Traditional aromatherapy in the clinical context of a therapeutic community for the treatment of substance use disorders

Western medicine and psychotherapy have historically overlooked the potential of engaging the sense of smell for therapeutic purposes. However, in other medical traditions, such as that of the Peruvian Amazon, specific therapeutic interventions based on the use of aromatic plants are commonly performed in conjunction with other healing modalities. Traditional specialized healers locally known as perfumeros conduct such healing sessions. This research describes how this kind of traditional Amazonian aromatherapy is used in the context of Takiwasi center, a therapeutic community specialized in the treatment of substance use disorders. Participant observation was carried out by shadowing the healers in charge of specific aromatherapy sessions including the so-called plant baths, sahumerio, and saunas. Additionally, semi structured interviews were conducted with several members of Takiwasi’s therapeutic staff, and non-peer reviewed publications and audio-video materials present in the Takiwasi archive were consulted and used as original data for this research. Data on users that received a plant bath from July 2019 to February 2021, were also acquired and discussed. The cosmology beyond this kind of traditional aromatherapy includes concepts such as “energetic body” and “spiritual entities”, opening the discussion on something beyond the mere materialistic aspect of aromatic chemistry and pharmacology

Adverse Drug Reactions in Children—A Systematic Review

Adverse drug reactions in children are an important public health problem. We have undertaken a systematic review of observational studies in children in three settings: causing admission to hospital, occurring during hospital stay and occurring in the community. We were particularly interested in understanding how ADRs might be better detected, assessed and avoided

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A systematic methodology to assess the identity of plants in historical texts: A case study. based on the Byzantine pharmacy text John the Physician's Therapeutics

Ethnopharmacological relevance: In recent decades, the study of historical texts has attracted research interest, particularly in ethnopharmacology. All studies of the materia medica cited in ancient and medieval texts share a concern, however, as to the reliability of modern identifications of these substances. Previous studies of European or Mediterranean texts relied mostly on authoritative dictionaries or glossaries providing botanical identities for the historical plant names in question. Several identities they suggest, however, are questionable and real possibility of error exists. Aim of the study: This study aims to develop and document a novel and interdisciplinary methodology providing more objective assessment of the identity of the plants (and minerals) described in these resources. Materials and methods: We developed an iterative experimental approach, using the 13th century Byzantine recipe text John the Physician's Therapeutics in its Commentary version (JC) as a case study. The methodology has six stages and relies on comparative analyses including statistical evaluation of botanical descriptions and information about medicinal uses drawn from both historical and modern sources. Stages 1-4 create the dataset, stage 5 derives the primary outcomes to be reviewed by experts in stage 6. Results: Using Disocorides' De Materia Medica (DMM) (1st century CE) as the culturally related reference text for the botanical descriptions of the plants cited in JC, allowed us to link the 194 plants used medicinally in JC with 252 plants cited in DMM. Our test sample for subsequent analyses consisted of the 50 JC plant names (corresponding to 61 DMM plants) for which DMM holds rich morphological information, and the 130 candidate species which have been suggested in the literature as potential botanical identities of those 50 JC plant names. Statistical evaluation of the comparative analyses revealed that in the majority of the cases, our method detected the candidate species having a higher likelihood of being the correct attribution from among the pool of suggested candidates. Final assessment and revision provided a list of the challenges associated with applying our methodology more widely and recommendations on how to address these issues. Conclusions: We offer this multidisciplinary approach to more evidence-based assessment of the identity of plants in historical texts providing a measure of confidence for each suggested identity. Despite the experimental nature of our methodology and its limitations, its application allowed us to draw conclusions about the validity of suggested candidate plants as well as to distinguish between alternative candidates of the same historical plant name. Fully documenting the methodology facilitates its application to historical texts of any kind of cultural or linguistic background

Pharmaceutical Terminology in Ancient and Medieval Time – "Andrachne", "Chrysocolla" and Others

Ancient and medieval pharmacological and medical texts contain a substantial amount of plant and mineral names. In some cases, the identification is straightforward. But for the majority of the data, we are unable to identify these ingredients with high certainty. In this paper, we discuss a selection of plant and mineral names both from a humanities and sciences point of view. In one case, the scientists were even able to examine a plant in situ. The conclusion of our paper is that a close collaboration between sciences and humanities is essential to avoid mistakes in the identification of materia medica

