The effect of honey on post-tonsillectomy pain relief: a randomized clinical trial

Abstract Objective: The study aimed to evaluate the effects of honey on the incidence of post-operative pain in patients undergoing tonsillectomy. Methods: This study is a double-blind and randomized controlled trial design. Twenty-four adult male patients underwent tonsillectomy surgery and were randomized assigned into three groups consist of honey group, placebo group, and control group. All subjects were given standard analgesia and antibiotics, also honey for the honey group and placebo for the placebo group, and only standard post-operative regimens for the control group. This study used silk-cotton tree or kapok tree honey (Ceiba pentandra). Honey was used by gargling every six hours for ten days. Likewise, the same method was applied in the placebo group. Pain scale was assessed for ten days using the Visual Analogue Scale questionnaire, and the frequency of analgesic drugs was recorded on days 1, 2, 4, 7, and 10. Result: Honey group showed significantly higher pain reduction when compared to placebo and control groups, with a significant reduction in the pain scale on day 1, 2, 4, 7 and 10 (p = 0.034; p = 0.003; p < 0.001; p = 0.001; p = 0.001) gradually; Significant differences were also observed in analgesic use, especially on day 2, 4 and 7 (p = 0.028; p = 0.001; p = 0.003). Conclusions: Administration of Kapok tree honey (C. pentandra) after tonsillectomy might reduce post-operative pain and reduce the need for analgesia. Therefore, honey can be considered a complementary medicine and can be administered routinely as adjunctive therapy for post-operative patients.

Conteo de carga viral en pacientes con VIH/SIDA usuarios de terapias alternativas o complementarias / Viral load count in patients with HIV/AIDS users of alternative and/or complementary therapies

Introducción: una alternativa para mitigar los efectos del virus de inmunodeficiencia humana (VIH) es la medicina complementaria, alternativa o integrativa (MCAI); sin embargo, esta puede tener una influencia negativa en los pacientes con VIH. Objetivo: estimar la relación entre la carga viral y el uso de MCAI en pacientes con VIH/SIDA. Metodología: estudio analítico con 232 pacientes de la clínica de VIH/SIDA de una unidad médica de segundo nivel de atención en Cancún, México. Previo consentimiento informado, a cada paciente se le aplicó un cuestionario para identificar el uso de la MCAI y simultáneamente se obtuvo el conteo de carga viral y el CD4 del expediente electrónico. Resultados: el 47.8% utilizaron herbolaria como tratamiento alternativo. No se encontró diferencia estadística entre la utilización de herbolaria y su conteo de carga viral (p > 0.646). La terapia cuerpo-mente, los suplementos vitamínicos, la homeopatía y la acupuntura se usaron del 5 al 24.6%, sin diferencia estadística (p > 0.05) entre los grupos. Por el contrario, el uso de sesiones de manipulación del cuerpo mostró diferencia en relación con quienes no las utilizaban (p < 0.05). Conclusiones: es importante que el profesional de la salud identifique los efectos adversos o benéficos de las terapias alternativas y complementarias, con la finalidad de orientar a sus pacientes y no afectar su tratamiento antirretroviral y, en consecuencia, su conteo de carga viral.

Introduction: An alternative to mitigate the effects of human immunodeficiency virus (HIV) is the complementary and alternative medicine (CAM); however, this could have a negative influence in patients with HIV. Objective: To estimate the relationship between viral load and the use of CAM in patients with HIV/AIDS. Method: Analytical study with 232 patients from the HIV/AIDS Clinic of a second-level healthcare unit in Cancun, Mexico. With prior informed consent, a questionnaire was administered to each patient to identify the use of CAM, and, simultaneously, the viral load and CD4 counts were obtained from their electronic file. Results: 47.8% used herbal medicine as an alternative treatment. No statistical difference was found between the use of herbal products and their viral load (p > 0.646). Body-mind therapy, vitamin supplements, homeopathy and acupuncture were used from 5 to 24.6% without statistical difference (p > 0.05) among groups. However, the use of massage therapy showed a difference in relation to those who did not use it (p < 0.05). Conclusions: It is important that health professionals identify the adverse or beneficial effects of alternative and complementary therapies, so that they can guide their patients and not affect their antiretroviral treatment and, consequently, their viral load.

Effectiveness and Safety Evaluation of Chinese Medicine in Treatment of Metastatic Colorectal Cancer after Chemotherapy Failure: Protocol of a Prospective Multicenter Cohort Study / 中国结合医学杂志

BACKGROUND@#Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC.@*OBJECTIVE@#To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy.@*METHODS@#The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals among Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score.@*DISCUSSION@#This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622 on ClinicalTrials.gov).

Postoperative analgesic effects of Reiki therapy in bitches undergoing ovariohysterectomy / Efeito analgésico pós-operatório da terapia Reiki em cadelas submetidas a ovariohisterectomia

ABSTRACT: This study aimed to evaluate the effects of Reiki therapy on postoperative pain in bitches undergoing elective minimally invasive ovariohysterectomy (OVH). Thirty bitches were randomly assigned to three groups: Control, Placebo, or Reiki. All dogs received methadone as preanesthetic medication (PAM), meloxicam in the preoperative period, propofol for anesthetic induction, and isoflurane for anesthetic maintenance. Immediately after OVH, the dogs in the Reiki were submitted to a single session of Reiki therapy, dogs in the Placebo received simulated Reiki therapy from a non-therapist, and dogs in the Control received no treatment. All dogs were evaluated for pain using short-form Glasgow composite measure pain scale (CMPS-SF) and visual analog scale (VAS) before (M0) and 2 (M2), 4 (M4), 8 (M8), 12 (M12), and 24 hours (M24) after administration of PAM. Comparing the CMPS-SF scores between the groups, at M2 Reiki scores were lower than those of the Placebo and at M4 those in the Reiki were lower than those of the Control or Placebo groups. Comparing the VAS scores, at M4 and M8, Reiki scores were lower than those of the Control or Placebo groups. Additional analgesia (morphine 0.2 mg.kg-1 intramuscularly) was administered to three bitches in Control and to four bitches of the Placebo. Reiki did not require additional opioid analgesia in the postoperative period. It was concluded that Reiki therapy provided analgesic effect and contributed to improve postoperative comfort of bitches submitted to elective OVH.

RESUMO: Este estudo teve o objetivo de avaliar os efeitos da terapia Reiki na dor do período pós-operatório de cadelas submetidas à ovariohisterectomia (OVH) eletiva pelo método minimamente invasivo com gancho. Para isso, foram utilizadas 30 cadelas alocadas aleatoriamente em três grupos experimentais: Controle, Placebo e Reiki. Todos os animais receberam metadona como medicação pré-anestésica (MPA), meloxicam, propofol na indução anestésica e isofluorano na manutenção anestésica. Imediatamente após a OVH, os animais do Reiki foram submetidos a uma única sessão de Reiki, os animais do Placebo receberam uma simulação da terapia Reiki por um indivíduo não terapeuta e os animais do Controle não receberam nenhum tratamento. Os animais foram avaliados por meio da forma curta da escala de dor de Glasgow (CMPS-SF) e da escala visual analógica (EVA) antes da administração da MPA (M0) e 2h (M2), 4h (M4), 8h (M8), 12h (M12) e 24h (M24) após a MPA. Comparando-se os valores obtidos pela CMPS-SF, em M2, os valores do Reiki foram menores que do Placebo e, em M4, os valores do Reiki foram menores que do Controle e do Placebo. Observando-se os dados obtidos com a EVA, em M4 e M8, os valores do Reiki foram menores que do Controle e do Placebo. Foi administrada analgesia adicional (0,2 mg.kg-1 de morfina por via intramuscular) em três animais do Controle e em quatro animais do Placebo. Os animais do Reiki não necessitaram de analgesia adicional no período pós-operatório. Concluiu-se que a terapia Reiki contribuiu com a analgesia e o conforto pós-operatório de cadelas submetidas à OVH eletiva.

Effectiveness of Foot Reflex Therapy in Post-Operative Pain among Patients Subjected to Major Abdominal Surgery

Most patients experience post–operative pain and it is unavoidable. It is the duty of the nurses to ensure that patients' pain is assessed and managed effectively when they are at the hospital. Foot reflex therapy is one effective way nurses can adopt to manage the patient with pain after surgery. We wanted to evaluate the effectiveness of foot reflex therapy on post-operative pain in patients who are subjected to major abdominal surgery. METHODSThis is a descriptive randomized control study that was conducted at Sri Ramachandra Medical College and Hospital, among 360 patients who underwent major abdominal surgery. They were equally divided into two groups as control and study groups and the results were analyzed statistically. RESULTSMajority of the patients in the study group showed a positive effect on pain control during 4th and 5th [ (Mean: 1.27 with SD: 1.12) (Mean: 0.03with SD: 0.32) at p < 0.001] post-operative day following foot reflex therapy. CONCLUSIONSThe existing pain and the post-operative pain can be managed by nurses, patients, their care takers or families together, whenever appropriate, in a multidisciplinary manner. Foot reflex therapy is one such alternative complementary therapy which the nurses can adopt to implement the techniques independently.

Efeito positivo da técnica de imposição de mãos análoga ao toque quântico sobre o crescimento das radículas de sementes de feijão submetidas ao estresse salino / Positive effect of the laying-on of hands technique analogue to the quantum touch on the radicles growth of bean seeds submitted to salinity stress

Introdução: o biocampo é um tipo de energia sutil emitido pelos organismos vivos que tem a capacidade de influenciar processos biológicos e a homeostase. O biocampo também pode ser definido como sendo o campo eletromagnético endógeno dos corpos de organismos vivos. Objetivo: determinar o efeito da técnica de imposição de mãos análoga ao toque quântico sobre o crescimento de radículas de sementes de feijão (Phaseolus vulgaris) submetidas ao modelo experimental de adoecimento do estresse salino. Método: a amostra de 1600 sementes de feijão foi distribuída equitativamente em quatro grupos: GE1 (sementes expostas ao toque quântico e ao estresse salino), GC1 (sementes submetidas apenas ao estresse salino), GE2 (sementes expostas ao toque quântico, mas não ao estresse salino) e GC2 (sementes não foram submetidas nem ao toque quântico e nem ao estresse salino). Resultado e Discussão: houve diferença significativa entre os comprimentos médios das radículas das sementes dos quatro grupos (ANOVA, F(3, 1303)=255,51, p <0,001). Conclusão: os resultados indicaram que a terapia de biocampo técnica de imposição de mãosanáloga ao toque quântico teve efeito fisiológico significativo sobre o crescimento de radículas de sementes de feijão submetidas ao estresse salino.

Introduction: the biofield is a kind of subtle energy emitted by living organisms that has the ability to influence biological processes and homeostasis. The biofield can also be defined as the endogenous electromagnetic field of the bodies of living organisms. Objective: the purpose of this study was to determine the effect of the laying-on of hands technique analogue to the quantum touch on the radicles growth of bean seeds (Phaseolus vulgaris) submitted to salinity stress. Methods: the sample of 1600 bean seeds was distributed equitably in four groups: GE1 (seeds exposed to quantum touch and salinity stress), GC1 (seeds exposed only to salinity stress), GE2 (seeds exposed quantum touch but not to salinity stress) and GC2 (seeds were not exposed to either quantum touch or salinity stress). Results and Discussion: there was a significant difference between the mean radicles lengths of the seeds of the four groups (ANOVA, F(3, 1303)=255,51, p <0,001). Conclusion: the results indicated that the laying-on of hands technique analogue to the quantum touch had a significant physiological effect on the growth of bean seeds radicles exposed to salinity stress.

Efectividad de la reflexología podal en pacientes con artrosis cervical / Effectiveness of podal reflexology in patients with cervical osteoarthritis

Se realizó una intervención terapéutica en 118 pacientes con artrosis cervical, atendidos en el Servicio de Rehabilitación Integral del Hospital Clinicoquirúrgico Docente Dr Joaquín Castillo Duany de Santiago de Cuba, desde julio de 2013 hasta diciembre de 2014, para evaluar la efectividad de la reflexología podal como modalidad de tratamiento. La muestra fue dividida en 2 grupos (de estudio y control), de 54 integrantes cada uno, pareados por edad y sexo. En ambos grupos, el mayor número de afectados superó los 50 años de edad; asimismo, poco más de dos tercios de los individuos seleccionados mejoraron a los 7 días de evolución y en tan solo 3 sesiones de tratamiento, hasta la resolución definitiva a los 21 días (9 sesiones). Se registró una reacción adversa y se concluyó que esta terapia garantiza una mejoría significativa de los síntomas, de ahí su elevada efectividad, sin consumo excesivo de tiempo

A therapeutic intervention in 118 patients with cervical osteoarthritis was carried out. They were assisted in the Comprehensive Rehabilitation Service of Dr Joaquín Castillo Duany Teaching Clinical Surgical Hospital in Santiago de Cuba, from July, 2013 to December, 2014, to evaluate the effectiveness of podal reflexology as a treatment modality. The sample was divided in 2 groups (study group and control group), of 54 members each, paired by age and sex. In both groups, the highest number of affected patients were over 50 years; also, a little more than two thirds of the selected individuals improved at 7 days of the clinical course and with only 3 treatment sessions, until the definitive resolution at 21 days (9 sessions). An adverse effect was registered and it was concluded that this therapy guarantees a significant improvement of symptoms, so its high effectiveness, without excessive consumption of time

Essential oils used in aromatherapy: A systemic review

Nowadays, use of alternative and complementary therapies with mainstream medicine has gained the momentum. Aromatherapy is one of the complementary therapies which use essential oils as the major therapeutic agents to treat several diseases. The essential or volatile oils are extracted from the flowers, barks, stem, leaves, roots, fruits and other parts of the plant by various methods. It came into existence after the scientists deciphered the antiseptic and skin permeability properties of essential oils. Inhalation, local application and baths are the major methods used in aromatherapy that utilize these oils to penetrate the human skin surface with marked aura. Once the oils are in the system, they remodulate themselves and work in a friendly manner at the site of malfunction or at the affected area. This type of therapy utilizes various permutation and combinations to get relief from numerous ailments like depression, indigestion, headache, insomnia, muscular pain, respiratory problems, skin ailments, swollen joints, urine associated complications etc. The essential oils are found to be more beneficial when other aspects of life and diet are given due consideration. This review explores the information available in the literature regarding therapeutic, medical, cosmetic, psychological, olfactory, massage aromatherapy, safety issues and different plants used in aromatherapy. All the available information was compiled from electronic databases such as Academic Journals, Ethnobotany, Google Scholar, PubMed, Science Direct, Web of Science, and library search.

A utilização das terapias complementares nos cuidados paliativos: benefícios e finalidades / The use of complementary therapies in palliative care: benefits and purposes / La utilización de las terapias complementarias en los cuidados paliativos: beneficios y finalidades

Estudo exploratório-descritivo que foi parte de recorte de um projeto de pesquisa realizado em 2011 e 2012, teve por objetivo analisar a utilização das terapias complementares nos cuidados paliativos pelas instituições brasileiras credenciadas nas Associações Nacionais e Latino-Americana de Cuidados Paliativos. A coleta de dados, com seis representantes de serviços de saúde, se deu por meio de um formulário semiestruturado. Os dados foram analisados quantitativamente utilizando-se percentagem simples e, qualitativamente, apoiou-se na Análise de Conteúdo. Os resultados revelaram que a musicoterapia, acupuntura e massagem foram as modalidades mais utilizadas nos cuidados paliativos; as terapias complementares, aliadas ao tratamento convencional, ajudam a aliviar a ansiedade, a depressão e a dor dos pacientes, promovendo relaxamento e facilitando a relação e a interação entre profissional-paciente-família. Assim, o uso das terapias complementares nos cuidados paliativos deve ser valorizado e empregado pelos profissionais habilitados, uma vez que colabora para melhora da qualidade de vida.

