 Paclitaxel (trade name Taxol) is derived from the bark of the Pacific yew tree (Taxus brevifolia) and is used to treat breast, lung, and ovarian cancer. In Agatha Christie's book A Pocket Full of Rye, the first victim is murdered when his marmalade is spiked with poisonous yew berries. What is popular lore on the poisonous or medicinal properties of the yew tree? Culpeper’s Complete Herbal & English Physician (1826) states “Many in this country have eaten yew berries and survived. The tree’s very powerful poisonous qualities rise by distillation.” He goes on to say that, despite these qualities, yew berries are “sometimes given usefully in obstructions of the liver and bilious complaints.” In The Complete Book of Herbs, Lesley Bremness notes that all parts of the English yew are poisonous, yet a homeopathic tincture made from the leaves and berries is used medicinally. In the homeopathic literature, the bark, branch tips, and needles of the yew are used to treat diphtheria, tapeworms, tonsillitis, liver conditions, and rheumatism.  HISTORY OF PACLITAXEL In 1961, the National Cancer Institute (NCI) began screening thousands of plant compounds for their anticancer properties. Samples of Pacific yew were first collected in 1962 by researchers from the U.S. Department of Agriculture (USDA) who were under contract to help the NCI in their search for natural products that might cure cancer. And compounds derived from the bark of the Pacific yew tree (Taxus brevifolia) showed promise. Extracts from this bark proved cytotoxic, although even after identification of the extract's most active component, it still took several years to isolate paclitaxel in its pure form. Testing was undertaken to identify the biological action of the new compound. It was not until 1977 that the NCI was able to confirm antitumor activity in a mouse melanoma model. Because of difficulties harvesting the drug and the complexity of synthesizing the compound, development toward the clinic was slow. The drug, however, showed effectiveness against mammary tumors and ovarian cancer, pushing researchers to find a means of isolating large quantities for clinical use. Clinical trials became possible when a method was derived to extract a precursor, 10-deacetyl-baccatin III, from the common yew. The precursor was then converted by chemical synthesis to paclitaxel. Today, a cell culture method is used to produce the drug. MECHANISM OF ACTION Paclitaxel is a novel agent that interferes with the normal function of microtubule growth; at high concentrations it induces mitotic arrest in the G2/M phase of cell growth, and at low concentrations it causes apoptosis in the G0 and G1/S phases. Paclitaxel promotes the assembly of microtubules from tubulin dimers and stabilizes microtubules by preventing depolymerization. This stability results in inhibition of the normal dynamic reorganization of the microtubule network that is essential for vital interphase and mitotic cellular functions. In addition, paclitaxel induces abnormal arrays or “bundles” of microtubules throughout the cell cycle. The drug binds to a cell's microtubule assembly and slows cell division and growth by stabilizing the microtubules, preventing shrinkage, and therefore blocking segregation of chromosomes. CHALLENGES It was difficult to formulate paclitaxel into a delivery system acceptable for human use. Initial activity was observed with bulk drug suspended in solution. Although paclitaxel was soluble in 75% polyethylene glycol, repeated testing using this formula produced inferior results. When the drug was formulated in an ethanol, Cremophor, and saline solution to a particular concentration, intraperitoneal activity was preserved at initial levels. Preclinical toxic effects were most evident in tissues with a high cell turnover, such as hematopoietic, lymphatic, gastrointestinal, and reproductive tissues. APPROVAL In 1992 the FDA approved paclitaxel (Taxol) for the treatment for ovarian cancer. Clinical trials to test treatment in other types of cancers and in combination with other therapies resulted in indications for breast cancer, lung cancer, and Kaposi's sarcoma. 
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Frontiers in Pharmacology review article examines the safety of herbal medicines EXPLOSIVE GROWTH OF HERBAL MEDICINES Viewed as a balanced and moderate approach to healing, herbal medicines have grown exponentially. This popularity is attributed to a preference for natural therapies and a greater interest in alternative medicines. Traditional medicinal practice involving herbs is an integral part of many communities, and the World Health Organization (WHO) estimates that 80% of the world’s population relies on herbal medicine as a primary source of healthcare. Strategic marketing by manufacturers of herbal medicines has expanded product visibility, and the continuous introduction of new herbal products into the market has led to public health issues and safety concerns. CHALLENGES All medicines must be safe and of suitable quality, yet a single herb plant may contain hundreds of natural constituents. Such complexity means that the control of raw herbal materials and finished herbal products is more involved than for conventional pharmaceuticals. A substantial proportion of the global drug market, herbal medicines require pharmacovigilance and safety monitoring. The WHO recommends national quality specifications and standards related to the manufacturing, import, and marketing of herbal materials; however, in most countries, herbal medicines arrive on the market without mandatory safety or toxicological evaluations and without evidence of quality and efficacy. The common misconception that natural products are nontoxic and devoid of adverse effects leads to improper use and unrestrained intake, along with the risk of severe poisoning and acute health problems. Herbal medicinal products have been implicated in cases of poisoning, with certain compounds capable of reacting with cellular macromolecules including DNA and inducing cellular toxicity and/or genotoxicity. SAFETY AND TOXICITY The safety of traditional and herbal medicines is paramount to national health authorities and the general public, yet:
Possible causes of adverse events resulting from the consumption of herbal medicines include mistaken use of the wrong plant species, misidentification of medicinal plants, adulteration of herbal products with undeclared medicines, mislabeling of herbal medicinal products, contamination with toxic or hazardous substances, overdose, and misuse of herbal medicines by healthcare providers or consumers – including concomitant administration with other medicines. Predictably, adverse event analysis with herbal medicines is more complex than with conventional pharmaceuticals. Evaluation of product safety is further complicated by geographical origin of the plant material, processing technique, route of administration, and compatibility with other medicines.  Aconitum species are used traditionally for pain relief.  Tussilago farfara, commonly known as coltsfoot. PROPERTIES OF SPECIFIC HERBS Aristolochic acids and Aristolochia species. After findings of potential nephrotoxicity and carcinogenicity of aristolochic acids, studies confirmed their genotoxic activity. Aristolochic acid-related DNA adducts have been found in the renal tissues of patients; these mutagenic adducts are usually poorly repaired and capable of persisting for years in DNA. All plants in the genus Aristolochia contain aristolochic acids and are banned in Europe and the United States. Intake of slimming pills containing the Chinese herb Aristolochia fangchi has been linked to Aristolochic acid nephropathy and the development of subacute interstitial fibrosis of the kidneys and urothelial malignancies. The tubers and roots of the Aconitum species have been used medicinally for centuries in herbal preparations for stroke, heart failure, diabetes, rheumatic fever, painful joints, gastroenteritis, edema, bronchial asthma, and other disorders. Aconitum carmichaeli and Aconitum kusnezoffii are used traditionally for pain relief. The toxicity of these plants derives primarily from the presence of diester diterpene alkaloids. Severe cases of cardiotoxicity from consumption of aconitine-containing herbal preparations manifest as ventricular tachycardia and fibrillation and eventually death. Bradycardia and hypotension have also been observed. The toxicity of aconitine and related diterpene alkaloids can be denatured by special processing and in China only the processed (i.e., detoxified) tubers and roots of Aconitum can be administered orally. More than 70 techniques are applied to the processing of Aconitum roots in order to reduce levels of toxic alkaloids below a certain threshold; note that this principle is not accepted in Europe.  Garlic (Allium sativum)  St. John's wort or Hypericum perforatum Traditionally, Tussilago farfara or coltsfoot has been used for thousands of years to treat pulmonary complaints, acute and chronic coughs, bronchitis, laryngitis, and asthma. The polysaccharides are anti-inflammatory and immuno-stimulating, as well as demulcent, and the flavonoids have anti-inflammatory and antispasmodic actions. Tussilago farfara is generally regarded as nontoxic, although total alkaloids isolated from this plant have demonstrated hepatotoxicity. Recently, the effects of the pyrrolizidine alkaloids found in Tussilago farfara were reviewed and hepatic veno-occlusive disease and cirrhosis suggested as potential disease outcomes in humans. Restricted intake of pyrrolizidine-containing herbs is recommended. There are reports on the efficacy of Garlic (Allium sativum) for management of hypertension and hypercholesterolemia. The main compound in the fresh plant is alliin, which on crushing undergoes enzymatic hydrolysis by alliinase to produce allicin. Due to the antiplatelet effects of garlic, care should be taken if given in combination with antiplatelet drugs and warfarin. Adverse effects associated with garlic extract include burning sensation in the gastrointestinal tract, nausea, diaphoresis, and lightheadedness. The active compounds of St. John’s wort (Hypericum perforatum) include hypericin, hyperforin, and melatonin. The plant has clinically well-established effects for mild depressive symptoms, although allergic reactions, headache, dizziness, restlessness, fatigue, gastrointestinal symptoms, and photosensitivity have been reported, as well as hyperesthesia and a syndrome of dyspnea and hyperventilation with mydriasis, nausea, palpitations, and tremors. Interaction of St. John’s wort with antidepressants and anticoagulants has been demonstrated and use is not recommended in pregnancy because of the herb’s uterotonic activity. RECOMMENDATIONS It is vital to inform and protect the public by identifying risks associated with herbal medicines, incorporating herbal products into pharmacovigilance systems, linking safety monitoring to the regulatory status of herbal medicines, promoting safe use through adequate labeling and appropriate patient information, advancing knowledge of traditional, complementary, alternative, and herbal medicines within national drug regulatory authorities, and standardizing definitions and categorizations of herbal medicinal plants on an international level. Herbal medicines must be assessed for safety, toxicity, efficacy, and quality. Providers of medicines – physicians, nurses, and pharmacists – need training to understand how herbal medicines affect the health of their patients. Healthcare professionals and medical communicators (translators and writers) must inform the public. The right knowledge base is crucial. Citation: Ekor M (2014) The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front. Pharmacol. 4:177. doi: 10.3389/fphar.2013.00177 Integrative Translations specializes in Chinese-to-English translation of conventional and complementary medicine.
Effectiveness of turmeric and tuina therapies |
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Healthcare for patients with limited English proficiency
OPEN LETTER TO GOVERNORS AND HOSPITALS
The Certification Commission for Healthcare Interpreters (CCHI) has issued an open letter to governors and hospital associations to raise awareness about the safety of healthcare interpreters and language access services for patients with limited English proficiency (LEP) and their families, as well as the safety of all healthcare workers during the current unprecedented COVID-19 pandemic. Healthcare interpreters work in close quarters and in close proximity to patients and the safety of all workers with direct patient contact must be the number one priority. This includes physicians, nurses, allied professionals, and face-to-face/on-site healthcare interpreters.
PERSONAL PROTECTIVE EQUIPMENT
The open letter reminds hospitals and healthcare systems that face-to-face/on-site healthcare interpreters should be provided the same level of protection and use of personal protective equipment (PPE) as any healthcare provider for whom they are interpreting while also recognizing that PPE shortages may necessitate certain limiting measures. It is extremely important for managers to have transparent and honest conversations with interpreters and collectively come to an understanding on when and to whom PPE is provided.
The Certification Commission for Healthcare Interpreters (CCHI) has issued an open letter to governors and hospital associations to raise awareness about the safety of healthcare interpreters and language access services for patients with limited English proficiency (LEP) and their families, as well as the safety of all healthcare workers during the current unprecedented COVID-19 pandemic. Healthcare interpreters work in close quarters and in close proximity to patients and the safety of all workers with direct patient contact must be the number one priority. This includes physicians, nurses, allied professionals, and face-to-face/on-site healthcare interpreters.
PERSONAL PROTECTIVE EQUIPMENT
The open letter reminds hospitals and healthcare systems that face-to-face/on-site healthcare interpreters should be provided the same level of protection and use of personal protective equipment (PPE) as any healthcare provider for whom they are interpreting while also recognizing that PPE shortages may necessitate certain limiting measures. It is extremely important for managers to have transparent and honest conversations with interpreters and collectively come to an understanding on when and to whom PPE is provided.
ALTERNATIVES TO ON-SITE INTERPRETATION
When PPE is not available there are alternatives to face-to-face/on-site interpretation. Ultimately, if appropriate PPE is not available for an interpreter, then alternatives must be provided to both reduce the spread of the coronavirus by interpreters and ensure their personal safety. Unlike most healthcare providers, interpreters work in different departments, different facilities, and even different campuses throughout the day. Their inadequate protection will result in spreading the virus not only in the community and to their families but also to other healthcare workers and patients within and outside a specific facility.
REMOTE INTERPRETING
The CCHI recommends that all hospitals, health systems, clinics, and healthcare providers deploy remote interpreting for most of their interactions with LEP patients and their families, as the primary modality for delivery of language access services in the time of this pandemic. The implementation of remote interpreting may take time and require certain information technology solutions as well as evaluation for compliance with laws and regulations. However, the implementation of remote interpreting will allow facilities to reserve much needed PPE for healthcare professionals who must be in direct contact with patients. Furthermore, face-to-face interpreters have a higher risk of becoming a vector of infection even with the appropriate use of PPE due to the mobility of their job. When institutions utilize telemedicine and telehealth options for providing care, they must incorporate remote interpreting into these solutions to ensure equal access to healthcare for limited English proficiency patients.
HOW TO IMPLEMENT REMOTE INTERPRETING
Remote interpreting may be implemented in the following ways:
When PPE is not available there are alternatives to face-to-face/on-site interpretation. Ultimately, if appropriate PPE is not available for an interpreter, then alternatives must be provided to both reduce the spread of the coronavirus by interpreters and ensure their personal safety. Unlike most healthcare providers, interpreters work in different departments, different facilities, and even different campuses throughout the day. Their inadequate protection will result in spreading the virus not only in the community and to their families but also to other healthcare workers and patients within and outside a specific facility.
REMOTE INTERPRETING
The CCHI recommends that all hospitals, health systems, clinics, and healthcare providers deploy remote interpreting for most of their interactions with LEP patients and their families, as the primary modality for delivery of language access services in the time of this pandemic. The implementation of remote interpreting may take time and require certain information technology solutions as well as evaluation for compliance with laws and regulations. However, the implementation of remote interpreting will allow facilities to reserve much needed PPE for healthcare professionals who must be in direct contact with patients. Furthermore, face-to-face interpreters have a higher risk of becoming a vector of infection even with the appropriate use of PPE due to the mobility of their job. When institutions utilize telemedicine and telehealth options for providing care, they must incorporate remote interpreting into these solutions to ensure equal access to healthcare for limited English proficiency patients.
HOW TO IMPLEMENT REMOTE INTERPRETING
Remote interpreting may be implemented in the following ways:
- Create in-house call centers. Current staff interpreters interpret remotely via video or
- Tools for remote video/phone interpreting. Provide current staff interpreters with tools to interpret from home via a video application or phone.
- Equip rooms for limited English proficiency patients. Provide patient rooms that have access to a phone or video device (tablet, computer monitor, TV screen) connected to the internet.
A BRIEF NOTE ON CONFERENCE INTERPRETING
The International Association of Conference Interpreters (AIIC) has issued best practices for interpreters during the COVID-19 crisis. AIIC's Technical and Health Committee and Taskforce on Distance Interpreting specify rules on social distancing in interpreting booths, social distancing for sign language teams, disinfection, and the use of disposable gloves and personal headset covers.
The International Association of Conference Interpreters (AIIC) has issued best practices for interpreters during the COVID-19 crisis. AIIC's Technical and Health Committee and Taskforce on Distance Interpreting specify rules on social distancing in interpreting booths, social distancing for sign language teams, disinfection, and the use of disposable gloves and personal headset covers.
REFERENCES
CCHI Open Letter on Ensuring Healthcare Interpreters’ Safety during the COVID-19 Pandemic. April 3, 2020. https://cchicertification.org/covid-19/covid-19-update/.
AIIC Taskforce on Distance Interpreting, Technical Committee. "AIIC best practices for interpreters during the Covid-19 crisis.” aiic.net March 17, 2020. http://aiic.net/p/8956.
CCHI Open Letter on Ensuring Healthcare Interpreters’ Safety during the COVID-19 Pandemic. April 3, 2020. https://cchicertification.org/covid-19/covid-19-update/.
AIIC Taskforce on Distance Interpreting, Technical Committee. "AIIC best practices for interpreters during the Covid-19 crisis.” aiic.net March 17, 2020. http://aiic.net/p/8956.
The connection between psychological and cardiovascular health
BEHAVIORAL CARDIOLOGY
In medical treatment today, heart health requires more than blood pressure control or the right pharmacologic therapy. Doctors advise lifestyle modifications in the form of diet and exercise yet may encounter resistance. Patients must be willing to comply with lifestyle modifications and often such motivation is tied to their psychological health. If a patient already has underlying depression, then news of serious cardiovascular disease may deepen such depression and dampen motivation.
Behavioral cardiology looks at the links between behavioral and psychosocial factors and the origin and progression of coronary heart disease. Randal Thomas notes in Behavioral Cardiology: Where the Heart and Head Meet (U.S. Cardiology Review, 2006) “Results of recent clinical research have strengthened the understanding and management of the links between psychological health and heart health, and have moved the field of behavioral cardiology steadily closer into the mainstream of current clinical cardiology.” Thomas notes the importance of behavioral cardiology: Adverse psychosocial factors are common in persons with coronary artery disease and up to 50% of survivors of myocardial infarction present with significant anxiety and/or depressive disorders. These adverse psychosocial factors can significantly worsen coronary artery disease risk and prognosis. Moreover, psychosocial health status is generally responsive to behavioral and pharmacologic therapies.
CARDIOLOGISTS ALERT TO PSYCHOLOGICAL AND CARDIOVASCULAR FACTORS
Physical and emotional factors contribute to feelings of overwhelming depression and hopelessness in a vulnerable patient who has recently experienced a heart attack. This presents an unusual dilemma in current cardiovascular healthcare. The cardiologist must treat the underlying disease and the risk of heart disease and at the same time be aware of related psychosocial factors, such as hostility and anxiety. Treatments that effectively treat both psychosocial and coronary artery disease outcomes can be elusive.
The cardiologist is often the first to see a patient during and after cardiovascular events at a time when adverse psychosocial factors may become more visible and patients are more open to therapeutic recommendations. The cardiologist's challenge is to identify coexisting heart disease and psychological distress, and then successfully intervene and initiate the early steps of psychosocial care.
PSYCHOSOCIAL FACTORS THAT INCREASE THE RISK OF HEART DISEASE
As important as smoking, high blood pressure, obesity, and cholesterol, psychological factors may be the final insult resulting in a heart attack or stroke. Psychological factors contribute to atherosclerosis, the slow, corrosive process that damages artery walls. Depression, stress, loneliness, pessimistic outlook, and other psychosocial factors influence heart health. Conversely, heart disease affects the brain and the mind.
DEPRESSION
Symptoms of depression, as well as full-blown major depression, contribute to heart disease. The prognosis is worse for people who become depressed after a heart attack or stroke, heart surgery, or the onset of heart failure.
ANGER AND HOSTILITY
Atherosclerosis seems to advance faster in people who score high on anger or hostility scales. Anger may even initiate heart attacks. In the Harvard-based Determinants of Myocardial Infarction Onset Study, one in every 40 heart attack survivors reported an "episode of anger" in the two hours before the attack.
ANXIETY
Intense anxiety associated with fear of enclosed places, heights, and crowds may set off a sudden cardiac arrest. These often-fatal heart attacks happen when the heartbeat abruptly turns fast and uncoordinated.
LACK OF SOCIAL SUPPORT
Among heart attack survivors, social isolation is almost as important as high cholesterol, high blood pressure, and smoking in the prediction of long-term survival.
CHRONIC STRESS
Constant stress from work, financial problems, a troubled marriage, taking care of sick family members, or even living in an unsafe neighborhood have been linked to the development of heart disease and poor prognosis.
SUDDEN EMOTIONAL STRESS
Sudden emotional turmoil can trigger a temporary but serious heart condition also known as broken heart syndrome or stress cardiomyopathy, in which stress hormones stun the cells of the heart. Researchers have documented broken heart syndrome after a death in the family, a divorce, a surprise (even a good surprise), a robbery, a car accident, or other physically draining event.
HEALTHY BEHAVIOR IS GROUNDED IN EMOTIONAL STATE
Healthcare providers agree that our health behaviors are grounded in the larger context of our emotions, moods, and even parts of our personality. Stress, loneliness, depression, and anxiety all exact a toll. Dr. Alan Rozanski divides the behavioral risk factors for coronary heart disease into physical health behaviors, negative emotions and negative mental mindsets, chronic stress, social isolation and poor social support, and lack of sense of purpose. "Negative psychosocial factors promote illness by fostering negative health behaviors and by their direct pathophysiological effects," he says. "These effects can vary according to the type of psychosocial stress, but as a group they include induction of autonomic dysfunction, heightened cardiovascular reactivity, insulin resistances, central obesity, increased risk for hypertension, endothelial and platelet dysfunction, and unfavorable alterations in brain plasticity and cognitive function.”
POSITIVE AND NEGATIVE FEEDBACK LOOPS OFFER TREATMENT OPPORTUNITY
Psychosocial factors form part of positive and negative feedback loops, which offer opportunities for overall approaches to treatment. Transforming one component of the negative feedback loop may create a positive feedback loop. For example, treating depression can improve health behaviors, reduce stress, improve social performance, and increase sense of purpose. Exercise reduces heart rate, blood pressure, and cortisol and glucose responses to psychosocial stress, and it buffers the relationship between depression and inflammation.