Treatment-resistant synovitis and radiographic progression are increased in elderly-onset rheumatoid arthritis patients : findings from a prospective observational longitudinal early arthritis cohort study

© 2020 Elsevier Inc. All rights reservedBackground: Clinical outcomes in elderly-onset rheumatoid arthritis (EORA), starting after the age of 60, are conflicting. Thus, we aimed to investigate in a unique biopsy-driven, treatment-naïve early arthritis cohort, the relationship between synovial pathobiology of elderly- (EORA) and younger-onset rheumatoid arthritis (YORA) patients through clinical, imaging and treatment response outcome-measures. Methods: Patients (n = 140) with early RA (<12months) starting before (YORA, n = 99) or after (EORA, n = 41) age 60 had an ultrasound-guided synovial biopsy prior to conventional immunosuppressive therapy and after 6 months. Clinical, ultrasound and radiographic data were collected prospectively and compared between groups and against immunohistological features. Using multivariate logistic regression, we determined predictors of clinical response (disease activity score-28-erythrocyte sedimentation rate [DAS28-ESR]<3.2) at 6 months and radiographic progression ( 1-unit-increase in Sharp van der Heijde [SvdH] score) at 12 months. Results: EORA patients were more frequently male and presented most commonly with an abrupt, polymyalgia rheumatica-like onset and extra-articular features. Both before and after treatment, DAS28-ESR was similar but ultrasound synovial-thickening (p<0.05) and power-Doppler (p<0.01) synovitis and SvdH (p<0.001) scores were higher in EORA patients. EORA was independently associated with poor treatment response at 6 months (OR=0.28, p = 0.047) and radiographic progression at 12 months (OR=4.08, p = 0.029). Synovial pathotype, synovitis scores and cellular infiltration were similar before treatment, but a pauci-immune-fibroid pathotype tended to be more common in YORA at 6 months (p = 0.093). Moreover, YORA patients had a marked improvement of all synovitis parameters (p<0.001), whereas EORA presented only mild decreases in synovitis (p<0.05), sublining macrophage (p<0.05) and T cell scores (p<0.05), with no significant changes in lining macrophages, B cells or plasma cells. Conclusion: Early EORA presents differently and has a worse overall prognosis than YORA, with poorer clinical, histological, ultrasonographic and radiographic outcomes.This work was supported by the Medical Research Council (grant number 36661, to PEAC); Arthritis Research UK (now Versus Arthritis; Experimental Arthritis Treatment Centre Grant, number 20022, to Centre for Experimental Medicine and Rheumatology); Fundação para a Ciência e Tecnologia (Interno Doutorando Bursary reference SFRH/SINTD/95030/2013, to VCR); European League Against Rheumatism (EULAR Scientific Training Bursary 2014, to VCR); and Sociedade Portuguesa de Reumatologia (Fundo de Apoio à Investigação da SPR 2015, to VCR).info:eu-repo/semantics/publishedVersio

Type 2 diabetes and its correlates in a first nationwide study among Cypriot adults

© 2017 Primary Care Diabetes Europe Obesity rates in Cyprus are very high and epidemiological information on type 2 diabetes mellitus is limited. The correlates of type 2 diabetes among adults remain unknown in the Cypriot population. Thus, the purpose of this study is to provide the first national estimate of the prevalence of type 2 diabetes and investigate its correlates. A randomly stratified nationally sample of 1001 adults aged 18–80 participated in the study. Only 950 subjects completed the study. All subjects were free of any diseases (known diabetes, kidney, liver), medication and supplementation. The overall prevalence of diabetes and pre-diabetes based on WHO criteria was 9.2% and 16.3%, respectively. After adjusting for age, energy intake, smoking and physical activity participants with obesity (BMI) (OR = 2.00, P \u3c 0.001), waist circumference (WC) (OR = 2.08, P \u3c 0.001), hypertension (HT) (OR = 1.99, P \u3c 0.001) and hypercholesterolemia (HC) (OR = 2.07, P \u3c 0.007) were most likely to develop T2DM compared with the normal ones. The odds of having diabetes were also found significant between subjects with high levels of triglycerides (TG) (OR = 1.49, P \u3c 0.007), compared with the normal ones and between subjects with low levels of HDL (OR = 1.44, P \u3c 0.008) compared with the ones with high levels of HDL. The prevalence of type 2 diabetes in Cyprus is relatively medium–high. However, the pre-diabetes rates are very high showing a promising increase toward total rates of type 2 diabetes. Obesity, HT, WC, TG, HC and low HDL are all strong correlates of type 2 diabetes. Healthy education programs should be initiated for young and older-aged people and those with described abnormal risk factors

