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Biomedical subjects

Adriane Fugh-Berman

Publications and source records attributed to Adriane Fugh-Berman.

16 recordsLinked to original sources
PubMed2006

Gynecologists and estrogen: an affair of the heart.

Although definitive studies have shown that hormone therapy in menopausal women has no overall or cardiovascular health benefit, obstetrician-gynecologists continue to believe that estrogen benefits women's health. This mistaken belief may stem from cultural factors unique to obstetrics and gynecology, as well as from the dependence of physicians on pharmaceutical companies for the provision and interpretation of scientific information.

Cardiovascular Diseases↗
PubMed2005

The corporate coauthor.

Drug marketing techniques include the sponsorship of articles signed by academic physicians or researchers and submitted to peer-reviewed medical journals. Some of these articles are authored or coauthored by ghostwriters who work for pharmaceutical companies or medical education companies hired by pharmaceutical companies. Conflicts of interest may be difficult to detect in the subset of articles and presentations sponsored by pharmaceutical companies that never mention the targeted drug, but focus on stimulating the perceived need for the targeted drug or highlighting problems with competing drugs. The current voluntary standards for declaring conflicts of interest to readers of medical journals and audiences at medical conferences are inadequate. A public database that contains conflicts of interest of physicians and researchers would be useful.

Anticoagulants↗
PubMed2004

Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: current status of clinical and basic research.

Seville orange (Citrus aurantium) extracts are being marketed as a safe alternative to ephedra in herbal weight-loss products, but C. aurantium may also have the potential to cause adverse health effects. C. aurantium contains synephrine (oxedrine), which is structurally similar to epinephrine. Although no adverse events have been associated with ingestion of C. aurantium products thus far, synephrine increases blood pressure in humans and other species, and has the potential to increase cardiovascular events. Additionally, C. aurantium contains 6',7'-dihydroxybergamottin and bergapten, both of which inhibit cytochrome P450-3A, and would be expected to increase serum levels of many drugs. There is little evidence that products containing C. aurantium are an effective aid to weight loss. Synephrine has lipolytic effects in human fat cells only at high doses, and octopamine does not have lipolytic effects in human adipocytes.

Animals↗
PubMed2003

"Bust enhancing" herbal products.

"Bust enhancing" herbal products are widely advertised. No clinical trials have been published. These products contain a variety of ingredients, including grains, hops, saw palmetto, dong quai, chaste-tree berry, wild yam, kava, fennel, black cohosh, and fenugreek. Several of these herbs are hormonally active; for example, hops contain 8-prenylnaringenin, a phytoestrogen that is more potent than other dietary phytoestrogens. Many bust-enhancing dietary supplements contain substrates for Fusarium, a fungus that produces zearalenone, a potent estrogen that has been associated with breast enlargement in humans and other species. The use of bust-enhancing products should be discouraged because of lack of evidence for efficacy and long-term safety concerns.

Animals↗
PubMed2002

Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials.

BACKGROUND: Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies. PURPOSE: To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research. DATA SOURCES: Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM ), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch. STUDY SELECTION: 29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies. DATA EXTRACTION: Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results. DATA SYNTHESIS: Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes. CONCLUSIONS: Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available.

Acupuncture Therapy↗
PubMed2002

Ethnobotanical literature survey of medicinal plants in the Dominican Republic used for women's health conditions.

This ethnobotanical literature survey is part of an on-going study in New York City investigating Dominican and Chinese healing systems and the herbal treatments used for the following women's conditions: uterine fibroids (benign tumors of uterine smooth muscle); menorrhagia (excessive uterine bleeding); endometriosis (growth of endometrial tissue outside of the uterus); and hot flashes (sudden brief sensations of heat commonly experienced during menopause). The objectives of this survey were: (1) to search literature on medicinal plants used in the Dominican Republic and identify those used for the above listed conditions and their symptoms; (2) to compare the use between herbal treatments reported in the literature with those prescribed by Dominican healers in New York City; and (3) to evaluate the extent to which healers may have changed their use of plants in order to adapt to availability in the New York City environment. A total of 87 plant species were reported in the Dominican literature for these conditions and symptoms. Nineteen species overlapped from the literature survey and the fieldwork with Dominican healers in New York City, representing 29% (n=65) of the plants prescribed by healers in New York City. This study offers a model to investigate changes in plant use as people migrate to urban centers where they are surrounded by diverse cultures, healing systems, and new environments.

Data Collection↗
PubMed2002

Herbal interactions with cardiovascular drugs.

