significant changes in laboratory safety parameters. The majority of patients (97.8%) took their treatments as prescribed, with no significant differences in compliance rates between the groups. There were 92 mild-to-moderate adverse effects in 18.5% of patients during the study, and most were gastrointestinal complaints. The incidence of gastrointestinal disorders was dose-dependent, with 4.9% in the 30 mg group, 8.9% in the 60 mg group, and 14.9% in the 90 mg group. No adverse effects that occurred were considered serious.

These results are in alignment with other clinical trials that have shown liquid EPs 7630 to be effective in treating acute bronchitis. The authors conclude that "60 mg EPs 7630 daily constitutes the optimal dose with respect to the benefit-risk ratio of EPs 7630 tablets." The improvements in coughing and rales at auscultation may be related to the improvement in ciliary beating observed in vitro. Since "a useful alternative for the treatment of acute bronchitis outside the strict indication for antibiotic use is expedient," EPs 7630 could be considered as a safe and effective means of reducing unnecessary antibiotic use and/or public health system and sick leave costs.

References: 1Minigh J. Pelargonium sidoides found to be effective as a treatment for acute bronchitis. HerbClip. January 31, 2008 (050271-345). Austin, TX: American Botanical Council. Review of Pelargonium sidoides preparation (EPs 7630) in the treatment of acute bronchitis in adults and children by Matthys H, Kamin W, Funk P, Heger M. Phytomed. 2007;14:SVI 69-73.

L'action volontaire des autorités de Hong Kong en médecine traditionnelle

http://www.bulletins-electroniques.com/actualites/63591.htm

Le 26 mai 2010, une cinquantaine de délégués de l'Organisation Mondiale de la Santé et des représentants de huit pays, dont l'Australie, la Chine continentale, l'Allemagne, la Corée du Sud, le Japon, les Pays-Bas, l'Angleterre et les Etats-Unis se sont réunis à Hong Kong à l'occasion d'un séminaire technique de trois jours portant sur le premierprojet de classification internationale des médecines traditionnelles. Parmi les participants à cet événement, étaient présents des praticiens et des membres du monde académique. Le projet vise à développer une série de standards internationaux afin d'harmoniser la terminologie et la classification pour les médecines traditionnelles. Entre autre, il permettra également de mettre en place une plateforme pour compiler des statistiques sur la santé et des informations sur les médecines traditionnelles. Co-organisé par le département de la santé de Hong Kong, ce séminaire donne suite aux résultats des discussions d'un précédent groupe de travail de l'OMS et qui s'étaient également tenu à Hong Kong.

Il conflitto d’interesse della febbre suina

Il Post, 4 giugno 2010 | Scienza

Il rapporto sui conflitti d'interesse nell'Organizzazione Mondiale della Sanità è stato pubblicato sul British Medical Journal. Gli scienziati che hanno redatto le linee guide sull'uso dei vaccini anti-H1N1 avevano avuto legami con le aziende farmaceutiche. Un’inchiesta pubblicata sul British Medical Journal ha fatto luce su conflitti d’interesse che mettono in dubbio la trasparenza delle rilevazioni dell’Organizzazione Mondiale della Sanità sulla pericolosità del virus H1N1, comunemente conosciuto come “febbre suina”. Si è infatti scoperto che i tre esperti consultati dall’organizzazione per tracciare le linee guida sull’uso dei vaccini per affrontare la malattia avevano tutti lavorato in precedenza per la Roche, la casa produttrice del Tamiflu, e per la GlaxoSmithKline, produttrice del Relenza, due delle aziende farmaceutiche che hanno poi guadagnato con la vendita dei vaccini anti-H1N1. Nonostante le 18.000 morti causate dal virus, la relazione dell’OMS, come scrive Al Jazeera, si è rivelata decisamente più allarmista rispetto al pericolo reale. I tre esperti - Fred Hayden, Arnold Monto, Karl Nicholson - avevano svolto parti diverse del lavoro, redatto per consigliare i governi sul da farsi in merito ai vaccini. I tre, interrogati, hanno spiegato che non avevano nascosto all’OMS i loro precedenti rapporti con le aziende farmaceutiche per cui avevano lavorato. I conflitti

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d’interesse dei suoi collaboratori non sono mai stati resi pubblici dall’OMS, che ha definito le investigazioni sulla cattiva gestione della pandemia “teorie complottiste”. Le aziende farmaceutiche hanno guadagnato circa 7 miliardi di dollari nella vendita di vaccini ai governi.

Auricolo ed enuresi

YJ Chen, GY Zhou, and JH Jin. Transcutaneous electrical acupoint stimulation combined with auricular acupoint sticking for treatment of primary nocturnal enuresis]. Zhongguo Zhen Jiu, May 1, 2010; 30(5): 371-4. Acupuncture Department, The Free Medical Service Hospital of Changyuan County, Xinxiang City of Henan Province, Xinxiang 453400, China. cyj369@eyou.com

OBJECTIVE: To observe the therapeutic effect of transcutaneous electrical acupoint stimulation (TEAS) combined with auricular acupoint sticking (AAS) for treatment of primary nocturnal enuresis (PNE). METHODS: Two hundred and fifty cases of PNE patients were randomly divided into an observation group and a control group, 125 cases in each group. Two groups were treated on basis of the routine treatment, the observation group was treated with TEAS at Zhongji (CV 3), Qihai (CV 6) and Sanyinjiao (SP 6) etc. combined with AAS at Xin (heart), Shen (kidney), and Jiaogan (sympathytic) etc., once each day, 15 days constituting one course, an interval of 5 days between two courses, the therapeutic effect was evaluated after 3 courses of continuous treatment. The control group was treated with oral administration of Desmopressin Acetate (DA) and Meclofenoxate, the therapeutic effect was evaluated after 2 months of continuous treatment. RESULTS: The total effective rate of 96.8% (121/125) in observation group was superior to that of 90.4% (113/125) in control group (P < 0.05), the observation group was superior to control group in reducing the times of nocturia and enuresis, onset time and duration of effect (all P < 0.05). CONCLUSION: TEAS combined with AAS can reduce the times of nocturia and enuresis of PNE children, with significant therapeutic effect, taking quick effect and keeping long effect duration.

Agopuntura e dolore 1

Zhang X, Fan XN, Ding L, Zhang HT, Wu LZ, Wang HR. Acupuncture treatment of regulating spirit, activating blood and relieving pain for thalamic pain. Zhongguo Zhen Jiu. 2010 May;30(5):367-70.

OBJECTIVE: To compare the clinical effect of acupuncture treatment and western medicine Carbamazepine for thalamic pain. METHODS: Crossover trial design was used, 11 cases diagnosed as thalamic pain were randomly divided into two groups according to the mini-unbalance-index method, group I (with 6 cases received acupuncture first and then western medicine) and group II (with 5 cases received western medicine first and then acupuncture). When the effects were evaluated, the two groups were named as acupuncture group and western medicine group, 11 cases in each group. The method of clearing away the heart fire, regulating the spirit, activating blood and relieving pain was adopted in acupuncture treatment, Ximen (PC 4), Yinxi (HT 6), Xuehai (SP 10) and Zhaohai (KI 6) were selected; the western medicine group was treated with oral administration of Carbamazepine, and one course as well as the eluting period were both 10 days. The effects were evaluated with visual analogue scale (VAS) and evaluation scale of Anderson Cancer Center pain in US (MD Pain Evaluation value) respectively. RESULTS: The VAS and MD value in two groups were obviously decreased after treatment (both P < 0.05), while there was no significant difference between two groups; the markedly effective rate of pain relieving in acupuncture group was 63.6% (7/11), which was higher than that of 36.4% (4/11) in western medicine group, but there was no significant difference between two groups. CONCLUSION: Acupuncture treatment of regulating spirit, activating blood and relieving pain has a better therapeutic effect for thalamic pain, and can reach to the same therapeutic effect with western medicine Carbamazepine.