In medical treatment today, heart health requires more than blood pressure control or the right pharmacologic therapy. Doctors advise lifestyle modifications in the form of diet and exercise yet may encounter resistance. Patients must be willing to comply with lifestyle modifications and often such motivation is tied to their psychological health. If a patient already has underlying depression, then news of serious cardiovascular disease may deepen such depression and dampen motivation.
Behavioral cardiology looks at the links between behavioral and psychosocial factors and the origin and progression of coronary heart disease. Randal Thomas notes in Behavioral Cardiology: Where the Heart and Head Meet (U.S. Cardiology Review, 2006) “Results of recent clinical research have strengthened the understanding and management of the links between psychological health and heart health, and have moved the field of behavioral cardiology steadily closer into the mainstream of current clinical cardiology.” Thomas notes the importance of behavioral cardiology: Adverse psychosocial factors are common in persons with coronary artery disease and up to 50% of survivors of myocardial infarction present with significant anxiety and/or depressive disorders. These adverse psychosocial factors can significantly worsen coronary artery disease risk and prognosis. Moreover, psychosocial health status is generally responsive to behavioral and pharmacologic therapies.
CARDIOLOGISTS ALERT TO PSYCHOLOGICAL AND CARDIOVASCULAR FACTORS
Physical and emotional factors contribute to feelings of overwhelming depression and hopelessness in a vulnerable patient who has recently experienced a heart attack. This presents an unusual dilemma in current cardiovascular healthcare. The cardiologist must treat the underlying disease and the risk of heart disease and at the same time be aware of related psychosocial factors, such as hostility and anxiety. Treatments that effectively treat both psychosocial and coronary artery disease outcomes can be elusive.
The cardiologist is often the first to see a patient during and after cardiovascular events at a time when adverse psychosocial factors may become more visible and patients are more open to therapeutic recommendations. The cardiologist's challenge is to identify coexisting heart disease and psychological distress, and then successfully intervene and initiate the early steps of psychosocial care.
PSYCHOSOCIAL FACTORS THAT INCREASE THE RISK OF HEART DISEASE
As important as smoking, high blood pressure, obesity, and cholesterol, psychological factors may be the final insult resulting in a heart attack or stroke. Psychological factors contribute to atherosclerosis, the slow, corrosive process that damages artery walls. Depression, stress, loneliness, pessimistic outlook, and other psychosocial factors influence heart health. Conversely, heart disease affects the brain and the mind.
DEPRESSION
Symptoms of depression, as well as full-blown major depression, contribute to heart disease. The prognosis is worse for people who become depressed after a heart attack or stroke, heart surgery, or the onset of heart failure.
ANGER AND HOSTILITY
Atherosclerosis seems to advance faster in people who score high on anger or hostility scales. Anger may even initiate heart attacks. In the Harvard-based Determinants of Myocardial Infarction Onset Study, one in every 40 heart attack survivors reported an "episode of anger" in the two hours before the attack.
ANXIETY
Intense anxiety associated with fear of enclosed places, heights, and crowds may set off a sudden cardiac arrest. These often-fatal heart attacks happen when the heartbeat abruptly turns fast and uncoordinated.
LACK OF SOCIAL SUPPORT
Among heart attack survivors, social isolation is almost as important as high cholesterol, high blood pressure, and smoking in the prediction of long-term survival.
CHRONIC STRESS
Constant stress from work, financial problems, a troubled marriage, taking care of sick family members, or even living in an unsafe neighborhood have been linked to the development of heart disease and poor prognosis.
SUDDEN EMOTIONAL STRESS
Sudden emotional turmoil can trigger a temporary but serious heart condition also known as broken heart syndrome or stress cardiomyopathy, in which stress hormones stun the cells of the heart. Researchers have documented broken heart syndrome after a death in the family, a divorce, a surprise (even a good surprise), a robbery, a car accident, or other physically draining event.
HEALTHY BEHAVIOR IS GROUNDED IN EMOTIONAL STATE
Healthcare providers agree that our health behaviors are grounded in the larger context of our emotions, moods, and even parts of our personality. Stress, loneliness, depression, and anxiety all exact a toll. Dr. Alan Rozanski divides the behavioral risk factors for coronary heart disease into physical health behaviors, negative emotions and negative mental mindsets, chronic stress, social isolation and poor social support, and lack of sense of purpose. "Negative psychosocial factors promote illness by fostering negative health behaviors and by their direct pathophysiological effects," he says. "These effects can vary according to the type of psychosocial stress, but as a group they include induction of autonomic dysfunction, heightened cardiovascular reactivity, insulin resistances, central obesity, increased risk for hypertension, endothelial and platelet dysfunction, and unfavorable alterations in brain plasticity and cognitive function.”
POSITIVE AND NEGATIVE FEEDBACK LOOPS OFFER TREATMENT OPPORTUNITY
Psychosocial factors form part of positive and negative feedback loops, which offer opportunities for overall approaches to treatment. Transforming one component of the negative feedback loop may create a positive feedback loop. For example, treating depression can improve health behaviors, reduce stress, improve social performance, and increase sense of purpose. Exercise reduces heart rate, blood pressure, and cortisol and glucose responses to psychosocial stress, and it buffers the relationship between depression and inflammation.
LIFESTYLE MODIFICATIONS FOR HEART HEALTH
Primary prevention measures and lifestyle interventions offer hope for the heart patient.
They include:
Healthy and balanced diet
Reduced salt intake, increased potassium intake
Weight loss
Smoking cessation
Appropriate exercise (moderate intensity, such as a 30-minute daily walk)
Stress reduction
Lipid regulation
Aspirin
Behavioral interventions including talk therapy, antidepressant therapy, and mindfulness practices
Behavioral interventions such as talk therapy, antidepressant therapy, and mindfulness practices relieve mental stress and maintain emotional balance. Treating heart disease by treating mood and emotion holds promise. Lifestyle interventions offer both physical and emotional benefits, and success with one modification may improve the patient's outlook in other areas.
Habits good for the heart seem to be good for the mind and brain as well. Ask anyone who exercises regularly about the mental benefits of exercise!
Primary prevention measures and lifestyle interventions offer hope for the heart patient.
They include:
Healthy and balanced diet
Reduced salt intake, increased potassium intake
Weight loss
Smoking cessation
Appropriate exercise (moderate intensity, such as a 30-minute daily walk)
Stress reduction
Lipid regulation
Aspirin
Behavioral interventions including talk therapy, antidepressant therapy, and mindfulness practices
Behavioral interventions such as talk therapy, antidepressant therapy, and mindfulness practices relieve mental stress and maintain emotional balance. Treating heart disease by treating mood and emotion holds promise. Lifestyle interventions offer both physical and emotional benefits, and success with one modification may improve the patient's outlook in other areas.
Habits good for the heart seem to be good for the mind and brain as well. Ask anyone who exercises regularly about the mental benefits of exercise!
