Harpgophytum procumbens for osteoarthritis and low back pain: A systematic review

BACKGROUND: The objective of this review is to determine the effectiveness of Harpagophytum procumbens preparations in the treatment of various forms of musculoskeletal pain. METHODS: Several databases and other sources were searched to identify randomized controlled trials, quasi-randomized controlled trials, and controlled clinical trials testing Harpagophytum preparations in adults suffering from pain due to osteoarthritis or low back pain. RESULTS: Given the clinical heterogeneity and insufficient data for statistical pooling, trials were described in a narrative way, taking into consideration methodological quality scores. Twelve trials were included with six investigating osteoarthritis (two were identical trials), four low back pain, and three mixed-pain conditions. CONCLUSIONS: There is limited evidence for an ethanolic Harpagophytum extract containing less than <30 mg harpagoside per day in the treatment of knee and hip osteoarthritis. There is moderate evidence of effectiveness for (1) the use of a Harpagophytum powder at 60 mg harpagoside in the treatment of osteoarthritis of the spine, hip and knee; (2) the use of an aqueous Harpagophytum extract at a daily dose of 100 mg harpagoside in the treatment of acute exacerbations of chronic non-specific low back pain; and (3) the use of an aqueous extract of Harpagophytum procumbens at 60 mg harpagoside being non-inferior to 12.5 mg rofecoxib per day for chronic non-specific low-back pain (NSLBP) in the short term. Strong evidence exists for the use of an aqueous Harpagophytum extract at a daily dose equivalent of 50 mg harpagoside in the treatment of acute exacerbations of chronic NSLBP

Geo-distributed simulation and verification infrastructure for safe train galileo-based positioning

The work shows the high level concept and methodology followed for designing a geo-distributed simulation and verification infrastructure connecting remotely GNSS excellence centres and ERTMS/ETCS laboratories to evaluate the GNSS performances in the railway environment. Proper methodology and tools are adopted to simulate GNSS behaviour in different railway scenarios in nominal or in presence of global and local hazards. Particularly, the test-bed main goals are: i) achieving a realistic characterization of the environment in terms of railway and GNSS infrastructures able to evaluate the performances and properties of some fail-safe train positioning components in nominal and fault conditions; ii) defining a common test process framework for zero on-site testing instead of testing on-site saving effort and time. The test-bed offers the unique advantage to stress the global system in presence of very rare GNSS fault events instead of performing long and expensive measurement campaigns on field for detecting them and analysing their impact on ETCS. The work will show its description and the methodology adopted for its design and implementation

L'écologie des mondes = Ecology of our worlds

International audiencePuisées dans les trésors de la littérature mondiale, les citations qui composent cet ouvrage laissent entendre les voix de poètes, de philosophes, de romanciers et d'artistes comme autant de témoignages sur la diversité et la complexité des liens qui, depuis la nuit des temps, unissent les humains à la Nature. De splendides illustrations, elles aussi issues de toutes les cultures et civilisations de l'humanité, viennent en contrepoint de ces paroles, publiées ici en français, en anglais, mais aussi dans leur langue d'origine. En ces temps de bouleversement du climat et de menaces fortes sur la biodiversité, chaque lecteur, d'où qu'il vienne, pourra avec ce recueil porter un autre regard sur l'environnement qui l'entoure et y trouver force et inspiration pour nouer des relations plus harmonieuses et responsables avec la Nature

L'écologie des mondes = Ecology of our worlds

International audiencePuisées dans les trésors de la littérature mondiale, les citations qui composent cet ouvrage laissent entendre les voix de poètes, de philosophes, de romanciers et d'artistes comme autant de témoignages sur la diversité et la complexité des liens qui, depuis la nuit des temps, unissent les humains à la Nature. De splendides illustrations, elles aussi issues de toutes les cultures et civilisations de l'humanité, viennent en contrepoint de ces paroles, publiées ici en français, en anglais, mais aussi dans leur langue d'origine. En ces temps de bouleversement du climat et de menaces fortes sur la biodiversité, chaque lecteur, d'où qu'il vienne, pourra avec ce recueil porter un autre regard sur l'environnement qui l'entoure et y trouver force et inspiration pour nouer des relations plus harmonieuses et responsables avec la Nature

Improved arthritic knee health in a pilot RCT of phytotherapy

Although practitioner-prescribed 'western' herbal medicine (phytotherapy) is a popular complementary therapy in the UK, no clinical studies have been reported on patient-orientated outcomes. The objective of this pilot study was to investigate the effects of phytotherapy on symptoms of osteoarthritis of the knee. A previous study of Chinese herbal medicine for the treatment of irritable bowel syndrome, published in the Journal of the American Medical Association,(1) acted as a model in the development of the protocol of this investigation. Twenty adults, previously diagnosed with osteoarthritis of the knee, were recruited from two Inner London GP practices into this randomized, double-blind, placebo-controlled, pilot study carried out in a primary-care setting. All subjects were seen in consultation three times by a herbal practitioner who was blinded to the randomization coding. Each subject was prescribed treatment and given lifestyle advice according to usual practice: continuation of conventional medication where applicable, healthy-eating advice and nutrient supplementation, Individualized herbal medicine was prescribed for each patient, but only dispensed for those randomized to active treatment - the remainder were supplied with a placebo. At baseline and outcome (after ten weeks of treatment), subjects completed a food frequency questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee health and Measure Yourself Outcome Profile (MYMOP) wellbeing questionnaires. Subjects completing the study per protocol (n = 14) reported an increased intake of wholegrain foods (p = 0.045) and oily fish (p = 0.039) compared to baseline, but no increase in fruit and vegetables and dairy products intakes. There was no difference in the primary outcome measure of knee health assessed as the difference in the mean response (baseline-week 10) in WOMAC score between the two treatment groups. However, there was, compared with baseline, improvement in the active group (n = 9) for the mean WOMAC stiffness sub-score at week 5 (p = 0.035) and week 10 (p = 0.060) but not in the placebo group (n = 5). Furthermore, for the active, but not the placebo group, the mean WOMAC total and sub-scores all showed clinically significant improvement (>= 20%) in knee symptoms at weeks 5 and 10 compared with baseline. Moreover, the mean MYMOP symptom 2 sub-score, mostly relating to osteoarthritis (OA), showed significant improvement at week 5 (p = 0.02) and week 10 (p = 0.008) compared with baseline for the active, but not for the placebo group. This pilot study showed that herbal medicine prescribed for the individual by a herbal practitioner resulted in improvement of symptoms of OA of the knee