This exploratory-descriptive study was an excerpt from the research project undertaken in 2011 to 2012, and aimed to analyze the use of complementary therapies in palliative care by Brazilian institutions accredited with the Brazilian and Latin-American Associations of Palliative Care. Data collection, with six representatives of the health services, occurred through a semi-structured questionnaire. The data were analyzed quantitatively using simple percentages, and qualitatively, based in Content Analysis. The results revealed that music therapy, acupuncture and massage were the modalities used most in palliative care; the complementary therapies, allied with conventional treatment, help to relieve the patients' anxiety, depression and pain, promoting relaxation, and facilitating the relationship with, and the interaction between, professional-patient-family. Thus, the use of the complementary therapies in palliative care must be valued and used by trained professionals, as it contributes to improving quality of life.

Estudio exploratório descriptivo que hizo parte de recorte de un proyecto de investigación realizado en 2011 y 2012 cuyo objetivo fue analizar la utilización de terapias complementarias en los cuidados paliativos por las instituciones brasileñas habilitadas en las Asociaciones Nacionales y Latinoamericanas de Cuidados Paliativos. Los datos fueron obtenidos con seis representantes de servicios de salud por medio de formulario semiestructurado. Fueron analizados de modo cuantitativo utilizándose porcentaje simple. Cualitativamente, se apoyó en el Análisis de Contenido. Los resultados revelaron que la musicoterapia, acupuntura y masaje fueron las modalidades más utilizadas en los cuidados paliativos; las terapias complementares, aliadas al tratamiento convencional, ayudan a aliviar la ansiedad y la depresión y el dolor de los pacientes, promoviendo relajamiento y facilitando la relación y la interacción entre profesional-paciente-familia. De ese modo, el uso de las terapias complementares en los cuidados paliativos debe ser valorado y empleado por los profesionales habilitados, una vez que colabora para mejorar la cualidad de vida.

Acupuncture effcctiveness as a complementary therapy in functional dyspepsia patients / Eficacia da acupuntura como terapia complementar em pacientes com dispepsia funcional

Context Functional dyspepsia represents a frequent gastrointestinal disorder in clinical practice. According to the Roma III criteria, functional dyspepsia can be classified into two types as the predominant sympton: epigastric pain and postprandial discomfort. Even though the pathophysiology is still uncertain, the functional dyspepsia seems to be related to multiple mechanisms, among them visceral hypersensitivity, changes in the gastroduodenal motility and gastric accommodation and psychological factors. Objective Evaluate the effectiveness of acupuncture as a complementary to conventional treatment in functional dyspepsia patients. Methods Randomized clinical trial in which were enrolled patients with functional dyspepsia patients in according with Rome III criteria. One group was submitted to drug therapy and specific acupuncture (GI) and the other to drug therapy and non-specific acupuncture (GII). The gastrointestinal symptoms, presence of psychiatric disorders and quality of life were evaluated, at the end and three months after treatment. Results After 4 weeks of treatment there was improvement of gastrointestinal symptoms in Group I (55 ± 12 vs 29 ± 8.8; P = 0.001) and Group II (50.5 ± 10.2 vs 46 ± 10.5; P = 0.001). Quality of life was significantly better in Group I than group II (93.4 ± 7.3 vs 102.4 ± 5.1; P = 0.001). Anxiety (93.3% vs 0%; P = 0.001) and depression (46.7% vs 0%; P = 0.004) were significantly lower in Group I than group II. When comparing the two groups after 4 weeks of treatment, gastrointestinal symptoms (29 ± 8.8 vs 46 ± 10.5; P<0.001) and quality of life (102.4 ± 5.1 vs 96 ± 6.1; P = 0.021) were significantly better in Group I than group II. Three months after the treatment, gastrointestinal symptoms remained better only in Group I, when compared to the pre-treatment values (38 ± ...

Contexto A dispepsia funcional representa uma frequente desordem gástrica da prática clínica. Segundo os critérios de Roma III, pode ser subdividida em dois tipos: do tipo dor epigástrica e tipo desconforto pós prandial, de acordo com o sintoma predominante. Embora de fisiopatologia incerta, a dispepsia funcional parece estar relacionada a múltiplos mecanismos, entre eles: a hipersensibilidade visceral, alterações da motilidade gastroduodenal e acomodação gástrica e participação de fatores psíquicos. Objetivos Avaliar a eficácia da acupuntura como forma complementar ao tratamento medicamentoso em pacientes com dispepsia funcional. Método Ensaio clínico randomizado, com portadores de dispepsia funcional, segundo os critérios de Roma III. Dois grupos foram formados: Grupo I (terapia medicamentosa e acupuntura específica) e; II (terapia medicamentosa e acupuntura não específica). Foram avaliados o índice de sintomas gastrointestinais, a presença de transtornos psíquicos e a qualidade de vida no início, no fim e 3 meses após o tratamento. Resultados Após 4 semanas de tratamento houve melhora dos sintomas gastrointestinais no Grupo I (55 ± 12 vs 29 ± 8,8; P = 0,001) e no Grupo II (50 ± 10 vs 46 ± 10,5; P = 0,001). Na comparação intergrupos, os sintomas gastrintestinais (29 ± 8,8 vs 46 ± 10,5; P<0,001) e os sintomas de ansiedade (0% vs 41,7%; P = 0,003) foram significativamente menores no Grupo I e a qualidade de vida (102,4 ± 5,1 vs 96,4 ± 6,1; P = 0,021) também foi significativamente melhor neste grupo. Três meses após o tratamento, os sintomas gastrointestinais permaneceram melhores no Grupo I, quando comparados aos valores pré-tratamento (38 ± 11,3 vs 55 ...

