COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?

Background: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for “respiratory diseases” within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. Results: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches

Evaluation of Anti-Inflammatory Activity of Citrus latifolia Tanaka Essential Oil and Limonene in Experimental Mouse Models

The genus Citrus (Rutaceae) includes several species of plants that produce some of the most cultivated fruits in the world, providing an appreciable content of essential oil. In folk medicine, they are used as a cholagogue, antipyretic, anti-inflammatory, sedative, and antitoxic effects. Lemon essential oil has been used since ancient times for its antiseptic, carminative, diuretic, and eupeptic effects. In this study, we investigated the anti-inflammatory activity of Citrus latifolia Tanaka essential oil (CLEO) and its main constituent LIM. In the cell viability assay, CLEO and LIM (3, 10, 30, and 90 g/mL) had low cytotoxicity. In zymosan-induced peritonitis, LIM (500 mg/kg) decreased the infiltration of peritoneal exudate leukocytes and decreased the number of polymorphonuclear leukocytes. In vitro chemotaxis revealed that CLEO and LIM (1, 3, and 10 g/mL) promoted a significant reduction of neutrophil migration toward fMLP and LTB 4 . LIM (500 mg/kg) also reduced TNF-levels but did not alter IL-10 levels in the peritoneal exudate. In conclusion, this study showed that LIM isolated from CLEO had potential anti-inflammatory effects, likely by inhibiting proinflammatory mediators present in inflammatory exudate and leukocyte chemotaxis

Evaluation of Anti-Inflammatory Activity of Citrus latifolia Tanaka Essential Oil and Limonene in Experimental Mouse Models

The genus Citrus (Rutaceae) includes several species of plants that produce some of the most cultivated fruits in the world, providing an appreciable content of essential oil. In folk medicine, they are used as a cholagogue, antipyretic, anti-inflammatory, sedative, and antitoxic effects. Lemon essential oil has been used since ancient times for its antiseptic, carminative, diuretic, and eupeptic effects. In this study, we investigated the anti-inflammatory activity of Citrus latifolia Tanaka essential oil (CLEO) and its main constituent LIM. In the cell viability assay, CLEO and LIM (3, 10, 30, and 90 μg/mL) had low cytotoxicity. In zymosan-induced peritonitis, LIM (500 mg/kg) decreased the infiltration of peritoneal exudate leukocytes and decreased the number of polymorphonuclear leukocytes. In vitro chemotaxis revealed that CLEO and LIM (1, 3, and 10 µg/mL) promoted a significant reduction of neutrophil migration toward fMLP and LTB4. LIM (500 mg/kg) also reduced TNF-α levels but did not alter IL-10 levels in the peritoneal exudate. In conclusion, this study showed that LIM isolated from CLEO had potential anti-inflammatory effects, likely by inhibiting proinflammatory mediators present in inflammatory exudate and leukocyte chemotaxis

Saúde Móvel: novas perspectivas para a oferta de serviços em saúde

Resumo OBJETIVO: revisar e discutir as novas perspectivas para a oferta de serviços em saúde decorrentes do desenvolvimento da saúde móvel e dos dispositivos vestíveis inteligentes. MÉTODOS: foi realizada revisão não sistemática da literatura para identificar artigos completos, cujos títulos destacassem o termo 'mHealth' e/ou 'Smart wearable', publicados nos últimos 15 anos. RESULTADOS: foram identificadas 467 publicações em periódicos indexados ao portal da Capes, 75 delas levadas em consideração pela análise; foram consolidadas evidências quanto às novas possibilidades decorrentes da disseminação da saúde móvel, aglutinadas segundo as categorias 'monitoramento de condições de saúde', 'transmissão de informações e análises de dados' e 'diagnóstico e terapêutica'. CONCLUSÃO: os trabalhos revisados sugerem que a oferta de serviços de saúde sofrerá alterações ao longo dos próximos anos, no que tange às categorias analisadas, o que exigirá um esforço de adaptação por parte dos profissionais de saúde, acadêmicos e usuários

Saúde Móvel: novas perspectivas para a oferta de serviços em saúde

Resumo OBJETIVO: revisar e discutir as novas perspectivas para a oferta de serviços em saúde decorrentes do desenvolvimento da saúde móvel e dos dispositivos vestíveis inteligentes. MÉTODOS: foi realizada revisão não sistemática da literatura para identificar artigos completos, cujos títulos destacassem o termo 'mHealth' e/ou 'Smart wearable', publicados nos últimos 15 anos. RESULTADOS: foram identificadas 467 publicações em periódicos indexados ao portal da Capes, 75 delas levadas em consideração pela análise; foram consolidadas evidências quanto às novas possibilidades decorrentes da disseminação da saúde móvel, aglutinadas segundo as categorias 'monitoramento de condições de saúde', 'transmissão de informações e análises de dados' e 'diagnóstico e terapêutica'. CONCLUSÃO: os trabalhos revisados sugerem que a oferta de serviços de saúde sofrerá alterações ao longo dos próximos anos, no que tange às categorias analisadas, o que exigirá um esforço de adaptação por parte dos profissionais de saúde, acadêmicos e usuários

Effects of Thymol and Carvacrol, Constituents of Thymus vulgaris L. Essential Oil, on the Inflammatory Response

Thyme (Thymus vulgaris L., Lamiaceae) is an aromatic and medicinal plant that has been used in folk medicine, phytopharmaceutical preparations, food preservatives, and as an aromatic ingredient. The effect of Thymus vulgaris essential oil (TEO) and its isolated constituents thymol and cavacrol (CVL) were studied in the following experimental models: ear edema, carrageenan-induced pleurisy, and chemotaxis in vitro. In the pleurisy model, TEO, CVL, and thymol significantly inhibited inflammatory edema. However, only TEO and CVL inhibited leukocyte migration. In the in vitro chemotaxis experiment, CVL inhibited leukocyte migration, whereas thymol exerted a potent chemoattractant effect. In the ear edema model, CVL (10 mg/ear), applied topically, reduced edema formation, exerting a topical anti-inflammatory effect. Thymol did not reduce edema formation but rather presented an irritative response, probably dependent on histamine and prostanoid release. Our data suggest that the antiinflammatory effects of TEO and CVL are attributable to the inhibition of inflammatory edema and leukocyte migration

Incorporation of hydrogen production process in a sugar cane industry: Steam reforming of ethanol

This work presents a technical, ecological and economic analysis of hydrogen production incorporation through ethanol steam reforming at a traditional sugarcane industry (sugar, ethanol). This proposal is reached through a reduction in the amount of fuel (bagasse) that is normally utilized to generate electricity without affecting the sugar and ethanol production processes, however. This surplus bagasse is utilized to produce steam for hydrogen production. In order to achieve this, it is calculated the available bagasse and maximum hydrogen amount and their inputs (hydrated and anhydrous ethanol). Based on the aforementioned, the investment needs are estimated, where the operation and maintenance cost, the operation period, the interest rate, and the annuity are considered. The incorporation of this new process is assessed through a comparison of this innovative plant with the traditional ones. (C) 2014 Elsevier Ltd. All rights reserved.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq