Tag Archives: Agency for Healthcare Research and Quality

Ceanothus velutinus

Botanical Name : Ceanothus velutinus
Family: Rhamnaceae
Genus: Ceanothus
Species:C. velutinus
Kingdom:Plantae
Order: Rosales

Common Names: Sticky Laurel, Snowbrush ceanothus, Hooker’s ceanothus, Red root, and Tobacco brush

Habitat : Ceanothus velutinus is native to western North America from British Columbia to California to Colorado, where it grows in several habitat types including coniferous forest, chaparral, and various types of woodland.

Description:
Ceanothus velutinus is an evergreen Shrub growing up to 4 meters tall but generally remains under three, and forms colonies of individuals which tangle together to form nearly impenetrable thickets. The aromatic evergreen leaves are alternately arranged, each up to 8 centimeters long. The leaves are oval in shape with minute glandular teeth along the edges, and shiny green and hairless on the top surface.
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The plentiful inflorescences are long clusters of white flowers. The fruit is a three-lobed capsule a few millimeters long which snaps open explosively to expel the three seeds onto the soil, where they may remain in a buried seed bank for well over 200 years before sprouting. The seed is coated in a very hard outer layer that must be scarified, generally by wildfire, before it can germinate. Like most other ceanothus, this species fixes nitrogen via actinomycetes on its roots.
Cultivation:
Prefers a warm sunny position but tolerates light shade. Tolerates some lime, but will not succeed on shallow chalk. One report says that this species is hardy to zone 5 (tolerating temperatures down to about -20°c) whilst another says that it needs the protection of a wall when grown outdoors in Britain. Plants dislike root disturbance, they should be planted out into their permanent positions whilst still small. Dislikes heavy pruning, it is best not to cut out any wood thicker than a pencil. Plants flower on the previous year’s growth, if any pruning is necessary it is best carried out immediately after flowering has finished. Constant pruning to keep a plant small can shorten its life. Fast growing, it flowers well when young, often in its second year from seed[11]. Hybridizes freely with other members of this genus. The leaves have a strong scent of balsam[200]. Some members of this genus have a symbiotic relationship with certain soil micro-organisms, these form nodules on the roots of the plants and fix atmospheric nitrogen. Some of this nitrogen is utilized by the growing plant but some can also be used by other plants growing nearby.
Propagation :
Seed – best sown as soon as it is ripe in a cold frame. Stored seed should be pre-soaked for 12 hours in warm water and then given 1 – 3 months stratification at 1°c. Germination usually takes place within 1 – 2 months at 20°c. One report says that the seed is best given boiling water treatment, or heated in 4 times its volume of sand at 90 – 120°c for 4 – 5 minutes and then soaked in warm water for 12 hours before sowing it. It then requires a period of chilling below 5°c for up to 84 days before it will germinat. Seeds have considerable longevity, some that have been in the soil for 200 years or more have germinated. The seed is ejected from its capsule with some force when fully ripe, timing the collection of seed can be difficult because unless collected just prior to dehiscence the seed is difficult to extract and rarely germinates satisfactorily. Prick out the seedlings into individual pots as soon as they are large enough to handle. Grow them on in the greenhouse for at least their first winter and plant them out into their permanent positions in late spring or early summer. Cuttings of half-ripe wood, taken at a node, July/August in a frame. Cuttings of mature wood of the current year’s growth, 7 – 12 cm with a heel, October in a cold frame. The roots are quite brittle and it is best to pot up the callused cuttings in spring, just before the roots break. Good percentage.
Edible Uses:.. Tea..The leaves are used as a tea substitute

Medicinal Uses:
The leaves are febrifuge. An infusion has been used in the treatment of coughs and fevers. A decoction of the leaves and stems has been used both internally and externally in the treatment of dull pains, rheumatism etc. The leaves contain saponins and have been used as a skin wash that is also deodorant and can destroy some parasites. The wash is beneficial in treating sores, eczema, nappy rash etc.

Other Uses
Baby care; Dye; Insecticide; Soap.