Agopuntura e dolore 2

Suarez-Almazor ME, Looney C, Liu Y, Cox V, Pietz K, Marcus DM, Street RL Jr. A Randomized controlled trial of acupuncture for osteoarthritis of the knee: Effects of patient-provider communication. Arthritis Care Res (Hoboken). 2010 Apr 21. [Epub ahead of print] Department of General Internal Medicine, Ambulatory Treatment, and Emergency Care - University of Texas M.D. Anderson Cancer Center (MSA, CL, VC).

OBJECTIVES: There is conflicting evidence on the efficacy of Traditional Chinese Acupuncture (TCA), and the role of placebo effects elicited by acupuncturists' behavior has not been elucidated. We conducted a 3-month randomized clinical trial in patients with knee osteoarthritis to compare the efficacy of TCA to sham acupuncture, and examine the effects of acupuncturists' communication style. METHODS: Acupuncturists were trained to interact in one of two communication styles: 'high' or 'neutral' expectations. Patients were randomized to one of 3 groups: waiting list, 'high' or 'neutral', and nested within style, TCA or sham acupuncture over 6 weeks. Sham acupuncture was performed in

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non-meridian points, with shallow needles and minimal stimulation. Primary outcome measures were: Joint-specific Multidimensional Assessment of Pain (J-MAP), Western Ontario McMaster Osteoarthritis Index (WOMAC), and satisfaction. RESULTS: 455 patients who received treatment (TCA or sham) and 72 controls were included. No statistically significant differences were observed between TCA or sham acupuncture, but both groups had significant reductions in J-MAP and WOMAC pain compared to the waiting group (-1.1, -1.0, and -0.1, p<0.001; -13.7, -14, -1.7, p<0.001). Statistically significant differences were observed in J-MAP pain reduction and satisfaction, favoring the 'high' expectations group. Fifty-two percent and 43% in the TCA and sham groups thought they had received TCA (kappa=0.05), suggesting successful blinding. CONCLUSION: TCA was not superior to sham acupuncture. However, acupuncturists' style had significant effects on pain reduction and satisfaction, suggesting that the analgesic benefits of acupuncture can be partially mediated through placebo effects related to the acupuncturist's behavior.

Agopuntura e dolore 3

Cassileth BR, Keefe FJ. Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain. Oncologist. 2010;15 Suppl 2:19-23. Memorial Sloan-Kettering Cancer Center, New York, New York, USA.

Integrative oncology is the synthesis of mainstream cancer care and evidence-based complementary therapies. Complementary strategies include massage therapies, acupuncture, fitness, and mind-body techniques, which take advantage of the reciprocal relationship between the mind and body. Neuropathic pain--and pain more generally--is part of a complex process involving the whole physical and psychosocial being, therefore requiring an integrative management approach. Several studies have demonstrated, for example, that social context plays an important role in the perception of pain and that a patient's coping strategies can influence the persistence of pain. In this article, we briefly describe research illustrating the promise of integrative approaches for the treatment of cancer-related neuropathic pain.

Agopuntura e vampate

Beer TM, Benavides M, Emmons SL, Hayes M, Liu G, Garzotto M, Donovan D, Katovic N, Reeder C, Eilers K. Acupuncture for Hot Flashes in Patients With Prostate Cancer. Urology. 2010 May 20. [Epub ahead of print] Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, Oregon.

OBJECTIVES: To determine the effect of acupuncture on hot flash frequency and intensity, quality of life, and sleep quality in patients undergoing hormonal therapy for prostate cancer. Hot flashes are a common adverse effect of hormonal therapy for prostate cancer. METHODS: Men who had a hot flash score >4 who were receiving androgen deprivation therapy for prostate cancer underwent acupuncture with electrostimulation biweekly for 4 weeks, then weekly for 6 weeks, using a predefined treatment plan. The primary endpoint was a 50% reduction in the hot flash score after 4 weeks of therapy, calculated from the patients' daily hot flash diaries. The hot flash-related quality of life and sleep quality and biomarkers potentially related to hot flashes, including serotonin, calcitonin gene-related peptide, and urinary 5-hydroxyindoleacetic acid, were examined. RESULTS: A total of 25 men were enrolled from September 2003 to April 2007. Of these, 22 were eligible and evaluable. After 4 weeks, 9 (41%, 95% confidence interval 21%-64%) of 22 patients had had a >50% reduction in the hot flash score. Of the 22 patients, 12 (55%, 95% confidence interval 32%-76%) met this response definition at any point during the therapy course. No patient had a significant increase in hot flash score during therapy. A reduced hot flash score was associated with improvement in the hot flash-related quality of life and sleep quality. CONCLUSIONS: Multiple placebo-controlled trials have demonstrated a 25% response rate to placebo treatment for hot flashes. Of the 22 patients, 41% had responded by week 4 and 55% overall in the present pilot study, providing evidence of a potentially meaningful benefit. Additional studies of acupuncture for hot flashes in this population are warranted. Copyright © 2010 Elsevier Inc. All rights reserved.

Medicine complementari e dolore

Schencking M, Kraft K. Inpatient treatment for postradical neck pain syndrome by use of complementary medicine] Forsch Komplementmed. 2010;17(2):81-6. Epub 2010 Mar 5. Kneippsche Kliniken, Bad Wörishofen, Germany. naturedoc@web.de

INTRODUCTION: The standard treatment of papillary thyroid cancer with a diameter >1 cm is thyroidectomy combined with a modified neck-dissection of the central (perithyroideal, prelaryngeal and tracheo-esophageal) lymph nodes and a consecutive radiation. Frequently, postoperative pain syndromes occur after this procedure. The so-called 'postradical neck pain syndrome' (PRNS) is a combination of cervical neuropathic pain, constricted and painful

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mobility of the shoulder region(s) including inhibited abduction capacity of the shoulder joint and a scapula alata. PRNS is often resistant to conventional therapy such as analgesics and physiotherapy. CASE REPORT: A 56-year-old female inpatient, suffering from a severe PRNS after thyroidectomy and neck dissection due to papillary thyroid cancer for the past 2 years, was treated with a combination of hydrotherapy according to Kneipp, conventional physiotherapy, acupuncture and cantharidin blisters in order to reduce neuropathic pain, increase the range of cervical mobility and improve parameters of health-related quality of life (based on SF-36). RESULTS: Within 4 weeks of combined treatment, the left-cervical neuropathic pain was improved remarkably, and the range of the cervical mobility was increased sufficiently. In addition, the SF-36 scales 'pain' and 'common well-being' were improved to a clinically relevant extent. The multi-modular treatment was well tolerated. CONCLUSIONS: In PRNS, a combination of several methods of complementary medicine may be an effective and well tolerated alternative to conventional treatment. Further clinical studies are required to confirm the results. Copyright 2010 S. Karger AG, Basel.