Servicios de medicina alternativa en Colombia / Complementary and alternative medicine services in Colombia

Objetivo: El objetivo general de este estudio es identificar la distribución de la oferta de servicios de Medicina Alternativa a nivel departamental y la concentración de oferta de servicios de Medicina alternativa en el país. Métodos: La información se obtuvo del Registro Especial de Prestadores publicado en el sitio Web del Ministerio de la Protección Social en Julio de 2010 Resultados: Se encontró que Bogotá D.C es la ciudad con mayor concentración de prestadores de servicios de salud que ofrecen el servicio de Medicina Alternativa, seguida por los departamentos de Antioquia, Valle del Cauca, Cauca y Cundinamarca con sus respectivas capitales y que no se diferencia el tipo de Medicina Alternativa - Terapia Alternativa que se ofrece. Discusión: Existen muchos municipios en el país donde aún no se registra oferta de servicios de Medicina Alternativa por lo que los profesionales de salud especializados en este tipo de medicina tienen grandes oportunidades en diversos lugares para ejercer su práctica profesional; así mismo, esta todo por desarrollar esta Medicina Alternativa en ámbitos ambulatorios e intrahospitalarios diferentes a los de consulta externa baja complejidad.

Objective This study's overall objective was to identify the supply and distribution of complementary and alternative medicine (CAM) services at departmental level and the concentration of CAM service supply in Colombia. Method The information was obtained from the special list of CAM providers published on the Colombian Ministry of Social Protection (Ministerio de Protección Social) web-site in July 2010. Results Bogotá was the city having the greatest concentration of CAM health-service providers, followed by the departments of Antioquia, Valle del Cauca, Cauca and Cundinamarca, with their respective capitals, and that the type of alternative medicine-therapy being provided differed very little. Discussion Many towns/municipalities in Colombia still lack a record of CAM service providers, meaning that health practitioners specialising in this kind of medicine have great opportunities for providing their services in many parts of the country; likewise, there is a whole field waiting for CAM services to be developed in outpatient and intra-hospital settings different to low-complexity external consultancy.

Conocimientos, actitudes y prácticas acerca de la medicina alternativa en médicos vinculados a hospitales públicos de Cundinamarca, Colombia / Knowledge, attitudes and practice concerning complementary and alternative medicine (CAM) amongst doctors working in public hospitals in Cundinamarca, Colombia

Objetivo: Identificar conocimientos, actitudes y practicas acerca de la medicina alternativa y complementaria en médicos vinculados a hospitales públicos en el departamento de Cundinamarca. Métodos: Se realizó un estudio cuantitativo observacional descriptivo. La población estuvo conformada por médicos generales y especialistas vinculados a los 37 hospitales públicos del departamento de Cundinamarca durante el periodo diciembre de 2009 a marzo 2010. La muestra incluyó a 280 médicos con un nivel de confianza del 95 % y error del 0,5 %. Resultados: Existe un desconocimiento para los sistemas médicos complejos del 93 % y para las terapéuticas de un 91 %. Sin embargo, el 41 % de los médicos entrevistados desea capacitarse formalmente en el área de medicina alternativa y complementaria (MAC) y el 15 % tiene alguna formación en esta área. El 18 % remiten a sus pacientes para tratamientos relacionados con MAC, el 25 % ha recibido tratamiento de MAC. La mitad de los médicos considera que se debe enseñar a los estudiantes de medicina sobre MAC. Conclusiones: Existe una tendencia positiva hacia la MAC de la experiencia y edad del médico. Además se considera que poseen una evidencia científica demostrable, por lo que desean recibir una educación formal en esta área. Existe una percepción de utilidad, uso y recomendación de estas medicinas tanto para su vida personal como en la práctica médica cotidiana, haciendo explicita la necesidad de acceso a las MAC a través del plan obligatorio de salud.

