European Journal of Integrative Medicine

IFC Editorial Board

2011-12-01

Editorial Board

2011-12-01

João Bosco Guerreiro da Silva

2011-10-28

João Bosco Guerreiro da Silva graduated in medicine in 1983 and after his medical residency in Public Health travelled to the Amazon region to work with the indigenous people. As a result of his work he realized the need for alternative approaches to enable him to work in such remote areas and began to study Acupuncture and Phytotherapy.

EuJIM editorial issue 4 2011

Nicola Robinson — 2011-10-26

Integrating complementary medicine into conventional care varies between countries as do the range of approaches used to improve health outcomes. It is important to learn from each other if we are to reduce the burden of ill health in society, particularly if the costs associated with long term conditions are to be reduced. However, in trying to address ill health, we may be at risk of forgetting the importance of health promoting activities, some of which are based in traditional systems of medicine. Wellbeing however, means different things to different people in different countries and includes satisfaction with life, having a good quality of life, having a balanced lifestyle and perhaps above all being happy.

College of Medicine: A new vision of healthcare

Kate Fismer, George Lewith — 2011-10-17

Abstract: The College of Medicine was launched at the end of 2010 and this was its inaugural conference. Its core values; are science, service and healing, underpinned by the belief that best possible, sustainable and cost effective healthcare can only be delivered by bringing together clinicians, scientists and most importantly patients on an equal footing. A more patient-centred approach improves outcomes, particularly in chronic conditions. These values will be sustained by our inclusive and non tribal professional approach and grounded through our structure, in particular our patient's council. The keynote from Dean Ornish illustrated the vast potential for lifestyle change to impact gene expression and possibly survival in prostate cancer, whilst William Bird and Michael Depledge updated us on how an environment conducive to wellbeing and a self empowered exercise programme might be delivered within the UK. The College's Innovation Network provides benchmarks for local initiatives of excellence. Stephen Holgate was also able to contextualise the increase of allergic disease within our changing environment. Support for this new and innovative organisation was clearly expressed by both politicians and many senior members of the medical establishment and we look forward to the College being in the vanguard of the changing face of medicine.

Acupuncture treatment for depression—A systematic review and meta-analysis

Trine Stub, Terje Alræk, Jianping Liu — 2011-10-24

Abstract: Aim of the study: To assess the beneficial effects of acupuncture in patients with depression and to evaluate the report quality of acupuncture treatment for depression in randomized controlled trials and systematic reviews.Introduction: Acupuncture has a long history of treating illnesses which we today in a biomedical context would understand and recognize as depression. Also in contemporary China and in the West patients are trying acupuncture as a treatment for depression. Randomized controlled trials have been conducted to investigate its efficacy.Materials and methods: The following electronic databases were searched: the Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, PsycINFO and PUBMED. These searches ended in January 2009. In addition new searches were completed in Asian databases in February 2010.Standard guidelines were followed when the methodological quality of the RCTs were assessed, including CONSORT and the criteria in the Cochrane Handbook. Systematic reviews were evaluated using the PRISMA checklist.Results: Four systematic reviews and 26 RCTs on acupuncture for treatment of depression were identified and included in this review. The methodological quality of the trial reports was generally low in terms of generation of the allocation sequence, allocation concealment, blinding and intention to treat. A significant beneficial effect was found for acupuncture in improvement of depression compared to pooled control measured by Hamilton Rating Scale for Depression (WMD −3.10, 95% CI −4.91 to −1.99, P=0.0008). Subgroup analysis suggested that electro-acupuncture (WMD −0.68, 95% CI −1.49 to 0.13, P=0.10) and TCM acupuncture (WMD 0.79, 95% CI −0.93 to 2.52, P=0.37), were not statistically different from medication. Acupuncture was regarded as generally safe in the clinical trials included in this review.Conclusions: Current evidence from this meta-analysis of randomized trials shows that acupuncture is effective in reducing severity of depression and that TCM- and electro acupuncture may have similar effect as current usual care. More rigorous trials are needed and long-term effects should be investigated if acupuncture is to be recommended for clinical use.

Self-reported changes in quality of life among people with multiple sclerosis who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners

L. Bjerre, I. Henningsen, L. Skovgaard, L. Launsø — 2011-11-03

Abstract: Aim of the study: This study assesses the changes in self-reported quality of life (QoL) from hospitalisation to 18 months later among people with multiple sclerosis (MS) who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners.Materials and methods: A pre- and post-test evaluation design including an intervention group and a comparison group was employed in this study. 142 people with MS were analysed in the intervention group and 142 in the comparison group. Each person in the intervention group was treated with combined interventions by a team of five healthcare providers and five CAM practitioners. The outcome measure was a change in QoL (measured as the difference in total score and sub-scores on the Functional Assessment of Multiple Sclerosis (FAMS) QoL scale).Results: From hospitalisation and through an 18-month period, people with MS who had participated in treatments based on collaboration between healthcare providers and CAM practitioners experienced a statistically significant different change in QoL compared to people with MS who had been treated within the current ‘best practice’ model. The difference in QoL was found within the areas of emotional well-being and thinking/fatigue.Conclusion: The results indicate that collaboration between healthcare providers and CAM practitioners can improve treatment outcomes regarding some of the psychological aspects of QoL over a period of 18 months for people with MS.

