ABSTRACT
In recent years, there has been a growing interest about complementary and alternative medicine (CAM), and the use of CAM interventions has become more common among people. For these reasons, health professionals must be able to effectively manage information in this field of knowledge according to an evidence-based point of view. This study assessed the anatomy of the available information about CAMs using PubMed, to give practical instructions to manage information in this field. We also analyzed the anatomy of information according to each alternative medicine branch, narrow and broad search methods, subset filters for indexed-for-Medline and non-indexed citations, and different publication types including randomized controlled trials (RCTs) and meta-analyses. Our results demonstrated that the use of CAMs subset (supplied by PubMed search engine) leads to a great number of citations determining an information overload. Our data reveal that it would be more useful to search for the CAM separately, identifying specific items and study design. Moreover, we found the largest number of randomized clinical trials and meta-analyses related to herbal medicine and acupuncture, neither RCTs nor meta-analyses were available for bach and flower remedies, auriculoacupuncture, iridology, and pranotherapy. For the first time, our study gives a comprehensive view of the anatomy of information regarding CAMs and each branch of them. We suggest a methodological approach to face with searching information about this emerging issue from an evidence-based point of view. Finally, our data pointed out some "grey zones" since neither RCTs nor meta-analyses were available for some CAMs.
Subject(s)
Decision Support Techniques , Evidence-Based PracticeABSTRACT
Tetraheptylammonium salts of various transition-metal-substituted heteropolyanions with alpha-Keggin ([XW(11)O(39)M](n)()(-)), alpha-Wells-Dawson ([P(2)W(17)O(61)M](m)(-)), and Weakley and Finke structures ([P(2)W(18)O(68)Co(4)](10)(-)) were investigated with respect to their reactivity with CO(2) in nonpolar solvents. It was found that copper(II)- and manganese(III)-substituted heteropolyanions do not react with CO(2). Germano- and silicotungstates with the alpha-Keggin structure do form complexes with CO(2) when substituted with Co(II), Ni(II), and Mn(II). In contrast, boro- and phosphotungstates substituted with Co(II), Ni(II), and Mn(II) are unreactive. The alpha(2) isomers of Wells-Dawson phosphotungstates show reactivity similar to that of alpha-Keggin silicotungstates-i.e., Co(II), Ni(II), and Mn(II) derivatives do react with CO(2). On the other hand, the alpha(1) isomer of the Co(II)-substituted Wells-Dawson anion does not react with CO(2), and neither does the Weakley and Finke cobaltotungstate. When reactions do occur, they are completely reversible. An excess of water decomposes the complexes. Traces of water are, however, necessary for the reactions to take place. The CO(2) adducts were characterized by UV/vis, IR, and (13)C NMR. The IR data could be explained as originating either from CO(2) complexes with a direct eta(1) metal-carbon bond or from bicarbonato complexes. IR spectra with isotopically enriched (13)CO(2) and C(18)O(2) support the presence of a eta(1) metal-carbon bond. The (13)C NMR spectra indicate the presence of two different kinds of paramagnetic CO(2) complexes after the reaction of alpha-[SiW(11)O(39)Co](6)(-) with CO(2) (chemical shifts 792 and 596 ppm at 26 degrees C). The variable-temperature experiments are consistent with the chemical exchange between these two species. UV/vis, IR, and NMR studies in the presence of controlled amounts of water or ethanol suggest the existence of H-bonding in the CO(2) complexes, similar to that reported in the past for complexes between heteropolyanions and dioxygen.
