Turmeric, a spice that has long been recognized for its medicinal properties, has received interest from both the medical/scientific world and from culinary enthusiasts, as it is the major source of the polyphenol curcumin. It aids in the management of oxidative and inflammatory conditions, metabolic syndrome, arthritis, anxiety, and hyperlipidemia. It may also help in the management of exercise-induced inflammation and muscle soreness, thus enhancing recovery and performance in active people. In addition, a relatively low dose of the complex can provide health benefits for people that do not have diagnosed health conditions. Most of these benefits can be attributed to its antioxidant and anti-inflammatory effects. Ingesting curcumin by itself does not lead to the associated health benefits due to its poor bioavailability, which appears to be primarily due to poor absorption, rapid metabolism, and rapid elimination. There are several components that can increase bioavailability. For example, piperine is the major active component of black pepper and, when combined in a complex with curcumin, has been shown to increase bioavailability by 2000%. Curcumin combined with enhancing agents provides multiple health benefits. The purpose of this review is to provide a brief overview of the plethora of research regarding the health benefits of curcumin.

https://www.mdpi.com/2304-8158/6/10/92/pdf

Curcumin: A Review of Its Effects on Human Health.

For the statistical consultant working with social science researchers the estimation of reliability and validity is a task frequently encountered. Measurement issues differ in the social sciences in that they are related to the quantification of abstract, intangible and unobservable constructs. In many instances, then, the meaning of quantities is only inferred. Let us begin by a general description of the paradigm that we are dealing with. Most concepts in the behavioral sciences have meaning within the context of the theory that they are a part of. Each concept, thus, has an operational definition which is governed by the overarching theory. If a concept is involved in the testing of hypothesis to support the theory it has to be measured. So the first decision that the research is faced with is \" how shall the concept be measured? \" That is the type of measure. At a very broad level the type of measure can be observational, self-report, interview, etc. These types ultimately take shape of a more specific form like observation of ongoing activity, observing video-taped events, self-report measures like questionnaires that can be open-ended or close-ended, Likert-type scales, interviews that are structured, semi-structured or unstructured and open-ended or close-ended. Needless to say, each type of measure has specific types of issues that need to be addressed to make the measurement meaningful, accurate, and efficient. Another important feature is the population for which the measure is intended. This decision is not entirely dependent on the theoretical paradigm but more to the immediate research question at hand. 6/14/2016 2 A third point that needs mentioning is the purpose of the scale or measure. What is it that the researcher wants to do with the measure? Is it developed for a specific study or is it developed with the anticipation of extensive use with similar populations? Once some of these decisions are made and a measure is developed, which is a careful and tedious process, the relevant questions to raise are \" how do we know that we are indeed measuring what we want to measure? \" since the construct that we are measuring is abstract, and \" can we be sure that if we repeated the measurement we will get the same result? \". The first question is related to validity and second to reliability. Validity and reliability are two important characteristics of behavioral measure and are referred to as …

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Validity and reliability.

Curcumin, a yellow pigment in the Indian spice Turmeric (Curcuma longa), which is chemically known as diferuloylmethane, was first isolated exactly two centuries ago in 1815 by two German Scientists, Vogel and Pelletier. However, according to the pubmed database, the first study on its biological activity as an antibacterial agent was published in 1949 in Nature and the first clinical trial was reported in The Lancet in 1937. Although the current database indicates almost 9000 publications on curcumin, until 1990 there were less than 100 papers published on this nutraceutical. At the molecular level, this multitargeted agent has been shown to exhibit anti-inflammatory activity through the suppression of numerous cell signalling pathways including NF-κB, STAT3, Nrf2, ROS and COX-2. Numerous studies have indicated that curcumin is a highly potent antimicrobial agent and has been shown to be active against various chronic diseases including various types of cancers, diabetes, obesity, cardiovascular, pulmonary, neurological and autoimmune diseases. Furthermore, this compound has also been shown to be synergistic with other nutraceuticals such as resveratrol, piperine, catechins, quercetin and genistein. To date, over 100 different clinical trials have been completed with curcumin, which clearly show its safety, tolerability and its effectiveness against various chronic diseases in humans. However, more clinical trials in different populations are necessary to prove its potential against different chronic diseases in humans. This review's primary focus is on lessons learnt about curcumin from clinical trials.

Linked Articles
This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc

https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/bph.13621

Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases

The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update.

Curcumin is the major constituent of turmeric (Curcuma longa). Turmeric has been widely used as a spice in foods and for therapeutic applications such as anti-inflammatory, antihyperlipidemic, and antimicrobial activities. Turmeric and curcumin are nonmutagenic and nongenotoxic. Oral use of turmeric and curcumin did not have reproductive toxicity in animals at certain doses. Studies on human did not show toxic effects, and curcumin was safe at the dose of 6 g/day orally for 4-7 weeks. However, some adverse effects such as gastrointestinal upsets may occur. Moreover, oral bioavailable formulations of curcumin were safe for human at the dose of 500 mg two times in a day for 30 days, but there are still few trials and more studies are needed specially on nanoformulations and it should be discussed in a separate article. In addition, curcumin is known as a generally recognized as safe substance. This review discusses the safety and toxicity of turmeric and curcumin in medicine. Turmeric and curcumin are nontoxic for human especially in oral administration. Turmeric and curcumin are also safe in animals. They are nonmutagenic and are safe in pregnancy in animals but more studies in human are needed.

Turmeric (Curcuma longa) and its major constituent (curcumin) as nontoxic and safe substances: Review

Treatment of osteoarthritis (OA) is challenging owing to the inefficacy and long-term adverse events of currently available medications including non-steroidal anti-inflammatory drugs. Curcuminoids are polyphenolic phytochemicals with established anti-inflammatory properties and protective effects on chondrocytes. The aim of this study is to investigate the clinical efficacy of curcuminoids in patients suffering from knee OA. A pilot randomized double-blind placebo-control parallel-group clinical trial was conducted among patients with mild-to-moderate knee OA. Patients were assigned to curcuminoids (1500 mg/day in 3 divided doses; n = 19) or matched placebo (n = 21) for 6 weeks. Efficacy measures were changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS) and Lequesne's pain functional index (LPFI) scores during the study. There was no significant difference in age, gender, body mass index, and VAS, WOMAC and LPFI scores between the study groups at baseline (p > 0.05). Treatment with curcuminoids was associated with significantly greater reductions in WOMAC (p = 0.001), VAS (p   0.05). There was no considerable adverse effect in both groups. To conclude, curcuminoids represent an effective and safe alternative treatment for OA. Copyright © 2014 John Wiley & Sons, Ltd.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/ptr.5174

Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial.

Objective:  Osteoarthritis (OA) is a degenerative joint disease associated with inflammation. The present study aimed to determine changes in serum levels of inflammatory biomarkers in OA patients whose clinical symptoms were improved as a result of supplementation with curcuminoids. Methods:  This study was a randomized double-blind placebo-control parallel-group clinical trial in which 40 subjects with mild-to-moderate degree knee OA were randomly allocated to receive either pure curcuminoids (1 500 mg/day in 3 divided doses; n=19) or matched placebo (n=21) for 6 weeks. In order to enhance the bioavailability of curcuminoids, piperine (15 mg/day) was added to the treatment regimen. Serum levels of interleukins 4 (IL-4) and 6 (IL-6), tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) and high-sensitivity C-reactive protein (hs-CRP), together with erythrocyte sedimentation rate (ESR) were determined at baseline as well as at the end of trial. Results:  Serum concentrations of IL-4 (p=0.001), IL-6 (p=0.006) and hs-CRP (p=0.004) were significantly reduced in the curcuminoid group whilst serum levels of TNF-α and TGF-β and mean ESR remained unaltered by the end of trial (p>0.05). In the placebo group, serum concentrations of IL-4 (p=0.001), IL-6 (p=0.003), TNF-α (p=0.003) and TGF-β (p=0.005) were significantly reduced but mean hs-CRP and ESR values remained statistically unchanged (p>0.05). Comparison of the magnitude of changes in the evaluated inflammatory biomarkers did not indicate any significant difference between the study groups (p>0.05). Conclusion:  Significant improvement in clinical symptoms of OA in curcuminoid-treated subjects cannot be attributed to the systemic anti-inflammatory effects of these phytochemicals.