Objective: Identifying the knowledge, attitudes and practices of doctors working in public hospitals in the Cundinamarca department, Colombia, regarding complementary and alternative medicine. Methods: This was a descriptive, quantitative observational study. The target population consisted of general practitioners and specialists involved in the 37 public hospitals in the Cundinamarca department from December 2009 to March 2010. The sample included 280 doctors (using 95 % confidence level and 0.5% error). Results: There was 93 % misunderstanding of complex medical systems and 91 % regarding therapeutic systems. However, 41 % of the doctors surveyed wished to receive formal training in the area of complementary and alternative medicine (CAM) and 15 % had some training in this area. 18 % referred patients for CAM-related treatment and 25 % had received MAC treatment. Half of the doctors considered that CAM should be taught to medical students. 40 % considered that CAM should be included in the compulsory health plan in Colombia. Conclusions: A positive trend regarding CAM was related to a doctor's age and experience. It was also believed that demonstrable scientific evidence was available regarding CAM so they wished to receive formal education in this area. These drugs were perceived to be useful, in current use and recommended concerning their personal life and everyday medical practice, making explicit the need for access to MAC through the compulsory Colombian health plan.

Complementary and alternative medicine use among people living with HIV or AIDS / El uso de medicina complementaria y alternativa en personas viviendo con VIH o SIDA

VIH y SIDA es una preocupación permanente en todo el mundo, a pesar de ello, solo 3 millones de personas tuvieron acceso al tratamiento antirretroviral durante el año 2007 y se estima que solo 11.6 millones de personas tendrán acceso este en el año 2015. El propósito de esta revisión de literatura es identificar el uso de medicinas y terapias complementarias y alternativas (CAM) que utilizan las personas que viven con VIH o SIDA. Esto permitirá evaluar la factibilidad de sugerir la incorporación de estas terapias en los planes de tratamiento. La búsqueda se realizó entre el 1 de junio y 3 de junio de 2011, utilizando como criterio de selección ser un artículo de los últimos 5 años. Esta revisión permitió identificar que CAM se usa hoy manejar y tratar varios problemas relacionados a vivir con VIH, tanto a nivel biológico, social y psicológico, logrando buenos resultados de acuerdo a la percepción de quienes lo utilizan. Es relevante considerar que CAM potencialmente podría servir como método de potenciar un tratamiento más integral y centrado en el paciente, para quienes estas terapias parecen ser formas de manejar los aspectos incontrolables de vivir con VIH.

HIV and AIDS is cause for concern all over the globe, however only 3 million people were reported to have access to antiretroviral treatment in 2007, and only 11.6 million are projected to have access in 2015. The purpose of this article is to review the existing literature on the use of complementary/alternative medicines and therapies (CAM) among people living with HIV or AIDS in order to suggest its incorporation into mainstream treatment plans. CAM is used to treat many aspects of living with HIV, whether biological, social or psychological. Searches were conducted including articles written in the past five years between June 1, 2011 and June 3, 2011. CAM is often chosen as a way to manage issues that antiretroviral medications do not control, for example the emotional aspects of living with HIV. CAM can potentially serve as a method of giving people living with HIV more integral, patient-centered treatment.

Alternative therapy in glaucoma management: Is there any role.

Glaucoma is one of the leading causes of blindness worldwide. Various randomized controlled clinical trials have shown that lowering intraocular pressure (IOP) does reduce progression of primary open-angle glaucoma. However, there is lots of interest in nonpharmacological options that includes lifestyle adjustment and alternative and complementary therapy (ACT). At least 5% glaucoma population uses ACT. Various lifestyle activities like exercise and alcohol can reduce IOP by 1 to 2 mm Hg but would have small effect on glaucoma. The psychological stress can increase IOP. Hypothetically and few studies do show neuroprotective effect (or effect on ocular blood flow) of alcohol, Gingko biloba, bilberry, but the current evidence is weak for its routine use. We must also remember the side effects of ‘medications’ (e.g., marijuana, alcohol) before promoting as remedy for glaucoma. In current armamentarium of glaucoma management, ACT cannot substitute the conventional treatment available to lower IOP.

O tratamento da ansiedade por intermédio da acupuntura: um estudo de caso / The treatment of anxiety through acupunture: a case study / El tratamiento de la ansiedad por intermedio de la acupuntura: un estudio de caso

A ansiedade é um fenômeno amplamente estudado no ocidente pela Psicologia, pela psicanálise e pela Medicina. caracteriza-se por um estado subjetivo desagradável de inquietação, tensão e apreensão. Embora a terminologia ansiedade não seja encontrada na literatura da medicina tradicional chinesa, os sintomas descritos são amplamente estudados. Tal literatura considera essa patologia metaforicamente uma desarmonia do espírito, e apresenta uma série de possibilidades de intervenções por técnicas tradicionais como a acupuntura. O objeto deste artigo é relatar o tratamento realizado por meio da acupuntura a uma paciente que apresentava transtorno de ansiedade. Após a identificação dos sintomas de ansiedade, realizados pela queixa da paciente e pela análise clínica embasada no DSM IV, foram realizadas 10 sessões de acupuntura tradicional chinesa, utilizando como referencial teórico a literatura clássica da medicina chinesa. Os resultados obtidos foram a diminuição parcial dos sintomas a partir da quarta sessão e uma significativa melhora da paciente, com o relato do alívio dos sintomas a partir da sexta sessão de tratamento....(AU)