Non-HDL and triglycerides are independently associated with anthropometrical indices in a cypriot population of healthy adults

BACKGROUND: The prevalence of overweight and obesity is increasing all over the world and is accompanied by multiple cardiovascular risk factors. Anthropometrical indices are closely related with traditional cardiovascular risk factors. However, data is limited in healthy adults from Cyprus. AIM: The aim of this study was to examine the relationship of different cardiovascular risk factors with anthropometrical indices in a healthy Cypriot population aged 18-80y. RESULTS: Age, Body Mass Index, Waist Circumference and Body Fat were positively correlated with SBP, DBP and Non-HDL in both sexes. In multiple regression analysis, BMI, WC and TBF were found to be independently associated with TG in the female group, (Beta: 0.009, %95 CI: 0.001-0.018, P\u3c0.033), (Beta: 0.005, %95 CI: 0.002-0.008, P\u3c0.01), (Beta: 0.003, %95 CI: 0.001-0.007, P\u3c0.046), respectively. In the male group, age and BMI were the only variables that have been found to be independently associated with Non-HDL (Beta: 0.527, %95 CI: 0.209- 0845, P\u3c0.01), (Beta: 0544, %95 CI: 0.44-1.045, P\u3c0.033), respectively. CONLUSION: Non-HDL and triglycerides seem to be independently associated with various anthropometrical indexes. Public health awareness and nutrition education are needed in order to monitor these CV factors

Diet quality of UK infants is associated with dietary, adiposity, cardiovascular, and cognitive outcomes measured at 7-8 years of age

Whereas the influence of pregnancy diet and milk feeding on children’s health and development is well characterized, the role of early food intake and eating behaviors is largely unexplored. This study aimed to determine whether the degree of adherence to complementary feeding guidelines was associated with dietary, obesity, cardiovascular, and cognitive outcomes at 7–8 y of age. Data were analyzed from the Avon Longitudinal Study of Parents and Children using parent-completed dietary questionnaires at 6 mo of age to calculate a Complementary Feeding Utility Index score. Regression analysis was used to explore associations between the index score and dietary patterns derived via principal component analysis (n = 4326), body mass index (BMI) (n = 4801), waist circumference (n = 4798), blood pressure (n = 4685), and lipids (n = 3232) measured at age 7 y; and intelligence quotient (IQ) measured at age 8 y (n = 4429) after adjustment for covariates. The index score was negatively associated with a ‘‘processed’’ dietary pattern (β = -0.16; 95% CI: -0.20, -0.13; P < 0.001) but positively associated with a ‘‘health conscious’’ dietary pattern [β = 0.18 (95%CI: 0.14, 0.21); P < 0.001]. A higher index score was also positively associated with total, verbal, and performance IQ scores at 8 y of age [β = 1.92 (95%CI: 1.38, 2.47); P < 0.001 for total IQ). The index score was weakly associated with waist circumference [β = -0.15 (95%CI: -0.31, -0.002); P = 0.046] and diastolic blood pressure [β = -0.24 (95%CI: -0.47, -0.01); P = 0.043] at 7 y of age but was not associated with BMI or other cardiovascular risk factors. These findings suggest that adherence to current complementary feeding guidelines may have implications for some, but not all, health and development outcomes in childhoodRebecca K. Golley, Lisa G. Smithers, Murthy N. Mittinty, Pauline Emmett, Kate Northstone, and John W. Lync