The prevalence of herb-drug interactions has been exaggerated. Nonetheless, some herbs, including garlic, ginkgo, ginseng, and St John's wort, can have a significant influence on concurrently administered drugs. Herbal medicines may mimic, decrease, or increase the action of prescribed drugs. This can be especially important for drugs with narrow therapeutic windows and in sensitive patient populations such as older adults, the chronically ill, and those with compromised immune systems.

Anticoagulants↗
PubMedDate not supplied

Complementary and alternative medicine (CAM) in reproductive-age women: a review of randomized controlled trials.

PURPOSE: Complementary and alternative medicine (CAM) therapies are widely used in the general population. This paper reviews randomized controlled trials of CAM therapies for obstetrical and gynecologic conditions and presents therapies that are likely to be used by women of reproductive age and by pregnant women. DATA SOURCES: Sources included English-language papers in MEDLINE 1966-2002 and AMED (1985-2000) and the authors' extensive holdings. STUDY SELECTION: Randomized controlled clinical trials of CAM therapies for obstetric and gynecologic conditions. DATA EXTRACTION: Clinical information was extracted from the articles and summarized in tabular form or in the text. DATA SYNTHESIS: Ninety-three trials were identified, 45 of which were for pregnancy-related conditions, 33 of which were for premenstrual syndrome, and 13 of which were for dysmenorrhea. Data support the use of acupressure for nausea of pregnancy and calcium for PMS. Preliminary studies indicate a role for further research on Vitamin B6 or ginger for nausea and vomiting of pregnancy; calcium, magnesium, Vitamin B6, or chaste-tree berry extract for PMS; and a low-fat diet, exercise, or fish oil supplementation for dysmenorrhea. CONCLUSIONS: Limited evidence supports the efficacy of some CAM therapies. Exposure of women of reproductive age to these therapies can be expected.

Adult↗
PubMedDate not supplied

Herbal Supplements: Indications, Clinical Concerns, and Safety.

Most herbal home remedies used in children, including teas made from chamomile, fennel, ginger, or mints, are benign. Most topical preparations are benign; however, garlic poultices can cause burns. Internal use of herbs containing saturated pyrrolizidine alkaloids should be avoided.

Journal Article↗
PubMedDate not supplied

Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies.

OBJECTIVE: To describe the prevalence and correlates of using conventional therapies, complementary and alternative therapies, or a combination of both types of therapies for menopausal symptoms and to examine the association between severity of symptoms and type of therapy use. DESIGN: Data on 2,602 women aged 45 years or older were gathered through a cross-sectional telephone survey conducted in Florida, Minnesota, and Tennessee during 1997 and 1998 using the Behavioral Risk Factor Surveillance System. Participants were asked a series of questions about their menopausal status, menopausal symptoms, healthcare provider selection in relation to menopause, and therapies used for menopausal symptoms. RESULTS: Of the eight menopausal symptoms assessed, the highest prevalence estimates were reported for hot flashes (62.9%), night sweats (48.3%), and trouble sleeping (41.1%). The average number of symptoms (range 0-8) was 3.10 (SD +/- 2.25) and, for women reporting symptoms, the average symptom severity score (range 1-24) was 6.78 (SD +/-4.63). About 45% of the women had not consulted with a healthcare provider for treatment of menopausal symptoms or for medical conditions related to menopause even though only 16.3% did not report any of the symptoms included in the survey. Forty-six percent of the women used complementary/alternative therapy either alone or in combination with conventional therapies. Age-adjusted average symptom severity scores were significantly higher among women who had undergone a hysterectomy, with removal of the ovaries (7.73; 95% CI 7.33,8.12) or without (7.60; 95% CI 7.16,8.05), than among women who experienced a natural menopause (6.42; 95% CI 6.14,6.71). Average severity scores were significantly higher among women who used both conventional and complementary/alternative therapies in relation to menopause (8.61; 95% CI 8.26,8.96) than among women who used only conventional therapies (7.09; 95% CI 6.67,7.50). This statistically significant association persisted when adjusted for age, education, income, race/ethnicity, state of residence, and menopausal category. CONCLUSIONS: In this sample, 46% of the women used complementary/alternative therapy either alone or in combination with conventional therapies, whereas a third of the women did not use any therapy in relation to menopause. Although causal inferences cannot be made, the menopausal symptom severity score was significantly higher among women who reported using a combination of conventional and complementary/alternative therapies than among women who used only conventional therapy, only complementary/alternative, or no therapy.

Aged↗