Agopuntura e dolore 4

Dean-Clower E, Doherty-Gilman AM, Keshaviah A, Baker F, Kaw C, Lu W, Manola J, Penson RT, Matulonis UA, Rosenthal DS. Acupuncture as Palliative Therapy for Physical Symptoms and Quality of Life for Advanced Cancer Patients. Integr Cancer Ther. 2010 May 18.

Background. Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL). METHODS: This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session. A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points. RESULTS: Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety, fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression (P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002), pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks. CONCLUSIONS: This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.

Infermiere e cancro

Kirshbaum M. Cancer-related fatigue: a review of nursing interventions. Br J Community Nurs. 2010 May;15(5):214-6, 218-9. School of Human and Health Sciences, University of Huddersfield. m.kirshbaum@hud.ac.uk

Fatigue is a common and distressing symptom that is a concern for cancer patients, their families, carers and health professionals. Cancer-related fatigue is a multidimensional phenomenon that is self-perceived and includes physical, emotional, cognitive and behavioural components. It can be unrelenting, disrupts daily life, fosters helplessness and may culminate in despair. The many causes of cancer-related fatigue stem from the disease itself, the cancer treatments and their side effects. The conclusion from a recent critical review of research evidence is that physical exercise and the treatment of underlying problems, such as anaemia or clinical depression, are effective interventions. However, a wide range of practical interventions and complementary therapies are likely to be helpful such as: acupressure and acupuncture, stress management and relaxation, energy conservation measures, anticipatory guidance and preparatory information, and attention-restoring activities. This article will provide a comprehensive review of current knowledge surrounding cancer-related fatigue and the nursing interventions that can be implemented in community practice.

Elettroagopuntura e cancro

Liu ZD, Pei J, Fu QH, Li HY, Yu QW, Zhang JY, Zhang DQ. [Influence of electroacupuncture and moxibustion and their treated mouse serum on the proliferation of the cultured splenetic CD4+ CD25+ regulatory T cells of tumor-bearing

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mice] Zhen Ci Yan Jiu. 2009 Aug;34(4):219-24. Department of Acu-moxibustion, Longhua Hospital Affiliated to Shanghai University of Chinese Medicine, Shanghai 200032, China. liu54643@163.com

OBJECTIVE: To observe the effect of electroacupuncture (EA) and moxibustion of "Dazhui" (GV 14) on the proliferation levels of the splenetic CD4+ CD25+ regulatory T cells (Tregs) of H22 tumor-bearing mice in vitro. METHODS: Forty eight Balb/c mice were randomized into control, model, moxibustion and EA groups, with 12 cases in each. H22 tumor-bearing model was set up by hypodermic injection of H22 tumor cells (0.2 ml, 1 x 10(7) cells/ml). EA (2 Hz, 2 mA) was applied to "Dazhui" (GV 14) and left "Huantiao" (GB 30) for 20 min, and moxibustion was applied to "Dazhui" (GV 14) 2 moxa-cones every time. The treatment was given from the 2nd day on after innoculation of tumor cells, once every other day, 6 times altogether. After the treatment, the mice were killed by peeling off the eyeball and blood samples were collected to be separated into serum. Then, Tregs of the spleen tissues of Balb/c mice in different groups were isolated by using megnetic activated cell sorting (MACS) system to be cultured independently, and co-cultured with EA-treated serum and moxibustion-treated serum separately in culture fluid for 96 h, added with 3H-tritiate thymidine (TdR) in the culture-fluid 12 h before the end of culture, followed by collecting the cells and detecting their proliferation levels (count per minute, cpm) by using a lipid scintillation device. RESULTS: The proliferation level of Tregs in model group was elevated significantly compared to normal control group (P < 0.05), while in comparison with model group, those of Tregs of EA and moxibustion groups decreased considerably (P < 0.01). After separate application of the diluted acupuncture-treated serum and moxibustion-treated serum at 1 : 1 and 1 : 8 (not 1 : 16 and 1 : 32) to the cultured Tregs, their proliferation levels (cpm) in EA and moxibustion groups were obviously upregulated in comparison to those of normal control group (P < 0.05), and the cpm in EA group was significantly higher than that in model group (P < 0.05), suggesting a different action mechanism between acupuncture-moxibustion treatment and serum stimulation. CONCLUSION: EA of "Dazhui" (GV 14) and "Huantiao" (GB 30) and moxibustion of "Dazhui" (GV 14) can effectively downregulate the proliferation level of the cultured splenetic Tregs of the tumor bearing mice. EA-treated serum and moxibustion-treated serum diluted at 1 : 1 and 1 : 8 can evidently upregulate the proliferation level of Tregs in vitro.

Meccanismo analgesico dell'agopuntura

Goldman N, Chen M, Fujita T, et al.Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture.Nat Neurosci. 2010 May 30.

L'agopuntura è una procedura invasiva usata comunemente per alleviare il dolore ed è una tecnica praticata in tutto il mondo, nonostante la difficoltà a conciliare i suoi principi con la medicina basata sulle prove di efficacia: questa l'introduzione dell'articolo di un gruppo di ricercatori americani sul meccanismo analgesico dell'agopuntura. I ricercatori hanno scoperto che una molecola, l'adenosina, neuromodulatore con proprietà analgesiche, viene rilasciata nei ratti durante il trattamento con agopuntura e che la sua azione analgesica dipende dall'espressione di un recettore adenosina A1. L'iniezione diretta di un agonista di questo recettore ha infatti replicato l'effetto analgesico indotto dall'agopuntura e l'inibizione di enzimi che degradano l'adenosina ha provocato un prolungamento dei benefici analgesici.

Neurotrofine e agopuntura

Manni L, Albanesi M, Guaragna M, Barbaro Paparo S, Aloe L. Neurotrophins and acupuncture.Auton Neurosci. 2010 May 7.

L'agopuntura è una tecnica terapeutica che è parte integrante della Medicina Tradizionale Cinese. Descrizioni occidentali dell'efficacia clinica di questa tecnica a livello del dolore, dell'infiammazione, della disfunzione motoria, dei disordini dell'umore e così via, sono basate sulla stimolazione di differenti classi di fibre sensoriali afferenti e sulla conseguente attivazione di processi fisiologici simili a quelli risultati dall'esercizio fisico o dal massaggio. La ricerca neurofisiologica ha evidenziato l'importanza degli oppioidi endogeni come principali mediatori biologici dell'azione terapeutica dell'agopuntura. Più recentemente l'accento è stato posto su altre classi di molecole, come i neurotrasmettitori, le citochine e i fattori di crescita, indicati come possibili mediatori per effetti specifici. Questo studio, di un gruppo di ricercatori italiani dell' Istituto di Neurobiologia e Medicina Molecolare del CNR di Roma, focalizza l'attenzione su alcuni fattori conosciuti come neurotrofine, implicati come mediatori nell'attività neurale e nella plasticità e riparazione a seguito di neurodegenerazione e/o danno da trauma, con particolare attenzione al ruolo del "nerve growth factor" (NGF) come mediatore degli effetti dell'agopuntura a livello del sistema nervoso centrale.

Agopuntura e performance sportiva

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Hübscher M, Vogt L, Ziebart T, Banzer W. Immediate effects of acupuncture on strength performance: a randomized, controlled crossover trial.Eur J Appl Physiol. 2010 May 25.

