The effect of auricular acupuncture in obese women: a randomized controlled trial.

BACKGROUND: The aims of this randomized study are to examine the effect of auricular acupuncture on obese women and to explore the relationship between the effect of auricular acupuncture and obesity-related hormone peptides. METHODS: Forty-five of 60 obese women aged between 16 and 65 years with body mass index (BMI) >27 kg/m2 and who had not received any other weight control maneuvers within the last 3 months completed this study. The subjects were blinded and randomly divided into groups A and B. Group A (n = 23) received auricular acupuncture, and group B (n = 22) received sham auricular acupuncture using placebo needles, twice each week for 6 weeks. The subjects' body weight (BW), BMI, waist circumference (WC), and obesity-related hormone peptides were measured at the beginning of the study and after 6 weeks of treatment. The data were compared and expressed as percent reductions. RESULTS: This study found no statistical difference in percent reduction in BW, BMI, and WC between the group receiving 6 weeks of auricular acupuncture treatment and the control group. After treatment, group A revealed a significant increase in ghrelin level and decrease in leptin level. On the other hand, group B, who received sham auricular acupuncture, showed no significant difference in ghrelin and leptin levels. CONCLUSIONS: This study found no statistical difference in percent reduction in BW, BMI, and WC between the two groups. No adverse effects of short-term auricular acupuncture treatment were seen in the study. Auricular acupuncture may have potential benefit on obesity-related hormone peptides.

An Evaluation of the Additive Effect of Natural Herbal Medicine on SARS or SARS-like Infectious Diseases in 2003: A Randomized, Double-blind, and Controlled Pilot Study.

Natural herbal medicine (NHM) has been used to control infectious diseases for thousands of years. In view of the possible beneficial effect of NHM on SARS, we conducted this study to examine whether NHM is of any benefit as a supplementary treatment of SARS or SARS-like infectious disease. This was a randomized, double-blind, placebo-controlled trial. Twenty-eight patients fulfilled the WHO inclusion criteria and our exclusion criteria. All enrolled patients received routine western-medicine treatment. Patients were randomly allocated to one of the three supplementary treatment groups: NHM A (Group A, n = 9) NHM B (Group B, n = 9) or placebo (Group C, n = 10). Chest X-ray was done every 1 or 2 days for every patient. Reading radiologists use a standard 0-3 scoring system (0: no infiltration; 1: focal haziness or even small patchy lesion; 2: ground glass picture; 3: lobar consolidation) according to the severity of infiltration in each lung field (three lung fields in both right and left lungs). The main outcome measurements were the improving chest radiographic scores (IRS) and the duration (days) till improvement (DI). One patient from the placebo group passed away. Patients from NHM A took less days before showing improvement (6.7 +/- 1.8) compared with placebo group (11.2 +/- 4.9), which showed statistical significance (P = 0.04). The cases were too few to be conclusive, the initial observations seem to indicate NHM appears to be safe in non-criticallly ill patients and clinical trials are feasible in the setting of pandemic outbreaks.

Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial.

AIMS: To examine the effect of green tea extract (GTE) on obese women and to explore the relationship between GTE and obesity-related hormone peptides. METHODS: A randomized, double-blind, placebo-controlled clinical trial was conducted from July 2006 to June 2007 in Taipei Hospital, Taiwan. Seventy-eight of 100 obese women aged between 16 and 60 years with BMI>27 kg/m(2) and who had not received any other weight control maneuvers within the last 3 months completed this study. The subjects were randomly divided into Groups A and B. Group A (n=41) received GTE while Group B (n=37) took cellulose as a placebo, one capsule (400mg) three times each day for 12 weeks. The body weight (BW), body mass index (BMI) and waist circumflex (WC) were measured at the beginning of the study and after 12 weeks of treatment with GTE. The data were compared and expressed as % reduction. RESULTS: There was only a 0.3% reduction in BW (0.15 kg) after 12 weeks of treatment with GTE. There was no statistical difference in % reduction in BW, BMI and WC between the GTE and placebo groups. Within group comparison revealed that the GTE group had significant reduction in LDL-cholesterol and triglyceride, and marked increase in the level of HDL-cholesterol, adiponectin and ghrelin. On the other hand, the placebo group showed significant reduction in triglyceride only, and a marked increase in the level of ghrelin alone. CONCLUSIONS: This study showed no statistical difference in % reduction in BW, BMI and WC between the GTE and placebo groups after 12 weeks of treatment. The intake of GTE (491 mg catechins containing 302 mg EGCG) for 12 weeks is considered safe as shown by the results.

The mushroom Agaricus blazei Murill extract normalizes liver function in patients with chronic hepatitis B.

BACKGROUND: Hepatitis B is a global health problem. Use of complementary and alternative medicine has been popular among patients with hepatitis B. This 1-year open-label pilot study aims to observe whether Agaricus blazei Murill extract improves liver function in patients with hepatitis B. METHODS: This study involved 12 months of clinical observation. Four (4) patients with hepatitis B who met the criteria (1) aged between 20 and 65 years; (2) being Chinese; (3) having been a hepatic B carrier (HBAg(+)) for more than 3 years; (4) alanine aminotransferase > 100 IU/L; and (5) not taking lamivudine, alpha-interferon, or other drugs for hepatitis participated in the study with informed consent. The enrolled patients were given Agaricus blazei Murill (ABM) extract of 1500 mg daily for 12 months. The level of alanine aminotransferase was taken as the major outcome measurement. RESULTS: At the end of the study, the mean level of aspartate aminotransferase and alanine aminotransferase decreased from 246.0 (+/- standard deviation [SD] 138.9) to 61.3 (+/- SD 32.6) IU/L and 151.0 (+/- SD 86.9) to 46.1 (+/- SD 22.5) IU/L, respectively. CONCLUSIONS: Our initial observation seems to indicate the potential benefit of ABM extract in normalizing liver function of patients with hepatitis B. Controlled studies with larger samples should be conducted in the future.

The impact of the menopause on coronary artery calcification examined by multislice computed tomography scanning.

BACKGROUND AND AIMS: To examine whether there is a difference in coronary artery calcification (CAC) scores between males and females aged above 50 years. METHODS AND RESULTS: A total of 479 subjects aged between 40 and 70 years with no clinical or family history of cardiovascular disease (CVD) were enrolled for this study. All subjects were assessed by multislice CT scanning (MCTS), and the CAC scores obtained were assigned to one of four quartiles for further assessment and comparison. The main outcome evaluated was the percentage of high CAC scores and mean CAC scores, comparing males and females of different age groups. This study found that the percentage of high CAC scores increased markedly from 5% (40-49 age group) to 21.2% (50-59 age group) among females. The increase was significantly less when comparing males from different age groups (from 25% in the 40-49 age group to 31.2% in the 50-59 age group). Females had higher odds ratios (ORs) postmenopausally (4.3 in the 50-59 age group) than males in the same age group (1.6). CONCLUSIONS: These initial findings seem to indicate that above 50 years of age, CAC is more dependent on age in females than in males, which might be due to the effect of the menopause.

The mushroom Agaricus Blazei Murill in combination with metformin and gliclazide improves insulin resistance in type 2 diabetes: a randomized, double-blinded, and placebo-controlled clinical trial.

BACKGROUND: Complementary and alternative medicine use in adults with type 2 diabetes is popular. Although most of the herbs and supplements appear to be safe, there is still insufficient evidence that demonstrates their definitive beneficial effects. This study was done to determine whether the supplement of Agaricus blazei Murill extract improves insulin resistance in type 2 diabetes. MATERIALS AND METHODS: This study was a clinical randomized, double-blind, placebo-controlled trial. Of a population of 536 registered diabetes patients with 72 subjects (1) aged between 20 and 75 years, (2) being Chinese, (3) having type 2 diabetes for more than 1 year, and (4) having been taking gliclazide and metformin for more than 6 months were enrolled in this study. The enrolled patients were randomly assigned to either receiving supplement of Agaricus blazei Murill (ABM) extract or placebo (cellulose) 1500 mg daily for 12 weeks. Homeostasis model assessment for insulin resistance (HOMA-IR) was used as the major outcome measurement. RESULTS: At the end of the study, subjects who received supplement of ABM extract (n = 29) showed significantly lower HOMA-IR index (3.6[standard deviation, 2.5] versus 6.6[standard deviation, 7.4], p = 0.04) than the control group (n = 31). The plasma adiponectin concentration increased 20.0(standard deviation, 40.7)% in the ABM group after 12 weeks of treatment, but decreased 12.0(20.0)% among those taking the placebo (p < 0.001). CONCLUSIONS: Supplement of ABM extract improves insulin resistance among subjects with type 2 diabetes. The increase in adiponectin concentration after taking AMB extract for 12 weeks might be the mechanism that brings the beneficial effect. Studies with longer periods of follow-up should be conducted in the future.

Seroprevalence of rubella infection after national immunization program in Taiwan: vaccination status and immigration impact.

