Impact of immigration on complementary and alternative medicine use in Hispanic patients.

J Am Board Fam Med. 2009 May-Jun; 22(3): 337-8White B, Knox L, Zepeda M, Mull D, Nunez FBACKGROUND: Although previous research has demonstrated frequent complementary and alternative medicine (CAM) use by Hispanic patients, it remains unclear whether the status of immigration plays a role in the frequency and reasons for use. METHODS: A survey of 164 patients from a federally qualified health center in South Central Los Angeles was used; the health center serves a predominantly Latino immigrant patient population. The study included the following variables: patient age; sex; place of birth; number of years living in the United States; CAM use within the last year; and, if positive CAM use, what type(s) and for what condition(s). RESULTS: Sixty-six percent of patients had used a CAM substance within the past year. Ninety-seven percent of the patients were immigrants (primarily from Mexico, El Salvador, and Guatemala). Differences in CAM use between recently arrived (< or =9 years) and long-term immigrants (> or =10 years) were not significant. Ninety-four percent of patients using CAM reported using herbal/tea/plant-based substances, with the most frequent reason for CAM use being digestive problems. Although most CAM substances were obtained from a market (64%), a not insignificant number of CAM substances were grown at home (23%). CONCLUSIONS: Time since immigration does not seem to impact the frequency of CAM use by Hispanic immigrant patients. Herbal/tea/plant-based substances are frequently used in the Hispanic patient population, often for digestive complaints.

Pharmacological investigation on the wound healing effects of Radix Rehmanniae in an animal model of diabetic foot ulcer.

J Ethnopharmacol. 2009 May 4; 123(1): 155-62Lau TW, Lam FF, Lau KM, Chan YW, Lee KM, Sahota DS, Ho YY, Fung KP, Leung PC, Lau CBETHNOPHARMACOLOGICAL RELEVANCE: Radix Rehmanniae (RR) has a very long history of usage in traditional Chinese medicine and is usually one of the principal herb found in many herbal formulae used in diabetic foot ulcer. AIM OF THE STUDY: RR aqueous extract was investigated for its wound healing effects in a diabetic foot ulcer rat model and its detailed mechanism of actions. MATERIALS AND METHODS: A previously established diabetic foot ulcer rat model was used to assess the effect of RR extract on wound area reduction, tissue regeneration and angiogenesis. Carrageenan-induced inflammation rat model was used for inflammation study; and diabetic control was evaluated using a neonatal streptozotocin-induced diabetic rat model. RESULTS: In the RR treated group, a trend of reduction of the wound area was observed from days 8 to 18 and a significant difference (as compared with control group) was found on day 8. The ulcer healing effect of RR extract was further supported by better developed scars and epithelialization as well as good formation of capillaries with enhanced VEGF expression. Carrageenan-induced inflammation was also significantly alleviated with RR extract. CONCLUSIONS: Our results demonstrated for the first time that Radix Rehmanniae was effective in promoting diabetic foot ulcer healing in rats through the processes of tissue regeneration, angiogenesis and inflammation control, but not glycemia control. The present study provided scientific basis to support the traditional use of Radix Rehmanniae in diabetic foot ulcer.

Mao's heritage: Medicinal plant knowledge among the Bai in Shaxi, China, at a crossroads between distinct local and common widespread practice.

J Ethnopharmacol. 2009 Jun 22; 123(2): 213-28Weckerle CS, Ineichen R, Huber FK, Yang YETHNOPHARMACOLOGICAL RELEVANCE: The study focuses on medicinal plant knowledge among the Bai in the Shaxi Valley, Northwest Yunnan, where no ethnobotanical study has been conducted so far. In an area of high biodiversity, distinct medicinal plant knowledge is documented and the influence of herbals on local knowledge is revealed. AIM OF THE STUDY: To analyse current medicinal plant knowledge among the Bai in the context of the influence of the Han culture and mainstream Chinese herbal medicine. MATERIALS AND METHODS: During fieldwork in summer 2005, semistructured interviews were conducted with 68 stakeholders, and voucher specimens of all plants mentioned were prepared. RESULTS: A total of 176 medicinal plant species were documented and 1133 use-reports have been collected. Overall, 91.5% of the documented plants are already established as known drugs, and are mentioned in books on medicinal plants in Yunnan and China. Furthermore, the way in which they are used largely coincides. Fourteen plant species represent novel recordings, 9 of which were independently mentioned by three or more informants. CONCLUSIONS: The medicinal plant knowledge of the Bai is strongly influenced by mainstream Chinese herbal medicine and especially by medicinal plant books from the 1970s, which were distributed under Mao Zedong's directive to improve rural health care. We conclude that these herbals have exerted, and continue to exert, a strong influence on the standardisation of plant knowledge among rural populations in China. However, distinct local use of plants also exists, indicating that plant knowledge specific to the Bai people is alive and practiced.

Assessing Quality of Case Series Studies: Development and Validation of an Instrument by Herbal Medicine CAM Researchers.

J Altern Complement Med. 2009 May 11; Yang AW, Li CG, Da Costa C, Allan G, Reece J, Xue CCAbstract Objectives: When higher level of evidence is absent, findings of case series studies can be used to generate hypotheses for further research. However, to date, there has been no established instrument for determining their quality. This study was to develop and validate an instrument to assess the quality of case series studies on herbal medicines. Design: A draft instrument was developed based on items generated by judges. Raters (including judges), consisting of herbal medicine researchers, herbal medicine practitioners, and other professionals, used the draft instrument to assess the quality of sample case series reports. The number of quality assessment items was then reduced as much as possible in the instrument while maintaining its reliability and validity. Content and construct validity, and inter-rater agreement of the instrument were used as the main outcome measures. Results: Seven (7) judges from different backgrounds independently generated 68 nonredundant items for inclusion in the initial draft instrument. The content validity of these items was assessed by all judges for consensus using a seven-point scale, and a 24-item second-draft instrument was derived. The wording and sequence of these items were further revised and then used by 20 raters (including seven judges) to assess the quality of 35 case series reports. A 13-item instrument was finally developed. All raters, including the judges, demonstrated a high level of consistency on quality of the reports by using this instrument, despite their different backgrounds. Conclusions: High-level consistency can be achieved by using this instrument to assess the quality of case series studies. This instrument may facilitate the improvement of reporting quality of case series studies.