Lo studio vuole valutare l'efficacia immediata dell'agopuntura, rispetto alla sham agopuntura e alla laser agopuntura placebo, sulla performance sportiva, in particolare sull'allenamento della forza. Sono stati randomizzati 33 atleti non professionisti in uno studio crossover in doppio cieco, e sottoposti a trattamento con agopuntura, sham agopuntura e placebo laser agopuntura (con laser disattivato), con misurazione del test drop-jump e della forza massima isometrica volontaria a livello del quadricipite, associata ad analisi elettromiografica. I risultati dimostrano una differenza statistica tra agopuntura e laser-placebo ma non tra agopuntura e sham agopuntura. Gli studiosi concludono sulle potenzialità dell'agopuntura in campo sportivo, sia a livello di preparazioen atletica che di riabilitazione della funzione neuromuscolare.

Ansia e agopuntura

Pilkington K. Anxiety, depression and acupuncture: A review of the clinical research. Auton Neurosci. 2010 May 5.

La depressione e l'ansia insieme costituiscono un problema notevole a livello della salute umana. L'agopuntura è utilizzata frequentemente per il trattamento di queste patologie, ed il ricorso a questa tecnica è indubbiamente in crescita. Scopo di questo studio è quello di valutare i risultati scientifici prodotti fino ad ora su questo argomento. La base teorica dell'uso dell'agopuntura infatti è fondata sui principi della Medicina Tradizionale Cinese mentre l'agopuntura clinica si basa in gran parte sulla diagnosi convenzionale e legata alla neurofisiologia contemporanea. I trial sulla depressione e sui problemi legati all'ansia non sono pochi ma gli interventi di agopuntura sono spesso differenti, così come i controlli utilizzati. Inoltre molti studi soffrono del problema legati alla numerosità ridotta di pazienti arruolati. E' quindi piuttosto difficile provare l'efficacia definitiva di questa tecnica nelle patologie citate e alcuni risultati che provano l'uguale efficacia di agopuntura e sham-agopuntura non aiutano a raggiungere un parere univoco di questo tema. I ricercatori concludono quindi con la necessità di programmare ulteriori e più specifici studi sull'argomento.

Osteoartrite del ginocchio e agopuntura

Suarez-Almazor ME, Looney C, et al.A Randomized controlled trial of acupuncture for osteoarthritis of the knee: Effects of patient-provider communication. Arthritis Care Res (Hoboken). 2010 Apr 21.

Ci sono prove di efficacia contrastanti riguardanti l'effetto dell'agopuntura tradizionale cinese e il ruolo del placebo, in relazione al livello di comunicazione tra terapista e paziente. Gli autori di questo articolo hanno condotto uno studio randomizzato di 3 mesi in pazienti affetti da osteoartrite del ginocchio, confrontando agopuntura vera e sham agopuntura ed esaminando l'effetto della comunicazione tra terapista e paziente sui risultati ottenuti. Gli agopuntori sono stati preparati a comunicare con il paziente in due modi: uno "neutrale" e uno "intenso", e i pazienti sono stati quindi randomizzati in 3 gruppi e trattati con agopuntura o sham-agopuntura o non trattati per 6 settimane. La sham agopuntura è stata effettuata a livello di punti fuori meridiano, con stimolazione minima ed aghi-sham. Gli out-come clinici sono stati misurati con la scala J-MAP, specifica per il dolore articolare, il WOMAC (indice specifico per l'osteoartrite) e il questionario di soddisfazione. Non sono state rilevate differenze statistiche degne di nota tra il gruppo trattato con agopuntura vera e quello trattato con sham agopuntura, ma entrambi hanno dimostrato una riduzione dei due indici sopra-citati rispetto al gruppo di controllo. Il gruppo trattato con una comunicazione "intensa" ha invece dimostrato una riduzione del dolore ed un senso di soddisfazione maggiore rispetto agli altri, indicando che lo stile di comunicazione del medico agopuntura influisce sui benefici analgesici della terapia stessa.

Omeopatia 1

Rodrigues-Neto JF, Figueiredo MF, Faria AA. Prevalence of the use of homeopathy by the population of Montes Claros, Minas Gerais, Brazil. Sao Paulo Med J. 2009 Nov;127(6):329-34.

CONTEXT AND OBJECTIVE: Homeopathy is a therapeutic system that uses small doses of substances to stimulate autoregulatory and self-healing processes. The aim of this study was to investigate the prevalence of the use of homeopathy by the population of Montes Claros, Brazil, and the socioeconomic profile of users. DESIGN AND SETTING: Probabilistic cross-sectional study with cluster sampling, in the city of Montes Claros, Minas Gerais. METHODS: This study was conducted by applying semi-structured questionnaires. The sample was composed of 3,080 people. For the statistical analysis, Student's t test and the chi-square test were used. The statistical significance level used was P < 0.05. RESULTS: We interviewed 3,090 people. The prevalence of the use of homeopathy was 2.4%. The factors associated with its use were female gender, schooling and income. The main reason that led to seeking

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homeopathy was "Conventional treatment did not have any effect". For 70.2% of the users, the cost of the treatment was considered reasonable or cheap. About 73% were satisfied or very satisfied with the treatment received through homeopathy. CONCLUSIONS: The prevalence of the use of homeopathy found here was less than that reported in other countries. People with higher income and schooling levels used homeopathy more frequently. There was higher prevalence among women. Most users declared themselves satisfied with the treatment received.

Omeopatia 2

Bhattacharyya SS, Paul S, Khuda-Bukhsh AR. Encapsulated plant extract (Gelsemium sempervirens) poly (lactide-co-glycolide) nanoparticles enhance cellular uptake and increase bioactivity in vitro. Exp Biol Med (Maywood). 2010 Jun 1;235(6):678-88.

Ethanolic extract of Gelsemium sempervirens (family: Loganiaceae), henceforth to be called EEGS, is used in various traditional systems of medicine. In homeopathy, EEGS is known as mother tincture of G. sempervirens, which is generally used to treat pain and respiratory ailments. We demonstrated earlier anticancer activity of crude EEGS by in vitro studies on human HeLa cells. To test the hypothesis if nanoparticle-encapsulated extract (now onwards to be called NEEGS) could enhance cellular uptake and thereby improve bioactivity, we formulated nanoparticle encapsulation based on poly (lactide-co-glycolide) (PLGA) and confirmed encapsulation by scanning electron microscopy (SEM) and atomic force microscopy. EEGS was encapsulated with 81.6% efficiency in PLGA biodegradable nanoparticle formulation and F68 (polyoxyethylene-polyoxypropylene) was used as a stabilizer. Dynamic laser light scattering and SEM indicated a particle diameter of 122.6 nm. The zeta potential of the drug-loaded nanoparticles was -14.8 mV. NEEGS was characterized for their biological activities in a skin cancer cell line A375 in vitro. NEEGS exhibited relatively rapid (30 min) and more efficient cellular uptake than their un-encapsulated counterpart (45 min). Analysis of data of apoptosis study using Annexin V-FITC, terminal transferase dUTP nick end labeling assay and DNA ladder revealed that encapsulated EEGS was more potent than their un-encapsulated counterpart in inducing apoptosis of A375 cells. Reverse transcriptase-polymerase chain reaction data of survivin, cyclin-D1, caspase-3, PCNA and p53 also corroborated well to suggest greater potentials of NEEGS as anticancer agents.