A green dye is obtained from the flowers. A poultice of the dried powdered leaves has been used as a baby powder for treating nappy rash etc. Smoke from burning the plant has been used as an insecticide to kill bedbugs. All parts of the plant are rich in saponins – when crushed and mixed with water they produce a good lather which is an effective and gentle soap. This soap is very good at removing dirt, though it does not remove oils very well. This means that when used on the skin it will not remove the natural body oils, but nor will it remove engine oil etc The flowers are a very good source, when used as a body soap they leave behind a pleasant perfume on the skin. The developing seed cases are also a very good source of saponins.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Ceanothus_velutinus
http://www.pfaf.org/user/Plant.aspx?LatinName=Ceanothus+velutinus

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SAMe (S-Adenosyl methionine )

Other Names: SAM-e, S-adenosylmethionine

Definition:-
S-Adenosyl methionine (SAM) is a coenzyme involved in methyl group transfers. SAM was first discovered in Italy by G. L. Cantoni in 1952. It is made from adenosine triphosphate (ATP) and methionine by methionine adenosyltransferase EC 2.5.1.6. Transmethylation, transsulfuration, and aminopropylation are the metabolic pathways that use SAM. Although these anabolic reactions occur throughout the body, most SAM is produced and consumed in the liver.

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The methyl group (CH3) attached to the methionine sulfur atom in SAM is chemically reactive. This allows donation of this group to an acceptor substrate in transmethylation reactions. More than 40 metabolic reactions involve the transfer of a methyl group from SAM to various substrates such as nucleic acids, proteins, and lipids.

In bacteria, SAM is bound by the SAM riboswitch, which regulates genes involved in methionine or cysteine biosynthesis.

The supplement SAMe is a synthetic form of a compound formed naturally in the body from the essential amino acid methionine and adenosine triphosphate (ATP), the energy-producing compound found in all cells in the body. It was first discovered in 1953.

SAMe is believed to work by being a methyl group donor in many reactions in the body. After donating the methyl group, it is converted to a compound called S-adenosyl-homocysteine.

Properties:-
Molecular formula: C15H23N6O5S+
Molar mass: 399.447

Biochemistry of S-adenosyl methionine:-

SAM cycle
The reactions that produce, consume, and regenerate SAM are called the SAM cycle. In the first step of this cycle, the SAM-dependent methylases (EC 2.1.1) that use SAM as a substrate produce S-adenosyl homocysteine as a product. This is hydrolysed to homocysteine and adenosine by S-adenosylhomocysteine hydrolase EC 3.3.1.1 and the homocysteine recycled back to methionine through transfer of a methyl group from 5-methyltetrahydrofolate, by one of the two classes of methionine synthases EC 2.1.1.13 or EC 2.1.1.14. This methionine can then be converted back to SAM, completing the cycle.

Polyamine biosynthesis
Another major role of SAM is in polyamine biosynthesis. Here, SAM is decarboxylated by Adenosylmethionine decarboxylase EC 4.1.1.50 to form S-adenosyl-5′-3-methylpropylamine. This compound then donates its n-propylamine group in the biosynthesis of polyamines such as spermidine and spermine from putrescine.

SAM is required for cellular growth and repair. It is also involved in the biosynthesis of several hormones and neurotransmitters that affect mood, such as dopamine and serotonin. Methyltransferases are also responsible for the addition of methyl groups to the 2′ hydroxyls of the first and second nucleotides next to the 5′ cap in messenger RNA.

Therapeutic uses
In the United States, SAM is sold as a nutritional supplement under the marketing name SAM-e (also spelled SAME or SAMe; pronounced “sam ee”). SAM is also marketed under the Gumbaral, Samyr, Adomet and Admethionine brand names. Some research has indicated that taking SAM on a regular basis may help fight depression, liver disease, and the pain of osteoarthritis. An authoritative report on SAMe is from the Agency for Healthcare Research and Quality (Dept Health and Human Services) at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1a.chapter.2159. Multiple clinical trials indicate benefits for depression, some liver conditions and osteoarthritis. All other indications are not yet proven.