DRUG-HERB AND DRUG-SUPPLEMENT INTERACTIONS
ROLE OF DIETARY SUPPLEMENTS IN MODERN LIFE
Many people today take dietary supplements, herbal remedies, botanicals, and other “natural products” as part of their daily wellness regimen. Dietary supplements come in the form of pills, powders, or liquids and are widely available. Note that in the United States, herbs and herbal remedies are regulated as dietary supplements.
DO SUPPLEMENTS PREVENT OR TREAT DISEASE?
While there is a lot of evidence that dietary supplements help to prevent and treat nutrient deficiency, there is less evidence about the usefulness of dietary supplements in preventing or treating disease. In an evidence-based study of the links between nutritional supplements and mood and neurological disorders, antioxidants, omega-3 fatty acids, quercetin, folate, and zinc demonstrated benefit for depression. Elsewhere, research indicates that pomegranate may ward off infection, turmeric has been studied for Alzheimer disease, rheumatoid arthritis, and prostate and colon cancer, and ginger has proven effective for nausea and vomiting.
DOES MY SUPPLEMENT OR HERB INTERACT WITH MY PRESCRIPTION DRUG?
Although herbs and herbal remedies are regulated as dietary supplements and not as drugs, prescription drugs and herbs may interact in harmful ways. Some supplements decrease the effects of a drug. Others may increase a drug’s effects and produce unwanted side effects.
Significantly, there is extensive evidence that St. John's wort interacts in dangerous, sometimes life-threatening ways, with a variety of prescription drugs including birth control pills, antidepressants, and some HIV drugs. There is still a lot we don’t know.
TELL YOUR HEALTHCARE PROVIDER
It’s important to tell your healthcare provider about all dietary supplements and drugs you take so they can help you avoid harmful interactions.
Many people today take dietary supplements, herbal remedies, botanicals, and other “natural products” as part of their daily wellness regimen. Dietary supplements come in the form of pills, powders, or liquids and are widely available. Note that in the United States, herbs and herbal remedies are regulated as dietary supplements.
DO SUPPLEMENTS PREVENT OR TREAT DISEASE?
While there is a lot of evidence that dietary supplements help to prevent and treat nutrient deficiency, there is less evidence about the usefulness of dietary supplements in preventing or treating disease. In an evidence-based study of the links between nutritional supplements and mood and neurological disorders, antioxidants, omega-3 fatty acids, quercetin, folate, and zinc demonstrated benefit for depression. Elsewhere, research indicates that pomegranate may ward off infection, turmeric has been studied for Alzheimer disease, rheumatoid arthritis, and prostate and colon cancer, and ginger has proven effective for nausea and vomiting.
DOES MY SUPPLEMENT OR HERB INTERACT WITH MY PRESCRIPTION DRUG?
Although herbs and herbal remedies are regulated as dietary supplements and not as drugs, prescription drugs and herbs may interact in harmful ways. Some supplements decrease the effects of a drug. Others may increase a drug’s effects and produce unwanted side effects.
Significantly, there is extensive evidence that St. John's wort interacts in dangerous, sometimes life-threatening ways, with a variety of prescription drugs including birth control pills, antidepressants, and some HIV drugs. There is still a lot we don’t know.
TELL YOUR HEALTHCARE PROVIDER
It’s important to tell your healthcare provider about all dietary supplements and drugs you take so they can help you avoid harmful interactions.
WHERE DO I LEARN MORE?
WEBSITES
National Center for Complementary and Integrative Health
https://nccih.nih.gov/health/herbsataglance.htm
Fact sheets on specific herbs or botanicals
MedlinePlus of the U.S. National Library of Medicine
https://medlineplus.gov/druginformation.html
Drugs, Herbs and Supplements page
BOOKS
Tarascon Pocket Pharmacopoeia 2020 Richard J. Hamilton, M.D., Editor-in-Chief. Ten pages detailing possible drug interactions with commonly used herbs.
Herbal Contraindications and Drug Interactions 2010 Frances Brinker, N.D. Comprehensive guide to drug-herb interactions with additional extensive appendices addressing common conditions, medications and nutritional supplements, and influences on phase I, II, and III metabolism.
Disclaimer: Information in this blog is presented for educational purposes only. Not intended to diagnose, treat, cure, or prevent any disease. The use of herbal preparations is not recommended without seeking the advice of a healthcare provider. Substances in herbal preparations may interact with prescription drugs to eliminate therapeutic efficacy or induce toxicity.
Dietary supplements found to contain hidden drug ingredients
ALPHA-MALE
FDA laboratory analysis confirmed that Alpha-Male contains sildenafil (the active ingredient in Viagra) and tadalafil (the active ingredient in Cialis). These undeclared ingredients may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels. People with diabetes, high blood pressure, high cholesterol, and heart disease often take nitrates.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-alpha-male-contains-hidden-drug-ingredients?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=e21990e7efc94becbc0a1eb56d5192b0&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
XXX PLATINUM WOODIE
FDA analysis has confirmed that XXX Platinum WOODIE, sold for sexual enhancement on various websites and possibly in retail stores, also contains sildenafil and tadalafil.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-xxx-platinum-woodie-contains-hidden-drug-ingredients?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=0e304f83cc0e4d44aa958e4111542af5&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
ORGAZEN GOLD 5800
The FDA has confirmed that OrgaZEN Gold 5800 contains the hidden drug ingredient sildenafil.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-orgazen-gold-5800-contains-hidden-drug-ingredient?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=d88bafeb7d3d4c6b8b13c92a1edb7840&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
RMFLEX
The Food and Drug Administration is advising consumers not to purchase or use RMFLEX, a product promoted and sold for joint pain and arthritis. FDA analysis has confirmed that RMFLEX contains diclofenac, a non-steroidal anti-inflammatory drug (NSAID). NSAIDs may increase the risk of cardiovascular events (heart attack, stroke) and serious gastrointestinal damage (bleeding, ulceration, and fatal perforation of the stomach and intestines). The hidden drug ingredient diclofenac may interact with other medications and significantly increase the risk of adverse events.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-rmflex-contains-hidden-drug-ingredient?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=98124bb963e1413ea7e9c8de8da63293&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
FDA laboratory analysis confirmed that Alpha-Male contains sildenafil (the active ingredient in Viagra) and tadalafil (the active ingredient in Cialis). These undeclared ingredients may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels. People with diabetes, high blood pressure, high cholesterol, and heart disease often take nitrates.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-alpha-male-contains-hidden-drug-ingredients?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=e21990e7efc94becbc0a1eb56d5192b0&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
XXX PLATINUM WOODIE
FDA analysis has confirmed that XXX Platinum WOODIE, sold for sexual enhancement on various websites and possibly in retail stores, also contains sildenafil and tadalafil.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-xxx-platinum-woodie-contains-hidden-drug-ingredients?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=0e304f83cc0e4d44aa958e4111542af5&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
ORGAZEN GOLD 5800
The FDA has confirmed that OrgaZEN Gold 5800 contains the hidden drug ingredient sildenafil.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-orgazen-gold-5800-contains-hidden-drug-ingredient?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=d88bafeb7d3d4c6b8b13c92a1edb7840&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
RMFLEX
The Food and Drug Administration is advising consumers not to purchase or use RMFLEX, a product promoted and sold for joint pain and arthritis. FDA analysis has confirmed that RMFLEX contains diclofenac, a non-steroidal anti-inflammatory drug (NSAID). NSAIDs may increase the risk of cardiovascular events (heart attack, stroke) and serious gastrointestinal damage (bleeding, ulceration, and fatal perforation of the stomach and intestines). The hidden drug ingredient diclofenac may interact with other medications and significantly increase the risk of adverse events.
https://www.fda.gov/drugs/medication-health-fraud/public-notification-rmflex-contains-hidden-drug-ingredient?utm_campaign=CDER%20New%2002%2F07%2F2020&utm_medium=email&utm_source=Eloqua&elqTrackId=98124bb963e1413ea7e9c8de8da63293&elq=1b44daefbf5e4619974f8708cc786cbb&elqaid=11159&elqat=1&elqCampaignId=9374
What are the latest integrative medicine or integrative health approaches in the disciplines of cardiology? endocrinology? hepatology? dermatology? gastroenterology? neurology?
