Use of Herbal Medicines for the Treatment of Mild Mental Disorders and/or Symptoms During Pregnancy: A Cross-Sectional Survey

Little is known about the treatment of mild mental disorders and/or symptoms (MDS) during pregnancy. Our main purpose was to compare the use of herbal medicines during pregnancy in women with and without MDS. A questionnaire consisting of 21 multiple-choice questions was distributed in the participating obstetrics clinics or birth centers in the Canton of Zurich, in Switzerland, from August 2018 to March 2019; 398 questionnaires were considered in the analysis. The use of any type of herbal medicines–including pharmaceutical herbal products as well as teas–during pregnancy was reported by 358 women (out of 398, 89.9%). Of these, 272 participants used pharmaceutical herbal products, whereby ginger (49.2%), raspberry leaf (42.7%), bryophyllum (37.8%), chamomile (27.2%), lavender (22%) and iron-rich herbs (12.3%) were the ones most commonly mentioned. More than half (207/398, 52.0%) of all participants reported suffering from MDS during pregnancy; only a few took (synthetic) psychoactive medications (5/398, 1.3%). The percentage of use of pharmaceutical herbal medicines was higher among women reporting MDS than among the remaining women (90.0 vs 75.9%; p < 0.001). At the same time, the prevalence of MDS was higher among users of pharmaceutical herbal products than among non-users (59.6 vs 34.0%; p = 0.001). Specific questions on candidate herbal medicines for the treatment of mild MDS revealed that bryophyllum (mentioned by 107 women), lavender (56 women) and valerian (20 women) were used to reduce stress, restlessness, sleep disorders and others, in part with perceived good to very good effectiveness and tolerability. The large majority of the pregnant women participating in the survey make use of herbal medicines. The particularly high prevalence of MDS among herbal medicine-users and the very rare use of synthetic psychoactive medications suggest that pregnant women rely on herbal medicines for treatment of mild MDS. The reported good effectiveness and tolerability of a few candidate herbal medicines deserve particular attention

Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial

International audienceAbstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2  300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016

Ventilatory settings in the initial 72 h and their association with outcome in out-of-hospital cardiac arrest patients: a preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial

International audienc