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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Panax ginseng C.A. Meyer is a well-known medicinal herb native to China and Korea, and has been used as a herbal remedy in eastern Asia for thousands of years. However, there is different evidence of ginseng efficacy between traditional Chinese medicine (TCM), modern pharmacological experiments and clinical trials. In TCM, ginseng is a highly valued herb and has been applied to a variety of pathological conditions and illnesses such as hypodynamia, anorexia, shortness of breath, palpitation, insomnia, impotence, hemorrhage and diabetes. Modern pharmacological experiments have proved that ginseng possesses multiple constituents (ginsenosides, polysaccharides, peptides, polyacetylenic alcohols, etc.) and actions (central nervous system effects, neuroprotective effect, immunomodulation, anticancer, etc.), ginsenosides as the active ingredients, especially, having antioxidant, antiinflammatory, antiapoptotic and immunostimulant properties. Recently, ginseng has been studied in a number of randomized controlled trials investigating its effect mainly on physical and psychomotor performance, cognitive function, immunomodulation, diabetes mellitus, cardiovascular risk factors, quality of life, as well as adverse effects. Equivocal results have been demonstrated for many of these indications. Because of the poor quality of most clinical trials on ginseng, reliable clinical data in humans are still lacking. Therefore, a broader understanding of medical knowledge and reasoning on ginseng is necessary.
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PMID:A comparison of the ancient use of ginseng in traditional Chinese medicine with modern pharmacological experiments and clinical trials. 1856 57

The US Food and Drug Administration (FDA) has approved several new drugs in the past 2 years. This article provides an overview of some of the newer drugs that are likely to find wider use in the future. The drugs reviewed in this article can be used to treat cardiovascular system problems, diabetes mellitus, multiple sclerosis, hepatitis B infection, hyponatremia, Parkinson's disease, rheumatoid arthritis, pain, constipation, and insomnia. Another drug discussed can be used to help a patient stop smoking. The article also discusses Gardasil, the recombinant vaccine against human papilloma virus (types 6, 11, 16, and 18).
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PMID:What's new in clinical pharmacology and therapeutics. 1859 82

Pruritus is a common complication of end-stage renal disease (ESRD), affecting about one-third of dialysis patients. It is a chronic, unpleasant symptom with a strong negative impact on patients' quality of life, often inducing sleeplessness and mood disorders. Recent data show that it is also associated with increased mortality. The pathogenesis of uraemic pruritus (UP) is multifactorial. Triggering factors may include uraemia-related abnormalities (particularly involving calcium, phosphorus and parathyroid hormone metabolism), accumulation of uraemic toxins, systemic inflammation, cutaneous xerosis, and common co-morbidities such as diabetes mellitus and viral hepatitis. Recent findings suggest that the neurophysiology of itch is similar to that of pain; this has led to the hypothesis that the two phenomena also closely interact in ESRD patients, who often also experience uraemic neuropathy. The management of UP needs to address several different issues, such as optimization of dialysis efficacy and skin hydration, and correction of calcium-phosphorus metabolism abnormalities. A wide range of antipruritic drugs have been suggested for the treatment of UP, although most of them have only been tested in small, uncontrolled trials, which have yielded conflicting results. Antihistamines are now known to have little or no efficacy, although they are still often prescribed. Novel neurotropic drugs such as gabapentin, along with opioid receptor modulators such as nalfurafine, appear to be effective and well tolerated, but their efficacy has not yet been directly compared. Finally, physical therapies, including UV radiation, may also have a role in patients with refractory symptoms.
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PMID:Uraemic pruritus: clinical characteristics, pathophysiology and treatment. 1927 70

Insomnia is a leading cause of absenteeism, presenteeism (lost productivity when employees are at work), accidents, and errors in the workplace. Overall direct and indirect costs exceed $30 billion annually. A significant portion of these costs are attributable to patients with comorbid insomnia, making these conditions a significant clinical public health issue. These comorbid conditions include mood and anxiety disorders; chronic pain; respiratory, urinary, and neurologic conditions; diabetes; and cardiovascular diseases. Traditional treatment for insomnia with comorbid conditions has focused on treating the comorbid condition with the expectation that the insomnia will resolve. Recent studies, however, suggest this approach is not the most appropriate. Instead, treating both conditions simultaneously may improve the outcomes for each.
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PMID:Comorbid insomnia: current directions and future challenges. 1929 4