Antifungal efficacy of Brazilian green propolis extracts and honey on Tinea capitis and Tinea versicolor

2011-10-24

Abstract: Aim of the study: This study aimed to determine the prevalence of Tinea capitis and Tinea versicolor, and evaluate the efficacy of bee products in management of skin disorders in Congolese school children.Methodology: Medical screening and care for skin disorders were carried out in five Congolese schools from November 2010 to April 2011. Hematological and mycological analyses were performed. Of the 2728 children, there were 305 patients with either Tinea capitis or Tinea versicolor. Of them, 242 eligible patients were randomly allocated to one of the following topical treatment arms: 2% Miconazole; 50mg/ml Brazilian green propolis extracts (BPE); 100mg/ml BPE; Acasia honey or Vaseline. Oneway ANOVA test was performed to assess the significance of the difference between treatment groups at baseline (day 1), adjusting for age, gender and the severity score of skin symptoms. Unpaired t-test was performed to assess the difference between treatments in terms of skin symptoms improvement, WBC count, leukocytes and erythrocytes sedimentation rate (ESR) on day 28 of treatment.Results: This study showed that Miconazole (p<0.01), both BPE solutions and Acasia honey (p<0.05) markedly improved erythema and desquamation (vs. Vaseline). In addition, 100mg/ml BPE, 50mg/ml BPE, Miconazole and Acasia honey (p<0.05) also significantly relieved pruritus (vs. Vaseline). No major adverse effect was observed throughout the study.Conclusions: Brazilian green propolis extracts improved skin lesions as efficiently as did Miconazole and may serve as an alternative treatment for Tinea mycosis.

Do patients tell their clinicians they are using both prescribed and over the counter allopathic and traditional medicines?

2011-11-10

Abstract: Objective: To investigate the simultaneous use of over-the-counter (OTC) and prescription medicines across allopathic western medicine (WM) and traditional Chinese medicine (TCM) modalities amongst urban Chinese patients.Method: Secondary analysis of the Hong Kong population representative Thematic Household Survey 2007 dataset (n=28,923, response rate 76.8%).Results: Of the enumerated population, 1.9% reported ever having used TCM OTC medications and WM prescription medicine simultaneously, of whom 59.3% did not disclose this to their WM doctors. Of respondents, 1.3% reported figure co-usage of WM OTC and TCM prescription medicines and 40.1% did not disclose this to their TCM practitioners. The top two reasons for non-disclosure were: the belief that WM and TCM medicines do not interact with each other, and clinicians did not initiate the discussion. Those with regular healthcare providers were more likely to disclose their co-usage. The majority of respondents cited healthcare professionals as their main source of information for OTC products.Conclusion: Since self medication is common, clinicians should proactively ask patients about their medication in both modalities of care; and provide appropriate education on potential risks. The population prefers to integrate WM and TCM under supervision of both types of clinicians, instead of making their own choices on medication use across modalities.Discussion: Policy makers should enhance interprofessional education for and communication between WM and TCM clinicians. However, further research on patients’ knowledge of herb–drug interactions, as well as accurate ascertainment of co-utilization patterns for each modality is needed before drawing firmer conclusions.

Decursin and decursinol angelate from Angelica gigas Nakai induce apoptosis via induction of TRAIL expression on cervical cancer cells

2011-10-24

Abstract: Aim of the study: The root of Angelica gigas Nakai (Korean “Dang-Gui”) has been used to treat female afflictions and anemia in traditional oriental herbal medicine since ancient times in Korea. The objective of this study is to identify the anti-cancer mechanism induced by A. gigas extract including decursin and decursinol angelate in human cervical cancer cells for scientific evidence regarding herbal therapy.Materials and methods: The extract of A. gigas, decursin, and decursinol angelate was used to evaluate the anti-cancer effects on HeLa cells. Cell viability was evaluated by MTT assay and cell cycle regulation was analysed by FACS program. The expression of apoptotic proteins was confirmed by Western blot analysis and proteome profiler array.Results: The extract of A. gigas containing decursin and decursinol angelate exhibited anti-cancer effect on HeLa cells through the significant activation of caspases and the cleavage of PARP. Expression of TRAIL and TRAIL receptors was also increased by two active components of A. gigas, respectively. In particular, two components regulated the expression of apoptosis-related proteins such as Bcl-2, Bcl-x, survivin, cIAP-1, -2, XIAP, etc.Conclusions: These results suggest that TRAIL expression induced by extract of A. gigas stimulates the extrinsic and intrinsic apoptosis pathway by activating caspase-8 and caspase-9, respectively. Thus, extract of A. gigas including decursin and decursinol angelate takes a role in inhibition of cell-proliferation and activation of apoptosis in cervical cancer and could be developed as therapeutic anti-cancer agent against cervical cancer.

