Ethnobotanical notes about some uses of medicinal plants in Alto Tirreno Cosentino area (Calabria, Southern Italy)

<p>Abstract</p> <p>Background</p> <p>The present paper contributes to enrich the ethnobotanical knowledge of Calabria region (Southern Italy). Research was carried out in Alto Tirreno Cosentino, a small area lying between the Tyrrhenian coast and the Pollino National Park. In the area studied medicinal plants still play a small role among farmers, shepherds and other people who live far from villages and built-up areas.</p> <p>Methods</p> <p>Information was collected by interviewing native people, mainly elderly – engaged in farming and stock-raising activities – and housewives. The plants collected, indicated by the locals, have been identified according to "Flora d'Italia". The <it>exsiccata </it>vouchers are preserved in the authors' own <it>herbaria</it>.</p> <p>Results</p> <p>52 medicinal species belonging to 35 families are listed in this article. The family, botanical and vernacular name, part of the plant used and respective manipulation are reported there and, when present, similar or identical uses in different parts of Calabria or other Italian regions are also indicated.</p> <p>Conclusion</p> <p><it>Labiatae</it>, <it>Rosaceae </it>and <it>Leguminosae </it>are the families most frequently present, whilst <it>Compositae </it>and <it>Brassicaceae </it>are almost absent. The uses of the recorded species relate to minor ailments, mainly those of the skin (15 species), respiratory apparatus diseases (11), toothache, decay etc. (10) and rheumatic pains (8). The easy availability of these remedies provides a quick way of curing various minor complaints such as tooth-ache, belly and rheumatic pain and headaches and can also serve as first aid as cicatrizing, lenitive, haemostatic agents etc. The role in veterinary medicine is, on the contrary, more important: sores, ulcers, tinea, dermatitis, gangrenous wounds of cattle, and even respiratory ailments are usually cured by resort to plants.</p

Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial

Background The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. Methods TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50\ue2\u80\u9375 years with type 2 diabetes inadequately controlled with metformin monotherapy (2\ue2\u80\u933 g per day) were recruited from 57 diabetes clinics in Italy. Patients were randomly assigned (1:1), by permuted blocks randomisation (block size 10), stratified by site and previous cardiovascular events, to add-on pioglitazone (15\ue2\u80\u9345 mg) or a sulfonylurea (5\ue2\u80\u9315 mg glibenclamide, 2\ue2\u80\u936 mg glimepiride, or 30\ue2\u80\u93120 mg gliclazide, in accordance with local practice). The trial was unblinded, but event adjudicators were unaware of treatment assignment. The primary outcome, assessed with a Cox proportional-hazards model, was a composite of first occurrence of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or urgent coronary revascularisation, assessed in the modified intention-to-treat population (all randomly assigned participants with baseline data available and without any protocol violations in relation to inclusion or exclusion criteria). This study is registered with ClinicalTrials.gov, number NCT00700856. Findings Between Sept 18, 2008, and Jan 15, 2014, 3028 patients were randomly assigned and included in the analyses. 1535 were assigned to pioglitazone and 1493 to sulfonylureas (glibenclamide 24 [2%], glimepiride 723 [48%], gliclazide 745 [50%]). At baseline, 335 (11%) participants had a previous cardiovascular event. The study was stopped early on the basis of a futility analysis after a median follow-up of 57\uc2\ub73 months. The primary outcome occurred in 105 patients (1\uc2\ub75 per 100 person-years) who were given pioglitazone and 108 (1\uc2\ub75 per 100 person-years) who were given sulfonylureas (hazard ratio 0\uc2\ub796, 95% CI 0\uc2\ub774\ue2\u80\u931\uc2\ub726, p=0\uc2\ub779). Fewer patients had hypoglycaemias in the pioglitazone group than in the sulfonylureas group (148 [10%] vs 508 [34%], p&lt;0\uc2\ub70001). Moderate weight gain (less than 2 kg, on average) occurred in both groups. Rates of heart failure, bladder cancer, and fractures were not significantly different between treatment groups. Interpretation In this long-term, pragmatic trial, incidence of cardiovascular events was similar with sulfonylureas (mostly glimepiride and gliclazide) and pioglitazone as add-on treatments to metformin. Both of these widely available and affordable treatments are suitable options with respect to efficacy and adverse events, although pioglitazone was associated with fewer hypoglycaemia events. Funding Italian Medicines Agency, Diabete Ricerca, and Italian Diabetes Society