WHAT IS INTEGRATIVE MEDICINE?
The roles of integrative medicine and complementary medicine are increasing in mainstream medical clinics and health maintenance organizations. According to the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health, "Integrative healthcare often brings conventional and complementary approaches together in a coordinated way. It emphasizes a holistic, patient-focused approach to healthcare and wellness." The mission of the NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and healthcare.
The roles of integrative medicine and complementary medicine are increasing in mainstream medical clinics and health maintenance organizations. According to the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health, "Integrative healthcare often brings conventional and complementary approaches together in a coordinated way. It emphasizes a holistic, patient-focused approach to healthcare and wellness." The mission of the NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and healthcare.
RESOURCES
MEMORIAL SLOAN KETTERING CANCER CENTER
https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine
https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine
JOHNS HOPKINS MEDICINE
https://www.hopkinsmedicine.org/health/wellness-and-prevention/integrative-medicine
https://www.hopkinsmedicine.org/health/wellness-and-prevention/integrative-medicine
SCRIPPS CENTER FOR INTEGRATIVE MEDICINE
https://www.scripps.org/services/integrative-medicine
https://www.scripps.org/services/integrative-medicine
MD ANDERSON CANCER CENTER
https://www.mdanderson.org/research/departments-labs-institutes/programs-centers/integrative-medicine-program.html
https://www.mdanderson.org/research/departments-labs-institutes/programs-centers/integrative-medicine-program.html
MAYO CLINIC
https://www.mayoclinic.org/tests-procedures/complementary-alternative-medicine/about/pac-20393581
https://www.mayoclinic.org/tests-procedures/complementary-alternative-medicine/about/pac-20393581
DUKE INTEGRATIVE MEDICINE
https://dukeintegrativemedicine.org/
https://dukeintegrativemedicine.org/
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH)
NATIONAL INSTITUTES OF HEALTH (NIH)
https://nccih.nih.gov/
Visit this site for a wealth of information, including All Health Topics from A-Z and
Información de Salud en Español https://nccih.nih.gov/health/espanol?lang=es
Subscribe to NCCIH emails for health and wellness information on the efficacy of herbs, dietary supplements, and other approaches in the treatment of specific medical conditions:
https://public.govdelivery.com/accounts/USNIHNCCIH/subscriber/new
A SAMPLING OF NCCIH TOPICS:
NATIONAL INSTITUTES OF HEALTH (NIH)
https://nccih.nih.gov/
Visit this site for a wealth of information, including All Health Topics from A-Z and
Información de Salud en Español https://nccih.nih.gov/health/espanol?lang=es
Subscribe to NCCIH emails for health and wellness information on the efficacy of herbs, dietary supplements, and other approaches in the treatment of specific medical conditions:
https://public.govdelivery.com/accounts/USNIHNCCIH/subscriber/new
A SAMPLING OF NCCIH TOPICS:
- La gripe y los resfriados: en detalles
- Dietary supplements and diabetes management
- Herbal supplements and cholesterol
- Cuidado con los "suplementos dietéticos" fraudulentos
- Mind and body approaches for chronic pain
- Hepatitis C and dietary supplements
- La espiritualidad en el tratamiento del cáncer
- Mind and body approaches for cancer symptoms and treatment side effects
- Dietary supplement safety alerts
Information provided as a public service for those seeking to learn more about integrative medicine. The inclusion of a particular resource does not represent endorsement of said resource.
Chinese herbs in coronavirus treatment
TRADITIONAL CHINESE HERBAL REMEDIES
As evidenced by a February 18th tweet from China Xinhua News, healthcare practitioners across China are relying on centuries-old remedies to treat the novel coronavirus. In the absence of targeted drugs and vaccines, with continual updates to the national diagnosis and treatment program for novel coronavirus, the role of traditional Chinese medicine (TCM) is on the rise. More COVID-19 patients are being treated with Chinese medicine or integrated Western-Chinese medicine, and the role of TCM herbal prescription formulas is expanding. What formulas are they using? What do the properties of these herbs tell us about TCM approaches to the virus?
USE OF CHINESE HERBS TO TREAT THE CORONAVIRUS
With an array of treatment methods and a wealth of experience in its arsenal, Chinese medicine has been used to fight plagues and epidemics for thousands of years. The focus of TCM is not just the virus itself but also symptoms and changes to the body caused by the invasion of the virus. Treatment starts with the patient as a whole, to identify patterns and then dispel sickness and support health.
HERBAL FORMULA USAGE RATES 80% TO 95%
Reports from throughout China indicate TCM formula usage rates of 80% to 95% in confirmed cases of novel coronavirus. One specialist described isolation wards containing a mix of mild, typical, and severe cases of novel coronavirus. Typical cases are characterized as imaging findings in the lungs but the absence of disease progression to respiratory failure. In hospitals, traditional Chinese medicine plays a significant role in regulating diarrhea, constipation, and other gastrointestinal symptoms; in addition, intervention with Chinese medicine may stop the condition from progressing to the severe and critical stages.
WHAT FORMULAS ARE BEING USED? WHAT FORMULAS HAVE BEEN VALIDATED?
清肺排毒汤
The National Health Commission and the State Administration of Traditional Chinese Medicine recommend Qing Fei Pai Du decoction (清肺排毒汤); clinical observation and data analysis have been performed on the therapeutic efficacy of this classical TCM formula. One formula for Qing Fei Pai Du decoction appearing on multiple sites, including Baidu, listed 21 ingredients. The top ingredients in terms of quantity are calcium sulfate, Radix bupleuri (common name bupleurum, effective in the treatment of alternating chills and fever; may induce headache or nausea), Poria cocos (efficacy in draining dampness and transforming phlegm; concurrent administration of diuretics contraindicated), Radix dioscoreae (Chinese yam, known to tonify qi and yin of the lungs, spleen, and stomach; may have hypoglycemic effects, use with caution in comorbid hepatobiliary disease).
肺炎一号
Pneumonia Formula No. 1 (肺炎一号), developed by the Chinese Medicine Department at Guangzhou Eighth People's Hospital, and its variations Pneumonia Formula No. 2, Pneumonia Formula No. 3, Pneumonia Formula No. 4, and Pneumonia Formula No. 5 are also in use. Formula No. 1 has achieved favorable clinical results in Guangzhou. Formula No. 1 includes two herbs that clear heat and relieve toxicity, Flos lonicerae (honeysuckle flower) and Fructus forsythiae (forsythia fruit), along with 16 other ingredients.