Quality of reporting of two-group parallel randomized controlled clinical trials of multi-herb formulae: A survey of reports indexed in the Science Citation Index Expanded

2011-10-13

Abstract: Introduction: An increasing number of trials of multi-herb formula interventions are being published in relatively high-ranked medical journals indexed in the Science Citation Index Expanded (SCIE). The aim of the study was to evaluate the quality of reporting of two-group parallel randomized controlled clinical trials (indexed in SCIE) of multi-herb formulae.Methods: Computerized literature searches were performed in SCIE from 1996 to November 2010. Two reviewers independently assessed the included trials using the modified Consolidated Standard of Reporting Trials (CONSORT) 2010 checklist and additional items reflecting the basic characteristics of traditional Chinese medicine (TCM). The number and proportion of reports describing each of the 38 modified CONSORT items and 6 additional TCM items were calculated. We also performed stratified analyses according to whether reports had or had not adopted the CONSORT statement, or according to Chinese reports (conducted in Mainland China, Hong Kong and Taiwan) or non-Chinese reports.Results: The reporting of the items recommended by the CONSORT 2010 statement was suboptimal as only 5 items were described in more than 80% of the 153 included reports. For the recommended CONSORT items, adherence was higher in CONSORT-adopters, and more items were reported in non-Chinese reports. The reporting of the TCM items was considered inadequate in the included studies, particularly in non-Chinese reports.Conclusions: The present study shows that the quality of reporting of these trials is suboptimal. We recommend all journals endorse the CONSORT statement, which would help researchers to improve the reporting of future randomized controlled trials. In addition, the reporting of the TCM items was considered inadequate in the included studies. All TCM practitioners should pay attention to the unique characteristics of TCM and improve the reporting of the recommended TCM items.

Magnolol: A multifunctional compound isolated from the Chinese medicinal plant Magnolia officinalis

2011-10-31

Abstract: Introduction: Chinese herbs are widely used as important remedies in Oriental integrative medicine. Magnolol is a small polyphenolic molecule with low toxicity that is isolated from the herb genus Magnolia. In preclinical experiments, magnolol was found to have anti-oxidative, anti-inflammatory, anti-tumorigenic, anti-diabetic, anti-microbial, anti-neurodegenerative and anti-depressant properties. Magnolol can also effectively regulate pain control, hormonal signalling, gastrointestinal and uterus modulation as well as provide cardiovascular and liver protective effects.Materials and methods: We briefly conducted PubMed and MEDLINE database reviews for articles that related to magnolol.Results: The major biological mechanisms of action and potential health benefits of magnolol are described.Conclusions: These health benefits of magnolol have provided an increased interest in bringing this herbal compound to the clinic as a novel therapeutic agent. Knowledge of the multiple activities of magnolol can assist with the development of magnolol derivatives and the design of clinical trials that will maximize the potential benefit of magnolol in the patient setting.

Complementary and Alternative Medicine (CAM) among adults in Italy: Use and related satisfaction

2011-10-03

Abstract: Introduction: Complementary and Alternative Medicine (CAM) is attracting attention within the context of health care provision in western countries. Patterns of CAM use and related satisfaction were analysed in Italy according to socio-demographic and health variables.Materials and methods: 104,544 individuals (aged>18) were interviewed by the cross-sectional ISTAT survey on “Health status of the population and use of health services” (2004–2005). CAM use and related satisfaction were evaluated by bivariate analysis and logistic regression models.Results: 14.4% (n=14,963) of sample used at least one CAM typology in the three years before the interview; manual treatments were the most widespread (7.6%), followed by homeopathy (7.0%), herbal medicine (4.1%), and acupuncture (2.1%). Factors associated with CAM use included gender, age, educational level, social class and area of residence: use was more frequent among women, middle-aged, highly educated and upper-middle class persons, living in Northern Italy. People with chronic diseases used CAM more frequently. Most CAM users reported complete satisfaction (60.6% acupuncture; 69.2% herbal medicine; 70.8% homeopathy; 77.8% manual treatments), with high satisfaction also among subjects with chronic conditions. A higher education level predicted satisfaction more than social class while refusing to combine conventional medicine and CAM was the strongest determinants of complete satisfaction.Conclusion: One out of seven adult Italians had used CAM the last three years. Users are mainly highly educated persons, belonging to the upper social class, and people affected by chronic conditions. Levels of self-rated satisfaction are generally high, both in the absence and in the presence of chronic diseases.

Iodine-induced psychic instability during two consecutive euthyreotic pregnancies

Christian Albrecht May, Kornelia Jahn — 2011-10-17

Abstract: Introduction: Iodine support is common during pregnancy to sustain the guiding value of 250μg iodine intake each day preventing deficiency and subsequent developmental retardation due to hypothyroidism. Iodine intake at these levels is described as safe without side effects. The fact that supplementation of iodine is not always harmless is illustrated here.Case report: A white European female showed iodine-triggered psychic instability during both pregnancies and breastfeeding even at low doses of iodine supplementation.Conclusions: Although toxic effects of iodine occur only above 1g iodine intake per day, iodine sensitivity can lead to severe effects even at low doses, persisting up to several days. Presumably, pregnancy and breastfeeding can increase this sensitivity towards clinical relevance. Therefore, additional intake of iodine should be advised more careful and adapted to the individual situation.