Therapeutic use of SAM has increased as dietary supplements have gained in popularity, especially after the Dietary Supplement Health and Education Act was passed in 1994. This law allowed the distribution of SAM as dietary supplement, and therefore allowed it to bypass the regulatory requirements for drugs of the Food and Drug Administration (FDA).

At first, a line of evidence suggested that abnormally low levels of endogenous SAM may play an important role in the development of Alzheimer’s disease (AD) and that SAM may therefore have therapeutic potential in the treatment of AD (further research indicates this effect is likely due to Vitamin B12 deficiencies, which cause neurologic defects through one carbon transfers with folate). Severely low levels of SAM have been found in the cerebrospinal fluid and in all brain regions of AD patients examined. Preliminary research suggests SAM may have therapeutic potential in treating AD patients and a recent study using a mouse model of AD found that supplementary SAM prevented oxidative damage and cognitive impairment. In that study (available online), Tchantchou et al also explain the biomechanics that in addition to the above findings make low SAM a likely causal component of AD pathology.

Oral forms:
Oral SAMe achieves peak plasma concentrations 3 to 5 hours after ingestion of an enteric-coated tablet (400 – 1000 mg). The half-life is about 100 minutes. It may require up to one month for it to reach full effectiveness in treating osteoarthritis. Because of structural instability, stable salt forms of SAM are required for its use as an oral drug. The University of Maryland lists the commonly used salts: tosylate, butanedisulfonate, disulfate tosylate, disulfate ditosylate, and disulfate monotosylate.

With the advent of FDA-mandated Good Manufacturing Practices (GMPs) in 2008, manufacturers are required to confirm that their products contain what is listed on the label through the end of shelf life. Whether they achieve this goal or not has been questioned. Subscribers to Consumer Labs have access to a comparative report on SAMe content of various supplements.

Claims that the SAMe butanedisulfonate salt is more stable or better absorbed are not supported by the references that are usually cited as evidence. Different salts have successfully been used in clinical trials, but there is no published head-to-head comparison

Usage
SAMe is best absorbed on an empty stomach. Enteric-coated tablets packaged in foil or foil blister packs increase stability and improve absorption. SAMe should be stored in a cool, dry place to prevent deterioration.
People Use SAMe In:-
Osteoarthritis
There have been a number of studies on the effectiveness of SAMe in the treatment of osteoarthritis. SAMe appears to diminish osteoarthritis pain as effectively as non-steroidal anti-inflammatory medication. It appears to be well-tolerated.

Depression
There have been a number of studies on the use of SAMe for depression. It has been hypothesized that SAMe increases the availaibility of neurotransmitter serotonin and dopamine.

Liver disease
Some evidence suggests that SAMe may help people with liver disease. Preliminary research suggests it may help to normalize liver enzyme levels and help with cholestasis.

Possible side effects:-
SAM-e & Homocysteine: Once SAM-e donates its methyl group to choline, creatine, carnitine, DNA, tRNA, norepinephrine, and other compounds, it is transformed into S-adenosyl-homocysteine, (SAH). Under normal circumstances, homocysteine, in the presence of Vitamin B6, B12, and folic acid (SAM-e’s main co-factors), will eventually be converted back into methionine, SAM-e, or cysteine, glutathione, and other useful substances. However, if adequate amounts of these vitamins are not present, SAM-e will not break down properly. As a consequence, the full benefits of SAM-e will not be obtained, and homocysteine may increase to unsafe levels.

High levels of homocysteine have been associated with atherosclerosis (hardening and narrowing of the arteries), as well as an increased risk of heart attacks, strokes, liver damage, and possibly Alzheimer’s disease. Therefore, Vitamin B supplements are often taken along with SAM-e. These vitamins help metabolize the homocysteine into other useful compounds.

Another reported side effect of SAMe is insomnia, therefore the supplement is often taken in the morning. Other reports of mild side effects include lack of appetite, constipation, nausea, dry mouth, sweating, and anxiety/nervousness, but in placebo-controlled studies these side effects occur at about the same incidence in the placebo groups.

Therapeutic doses range from 400 mg/day to 1600 mg/day, although higher doses are used in some cases. Consult with your physician before and during use.