Impact of Supplementation with Curcuminoids on Systemic Inflammation in Patients with Knee Osteoarthritis: Findings from a Randomized Double-Blind Placebo-Controlled Trial.

Cerebral palsy is the most common cause of spasticity and physical disability in children and spasticity is one of the commonest problems in those with neurological disease. The management of spasticity in children with cerebral palsy requires a multidisciplinary effort and should be started as early as possible. There are a number of treatments available for the management of spasticity. This article reviews the variety of options available for the clinical management of spasticity.

Management of Spasticity in Children with Cerebral Palsy

Concomitant knee injury is a common finding in femoral fractures but can be easily missed during early management of the initial trauma. Degrees of damage to the articular structures vary considerably; from only a mild effusion to complete ligamentous and meniscal tears. Since previous reports were mostly from developed societies, this study was designed to look into characteristics of associated knee injury in a sample from Iran, to represent a developing country perspective. Consecutive patients admitted to an orthopedic ward of Baqiyatallah hospital (Tehran, Iran) with diagnosis of femoral fracture were enrolled in this study between October 2008 and September 2009. In patients who met the inclusion criteria of the study, arthroscopic or open surgical examination of the knee, ADT, Lachman test, varus and valgus stress tests under anesthesia were carried out to determine the incidence of knee injury. Forty patients with ipsilateral and two patients with bilateral femoral fractures were studied. Arthroscopy revealed medial meniscus injury in 12 (27 %) knees. Three (7 %) lateral meniscus injuries, 18 (40.9 %) ACL injuries and 2 (4.5 %) PCL injuries were also found. In varus and valgus stress tests, 15 (34 %) MCL and 4 (9 %) LCL laxities were noticed. The Lachman test was positive in 3 (6 %), and ADT was positive in 2 (4.5 %) patients. Based on our observations, concomitant ligamentous and meniscal knee injury is a common finding in femoral shaft fractures and rates of these injuries are generally in concert with reports from developed nations.

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Concomitant ligamentous and meniscal knee injuries in femoral shaft fracture

Segmental defects of the tibia are challenging therapeutic problems for both the physician and the patient. These defects may be caused by severe trauma, infection, tumors and congenital processes. Several different techniques have been described for treatment of these defects including the Papineau technique, allograft reconstruction, bone transport using the Ilizarov frame, free vascularized fibular graft, tibiofibular synostosis and medial transport of the fibula with Tuli’s technique, use of the Ilizarov frame and Huntington’s procedure. All of these techniques have their specific advantages as well as disadvantages. Some of these techniques are used rarely i.e. the Papineau technique. The procedure of choice for most large tibial defects is bone transport with Ilizarov’s technique; but in some cases the tibial remnant is inadequate for lengthening and we must use alternative treatments. In the three aforementioned techniques, the fibula is transferred with peroneal and anterior tibial muscles on a pedicle of peroneal vessels. This transfer retains a biological component of vital bone that allows for a shorter time for consolidation, increased remodeling potential and resistance to infection. It also has better long-term mechanical properties. Hypertrophy of the centralized fibula is described as attaining twice its original diameter or twice the size of the contralateral tibia. Hypertrophy has been seen in nearly all cases of the fibular centralization. Maximum hypertrophy is seen in children and besides patient age, is related to bony union and weight bearing. The reported time for hypertrophy of fibula varies from one to four years. No significant change in the diameter of the fibula was observed after five years. Fracture of tibialized fibula was not reported in many studies of fibular centralization with different techniques. In the reviewed articles, there were no cases of valgus deformity of the ankle. Either the patients were satisfied with the final results despite appearance of the lower extremity and the presence of some angular deformities, although in most cases, the deformities were mild. In this review we conclude that tibialisation of the fibula in selected cases is a reasonable alternative for the treatment of massive tibial defects.

Alireza Rahimnia

Papers

Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial.

Impact of Supplementation with Curcuminoids on Systemic Inflammation in Patients with Knee Osteoarthritis: Findings from a Randomized Double-Blind Placebo-Controlled Trial.

Management of Spasticity in Children with Cerebral Palsy

Concomitant ligamentous and meniscal knee injuries in femoral shaft fracture

Treatment of Segmental Loss of the Tibia by Tibialisation of the Fibula: A Review of the Literature