Anxiety is a phenomenon widely studied in the West by psychology, psychoanalysis and medicine. It is characterized by an unpleasant subjective state of worry, tension and apprehension, in which it is difficult to relax. Although the terminology anxiety is not found in the literature of chinese traditional medicine, the described symptoms are studied widely. Such literature considers that pathology metaphorically as a discord of the spirit and presents a series of possibilities of interventions for traditional techniques as the acupuncture. The objective of this article was the treatment accomplished through acupuncture to a patient that presented anxiety disorder. After the confirmation of the diagnosis 10 sessions of chinese traditional acupuncture were accomplished, using as theoretical reference the classic literature of chinese medicine. The results were the partial suppression of the symptoms starting from the fourth session and a total recovery of the patient by the disappearance of all of the symptoms starting from the sixth treatment session....(AU)

La ansiedad es un fenómeno ampliamente estudiado en el occidente por la Psicología, por el psicoanálisis y por la Medicina. Se caracteriza por un estado subjetivo desagradable de inquietud, tensión y aprehensión. Aunque la terminología ansiedad no sea encontrada en la literatura de la medicina tradicional china, los síntomas descritos son ampliamente estudiados. Tal literatura considera esa patología metafóricamente una desarmonía del espíritu, y presenta una serie de posibilidades de intervenciones por técnicas tradicionales como la acupuntura. El objeto de este artículo es relatar el tratamiento realizado por medio de la acupuntura a una paciente que presentaba trastorno de ansiedad. Después de la identificación de los síntomas de ansiedad, realizados por la queja de la paciente y por el análisis clínico basado en el DSM IV, fueron realizadas 10 sesiones de acupuntura tradicional china, utilizando como referencial teórico la literatura clásica de la medicina china. Los resultados logrados fueron la disminución parcial de los síntomas desde la cuarta sesión y una significativa mejora de la paciente, con el relato del alivio de los síntomas desde la sexta sesión de tratamiento....(AU)

A study on the use of massage by nurses to relieve cancer pain and factors affecting this usage

<b>Purpose</b>: This study investigates the situation surrounding the use of massage to relieve cancer pain by nurses in hospices and palliative care wards all over Japan and factors affecting this usage. <b>Methods</b>: We conducted a survey of 989 nurses with two or more years of clinical experience employed at approved palliative care wards around Japan, using a questionnaire prepared by researchers. <b>Results</b>: The questionnaire was answered by 606 nurses, and 95.7% of the subjects used massage in their routine nursing care. They recognized the benefits, such as comfort, reducing anxiety and so on. From a multivariate logistic model, 'a great number of years of clinical experience in cancer nursing' (OR: 2.51, 95%CI: 1.20-4.80) and 'the superior assessment ability for the use of massage' (OR: 1.18, 95%CI: 1.09-1.27) had a significant impact on the active use of massage. <b>Conclusion</b>: In order to use massage more effectively it is necessary to develop knowledge acquired through clinical experience and improve nurse's assessment ability. Palliat Care Res 2010; 5(1): 101-113

Ação do Viscum album em cultivo celular de carcinoma epidermoide de cabeça e pescoço / Viscum album effect in head and neck squamous cell carcinoma cell culture

O carcinoma epidermoide de cabeça e pescoço, hoje considerada mundialmente uma das neoplasias mais frequentes desta região, tornou-se um problema de saúde pública, necessitando urgente de medidas a serem tomadas, a fim de melhorar a qualidade de vida dos pacientes acometidos, consequentemente aumentando a sobrevida, avaliada em cinco anos. O carcinoma epidermoide de cabeça e pescoço é uma doença complexa, e inclui vários fatores etiológicos, além de alterações moleculares, capazes de desencadear e dar continuidade a alguns eventos. No geral os carcinomas orais são tratados primeiramente com cirurgia excisional ou radioterapia individualmente, ou em combinação para os estágios mais avançados. As preparações dos extratos fermentados de Viscum album (VA), uma planta semiparasita da família das Lorantáceas, vêm sendo utilizada, principalmente em países da Europa, com resultados promissores no âmbito das terapias coadjuvantes, especialmente a medicina antroposófica. Em conjunto com as terapias convencionais, tem demonstrado uma melhora na qualidade de vida dos pacientes portadores de neoplasias malígnas. Estudos in vitro, realizados em células cancerígenas, têm demonstrado que vários tipos de VA podem apresentar citotoxicidade em células de carcinoma, sendo capazes de ativar a cascata apoptótica ou levando as células à necrose. Este estudo teve por objetivo verificar a ação de três tipos de extratos de VA (Iscador Qu Spezial, Iscador P e Iscador M), em linhagens celulares de carcinoma epidermoide de língua (SCC9 e SCC25). Para isso foi verificada a ação citotóxica do fármaco Iscador Qu Spezial, por meio do teste de viabilidade celular, para a obtenção da IC50...

Head and neck squamous cell carcinoma, one of the most common malignancies worldwide in this area, became a public health problem that requires urgent attitudes to be taken in order to improve the quality of life of the affected patients, increasing survival that today valued at five years. Head and neck squamous cell carcinoma is a complex disease which includes several etiologic factors and different molecular changes that may trigger and get on with some events. In general, oral carcinomas are treated primarily with surgical excision or radiotherapy alone or in combination for cases in more advanced stages. Preparations of fermented extracts from fermented Viscum album (VA), a plant from the Loranthaceae family have been used, mainly in European countries, with promising results as adjuvant therapies, especially in the Anthroposophy Medicine. In combination with conventional therapies, VA has lead to improvement in quality of life of patients with cancer. in vitro studies have demonstrated that various types of VA may have cytotoxicity in carcinoma cells being able to activate the apoptotic cascade or leading cells to necrosis. The present study aimed to verify the effect of three types of VA extracts (Iscador Qu Spezial, Iscador P and Iscador M) in squamous cell carcinoma of the tongue (SCC9 and SCC25). The cytotoxic action of Iscador Qu Spezial was verified by cell viability test obtaining the IC50. The three drugs were tested as follow: Tunnel to evaluate apoptosis, Annexin V and FITC/propidium iodide were evaluated by flow cytometry to quantify the apoptosis rate induced by the drugs...