Rubella vaccination was implemented nationwide in 1992 in Taiwan. A cross-sectional survey was conducted to determine the age-specific seroprevalence of anti-rubella in female students aged 7-22 years old and women of reproductive age in Taipei County. Seropositivity of anti-rubella antibodies was defined as a serum IgG level > or =10 IU/ml tested by enzyme immunoassay. Information on possible predictors of anti-rubella seronegativity was obtained from structured questionnaire interview. Multivariate-adjusted odds ratios (ORm) with their 95% confidence interval (CI) were derived for each predictor using multiple logistic regression analysis. A total of 826 female students and 318 women were recruited. Anti-rubella seropositive rates were 98.3% (282/287), 99.6% (234/235), 96.8% (179/185), 92.4% (110/119), 81.4% (197/242), and 89.5% (68/76) for the age groups of 7-9, 11-13, 15-17, 19-22, 25-33, and 34-44 years old, respectively. Among female students, negative serology for rubella antibodies was associated significantly with the age group and foreign nationality of mother, showing ORm (95% CI) of 1.2 (1.06-1.27) for each year increase in age, and 20.9 (6.31-68.97), respectively. Among women at the reproductive age, low maternal education level 91.6 (9.12-920.74), unmarried status 21.2 (6.16-72.89), and no rubella vaccination 98.9 (11.64-840.25) were associated significantly with an increased evidence of seronegativity to rubella. The National Rubella Vaccination Program has led to herd immunity of school girls. However, in order to eradicate the Rubella syndrome, greater effort is required to vaccinate foreign brides in Taiwan.

The lesson of supplementary treatment with Chinese medicine on severe laboratory-confirmed SARS patients.

Chinese medicine (CM) has been used to control infectious diseases for thousands of years. In 2003 outbreaks of severe acute respiratory syndrome (SARS) occurred in China, Hong Kong and Taiwan. In view of the possible beneficial effect of CM on SARS, we conducted this study to examine whether CM is of any benefit as a supplementary treatment of SARS. Four severe laboratory-confirmed SARS patients received routine western-medicine treatment plus different supplementary treatment: CM A, CM B and CM C (placebo control). We reported the course of the cases in terms of changes in chest radiographic scores. Case 1 treated as a placebo control passed away on the 9th day after onset of disease. The other three cases treated with CM A or CM B survived. The initial findings seemed to indicate a favorable effect of CM on management of SARS. The findings need to be verified with a larger sample. Using CM as a supplementary treatment of severe SARS seems to indicate that natural herbal medicine can be used against avian influenza. Hence, such related experience or clinical trials should be taken into consideration when facing the possible outbreak of avian influenza in the future.

Rubella seroprevalence among young women taipei county after routine measles, mumps and rubella immunization program.

To better target rubella immunization efforts by determining the age-specific rubella seroprevalence and the related factors for children in Taiwan after the 1986 national vaccine policy. A cross-sectional study was conducted for these girls aged 10 years (1994 cohorts), 13 years (1991 cohorts), 16 years (1988 cohorts), and 19 to approximately 22 years (1982-1985 cohorts), respectively, in 2004 in Taipei county. Participants were given a questionnaire detailing family income, education level, ethnicity of mother, number of siblings, and history of rubella infection. Possible predictors of rubella seropositivity and differences in seroprevalence were calculated by multivariate logistic regression analysis. A total of 826 cases were recruited. The geometric mean titer of rubella IgG antibody was 60.7 +/- 2.1 IU/ml. Rubella seropositive rates were 282/287 (98.3%) in children aged 10 years, 234/235 (99.6%) in aged 13 years, 179/185 (96.8%) in aged 16 years, and 110/119 (92. 4%) in aged 19-22 years. Older age, low maternal education level, and foreign mothers were correlated with seronegativity (p < 0.05). The MMR vaccine program has induced effectively the immunity against rubella. However, to eliminate congenital rubella syndrome, more effort should be taken for the vaccination of susceptible adolescents and young women.

Genetic and environmental predictors for pediatric atopic dermatitis.