Omeopatia 3

Thompson EA, Bishop JL, Northstone K. The use of homeopathic products in childhood: data generated over 8.5 years from the Avon Longitudinal Study of Parents and Children (ALSPAC). J Altern Complement Med. 2010 Jan;16(1):69-79.

BACKGROUND: Very little is known about the use of homeopathic products (HP) in children. The Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based cohort in the South-West of England, has collected homeopathic data through self-completion questionnaires posted to the mother at regular time points throughout childhood. The aim of this article is to describe the use of these products in a large cohort of children from birth to 8.5 years of age. METHODS: Questions asked about the use of HP within a preceding time period at seven time points from birth to 8.5 years of age. Additional questions at 18 and 81 months asked about the conditions treated and at 81 months who had prescribed the HP. RESULTS: Eleven and eight-tenths percent (11.8%) of this cohort used a HP at least once up to 8.5 years of age. Chamomilla for teething and Arnica for soft-tissue bruising were the most commonly used products. The most frequently prescribed products were for common self-limiting infantile conditions such as colic, cuts and bruises, and teething. Parents were most likely at 81 months to prescribe HP for their children (46.3% of all prescription sources) and 10% of products were prescribed by general practitioners. Confusion about what constituted a HP was present in nearly 10% of answers. CONCLUSIONS: No other study, to our knowledge, has been able to map the use of HP over such a long time period in such a large cohort of children. The amount of HP use reflects a significant minority of the population who use complementary and alternative medicine treatments to manage the health of their family. Health care professionals should be aware of the confusion surrounding HP and have knowledge around some of the more commonly used HP. Parents and carers are using homeopathy wisely with appropriate remedies consistently used for acute problems. Research could focus on greater information delivery to the community and monitoring of potential health and cost benefits, or side-effects of the use of HP for acute and chronic conditions in children.

E' recentissimo questo lavoro su JACM dedicato a valutare, attraverso un record di 8,5 anni il tipo di prescrizione omeopatica effettuata nei pazienti pediatrici. Lo studio, denominato "Avon Longitudinal Study of Parents and Children" (ALSPAC), è stato condotto nel Regno Unito (nell'ospedale omeopatico e universitario di Bristol) arruolando 14.541 donne in gravidanza che hanno consentito di monitorare 13.988 nati vivi alla fine del primo anno di vita. I dati ottenuti hanno riguardato le caratteristiche genetiche, ambientali, socioeconomiche delle famiglie prese in esame e, a scadenze programmate (1,5, 4,5, 5,5, 6,5, 7,5, e 8,5 anni) ha previsto domande dettagliate sull'uso di farmaci omeopatici: quali, per quali indicazioni e sulla base di quale prescrizione. I risultati sono molto interessanti. L'11,8% dei bambini ha usato almeno una volta un farmaco omeopatico all'età di 8 anni. L'uso più frequente è stato all'età di 1,5 e di 8,5 anni, mentre l'uso più saltuario all'età di 6,5. Chamomilla è stato il farmaco più usato a 18 mesi mentre Arnica lo è stato in tutte le altre fasce di età. Tra gli altri farmaci o prodotti si segnala Belladonna, Pulsatilla, Aconitum

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e Calendula (quest'ultima per applicazioni topiche). Le patologie più frequentemente affrontate sono differenti in base all'età: a 18 mesi le coliche, le malattie da raffreddamento, la tosse, i disturbi da dentizione, l'eczema; negli anni successivi sintomi respiratori, sintomi intestinali, traumi. E' interessante la segnalazione relativa a chi ha stabilito la terapia: i genitori nel 46% dei casi, un medico omeopata nel 14,7% dei casi, uno specialista omeopata nel 12% dei casi, il medico di famiglia nel 10% dei casi, il farmacista nel 6,3% dei casi. Ricerche di questo tipo, molto importanti per fornire dati utili e indicare le opportunità di inserimento della medicina omeopatica nel sistema sanitario, prevedono sicuramente un impegno rilevante considerando la vastità del campione e la durata della ricerca, tale da poter richiedere l'avvicendarsi di più ricercatori nel tempo.

Omeopatia 4

Lewith G, Barlow F, Eyles C, Flower A, Hall S, Hopwood V, Walker J. The context and meaning of placebos for complementary medicine. Forsch Komplementmed. 2009 Dec;16(6):404-12. Epub 2009 Dec 4.

Calls for placebo-controlled randomised trials in complementary and alternative medicine (CAM) are entirely reasonable. However, they present major methodological problems, particularly when we understand so little about the underlying biological mechanisms involved for many of these therapies. Designing a placebo in CAM is frequently dependent on unsubstantiated assumptions about the specificity of a particular CAM intervention. In this paper we address the development and application of placebos to clinical trials of homeopathy, acupuncture, kinesiology, Chinese herbal medicine and healing. Each therapy-based vignette is authored by a researcher from the Complementary and Integrated Medicine Research Unit at the University of Southampton who has specific expertise in the field. The essential research question within this review is; can we legitimately claim to have placebos for these particular CAM interventions? In some areas of CAM the debate has become very involved and sophisticated, for instance in acupuncture but for other areas, such as healing, our understanding of placebos is currently limited and very naïve. For instance, if acupuncture is not point specific, then many so-called 'placebo-controlled' acupuncture trials are both misconceived and misleading. We have addressed this debate in what we hope is a thoughtful and rigorous manner with a view to developing realistic, reliable and credible placebos for randomized controlled studies when and where possible. However, our conclusions suggest that we are some way from developing valid, credible and reliable placebos for most CAM therapies.

Piante

Zhang MJ, Chu KD, Cheng XL. Effect of aike mixture on fibroplasia and inflammatory infiltration in rats with non-bacterial prostatitis. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Jan;29(1):46-50.

OBJECTIVE: To assess the anti-inflammatory effect of Aike Mixture (AKM) on rats with nonbacterial prostatitis (NBP). METHODS: Rat model of NBP was established by injection of Xiaozhiling Injection. The experimental rats were randomized into 7 groups: the three AKM groups (A1, A2 and A3), treated with high, middle and low dose of AKM respectively, the 2 positive control groups (C1 and C2), treated by Bazheng Mixture (BZM) and Qianliexian Decoction (QLXD) respectively, the model control group (Cm) and the sham-operative control group (Cso). The pathological changes in rats' prostate were observed by light microscope and transmission electron microscope. RESULTS: Significant differences in the number and structure of acini, mesenchyma, as well as the degrees of anti-fibroplasia and inflammatory cell infiltration were shown between the treated groups (A1, A2, A3, C1, C1, C2) and the untreated groups (Cm, Cso), with statistical significance (P < 0.05 or P < 0.01). However, the anti-fibroplasia and anti-inflammatory effects in A1 were better than that in the two positive control groups significantly (P < 0.05 or P < 0.01). CONCLUSIONS: AKM is a new TCM drug functioned for dispersing Gan-qi in treating NBP. It shows a better efficacy than that of BZM and QLXD, the two Chinese herbal medicines for clearing heat with remove dampness and activating blood circulation to remove stasis, respectively. Aike Mixture; prostatitis; pathological observation