High dose glucocorticoids (GC) are commonly used for the treatment of autoimmune diseases. The frequencies, occurrence day and dose-dependency for side effects may be different among the events such as diabetes mellitus, hyperlipidemia, infectious disease, osteoporosis, and peptic ulcer. We investigated GC-induced side effects in 68 patients treated with GC for autoimmune diseases. Initial dose of GC (prednisolone equivalent) was 0.67+/-0.35 mg/kg/d. Hypercholesterolemia (66%), hypertension (62%), insomnia (50%), hypertriglyceridemia (44%), excessive appetite (38%), hyperglycemia (18%), digestive symptom (16%), moon-shaped face (13%) and oral candidiasis (12%) were observed in 63 patients treated with GC. Hypercholesterolemia, excessive appetite, digestive symptom, moon-shaped face, and oral candidiasis were associated with the initial dose of prednisolone greater than 0.80 mg/kg/d. Insomnia [median 6 days (range 1-88)], excessive appetite [7 days (2-57)], hypertension [8 days (1-37)], digestive symptom [15 days (1-87)] and hypercholesterolemia [19 days (3-77)] were observed early after 6-19 days starting GC. On the other hand, hypertriglyceridemia [33 days (2-131)], oral candidiasis [35 days (7-52)] and hyperglycemia [60 days (4-134)] were developed after 33-60 days starting GC. Since the frequencies, dose-dependency and occurrence day were different among the side effects of GC, medical staffs including physicians and pharmacists should pay attention such features of the events in the treatment of autoimmune diseases.
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PMID:[Investigation of glucocorticoid-induced side effects in patients with autoimmune diseases]. 1933 98

Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 +/- 17.2 years and mean duration on dialysis 40.4 +/- 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and management of sleep disorders.
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PMID:Restless legs syndrome in patients on dialysis. 1941 38

Evidence is reviewed documenting an intimate relationship among restless legs syndrome (RLS) / periodic limb movements in sleep (PLMS) and hypertension and cardiovascular and cerebrovascular disease. Sympathetic overactivity is associated with RLS/PLMS, as manifested by increased pulse rate and blood pressure coincident with PLMS. Causality is far from definitive. Mechanisms are explored as to how RLS/PLMS may lead to high blood pressure, heart disease, and stroke: (a) the sympathetic hyperactivity associated with RLS/PLMS may lead to daytime hypertension that in turn leads to heart disease and stroke; (b) in the absence of daytime hypertension, this sympathetic hyperactivity may predispose to heart disease and stroke either directly or indirectly via atherosclerotic plaque formation and rupture; and (c) comorbidities associated with RLS/PLMS, such as renal failure, diabetes, iron deficiency, and insomnia, may predispose to heart disease and stroke. One theoretical cause for sympathetic hyperactivity is insufficient All diencephalospinal dopaminergic neuron inhibition of sympathetic preganglionic neurons residing in the intermediolateral cell columns of the spinal cord. We cannot exclude the possibility that peripheral vascular, cardiovascular, and cerebrovascular disease may also contribute to RLS/PLMS, and mechanisms for these possibilities are also discussed.
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PMID:Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. 2033 85

The prevalence of chronic insomnia in the adult population in Israel is 29.8%, which is comparable to other Western countries. The consequences of insomnia include fatigue, accidents, low level of well-being, and a high need for medical services. One of the well-known treatments for insomnia is sleeping pills. Physicians are educated that hypnotics are an appropriate treatment for transient insomnia but not for chronic use. It is believed that transient users are at high risk of becoming addicted to sleep medications although research has not proven this theory. NonetheLess, physicians often try to convince insomnia patients not to use these medications. In the U.S.A., only 3% of chronic insomniacs use sleep medications. There are no data on the use of sleep medications in Israel. The present study was performed using a large database comprised of 1.1 million adult patients of Maccabi Health Services. It is the first study examining sleep medication usage habits of the adult population in IsraeL. The main findings are: 2.8% of Maccabi patients use sleep medications, however only 4.5% of this group are chronic users; most chronic users started sleep medications at the age of 65 or older and they suffer more than the transient users from medical conditions such as ischemic heart disease, hypertension, and diabetes mellitus, have higher usage of antidepressant and anxiolytic medication, receive greater national financial support and are more likely to be new immigrants. The results of this study should evoke physicians to reassess their position against prescribing sleep medications to patients for whom it may help in relieving their insomnia.
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PMID:[Chronic use of sleep medications--how serious is it in Israel?]. 1963 Mar 57

Previous studies have shown that several physiological and psychological conditions, such as hyperglycemia, diabetic neuropathy, sleep apnea syndrome and depression, may cause sleep disturbances, insomnia in diabetic patients. On the other hand, epidemiological evidences are indicating that chronic partial sleep loss may increase the risk of diabetes. Laboratory studies have shown that sleep restriction is associated with an increase in sympathetic nervous activity and a decrease in insulin sensitivity without adequate compensation in beta-cell function, resulting in an impact on glucose homeostasis and an elevated risk of diabetes. Sleep curtailment is also associated with a dysregulation of the neuroendocrine control of appetite, with a reduction of the satiety factor, leptin, and an increase in hunger-promoting hormone, ghrelin. The adverse impact of sleep deprivation on energy homeostasis is likely to be driven by increased activity of neuronal populations expressing in orexin system that promotes waking, feeding and energy-expenditure.
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PMID:[Insomnia in diabetes]. 1976 35

People are sleeping less in modern societies. It is said that short duration of sleep could play a role in the etiology of not only diabetes mellitus (DM) but also hypertension. Sleep disorders inducing sleep fragmentation and sleep deprivation, such as insomnia, obstructive sleep apnea syndrome (OSAS), and periodic limb movement disorder (PLMD), have been suggested to be independent risk factors for hypertension. OSAS is associated with a range of cardiovascular complications, in particular hypertension. All of hypertensive patients should be routinely screened for possible sleep disorders.
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PMID:[Hypertension]. 1976 36


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