VARIATIONS
In Chinese medicine, the treatment regimen adopted varies by person. If a patient is in poor physical condition, dispelling disease is not enough, treatment must focus on supporting health. For example, in those with poor appetite it is necessary to focus on spleen health; in patients with damp-heavy qi and thick tongue coating it is necessary to improve the flow of urine. Ear needling (acupuncture) may be used to treat the patient’s psychological state and resolve issues of insomnia, in order to restore the patient’s biological clock.
Just as treatment varies by individual patient, the virus varies by region. This too is a factor in treatment selection. It would not be appropriate to select one uniform formula for the entire nation.
NOT ADVOCATED FOR THE HEALTHY
NOT ADVOCATED FOR THE PREVENTION OF CORONAVIRUS
According to the head of a university of traditional Chinese medicine, the entire populace does not need to take this medicine. Healthy people need to improve resistance in order to avoid getting sick. High-risk populations, including healthcare providers, may take herbal remedies as appropriate.
Practitioners emphasized that these are treatment prescriptions and are not recommended as preventive prescriptions. The general public should not self-administer these prescriptions.
As evidenced by a February 18th tweet from China Xinhua News, healthcare practitioners across China are relying on centuries-old remedies to treat the novel coronavirus. In the absence of targeted drugs and vaccines, with continual updates to the national diagnosis and treatment program for novel coronavirus, the role of traditional Chinese medicine (TCM) is on the rise. More COVID-19 patients are being treated with Chinese medicine or integrated Western-Chinese medicine, and the role of TCM herbal prescription formulas is expanding. What formulas are they using? What do the properties of these herbs tell us about TCM approaches to the virus?
USE OF CHINESE HERBS TO TREAT THE CORONAVIRUS
With an array of treatment methods and a wealth of experience in its arsenal, Chinese medicine has been used to fight plagues and epidemics for thousands of years. The focus of TCM is not just the virus itself but also symptoms and changes to the body caused by the invasion of the virus. Treatment starts with the patient as a whole, to identify patterns and then dispel sickness and support health.
HERBAL FORMULA USAGE RATES 80% TO 95%
Reports from throughout China indicate TCM formula usage rates of 80% to 95% in confirmed cases of novel coronavirus. One specialist described isolation wards containing a mix of mild, typical, and severe cases of novel coronavirus. Typical cases are characterized as imaging findings in the lungs but the absence of disease progression to respiratory failure. In hospitals, traditional Chinese medicine plays a significant role in regulating diarrhea, constipation, and other gastrointestinal symptoms; in addition, intervention with Chinese medicine may stop the condition from progressing to the severe and critical stages.
WHAT FORMULAS ARE BEING USED? WHAT FORMULAS HAVE BEEN VALIDATED?
清肺排毒汤
The National Health Commission and the State Administration of Traditional Chinese Medicine recommend Qing Fei Pai Du decoction (清肺排毒汤); clinical observation and data analysis have been performed on the therapeutic efficacy of this classical TCM formula. One formula for Qing Fei Pai Du decoction appearing on multiple sites, including Baidu, listed 21 ingredients. The top ingredients in terms of quantity are calcium sulfate, Radix bupleuri (common name bupleurum, effective in the treatment of alternating chills and fever; may induce headache or nausea), Poria cocos (efficacy in draining dampness and transforming phlegm; concurrent administration of diuretics contraindicated), Radix dioscoreae (Chinese yam, known to tonify qi and yin of the lungs, spleen, and stomach; may have hypoglycemic effects, use with caution in comorbid hepatobiliary disease).
肺炎一号
Pneumonia Formula No. 1 (肺炎一号), developed by the Chinese Medicine Department at Guangzhou Eighth People's Hospital, and its variations Pneumonia Formula No. 2, Pneumonia Formula No. 3, Pneumonia Formula No. 4, and Pneumonia Formula No. 5 are also in use. Formula No. 1 has achieved favorable clinical results in Guangzhou. Formula No. 1 includes two herbs that clear heat and relieve toxicity, Flos lonicerae (honeysuckle flower) and Fructus forsythiae (forsythia fruit), along with 16 other ingredients.
VARIATIONS
In Chinese medicine, the treatment regimen adopted varies by person. If a patient is in poor physical condition, dispelling disease is not enough, treatment must focus on supporting health. For example, in those with poor appetite it is necessary to focus on spleen health; in patients with damp-heavy qi and thick tongue coating it is necessary to improve the flow of urine. Ear needling (acupuncture) may be used to treat the patient’s psychological state and resolve issues of insomnia, in order to restore the patient’s biological clock.
Just as treatment varies by individual patient, the virus varies by region. This too is a factor in treatment selection. It would not be appropriate to select one uniform formula for the entire nation.
NOT ADVOCATED FOR THE HEALTHY
NOT ADVOCATED FOR THE PREVENTION OF CORONAVIRUS
According to the head of a university of traditional Chinese medicine, the entire populace does not need to take this medicine. Healthy people need to improve resistance in order to avoid getting sick. High-risk populations, including healthcare providers, may take herbal remedies as appropriate.
Practitioners emphasized that these are treatment prescriptions and are not recommended as preventive prescriptions. The general public should not self-administer these prescriptions.
This blog briefly examines TCM principles and herbal remedies in light of recent Chinese media reports on novel coronavirus treatment in China. This examination is not intended to replace medical advice from a trained and qualified professional, and the use of herbal preparations is not recommended without the advice of a healthcare provider. Substances in herbal preparations may interact with prescription drugs to eliminate therapeutic efficacy or induce toxicity.
COMMON MISTAKES IN CHINESE-TO-ENGLISH TRANSLATION AND HOW TO ENSURE TRANSLATION QUALITY
| At minimum, awkward word choices and poorly written English distract the reader. In the worst-case scenario, poor English translations are incomprehensible and the goal of clear and accurate communication is not met. Below are errors encountered in Chinese-to-English translations. Errors in verb tense Verbs are not inflected, or conjugated, in Chinese. The translator must look for context clues, such as "previously" or "in the future," in order to select the correct verb tense for the English translation. Auxiliary verbs in the Chinese source text may pose challenges in English translation, for example, the past conditional tense, "I would have gone." Errors in number The Chinese language does not differentiate singular and plural nouns. Again, context is key. Improper use of articles There are no definite (the) or indefinite (a, an, some) articles in the Chinese language. Proper understanding of English rules for the use of definite and indefinite articles is vital to the production of accurate written English. Awkward word order or syntax Chinese has many options for sentence construction: subject + verb + object descriptive phrase/relative clause + noun + verb topic (subject or object) + comment (sentence or phrase) A common error in rendering text from Chinese to English is to mirror the Chinese word order exactly, almost a one-to-one replacement. Word choice English has one of the largest vocabularies of all the world's languages. Its influences include Greek, German, Latin, and French, and the borrowing continues to this day! With so many options and so many synonyms or near synonyms, the right word choice is not always obvious. In certain situations the Germanic word is preferred, and in other situations the Latinate word is preferred. Preposition choice is especially thorny. The preposition a writer chooses may reveal non-native facility with the English language. | Options for the translation of Chinese medical terms into English: 肝 liver 肝 hepatic 心 heart 心 cardiac 肺 lung 肺 pulmonary 肾 kidney 肾 renal Note that the same Chinese character is used for different registers in English. |
What's the solution? Hire an experienced translator to ensure accurate translations. The standard in the translation industry is to translate into one's native language, thus a native English speaker is the best choice for Chinese-to-English translations. Look for a language professional with relevant language training, professional experience, and excellent written English. Grammatical errors and typos are red flags!