Piante

Li CJ, Liu JX, Liu LS. Regulatory effect of jianpi wenshen recipe in combining with chemotherapy on the blood level of estradiol in patients with lung cancer. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Jan;29(1):26-9. Shanghai Clinical Medicine Centre of Traditional Chinese Medicine Oncology, Tumor Department of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai. lichunjie1997@hotmail.com

OBJECTIVE: To observe the regulatory effect of Jianpi Wenshen Recipe (JPWS), a Chinese herbal preparation for strengthening Pi and warming Shen, combined with chemotherapy on the level of estradiol (E2) in patients with mid-late non-small cell lung cancer (NSCLC), and to analyse the relationship between the changes of estradiol and tumor

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size. METHODS: Fifty-one NSCLC patients were randomized into three groups: 16 cases in the JPWS group treated with JPWS alone, 18 cases in the test group treated with combined therapy of JPWS plus chemotherapy, and 17 cases in the chemotherapy group treated with chemotherapy alone, all were treated for 2 months. The changes of blood E2 level and tumor size before and after treatment were compared. RESULTS: The disease control rate in the JPWS group and combined therapy group was 53.85% (7/13) and 80.00% (8/10), respectively, both were higher than that in the chemotherapy group (44.40%, 4/9), but the difference showed statistical insignificance (P > 0.05). E2 level was significantly lowered after treatment in the former two groups (all P < 0.05), and the change was in accordance with that of tumor size in 26 out of 31 patients (P < 0.01). CONCLUSION: JPWS combined with chemthherapy can stabilize the tumor size and down-regulate E2 levelo, with the change of E2 correlated with that of tumor size in patients. Hence, decreasing E2 is one of the mechanisms for JPWS in treating lung cancer.

Piante

Sun HX, Qin J, Zhou YQ. [Influence of xlaoliu baofei pill combined with chemotherapy on quality of life of patients with advanced non-small cell lung cancer] .Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Jan;29(1):23-5. Henan Provincial Traditional Chinese Medicine Hospital, Zhengzhou. doctorsun995@yahoo.com.cn

OBJECTIVE: To objectively assess the influence of Xiaoliu Baofei Pill (XBP) combined with chemotherapy on quality of life (QOL) of patients with stage III-IV non-small cell lung cancer (NSCLC). METHODS: Forty NSCLC patients were equally randomized into 2 groups, the treated group treated with XBP plus chemotherapy, and the control group treated with chemotherapy alone. Patients' QOL was assessed by Functional Assessment of Cancer Therapy (FACT-L) before and after treatment. RESULTS: The scores of the physical condition in the treated group was relatively stable while it lowered significantly as time went by in the control group, significant difference was shown as compared with before treatment and with that in the treated group at the same time points (P < 0.05); scores of the mood condition, the function conditions and additional concerned condition were improved gradually from the 3rd collection in the treated group, but decreased in the control group, although some improvement of mood and function conditions had revealed temporarily in the early stage of treatment. Comparison between groups showed significant difference (P < 0.05). Besides, no significant change was found in domains of patient-doctor relation and society/family condition in both groups. CONCLUSION: XBP combined with chemotherapy can obviously improve the QOL of advanced NSCLC patients.

Piante

Wu WY, Long SQ, Chai XS. [Effect of shenfu injection for attenuating the toxicity of cisplatin-based regimens in treating non-small cell lung cancer] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Jan;29(1):19-22. Department of Cancer, Second Clinical School of Guangzhou University of Traditional Chinese Medicine. wwanyin@126.com

OBJECTIVE: To observe the effect of Shenfu Injection (SFI) for attenuating the toxicity of chemotherapy in treating non-small-cell lung cancer (NSCLC), by the regimens of combined Cisplatin (DDP) with new chemotherapeutic agents, Taxol (TXT), Vinorelbine (NVB) and Gemcitabine (GEM), respectively. METHODS: One hundred and thirty-three patients with NSCLC, who were scheduled to be treated by at least 2 cycles of chemotherapy, with regimen TP (45 cases), NP (42 cases) and GP (46 cases), were enrolled. They were randomized into 2 groups: 67 cases in the SFI pre-treated group and 66 cases in the SFI post-treated group, on them SFI was administered for 10 successive days on the 1st, 2nd, 3rd day of the 1st and the 2nd cycle, respectively. The effects of SFI on toxicity of the three regimens were observed through a self-controlled crossover design. RESULTS: The hemato-toxicity (the toxicity on leukocyte, neutrophil, hemoglobin and platelet) and the digestive toxicity (represented as vomiting, constipation or diarrhea) of chemotherapy revealed in the treated stage (the cycle treated with SFI) were all less than those in the control stage (the cycle untreated with SFI), no matter when SFI was applied, all showed statistical significance (P < 0.05 or P < 0.01). Besides, SFI showed a better toxicity attenuating effect on patients of qi-deficiency and phlegm-dampness type (P < 0.01). CONCLUSION: SFI can relieve the hemato-toxicity and the digestive toxicity of chemotherapy by regimen of combining DDP with TXT, NVB or GEM, and the effect is more significant on patients of qi-deficiency and phlegm-dampness type.

Martelletto e paralisi

Han X, Shang Q, Ma BX. [Clinical observation on plum-blossom needle on Governor Vessel and point Jiaji (EX-B 2) for treatment of cerebral palsy of involuntary movement] Zhongguo Zhen Jiu. 2010 May;30(5):359-63.

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OBJECTIVE: To probe into an effective therapy for treatment of cerebral palsy of involuntary movement. METHODS: Sixty cases were randomly divided into two groups, the control group was treated with routine rehabilitation method (Bobath + Tuina + scalp acupuncture), while the observation group was treated with plum-blossom needle on Governor Vessel and point Jiaji (EX-B 2) on the basis of routine rehabilitation method. After 3 months of treatment, therapeutic effect, total percentage of Gross Motor Function Measurement (GMFM), incurvation reflex and muscular tension fluctuation were compared. RESULTS: The obvious effective rate of 53.3% (16/30) in the observation group was superior to that of 20.0% (6/30) in the control group (P < 0.05); the total percentage of GMFM increased, incurvation reflex disappeared, muscular tension fluctuation relieved in both groups after treatment (P < 0.05, P < 0.01), but the indices above all improved more significantly in the observation group than those in the control group (P < 0.05, P < 0.01). CONCLUSION: Plum-blossom needle on Governor Vessel and point Jiaji (EX-B 2) on the basis of routine rehabilitation method for treatment of cerebral palsy of involuntary movement can enhance the gross motor function, make the incurvation reflex disappear effectively, relieve the muscular tension fluctuation.

Broccoli e cancro

Yanyan Li, et al. Sulforaphane, a Dietary Component of Broccoli/Broccoli Sprouts, Inhibits Breast Cancer Stem Cells. Clin Cancer Res; 16(9); 2580–90. ©2010 AACR.

