Is a shorter hot flash diary just as good as a 7-day diary?

Menopause. 2009 May 5; Grady D, Macer J, Kristof M, Shen H, Tagliaferri M, Creasman JOBJECTIVE:: In randomized trials, the most common way to measure the effect of treatment on the frequency and severity of menopausal hot flashes is a 7-day self-reported diary. However, adherence with completing the hot flash diary in real time may be poor, and completing a diary is cumbersome for study participants. Our objective was to determine if a shorter diary for recording self-reported hot flashes is as accurate and precise as the traditional 7-day diary. METHODS:: Using cross-sectional data from a multicenter randomized clinical trial of an herbal preparation (MF101, an estrogen receptor beta-selective agonist for treatment of menopausal hot flashes), we compared findings based on shorter diaries with findings based on a 7-day diary. RESULTS:: With 3 days of diary keeping, the mean number of hot flashes per day and mean severity were almost identical to the means based on the 7-day diary, the SDs of the means were almost identical, and the intraclass correlations were almost perfect. The difference in the mean number of hot flashes per day compared with the 7-day diary was only 12% of one hot flash. Data from a different clinical trial revealed similar correspondence between the findings of a 3- and 7-day diary. CONCLUSIONS:: In our study, the optimal duration of diary keeping to record menopausal hot flashes seems to be 3 days. In addition to being as good as a 7-day diary, a 3-day diary would be less burden on study participants and research staff and less expensive.

Treatment strategies for hot flushes.

Expert Opin Pharmacother. 2009 May; 10(7): 1133-44Shen W, Stearns VBACKGROUND: Vasomotor symptoms are the most common complaints for which menopausal women seek medical care. Eighty per cent of all menopausal women will have hot flushes and night sweats, and of these 9% will have severe symptoms impacting their quality of life. Ideally, treatment should target the group most severely afflicted, and options for treatment should be tailored to each woman, since, for most women, vasomotor symptoms spontaneously resolve in 3 - 5 years. Recommendation at this time is for the shortest duration of therapy, which means that episodic review of therapy is indicated. OBJECTIVE: To review the latest literature investigating therapies for vasomotor symptoms and to discuss their effectiveness with emphasis on placebo-controlled, randomized clinical trials. METHODS: A literature search in PubMed for 'vasomotor symptoms', 'menopause symptoms', 'hot flushes', 'hot flashes' and 'night sweats' from 2003 to the present was performed. CONCLUSIONS: Estrogen remains the gold standard for treating vasomotor symptoms. As investigations into the physiology of hot flushes continue, centrally active drugs (selective serotonin or norepinephrine-serotonin reuptake inhibitors and gabapentin) have increased in use. The benefit from dietary herbal supplements is still inconclusive; however, recent studies have shown some mild response to soy and black cohosh.

Comparison of the phenolic component profiles of skullcap (Scutellaria lateriflora) and germander (Teucrium canadense and T. chamaedrys), a potentially hepatotoxic adulterant.

Phytochem Anal. 2009 Apr 29; Lin LZ, Harnly JM, Upton RINTRODUCTION: Scutellaria lateriflora, commonly known as skullcap, is used as an ingredient in numerous herbal products. Unfortunately, it has occasionally been adulterated with Teucrium canadense or T. chamaedrys, commonly known as germander, which contains potentially hepatotoxic diterpenes. Chromatographic profiles of the phenolic components provide a means of distinguishing between these plants and enhancing public safety. OBJECTIVE: To develop a chromatographic method for the identification of Scutellaria lateriflora and two Teucrium species and to quantify the latter as adulterants. METHODOLOGY: Samples were extracted with aqueous methanol and the extracts were analysed using a standardised LC-DAD-ESI/MS profiling method to obtain their phenolic profiles. RESULTS: Skullcap contained primarily flavonoids, while the major phenolic components of the two Teucrium species were the phenylethanoids, verbascoside and teucrioside. Using the phenylethanoids as markers, it was possible to clearly distinguish between the two genus and to determine 5% Teucrium mixed with Scutellaria using either ultraviolet absorption spectrometry or mass spectrometry in the total ion count mode. Using MS in the selective ion monitoring (SIM) mode, 1% Teucrium could be measured. CONCLUSIONS: This study showed that chromatographic profiling was able to identify Scutellaria and Teucrium, separately and when mixed together. Copyright (c) 2009 John Wiley & Sons, Ltd.

Dosage effects of EGb761 on hydrogen peroxide-induced cell death in SH-SY5Y cells.

Chem Biol Interact. 2009 May 1; Shi C, Zhao L, Zhu B, Li Q, Yew DT, Yao Z, Xu JStandardized extract from the leaves of the Ginkgo biloba tree, labeled EGb761, is one of the most popular herbal supplements, taken for its multivalent properties. In this study, dosage effects of EGb761 on hydrogen peroxide (H(2)O(2))-induced apoptosis of human neuroblastoma SH-SY5Y cells were investigated. It was found that, H(2)O(2) induced apoptotic cell death in SH-SY5Y cells, which was revealed in DNA fragmentation, mitochondrial membrane potential depolarization, and activation of Akt, c-Jun N-terminal kinases (JNK) and caspase 3. Low doses of EGb761 (50-100mug/ml) inhibited H(2)O(2)-induced cell apoptosis via inactivation of Akt, JNK and caspase 3 while high doses of EGb761 (250-500mug/ml) enhanced H(2)O(2) toxicities via inactivation of Akt and enhancement of activation of JNK and caspase 3. Additional experiments revealed that, H(2)O(2) decreased intracellular GSH content, which was also inhibited by low concentrations of EGb761 but enhanced after high concentrations of EGb761 treatment. This further suggests to us that, dosage effects of EGb761 on apoptotic signaling proteins may be correlated with regulation of cell redox state. Therefore, treatment dosage may be one of the vital factors that determine the specific action of EGb761 on oxidative stress-induced cell apoptosis. To understand the mechanisms of dosage effects of EGb761 may have important clinical implications.