MotherSafe: Review of three years of counselling by an Australian teratology Information Service.

Aust N Z J Obstet Gynaecol. 2009 Apr; 49(2): 168-72Lim JM, Sullivan E, Kennedy DBACKGROUND: MotherSafe was established in January 2000 at the Royal Hospital for Women as Australia's first 'purpose-built' Teratogen Information Service and since then has received over 75,000 calls regarding exposures during pregnancy and lactation. AIM: To describe the patterns of use of MotherSafe over a three-year period. METHODS: Retrospective descriptive epidemiological study using data from the database established at MotherSafe. Records from all the calls logged at MotherSafe between January 2005 and December 2007 were analysed to determine total number of calls, demographic characteristics of callers, including age, caller category and postcode, reason for call, source of referral and type of exposure. RESULTS: A total of 47,138 calls were recorded to the MotherSafe service from January 2005 to December 2007. The majority of calls were regarding exposures in pregnancy (55%) and breast-feeding (38%). Average age of patients was 32.3 years. Of the calls made, 81.9% (38,485 of 46,968) were by consumers (the pregnant or lactating woman herself or a relative). The most common primary exposure categories were: over-the-counter medications (11.3%), psychotropic medication (9.0%), herbal or vitamin products (8.2%), antibiotics (7.0%), gastrointestinal medications (6.8%) and topical products (6.6%). Forty per cent of callers enquired about multiple exposures. CONCLUSIONS: The utilisation of MotherSafe by consumers and general practitioners continues to increase, reflecting the strong demand for a teratogen counselling service that provides high-quality, evidence-based information on exposures during pregnancy and lactation.

MAPK activation is necessary to the apoptotic death of KB cells induced by the essential oil isolated from Artemisia iwayomogi.

J Ethnopharmacol. 2009 Jun 22; 123(2): 308-14Cha JD, Jeong MR, Kim HY, Lee JC, Lee KYAIM OF THE STUDY: Artemisia iwayomogi is a perennial small herbal plant that has long been used as a chemopreventive agent in traditional Korean medicine. Previously, the purified essential oil was isolated from Artemisia iwayomogi, herein named AIEO, and found to contain the active components responsible for the chemopreventive potential of the herb. MATERIALS AND METHODS: This study examined whether or not AIEO has potential chemopreventative effects against cancer using the human oral epidermoid carcinoma cell line, KB cells. The possible mechanism of AIEO-induced apoptosis was also examined. RESULTS: The results showed that AIEO induces the apoptotic death of KB cells, which is mediated by mitogen-activated protein kinases (MAPKs). In addition, AIEO not only induced an imbalance between the mitochondrial Bcl-2 and Bax levels with the concomitant release of Cytochrome c into the cytosol but also induced the activation of caspases and the cleavage of PARP. This induction was significantly suppressed by MAPK inhibitors. Moreover, pretreating the cells with each of the caspase or MAPK-specific inhibitors apparently inhibited AIEO-induced cytotoxicity of KB cells. CONCLUSIONS: These results strongly suggest that AIEO might have cancer chemopreventive and therapeutic potential, which is closely related to its ability to activate the MAPK-mediated signaling pathways with the subsequent induction of a mitochondria- and caspase-dependent mechanism.

Advances of Molecular Clinical Pharmacology in Gastroenterology and Hepatology.

Am J Ther. 2009 May 8; Prandota JDuring developmental age, differences in pharmacodynamic reactions to several drugs may reflect polymorphisms of genes encoding drug-transporting proteins, receptors, drug targets, and gene products, whose disturbed activity sometimes plays an important role in certain diseases. Administration of drugs with a narrow therapeutic index may quite easily be associated with changes in pharmacokinetics and development of adverse drug reactions, which occasionally may cause fatalities. In such cases, polypragmasy and resulting drug interactions may enhance effects of changes in drug-metabolizing enzymes' activities. Phenotyping and genotyping of patients slowly are finding their place in some therapeutic regimens used in clinical gastroenterology and hepatology. At present, some assays to measure, for example, thiopurine S-methyltransferase activity are already commercially available. Polymorphisms of CYP450 enzymes, interleukins, and altered gene expression play an important role in some patients' various gastrointestinal tract and liver diseases. Herbal drugs also affect proinflammatory and antiinflammatory cytokine and nitric oxide balance in the body. Therapeutic use of recombined proteins, such as infliximab, natalizumab, onercept, humanized antibody to integrin alpha-4 beta-7, or IFN-beta in some large-bowel diseases increased therapeutic efficacy. IFN-alpha used in the patients with chronic hepatitis C improved cellular immunity in these subjects and exerted antiviral activity. Practical application of progress in pharmacogenetics, pharmacokinetics, pharmacodynamics, and use of bioproducts in novel therapeutic regimens has opened therapeutic frontiers and increased clinical safety.

Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam.

Phytother Res. 2009 May 13; Carrasco MC, Vallejo JR, Pardo-de-Santayana M, Peral D, Martín MA, Altimiras JThere is an increasing interest in the health risks related to the use of herbal remedies. Although most consumers think that phytomedicines are safe and without side effects, interactions between complementary alternative and conventional medicines are being described. The aim of this clinical case report is to highlight the importance of the safe use of herbal remedies by providing a clinical interaction study between pharmaceutical medicines and herbal medicinal products. The case of a patient self-medicated with Valeriana officinalis L. and Passiflora incarnata L. while he was on lorazepam treatment is described. Handshaking, dizziness, throbbing and muscular fatigue were reported within the 32 h before clinical diagnosis. The analysis of family medical history ruled out essential tremor, Parkinson's disease, Wilson's disease and other symptom-related pathologies. His medical history revealed a generalized anxiety disorder and medicinal plant consumption but no neurological disorder. Appropriate physical examination was carried out. An additive or synergistic effect is suspected to have produced these symptoms. The active principles of Valerian and passionflower might increase the inhibitory activity of benzodiazepines binding to the GABA receptors, causing severe secondary effects. Due to the increase in herbal product self-medication, the use of herbal remedies should be registered while taking the personal clinical history. Multidisciplinary teams should be created to raise studies on medicinal plants with impact on medical praxis. Copyright (c) 2009 John Wiley & Sons, Ltd.