Purpose: The existence of cancer stem cells (CSCs) in breast cancer has profound implications for cancer prevention. In this study, we evaluated sulforaphane, a natural compound derived from broccoli/broccoli sprouts, for its efficacy to inhibit breast CSCs and its potential mechanism. Experimental Design: Aldefluor assay and mammosphere formation assay were used to evaluate the effect of sulforaphane on breast CSCs in vitro. A nonobese diabetic/severe combined immunodeficient xenograft model was used to determine whether sulforaphane could target breast CSCs in vivo, as assessed by Aldefluor assay, and tumor growth upon cell reimplantation in secondary mice. The potential mechanism was investigated using Western blotting analysis and β-catenin reporter assay. Results: Sulforaphane (1-5 μmol/L) decreased aldehyde dehydrogenase–positive cell population by 65% to 80% in human breast cancer cells (P < 0.01) and reduced the size and number of primary mammospheres by 8- to 125-fold and 45% to 75% (P < 0.01), respectively. Daily injection with 50 mg/kg sulforaphane for 2 weeks reduced aldehyde dehydrogenase–positive cells by >50% in nonobese diabetic/severe combined immunodeficient xenograft tumors (P = 0.003). Sulforaphane eliminated breast CSCs in vivo, thereby abrogating tumor growth after the reimplantation of primary tumor cells into the secondary mice (P < 0.01). Western blotting analysis and β-catenin reporter assay showed that sulforaphane downregulated the Wnt/β-catenin self-renewal pathway. Conclusions: Sulforaphane inhibits breast CSCs and downregulates the Wnt/β-catenin self-renewal pathway. These findings support the use of sulforaphane for the chemoprevention of breast cancer stem cells and warrant further clinical evaluation.

Polifenoli e the verde

K. Schutz, M. Sass, A. de With, H-J. Graubaum, J. Grunwald. “Immune-modulating efficacy of a polyphenol-rich beverage on symptoms associated with the common cold: a double-blind, randomised, placebo-controlled, multi-centric clinical study” British Journal of Nutrition, Published online ahead of print, 04-Jun-2010

A juice containing of green tea, grape seed and grape skin extract and shiitake mushroom may reduce the incidence of common cold, says a new study from Germany. Volunteers receiving the polyphenol-rich drink experienced improvements in their symptoms of the common cold indicating a strengthening of the body’s immune defences, according to findings published in the British Journal of Nutrition. “The study population can be characterised as having impaired immune defence, similar to subjects eating an unbalanced diet or exposed to physical stress, and thus, being sensitive for nutritional benefits,” wrote researchers from Rudolf Wild GmbH and Berlin-based CRO analyze & realize. “Therefore, the study population can be further considered as an appropriate target to demonstrate the clinical benefits of an immune stimulation and there is no reason to assume that the observed improvement cannot be extrapolated to the general population.”

Antioxidants. Polyphenols are receiving extensive research due to their potent antioxidant activity, their ability to mop-up harmful free radicals, and the associated health benefits. Many have also been implicated in possible protection against diseases such as cancer and cardiovascular disease, while some have been reported to potentially offer protection from Alzheimer's. The new study, funded by Rudolf Wild GmbH, indicates a potential role as an immune booster. The German scientists recruited 98 people reporting symptoms of the common cold that started in the previous 24 hours. The participants were randomly assigned to received the polyphenol-rich beverage of a control beverage twice a day for 10 days. At the end of the study, results showed a significant decrease in the severity of symptoms, including ‘general feeling of sickness’, ‘stuffy nose/sniffle’, ‘sore throat and/or difficulty swallowing’, ‘headache and/or joint aches’, and ‘hoarseness and/or cough’. This showed a “clear improvement”, said the

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researchers, compared with the placebo group that showed less of a decrease. The difference between the groups was “highly significant”, said the researchers. Commenting on the potential mechanism, the researchers note that previous studies have shown that green tea catechins and L-theanin may improve the function of T-cells, thereby boosting immune function. The presence of the compound cyanidin 3-O-glucoside in grapes may also explain the results. An earlier study has reported that the compound may inhibit COX-1 and COX-2 enzymes in a similar way to “non-steroidal anti-inflammatory and analgesic drugs such as aspirin and ibuprofen, explaining the pronounced effect on headache and joint pains seen in the [polyphenol-rich juice] group”. The vitamin C content of the juice (61.4 milligrams per 500 ml) may also be enhancing immune function, added the researchers. “The results of the present study suggest that consumption of the investigated polyphenol-rich beverage strengthens the body’s defence and improves immune function in the general population, which may translate into clinically measurable effects in individuals having impaired immune defence due to physical stress or already existing infections,” they concluded.

Zenzero e dolore muscolare

Christopher D. Black, Matthew P. Herring†, David J. Hurley‡, Patrick J. O'Connor. Ginger (Zingiber officinale) Reduces Muscle Pain Caused by Eccentric Exercise. Jounarl of pain, published online 26 April 2010.

Ginger has been shown to exert anti-inflammatory effects in rodents, but its effect on human muscle pain is uncertain. Heat treatment of ginger has been suggested to enhance its hypoalgesic effects. The purpose of this study was to examine the effects of 11 days of raw (study 1) and heat-treated (study 2) ginger supplementation on muscle pain. Study 1 and 2 were identical double-blind, placebo controlled, randomized experiments with 34 and 40 volunteers, respectively. Participants consumed 2 grams of either raw (study 1) or heated (study 2) ginger or placebo for 11 consecutive days. Participants performed 18 eccentric actions of the elbow flexors to induce pain and inflammation. Pain intensity, perceived effort, plasma prostaglandin E2, arm volume, range-of-motion and isometric strength were assessed prior to and for 3 days after exercise. Results Raw (25%, –.78 SD, P = .041) and heat-treated (23%, –.57 SD, P = .049) ginger resulted in similar pain reductions 24 hours after eccentric exercise compared to placebo. Smaller effects were noted between both types of ginger and placebo on other measures. Daily supplementation with ginger reduced muscle pain caused by eccentric exercise, and this effect was not enhanced by heat treating the ginger. Perspective. This study demonstrates that daily consumption of raw and heat-treated ginger resulted in moderate-to-large reductions in muscle pain following exercise-induced muscle injury. Our findings agree with those showing hypoalgesic effects of ginger in osteoarthritis patients and further demonstrate ginger's effectiveness as a pain reliever.

Succo di mirtillo e metabolismo cellulare

P. E. Milbury, J. A. Vita, J. B. Blumberg. Anthocyanins are Bioavailable in Humans following an Acute Dose of Cranberry Juice. The Journal of Nutrition,Published online ahead of print: doi:19-May-2010

A new US study shows cranberry juice anthocyanins have only limited absorption but the researchers note that, in spite of this low bioavailability, the levels may be sufficient to generate a sustained health beneficial effect in terms of cell metabolism and gene expression. Cranberries contain a variety of anthocyanins, which are a sub-group of flavonoids, with reports in the literature suggesting flavonoids are powerful antioxidants, protecting the body from oxidative stress. Health benefits recently linked to cranberries include cardioprotective effects, anti-cancer properties and reversal of age-related motor behavioural deficits. However, the authors of the study, which was published in The Journal of Nutrition, said that teh compounds responsible for this bioactivity have not yet been fully determined. The researchers, based at Tufts University and Boston University Medical Center, said that, to their knowledge, there have been no detailed pharmacokinetic studies of anthocyanins after acute cranberry juice consumption. They added that little is known about the absorption and metabolism of anthocyanins. And the trigger for their research, they said, was a desire to increase understanding of the bioavailability and benefits of these compounds. Method. Fifteen volunteers with an average age of 62 and with established coronary artery disease were recruited to participate in this research, said the authors. They explained that after fasting overnight, the participants arrived at the Boston University Medical Center where they each drank 480 ml of a double-strength cranberry juice containing 94 mg anthocyanins. Plasma samples, continued the scientists, were taken immediately prior to juice consumption and then at intervals of one, two, three and fours hours subsequent to drinking the juice. They added that urine was collected at the beginning and end of the four hour study, with samples then analyzed for anthocyanin concentrations. Findings. Following cranberry juice consumption, the researchers said they were able to detect 7 of the 15 known cranberry-derived anthocyanins in both blood and urine, while highest plasma concentrations tended to occur within 1.4 hours after consumption. However, they found that the concentrations detected in plasma confirmed a relatively low level of intestinal absorption of these compounds. In addition, the scientists said they found significant variability among individuals in