Patterns of Complementary and Alternative Medicine Therapies in Patients with Chronic Fatigue or Pain / 가정의학회지

BACKGROUND: It is well-known that patients with chronic fatigue or frequent pain seek complementary and alternative medicine therapies (CAT) in Western countries. We conducted this study to determine the pattern of CAT use and the factors related to CAT use in patients with chronic fatigue or pain in Korea. METHODS: This was a cross-sectional study. The participants (n = 143) with chronic fatigue or pain completed a self-reported questionnaire including demographic characteristics and lifestyle as well as disease-related and CAT-related items. RESULTS: The frequency of CAT use was 51.0& and 39.2& over the past 10 years and 1 year, respectively. The most common type of CAT used was herbal medicine. The therapeutic effects of the CAT were similar to physicians' prescriptions. CAT were most often used in combination with conventional medicine rather than alone. More than 70.0& of subjects did not consult their physicians for the use of CAT. The duration of illness, severity of fatigue and pain was signifi cantly related to the use of CAT. CONCLUSION: Many patients with chronic fatigue or pain use CAT. Most of these patients do not consult their physicians regarding CAT use.

The Analysis of the Korean Nursing Research Trends on Complementary and Alternative Therapies for Cancer Patients / 종양간호학회지

PURPOSE: The purpose of this study was to analyze nursing research trends on the complementary and alternative therapies (CAT) for the cancer patients in Korea. METHOD: Thirty eight articles published in 17 nursing-related journal from 1987 to 2008 were analyzed. RESULTS: Nursing Researches on CAT for the cancer patients have increased since 2000. Among the 38 studies, 34 studies used Quasi-experimental design and 13 studies (33%) were conducted for the breast cancer patients. Mind-body therapy (53%), manual healing therapy (42%), and pharmacologic and biological therapy (5%) were the often used CAT types. Nausea, vomiting, vital signs, immune cell, pain, and fatigue were measured as physiologic outcome variables; anxiety, depression, and hope as psychological outcome variables; and quality of life as social outcome variables. CONCLUSION: More CAM studies are needed targeting the patients with various cancer types and home-based cancer patients.

Revisión de la efectividad de los ingredientes de productos alternativos para la pérdida de peso / A systematic review of the effectiveness of alternative weight-loss products' ingredients

Objetivo La alta demanda para el tratamiento de la obesidad y la poca efectividad de las terapias convencionales favorecen el consumo de productos alternativos. Evaluar ensayos clínicos aleatorios sobre la pérdida de peso con los ingredientes de los productos alternativos de mayor consumo en México. Metodología Se realizó una encuesta para valorar la prevalencia de consumo de productos alternativos para la pérdida de peso en Ensenada, Baja California. Se investigaron los productos más vendidos y se obtuvieron los componentes activos. Se revisaron ensayos clínicos aleatorios registrados en Pubmed para los componentes activos mas utilizados. Se incluyeron y analizaron aquéllos que evaluaran cambios en el peso. Resultados Treinta y seis porciento de los encuestados han utilizado algún método alternativo para la pérdida de peso (83 por ciento mujeres). Los productos más referidos fueron licuados, tés, pastillas y linaza. Se encontraron 16 ensayos clínicos aleatorios de cuatro ingredientes: Garcinia Cambodia, té verde, L-carnitina y linaza. Solamente dos estudios demostraron una pérdida de peso significativa (2 5 por ciento) entre el grupo control y el experimental. En los estudios de L-Carnitina y linaza no se encontró una diferencia significativa. Conclusión Se concluye que no hay evidencias suficientes y de calidad que justifiquen la utilización de los productos alternativos para la pérdida de peso.

Objective The high demand for obesity treatment and conventional therapies' lack of effectiveness increases the use of alternative products. This study was aimed at assessing evidence from randomised clinical trials regarding the effectiveness of alternative weight-loss products' ingredients. Methods A survey was conducted in Ensenada, Baja California, to assess the frequency of consuming alternative products used for weight reduction. The ingredients in the products most in demand were included in this review. The Pubmed database was searched for all randomised clinical trial papers including these ingredients and assessing weight loss. Results Thirty-six percent of the subjects questioned had used alternative methods for weight-loss, 83 percent of them being women. The most frequently used products were shakes, tea, pills and flaxseed/linseed. Sixteen randomised clinical trials using four ingredients were used: Garcinia cambogia, green tea, L-carnitina and flaxseed. Only two studies (green tea and Garcinia cambogia) showed significant weight-loss (25 percent) amongst control and experimental groups. There was no significant difference between the groups in the studies regarding L-carnitina and flaxseed. Conclusions There is a lack of evidence regarding quality studies justifying the use of alternative products for weight loss.