Adverse effects:-
Gastrointestinal disorder, diarrhea, dyspepsia, anxiety, headache, psychiatric, insomnia, allergy, and rashes. Long-term effects are unknown.

Serotonin syndrome:
There is concern and one report of the potentially fatal serotonin syndrome in association of SAMe with other medications.

Induction of mania:
In an extensive MEDLINE search on SAMe, Kagan found induction of mania in one patient out of fifteen treated with parenteral SAMe. In the same review, Lipinski found the apparent induction of mania in two patients with bipolar disorder (total of nine depressed patients studied).Both depression and mania can be life-threatening conditions that may cause cognitive dysfunction even after remission. There is concern that antidepressants in general can induce hypomania, mania, or both.

The safety of SAMe during pregnancy and during breastfeeding is unknown.

People with bipolar disorder, anxiety disorders and other psychiatric conditions should only use SAMe under the supervision of their healthcare provider. SAMe has been associated with hypomania and mania.

The most common side effects are digestive complaints, particularly nausea. Other side effects include skin rash, lowered blood sugar, dry mouth, blood in the stool, thirst, increased urination, headache, hyperactivity, anxiety and insomnia.

People with Parkinson’s disease should avoid SAM-e.

For more knowledge you may click to see
:->

S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease (Evidence Report/Technology Assessment:)

What Is SAMe

Disclaimer:The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.

Resources:
http://en.wikipedia.org/wiki/S-Adenosyl_methionine
http://altmedicine.about.com/od/treatmentsfromatod/a/SAMe.htm

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Getting a Grip on the Winter Blues (SAD)

It is that time of year again, when despite the ratcheting up of festivities for the holidays, fully one person in five in the United States ratchets down. The cause is a now well-known but still infrequently treated disorder, winter blues or SAD, for seasonal affective disorder.

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There are several remedies to help those affected by SAD escape an affliction that leaves many wanting to climb into bed, put their heads under the covers and not come out until spring. Indeed, some experts refer to SAD as a form of hibernation.

The problem typically starts gradually as the days become shorter in late summer or fall and peaks in midwinter in regions where there may be just 9 or 10 hours of daylight, if that.

For the estimated 14 million severely affected American adults, SAD can send them into a tailspin that makes it difficult if not impossible to fulfill daily responsibilities and derive any joy from life. An additional 33 million people are less severely affected but may experience declines in energy, cheerfulness, creativity or productivity in the dark days of winter.

The most commonly used treatment is exposure for up to several hours a day to high-intensity artificial light, in an effort to simulate the longer days of summer when people with SAD function at top speed.

Jet Lag and Circadian Rhythm
Dr Alfred J. Lewy, a psychiatrist who has been studying the biology behind SAD, describes it as a form of jet lag, a concept he proposed 20 years ago. He recently published experimental evidence that he says attests to the validity of this theory. If true, this would make SAD a disturbance in the circadian rhythm, the 24-hour pattern that normally aligns the sleep-wake cycle with all the other bodily rhythms. Dr. Lewy suggests that with the delayed dawn and shorter days of fall and winter, the rhythms of people afflicted with SAD drift out of phase with the sleep-wake cycle, as if they had traveled across many time zones.

With jet lag, recovery occurs over a matter of days, and the circadian rhythm once again becomes synchronized with day and night. “In people with SAD, this adjustment takes five months,” Dr. Lewy said.

If his theory is substantiated by further research, it may one day be possible to treat SAD with tiny daily doses of time-released melatonin, the substance in the brain that regulates the sleep-wake cycle. Melatonin naturally increases in the evening, causing sleepiness, and falls off as morning approaches. The idea would be to tailor the administration of melatonin in a way that realigns the out-of-sync circadian rhythm in people with SAD, just as tiny doses (much smaller than those typically sold in health-food and drug stores) of melatonin can be used to speed recovery from jet lag.

In his study, conducted with three colleagues at Oregon Health Sciences University, Dr. Lewy identified two types of SAD patients. About two-thirds required morning light or evening melatonin to correct their body clocks. The remainder needed evening light or morning melatonin to put their body rhythms back on track. Currently, there is no commercial source of time-release low-dose melatonin that could be used, with or without light therapy, to help people with SAD.