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terms of when and how much of the anthocyanins were absorbed and excreted. Recovery of these compounds in the urine ranged from 0.078-3.2 per cent, added the authors. This variability, they explained, might be due to small genetic differences (polymorphisms) leading to differences in absorption and metabolic clearance between individuals or to differences intestinal microorganism populations that break down and metabolize the various anthocyanins. The authors concluded that circulating anthocyanin levels after cranberry juice consumption are too low to have health beneficial effects in terms of free radical quenching. But they concluded that the levels of the compounds may be sufficient to influence cell signal transduction, gene expression, and cellular metabolism and could have a more sustained health beneficial effect.

The verde e obesità

F. Thielecke, G. Rahn, J. Böhnke, F. Adams, A.L. Birkenfeld, J. Jordan, M. Boschmann. Green tea extract effective for weight loss at low doses. “Epigallocatechin-3-gallate and postprandial fat oxidation in overweight/obese male volunteers: a pilot study” European Journal of Clinical Nutrition. Published online ahead, 09-Apr-2010

Daily supplements of a purified extract of green tea may increase energy expenditure and help men beat the bulge, say results from a new human study. A low dose of epigallocatechin gallate (EGCG) from green tea was found to increase fat oxidation by 33 per cent, according to findings published in the European Journal of Clinical Nutrition. “This pilot study provides for the first time evidence that a single green tea catechin, EGCG, can increase fat oxidation in obese men, at least within 2 h after meal intake. Within this postprandial phase, EGCG is equipotent with caffeine with regard to fat oxidation,” wrote the authors, led by Frank Thielecke from DSM Nutritional Products. Growing waistlines, growing market. With the World Health Organization estimating that by 2015, there will be more than 1.5 billion overweight consumers, incurring health costs beyond $117 billion per year in the US alone, the opportunities for a scientifically-substantiated weight management food product are impressive. Green tea has been studied extensively for its potential in the weight management category, with the compound epigallocatechin gallate (EGCG) highlighted as a key component. Three mechanisms have been proposed: EGCG could increase energy metabolism and fatty acid oxidation; inhibit fat cell development (apidogenesis); and/or reduce lipid absorption and increase fat excretion. It has also been reported that caffeine must also be present as, for EGCG to aid weight loss, a stimulated nervous system is needed. The new research, performed in collaboration with scientists from Universitary Medicine Berlin, supports the link between caffeine and EGCG, but also found that the compounds produce similar effects. A daily dose of 300 mg of EGCG was associated with a 33 per cent increase in fat oxidation, while a daily dose of 200 mg caffeine was linked to a 34.5 per cent increase. When male subjects were given a combination of EGCG (300 mg) and caffeine (200 mg), fat oxidation increased by almost 50 per cent, added the researchers. The EGCG used in the study was DSM's Teavigo ingredient, with 94 per cent EGCG purity.

Study details. Thielecke and his co-workers recruited ten healthy overweight and obese men (average BMI of 31.3 kg/m2) to participate in the randomized, placebo-controlled, double-blind crossover trial. The men were randomly assigned them to one of five groups: Placebo, low-dose EGCG (300 mg), high-dose EGCG (600 mg), caffeine (200 mg), or EGCG plus caffeine (300 mg/200 mg). The men took the supplements for three days, then seven days of washout, and cross-over to another group. At the end of the study, all the men had participated in each group. Results showed that during two hours after a meal, the low-dose EGCG supplementation was associated with a 33 per cent increase in fat oxidation. The high-dose EGCG supplementation produced a non-significant 20 per cent increase, compared to placebo. Caffeine alone was associated with a 34.5 per cent increase, compared with placebo, while the combined EGCG/ /caffeine supplement boosted fat oxidation by 49 per cent. “There is no synergism of low EGCG and 200 mg caffeine,” stated the researchers. Commenting on the difference between high and low dose EGCG, the researchers noted that the lower dose may be optimal for affecting energy expenditure and higher doses do not provide any additional effects. The results obtained for the combination of EGCG and caffeine may be related to the amount of time the compounds remain in the blood, with the so-called half-life of EGCG reprted to be about two hours while caffeine has a half-life of about four hours. “Therefore, EGCG affects obviously the early, whereas caffeine affects both early and late postprandial fat oxidation,” added Thielecke and his co-workers.

Support from other science. A recent review from researchers at Pennsylvania State University concluded that the science supporting the weight management potential of green tea and its extracts was (Journal of Nutrition, doi: 10.3945/jn.109.115972). Dr Josh Lambert, assistant professor in the Department of Food Science at Penn State told NutraIngredients.com that laboratory studies and small-scale human intervention studies “indicate that consumption of tea might promote weight loss, help maintain body weight following weight loss, and prevent the development of some diseases associated with obesity such as diabetes and fatty liver disease”. “The effective doses seem to be 3 to 10 cups of green tea per day,” he added.

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Erbe e legislazione

EU Herbal medicines directive discussed in China. http://www.nutraingredients.com/ By staff reporter, 21-May-2010

Legislation such as the Traditional Herbal Medicinal Products Directive (THMPD) based on western ideas of medicine must be rethought if whole sectors such as Traditional Chinese Medicines (TCMs) are not be wiped from shelves, a delegation to China has heard. Dr Robert Verkerk and Meleni Aldridge of the Alliance for Natural Health International (ANH-I) visited government authorities, academic and research institutions and enterprise organisations who registered concern at the course being adopted by regulations such as the THMPD. The THMPD is due to take full effect in March 31, 2011. The meetings were organised by Professor Mei, the vice chair of the World Federation of Chinese Medicine Societies and the Specialty Committee of the Chinese Materia Medica. Professor Mei said of the visit: “The issue of optimum integration of eastern and western healthcare systems is high on the agenda if healthcare systems are to benefit from medical traditions that have evolved over millennia. I strongly support all actions that work towards achieving this aim. As an east-west integrator, my life's work is devoted to cultivating East-West understanding for a better world. Regulations should be reasonable to engender human progress.” Dr Verkerk and Aldridge made presentations criticising the “severe and disproportionate” impact of the THMPD on TCMs, and said those with TCM interests in China and Europe, “will seek to forge a reasonable regulatory regime for non-European traditions.” “EU legislation on traditional medicines has not taken into account the complex nature of very long-standing non-European medical systems,” Dr Verkerk said. “As a result, it discriminates against the traditional medical systems of both China and the Indian sub-continent, amongst others. These two systems alone are integral to over one-third of the world’s population. It is vital that amendments to the THMPD are enacted urgently to allow its better adaptation to the diverse range of long-standing traditions for which it was originally designed.”