Article

False diagnosis of maple syrup urine disease owing to ingestion of herbal tea

University Hospital Frankfurt, Frankfurt, Hesse, Germany
New England Journal of Medicine (Impact Factor: 54.42). 10/1999; 341(10):769. DOI: 10.1056/NEJM199909023411020
Source: PubMed
0 Followers
 · 
58 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Information about the safety of herbal medicine often comes from case reports published in the medical literature, thus necessitating good quality reporting of these adverse events. The purpose of this study was to perform a systematic review of the comprehensiveness of reporting of published case reports of adverse events associated with herb use in the pediatric population. Electronic literature search included 7 databases and a manual search of retrieved articles from inception through 2010. We included published case reports and case series that reported an adverse event associated with exposure to an herbal product by children under the age of 18 years old. We used descriptive statistics. Based on the International Society of Epidemiology's "Guidelines for Submitting Adverse Events Reports for Publication," we developed and assigned a guideline adherence score (0-17) to each case report. Ninety-six unique journal papers were identified and represented 128 cases. Of the 128 cases, 37% occurred in children under 2 years old, 38% between the ages of 2 and 8 years old, and 23% between the ages of 9 and 18 years old. Twenty-nine percent of cases were the result of an intentional ingestion while 36% were from an unintentional ingestion. Fifty-two percent of cases documented the Latin binomial of the herb ingredients; 41% documented plant part. Thirty-two percent of the cases reported laboratory testing of the herb, 20% documented the manufacturer of the product, and 22% percent included an assessment of the potential concomitant therapies that could have been influential in the adverse events. Mean guideline adherence score was 12.5 (range 6-17). There is considerable need for improvement in reporting adverse events in children following herb use. Without better quality reporting, adverse event reports cannot be interpreted reliably and do not contribute in a meaningful way to guiding recommendations for medicinal herb use.
    03/2013; 2(2):46-55. DOI:10.7453/gahmj.2012.071
  • [Show abstract] [Hide abstract]
    ABSTRACT: The odor of amniotic fluid is repeatedly discussed with regard to its potential to provide olfactory cues to the unborn. However, the chemical basis for such assumptions is still unclear and the odorous composition of amniotic fluid, as well as inter-individual variances, has not yet been fully investigated. However, thorough examination of the odor and flavor profiles of the intra-uterine environment might support our understanding of early sensory triggers and potential sensory conditioning processes. Therefore, the aim of the present study was to characterize specific odorants in individual samples of amniotic fluid and to identify the most potent odor-active substances in this physiological fluid by means of gas chromatography olfactometry and aroma extract dilution analysis. The identification led to six new substances, which were not reported, to the best of our knowledge, for amniotic fluid before—among them the two steroids 5α-androst-16-en-3-one and 4, 16-androstadien-3-one.
    Chemosensory Perception 03/2014; 7(1). DOI:10.1007/s12078-013-9161-0 · 1.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The volatile and odorous profile of human urine may be a rich source for physiological information and could increase our understanding of metabolization and excretion processes of low-molecular weight compounds originating from, for example, dietary or endogenous sources. However, the diagnostic potential of the urinary volatile fraction is not yet fully understood, probably due to the limited application of modern analytical tools in urine volatile analysis. Accordingly, the aim of this study was to evaluate a combined chemo-analytical and human-sensory approach for characterization of the human urine odorant composition. We used one- and two-dimensional high resolution gas chromatography–olfactometry/mass spectrometry to identify commonly occurring and potent odorants in human urine. The studies were carried out on both native urine and on urine that had been treated by glucuronidase assays, with analysis of the liberated odor-active compounds using the same techniques. Based on retention indices, odor qualities and intensities, and mass spectra compared to references, a total of 14 odorants were detected in the majority of the untreated urine samples, and 24 odorants in the glucuronidase-treated samples. A major part of the identified substances are reported here for the first time. Our results show that chemosensory approaches are a useful strategy for the characterization of the odorant profile of human urine.
    Metabolomics 02/2012; 9(1):9-20. DOI:10.1007/s11306-012-0425-5 · 3.97 Impact Factor