Blue Cohosh: History, Science, Safety, and Midwife Prescribing of a Potentially Fetotoxic Herb

Abstract: Blue Cohosh: Science, Safety, And Patterns of Midwife Prescribing Of A Potentially Fetotoxic Herb Aviva Jill Romm (Sponsored by Errol Norwitz) Department of Obstetrics and Gynecology, Yale University School of Medicine Background: Blue cohosh (Caulopyhyllum thalictroides) has been used traditionally and historically as an obstetric aid for labor induction, to assure a prompt delivery, to relieve childbirth pain, and to induce abortion. Officially listed in the United States Pharmacopoeia from 1882-1905 and in the National Formulary from 1916-1950 for labor induction, its use remains popular. Maternal ingestion has been implicated in acute nicotinic toxicity, neonatal heart failure, perinatal stroke, and multiorgan ischemia. Hypothesis and Aims of the Study: This study evaluates blue cohosh use patterns amongst midwives and asseses the relationship between maternal ingestion in pregnancy and adverse neonatal outcomes. Methods: (1) A systematic review of the literature was conducted in major computerized databases (MEDLINE, CAB Abstracts, CINAHL, BIOSIS, and Cochrane Library) using the subject headings pregnancy AND blue cohosh; pregnancy and Caulophyllum thalictroides; blue cohosh; and Caulophyllum thalictroides; and (2) a formal structured survey was devised and implemented to evaluate midwife use of this herb. Results: 1) A systematic review of the literature identified 10 published pharmacology papers from 1954-2008, 2 abstracts, a college senior paper; 1 teratogenicity study, 4 independent case reports, 2 general papers, 1 review of blue cohosh associated risks, and 6 published letters. 2) Survey: Blue cohosh was the most popular labor induction agent amongst the 90 midwife-respondents to the survey. The rate of adverse effects was 22%. Conclusions: While the pharmacology of blue cohosh supports the adverse outcomes with which use of this herb has been associated, the case reports do not demonstrate causality. While midwives report an increased incidence of adverse effects with use of this herb, confounding factors may be responsible. Nonetheless, the pharmacology of the herb and the ease with which it is available over the counter is cause for concern. Prospective and retrospective studies of use in pregnancy must be conducted to adequately determine safety. First trimester use and use as a partus preparator must be avoided; use for labor induction and augmentation should only occur with the guidance of a trained obstetric care provider, if at all

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 132

This special bibliography lists 261 reports, articles, and other documents introduced into the NASA scientific and technical information system in August 1974

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 267, January 1985

This publication is a cumulative index to the abstracts contained in the Supplements 255 through 266 of Aerospace Medicine and Biology: A Continuing Bibliography. It includes seven indexes--subject, personal author, corporate source, foreign technology, contract number, report number, and accession number

Aerospace Medicine and Biology: 1983 cumulative index

This publication is a cumulative index to the abstracts contained in the Supplements 242 through 253 of Aerospace Medicine and Biology: A Continuing Bibliography. It includes six indexes--subject, personal author, corporate source, contract number, report number, and accession number

Modern Telemetry

Telemetry is based on knowledge of various disciplines like Electronics, Measurement, Control and Communication along with their combination. This fact leads to a need of studying and understanding of these principles before the usage of Telemetry on selected problem solving. Spending time is however many times returned in form of obtained data or knowledge which telemetry system can provide. Usage of telemetry can be found in many areas from military through biomedical to real medical applications. Modern way to create a wireless sensors remotely connected to central system with artificial intelligence provide many new, sometimes unusual ways to get a knowledge about remote objects behaviour. This book is intended to present some new up to date accesses to telemetry problems solving by use of new sensors conceptions, new wireless transfer or communication techniques, data collection or processing techniques as well as several real use case scenarios describing model examples. Most of book chapters deals with many real cases of telemetry issues which can be used as a cookbooks for your own telemetry related problems

Psychology

Psychology is designed to meet scope and sequence requirements for the single-semester introduction to psychology course. The book offers a comprehensive treatment of core concepts, grounded in both classic studies and current and emerging research. The text also includes coverage of the DSM-5 in examinations of psychological disorders. Psychology incorporates discussions that reflect the diversity within the discipline, as well as the diversity of cultures and communities across the globe.https://commons.erau.edu/oer-textbook/1000/thumbnail.jp

Aerospace medicine and biology, an annotated bibliography. volume xi- 1962-1963 literature

Aerospace medicine and biology - annotated bibliography for 1962 and 196

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Neuroglia

This book is a compiled version of the journal Neuroglia. It was a peer-review Open Access journal by MDPI that investigated a wide range of glia related topics. Now the journal is published as a section of the journal Brain Sciences, with a new section Editor-in-Chief Prof. Sergey Kasparov