More questions about translation? Contact Integrative Translations.
More questions about translation? Contact Integrative Translations.
JANUARY 24TH UPDATE FROM THE CHINESE GOVERNMENT WEBSITE
The January 24, 2020, news update from the Health Emergency Response Office on the Chinese government website reported hundreds of confirmed cases of novel coronavirus nationwide and 25 deaths in Hubei Province and Hebei Province – an additional eight deaths compared to the January 23rd update, which detailed the anonymized medical histories of these initial 17 deaths. The majority were of advanced age (15 of the 17 over age 60), male (13 of 17), and suffered from such underlying conditions as liver cirrhosis, hypertension, cerebral infarction, diabetes, heart disease, chronic obstructive pulmonary disease, chronic renal insufficiency, Parkinson’s disease, and bronchitis. Most but not all presented with fever. Other symptoms at admission:
Novel coronavirus was confirmed through positive nucleic acid testing and monitored by electrocardiogram, lung CT, and blood-gas analysis. Therapies included oxygen, extracorporeal membrane oxygenation, endotracheal intubation (refused in some cases), anti-infectives, antibiotics, antipyretics, analgesics, and sedatives, supplemental fluids, and symptomatic therapies.
Outcomes were intensifying respiratory failure, continuous declines in terminal oxygen saturation, reduced blood pressure, and ultimately death.
Seven hospitals in Wuhan are offering intake for patients with high fever in order to identify new cases.
- cough
- headache
- systemic chills and body aches
- weakness
- fatigue
- breathing difficulties
- loss of appetite
- chest pain
Novel coronavirus was confirmed through positive nucleic acid testing and monitored by electrocardiogram, lung CT, and blood-gas analysis. Therapies included oxygen, extracorporeal membrane oxygenation, endotracheal intubation (refused in some cases), anti-infectives, antibiotics, antipyretics, analgesics, and sedatives, supplemental fluids, and symptomatic therapies.
Outcomes were intensifying respiratory failure, continuous declines in terminal oxygen saturation, reduced blood pressure, and ultimately death.
Seven hospitals in Wuhan are offering intake for patients with high fever in order to identify new cases.
How to tell if a document is written in Chinese, Japanese, or Korean
 爱 Chinese | 愛 Japanese | 사랑 Korean |
CHINESE VS JAPANESE VS KOREAN LANGUAGE
Chinese, Japanese, and Korean all use characters, sometimes they use the same characters. While modern Japanese is a mix of kanji (Chinese characters) and the katakana and hiragana syllabaries, most of the time Korean is written in the Hangul alphabet, although I have seen older Korean documents written with Chinese characters.
Chinese, Japanese, and Korean all use characters, sometimes they use the same characters. While modern Japanese is a mix of kanji (Chinese characters) and the katakana and hiragana syllabaries, most of the time Korean is written in the Hangul alphabet, although I have seen older Korean documents written with Chinese characters.
WHAT DOES CHINESE WRITING LOOK LIKE?
Here are some clues to help you differentiate: Chinese characters are, in general, more complex. They look denser. A written Chinese character, whether traditional (Hong Kong, Taiwan) or simplified (China, Singapore), has more strokes than a Japanese or Korean character.
Here are some clues to help you differentiate: Chinese characters are, in general, more complex. They look denser. A written Chinese character, whether traditional (Hong Kong, Taiwan) or simplified (China, Singapore), has more strokes than a Japanese or Korean character.
WHAT DOES JAPANESE WRITING LOOK LIKE?
Look for "no" (の). Look for dots(び). The Japanese language uses Chinese characters (kanji) and it uses two syllabaries (kana) of characters with only a few strokes. A Japanese document will contain multiple occurrences of the character “no” (の) which means “of” or denotes possession. So, glance through the document, do you see の scattered throughout? Then, it’s Japanese. Double dots also appear frequently, e.g., グ and ガ and ド.
Look for "no" (の). Look for dots(び). The Japanese language uses Chinese characters (kanji) and it uses two syllabaries (kana) of characters with only a few strokes. A Japanese document will contain multiple occurrences of the character “no” (の) which means “of” or denotes possession. So, glance through the document, do you see の scattered throughout? Then, it’s Japanese. Double dots also appear frequently, e.g., グ and ガ and ド.
WHAT DOES KOREAN WRITING LOOK LIKE?
I look for ovals. The Korean language has its own phonetic writing system, sometimes described as an alphabetic syllabary, and an oval shape appears frequently, for example, 여 and 우 and 으 and 어. You won’t see these oval shapes in Chinese. When you see a oval or circle shape in the Japanese language, it is a small circle パ.
I look for ovals. The Korean language has its own phonetic writing system, sometimes described as an alphabetic syllabary, and an oval shape appears frequently, for example, 여 and 우 and 으 and 어. You won’t see these oval shapes in Chinese. When you see a oval or circle shape in the Japanese language, it is a small circle パ.
MORE EXAMPLES
敏捷的棕色狐狸跳過了懶狗 (traditional Chinese)
敏捷的棕色狐狸跳过了懒狗 (simplified Chinese)
빠른 갈색 여우는 게으른 개를 뛰어 넘는다 (Korean)
速い茶色のキツネは怠惰な犬を飛び越える (Japanese)
敏捷的棕色狐狸跳過了懶狗 (traditional Chinese)
敏捷的棕色狐狸跳过了懒狗 (simplified Chinese)
빠른 갈색 여우는 게으른 개를 뛰어 넘는다 (Korean)
速い茶色のキツネは怠惰な犬を飛び越える (Japanese)
WHAT ABOUT OTHER LANGUAGES AND OTHER WRITING SYSTEMS?
จิ้งจอกสีน้ำตาลอย่างรวดเร็ว (Thai)
cáo nâu nhanh (Vietnamese)
хурдан бор үнэг (Mongolian)
быстрая коричневая лиса (Russian)
γρήγορη καστανή αλεπού (Greek)
الثعلب البني السريع (Arabic)
שועל חום מהיר (Hebrew)
ፈጣን ቡናማ ቀበሮ (Amharic)
จิ้งจอกสีน้ำตาลอย่างรวดเร็ว (Thai)
cáo nâu nhanh (Vietnamese)
хурдан бор үнэг (Mongolian)
быстрая коричневая лиса (Russian)
γρήγορη καστανή αλεπού (Greek)
الثعلب البني السريع (Arabic)
שועל חום מהיר (Hebrew)
ፈጣን ቡናማ ቀበሮ (Amharic)
Still have questions?
Write me at https://www.integrativetranslations.com/contact.html. I will look at your document and let you know.
Write me at https://www.integrativetranslations.com/contact.html. I will look at your document and let you know.