Current Remedies
Dr. Norman E. Rosenthal, a native of South Africa who discovered his own serious problem with SAD while a resident in psychiatry at the New York State Psychiatric Institute in 1976, has become an expert in diagnosing and treating the problem. His knowledge and experience in helping himself and countless patients afflicted with SAD are summarized in “Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder,” whose revised edition the Guilford Press published this year.

Dr. Rosenthal aptly describes SAD as “an energy crisis.” Patients are not depressed in the usual emotional sense, but rather feel as if their batteries have run down.

The symptoms of SAD do mimic those of serious depression. Patients say they have to drag themselves out of bed in the morning, even after 10 hours of sleep, and force themselves to perform necessary chores. They feel leaden and would just as soon not see anybody or do anything. They find it difficult to concentrate and think clearly and quickly.

Sex drive often dwindles markedly but is often replaced by an insatiable appetite for carbohydrates — breads, pasta, potatoes, rice and sweets — that results in weight gain. Many people with SAD have two wardrobes, the one for winter being two sizes larger.

The most common remedy is light therapy. But not just any light. Patients are advised to sit in front of a specially designed light box that emits about 10,000 lux from a fluorescent bulb, most often in the morning for at least 45 minutes. Some patients require hours of light therapy each day to ward off the symptoms of SAD, which may mean having one light box at home and a second at work.

Among commercial sources for these light boxes is the Center for Environmental Therapeutics, which sells them for $200. Its Web site, www.cet.org, is a useful source of information about SAD.

Among other light-enhancing suggestions from Dr. Rosenthal are planning a winter vacation in a sunny climate or relocating to someplace nearer the Equator, where the days are longer in winter. (But, he cautions, first be sure you can tolerate the summer there.)

Helpful Machines and Therapies
For those who remain in northern latitudes, Michael and Jiuan Su Terman of the New York State Psychiatric Institute at Columbia University, who have conducted pioneering studies of SAD remedies, suggest considering a “dawn simulator.” This device gradually turns on a bedroom light every morning while you are still asleep, helping ease SAD symptoms by making the body think that it is experiencing the early sunrises of summer.

This might also help people who do not have SAD but who hate getting up in the morning when it is still dark out.

The Termans have also found another helpful gadget, a negative-ion generator. They showed that sitting in front of a machine that emits negative ions at a high rate for 30 minutes every morning was as effective as sitting in front of a light box for the same time. The generators are available for $165 from the Center for Environmental Therapeutics (Michael Terman is the president of its board). The advantage of this device is that it can be used while sleeping.

A third approach that has proved effective is cognitive behavioral therapy, when used with or without light therapy. Kelly J. Rohan of the Uniformed Services University of the Health Sciences in Bethesda, Md., (and currently of the University of Vermont) found that this therapy, a brief form of psychotherapy that helps people change negative thoughts and behaviors, was as effective as light therapy in a study of 23 patients with SAD.

And unlike light therapy used alone, cognitive behavioral therapy helped prevent a relapse of SAD symptoms the next winter.

Dr. Rosenthal also recommends eating a diet relatively high in protein and low in carbohydrates and performing regular physical exercise, which is especially helpful if it is outdoors in the morning or, if indoors, in front of a light box.

Source:The New York Times

SHOULD YOUNG WOMEN GET MAMMOGRAMS?

Research from The Lancet questions the benefit of women starting annual mammograms at age 40. New data from a large United Kingdom study of more than 160,000 women finds that mammogram screening in younger women may provide little benefit in terms of reducing breast cancer risk, while at the same time exposing women to more radiation and the possibility of false alarms. Overall, women in the 40s who received mammograms saw a small drop in breast cancer deaths, around 17 percent, a figure that was not statistically different from chance. Also, 23 percent of the women had at least one false alarm   higher than the rate of 12 percent seen in women in their 50s. A related editorial says that it’s not clear that women in the 40s get a net benefit from mammogram screening because the potential harms may offset any benefit, and that women should decide individually whether they want the peace of mind from screening or the possibility of unnecessary radiation exposure from additional mammograms.

Source:   ABC News