BACKGROUND: The purpose of this study was to evaluate the influence of genetic and various environmental factors for atopic dermatitis (AD) occurring in the first 18 months of life. METHODS: We used the multistage stratified systematic sampling to recruit 2,048 mother-child pairs from the Taiwan National Birth Registry in 2003. Information on family history of atopy and environmental risk factors for AD of children were gathered by questionnaires at 18 months of age. Multiple logistic regressions were performed to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) for risk factors of the AD after adjusting for potential confounders. RESULTS: AD was noted in 147/1618 (9.08%) of the children. We found maternal history of AD, maternal grandparents' history of AD, higher family income, and higher maternal education level increased the risk of pediatric AD. The adjusted ORs and their 95% CIs were 4.10 (1.27-13.25), 4.56 (1.39-15.00), 1.66 (1.00-2.77), and 1.71 (1.56-6.97), respectively. However, duration of breast feeding did not alter the risk estimates of AD. CONCLUSIONS: AD may be inherited preferentially through the maternal line. Prevention of special environmental exposures is urgently needed for children with maternal history of AD.

Electroacupuncture in obese women: a randomized, controlled pilot study.

OBJECTIVE: To compare the effects of electroacupuncture and sit-up exercise on reducing body weight (BW) and waist circumference (WC) among obese women. METHODS: A randomized, controlled clinical trial was conducted from July 1, 2002, to June 30, 2003, in the outpatient department of Taipei Hospital, Taiwan. The subjects were 72 obese women, with WC>90 cm and body mass index (BMI)>30 kg/m2 and who had not received any other weight control maneuver within the prior 3 months. The subjects were randomly divided into groups A, B, and C. Group A (n=22) received electroacupuncture, group B (n=20) was assigned sit-up exercises, and group C (n=21) received no intervention. All three treatments lasted for 6 weeks. The measurements of BW, BMI, and WC were performed in the beginning and after 6 weeks. The data were compared and expressed as percent reductions. RESULTS: Electroacupuncture showed significantly greater percent reductions in BW (p=0.009, 0.004), BMI (p=0.008, 0.016), and WC (p=0.013, 0.006) compared with sit-up exercises or no intervention. CONCLUSIONS: In this pilot study, electroacupuncture treatment was more effective than situp exercise or no intervention in reducing BW, BMI, and WC.

Correlation between age and allergens in pediatric atopic dermatitis.

BACKGROUND: There has been significant progress recently in the clinical investigation of atopic dermatitis (AD), especially in the recognition of aeroallergens as aggravating factors in AD. However, sensitization to food allergens and aeroallergens in children with AD has not been fully studied. OBJECTIVE: To evaluate the correlation between age and allergens in children with AD. METHODS: A retrospective cross-sectional study was performed between January 1, 1999, and December 31, 2002, on 262 children with a definitive diagnosis of AD aged 0 to 16 years. Comparison of 3 age groups (<2 years, 2-5 years, and >5 years) with the correlation of food allergens and aeroallergens using the CAP-FEIA test was made using linear regression and logistic regression analyses. RESULTS: In children younger than 2 years, AD was associated with food allergens. In children aged 2 to 5 years, both food allergens and aeroallergens played an important role. In children older than 5 years, only elevated aeroallergen specific IgE levels were noted (P < .02). Age correlated negatively with food allergens and positively with aeroallergens after adjusting for sex (P < .04). Sensitization to aeroallergens may correlate with acquisition of the respiratory symptoms of the atopic state. CONCLUSIONS: Food allergens may be the major trigger of AD in early life, after which the role of environmental aeroallergens become more important and may be associated with respiratory sensitization.

Clinicopathology of severe acute respiratory syndrome: an autopsy case report.

In mid-April 2003, a major outbreak of severe acute respiratory syndrome (SARS) developed in Taiwan. During the outbreak, SARS-associated coronavirus (SARS-CoV) was documented in 346 patients and 73 of them died. Autopsy was performed in 9 of the suspected SARS patients who died during the outbreak, but SARS was the cause of death in only 1 of these patients. Here we report the histological features of this patient and their clinicopathological correlations. The patient, a 36-year-old Indonesian woman, was a caretaker working for a Taiwanese family. She stayed in Taipei Jen-Chi Hospital from April 10 to April 19 to take care of her elderly employer. She developed fever on April 21 and respiratory distress on April 25, and received ribavirin, intravenous immunoglobulin, and steroid. The respiratory distress persisted and worsened, and intubation was performed on April 27. The respiratory condition improved initially after mechanical ventilation, but subcutaneous emphysema and pneumomediastinum developed on May 1. Her condition deteriorated rapidly and she died on May 2, 11 days after the onset of fever. Autopsy was performed on the same day. Histologically, the lungs showed severe diffuse alveolar damage and bronchopneumonia, but no viral inclusion. The spleen and lymph nodes revealed lymphoid depletion and the liver showed microvesicular steatosis. No specific pathological change was seen in the gastrointestinal tract and kidneys. SARS-CoV genome was detected in the nasopharyngeal aspirate and the autopsy lung specimen.